Patho - Fluid & Electrolyte Balance W12/13

Question 1

What can cause dehydration

Answer 1

V/D, hemorrhaging, third-spacing

Question 2

What are the S/S of dehydration

Answer 2

Decreased BP, OHoTN, syncope, dizziness, Liguria, dry stool, weight loss, risk hypernatremia, hyperkalemia, hypercalcemia

Question 3

What can case fluid excess

Answer 3

Drinking too much, CHF, kidney failure, liver disease, over-secretion of ALDO and ADH

Question 4

What are the S/S of fluid excess

Answer 4

Weight gain, edema, acites, N/V, confusion, headache

Question 5

At what point would Na+ be in considered at a deficit in the body

Answer 5

<135mEq/L

Question 6

What can cause hyponatremia

Answer 6

Excessive sweating, V/D, ALD deficit, excess H2O intake, renal failure

Question 7

What are the S/S of hyponatremia

Answer 7

Poor nerve conduction, muscle cramps, fluid shift from ECF to ICF, headaches

Question 8

At what point would Na+ be considered in abundance

Answer 8

> 142mEq/L

Question 9

What can cause hypernatremia

Answer 9

ADH deficit, watery diarrhea, hypertonic water loss

Question 10

What are the S/S of hypernatremia

Answer 10

Hypovolemia, fluid shifts from ICF to ECF, decreased urine output, increased thirst

Question 11

At what point would K+ be in considered at a deficit in the body

Answer 11

<3.8mEg/L

Question 12

What can cause hypokalemia

Answer 12

Diarrhea, decreased dietary intake, increased ALDo, thiazide/loop diuretics

Question 13

What are the S/S of hypokalemia

Answer 13

Muscle weakness, increasing pH [hypoventilation], polyuria, sagging ST segment when <3nEg/L

Question 14

How much urine the body should produce per hour

Answer 14

1-1.5mL per Kg per hour (anuria: less than .5)

Question 15

At what point would K+ be considered in abundance in the body

Answer 15

> 5mEq/L

Question 16

What can cause hyperkalemia

Answer 16

Severe burns, renal failure, decreased ALDO, K+ sparing diuretics, muscle damage, cellular damage, acidosis, increased intake (supplement), increased ALDO (Addison’s disease), ACE inhibitors/angiotensin 2 blockers

Question 17

What are the S/S of hyperkalemia

Answer 17

Muscle weakened/fatigue, nausea, decreased pH [hyperventilation], dysrhythmias [pwave flattens and disappears], bradycardia [peaked twave, widened QRS at >5.5]

Question 18

At what point would Ca2+ be considered at a deficit in the body

Answer 18

<2mmol/L

Question 19

What can cause hypocalcemia

Answer 19

Decreased PTH, increased retention if phosphate, alkalosis, decreased albumin

Question 20

What are the S/S of hypocalcemia

Answer 20

Increased neuron excitability (spasms, paresthesia, hyperreflexia), increasing BP cuff pressure can cause wrist spasms, decreased BP, negative inotropic effect

Question 21

What is a trousseau sign

Answer 21

Increasing BP causes wrist spasms

Question 22

What is a chrostek’s sign

Answer 22

Tickling cheek by ear causes facial tics

Question 23

At what point would Ca2+ be considered in abundance in the body

Answer 23

> 2.6mmol/L

Question 24

What can cause hypercalcemia

Answer 24

Increased PTH, thiazide diuretics, prolonged immobilization, certain neoplasms, acidosis

Question 25

What are some S/S of hypercalcemia

Answer 25

Decreased neuron excitability (weakness, decreased muscle tone, hyporeflexia), positive inotropic effect, dysrhythmias, loss of bone density (related to increased PTH, immobilization), kidney stones, decreased ADH = hypovolemia, renal failure

Question 26

What can generally cause potassium issues

Answer 26

-too much in (unlikely) -re-distribution (acidosis) -too little of (chronic renal failure)

Question 27

What is the main issues with potassium

Answer 27

Dysrhythmias

Question 28

What are the 3 mechanisms of pH regulation

Answer 28

-buffers in blood -respiratory system -renal system

Question 29

How to buffers in the blood work

Answer 29

[short term] HCO3- + H+ = H2CO3 = H20 + CO2 (wants body to blow odd CO2) Hb [in RBC] + H+ = HHB

Question 30

How does the respiratory system help regulate pH

Answer 30

(Intermediate) Chemoreceptors in lung detect changes in H+ which alter RR More CO2 = increased rate and depth of breathing

Question 31

How does the renal system help regulate pH

Answer 31

(Long term) Secretion of H+ into DCT of nephron Reabsorption of HCO3-

Question 32

What is a normal pH

Answer 32

7.35-7.45

Question 33

What is the normal paCO2

Answer 33

45-35

Question 34

What is the normal HCO3-

Answer 34

22-26

Question 35

What can cause respiratory acidosis

Answer 35

Reduced pulmonary ventilations either by drugs/COPD/CNS damage

Question 36

What are the signs of respiratory acidosis

Answer 36

↓pH, ↑CO2, norm HCO3- (headache, confusion, anxiety, drowsiness, stupor)

Question 37

What can cause respiratory alkalosis

Answer 37

Can be caused by anything that increases pulmonary ventilation (pain/fever/seizures/hypoxia)

Question 38

What are the signs of respiratory alkalosis

Answer 38

↑pH,↓CO2, norm HCO3- (lightheadedness, syncope, confusion, parenthesis, cramps)

Question 39

What are the signs of respiratory acidosis with metabolic compensation

Answer 39

↓/= pH, ↑CO2, ↑HCO3-

Question 40

What are the signs of respiratory alkalosis with metabolic compensation

Answer 40

↑/= pH,↓CO2,↓HCO3-

Question 41

What can cause metabolic acidosis

Answer 41

Renal failure/dysfunction, DKA, lactic acidosis, hyperkalemia, excessive HCO3- though GI

Question 42

What are the signs of metabolic acidosis

Answer 42

↓pH, norm CO2,↓HCO3- (headache, confusion, anxiety, drowsiness, stupor, hypercalcemia)

Question 43

What can cause metabolic alkalosis

Answer 43

Excessive loss of hydrogen (V/D), hypokalemia, hypotonic volume loss = ALD secretion

Question 44

What are the signs of metabolic alkalosis

Answer 44

↑pH, norm CO2, ↑HCO3- (decreased ventilations, N/V, malaise)

Question 45

What are the signs of metabolic acidosis with respiratory compensation

Answer 45

↓pH, CO2, HCO3-

Question 46

What are the signs of metabolic alkalosis with respiratory compensation

Answer 46

↑pH, CO2, HCO3-

Question 47

How do you find out the pH direction, based on the three vitals

Answer 47

-find the 2 that are the same (ie too high/low) -see what direction the last one is in (often in opposite direction)

Question 48

What is the tx for respiratory acidosis (high CO2)

Answer 48

Mechanical ventilations

Question 49

What is the tx for respiratory alkalosis (high pH, low CO2)

Answer 49

Manage primary problem

Question 50

What is the tx for metabolic acidosis (low pH & HCO3-)

Answer 50

HCO3- / hemodialysis

Question 51

What is the tx for metabolic acidosis

Answer 51

Manage the primary problem