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NUR 113 > PP - ELEC FLUID ACID BASE (112) > Flashcards

PP - ELEC FLUID ACID BASE (112) Flashcards

1
Q

solvents

A

liquids that hold a substance in solution (H20)

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2
Q

solutes

A

substances dissolved in a solution (electrolytes / non electrolytes)

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3
Q

osmosis

A

water passed from an area of lesser solute concentration to greater concentration until equilibrium is established

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4
Q

diffusion

A

tendency of solutes to move freely throughout a slovent (downhill??)

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5
Q

active transport

A

required energy (ATP - adenosine triphosphate) for movement of substances through the cell membrane from lesser solute concentration to higher solute concentration (salmon swimming upstream)

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6
Q

filtration

A

passage of fluid through a permeable membrane from the area of higher pressure to lower pressure ( like a mister or a balloon in the wind)

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7
Q

colloid osmotic pressure

A

the osmotic pressure exerted by large molecules, serves to hold water within the vascular space. It is normally created by plasma proteins, namely albumin, that do not diffuse readily across the capillary membrane LOOK UP ON NURSING>COM OR OSMOSIS

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8
Q

hydrostatic pressure

A

Hydrostatic pressure is the pressure that is exerted by a fluid at equilibrium at a given point within the fluid, due to the force of gravity LOOK UP ON NURSING>COM OR OSMOSIS

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9
Q

The average person’s weight is * one-half to two-thirds water.

A

60/40/20 rule

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10
Q

When a person is unable to drink enough fluids to compensate for excess water loss,

A

dehydration can occur

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11
Q

Thirst results from

A

nerve centers in the brain being stimulated when the body needs water. Osmoreceptors

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12
Q

In order to conserve water, the pituitary gland secretes

A

vasopressin (the antidiuretic hormone).

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13
Q

The vasopressin stimulates the kidneys to

A

excrete less urine which helps to conserve water.

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14
Q

Atrial natriuretic factor secreted by herat atria in resonse to atrial stretch

A

suppresses renin production, which limits aldosterone production -/kidneys will then excrete more sodium.

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15
Q

(Aldosterone stimulates

A

reabsorption of sodium excretion of potassium by the kidneys.

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16
Q

if aldosterone was released, it would promotes

A

retention of sodium and

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17
Q

An elevated secretion of aldosterone - lead to

A

sodium retention and, as a result, promote fluid retention. Ie increase BP

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18
Q

Atrial natriuretic factor (ANF) hormone secreted mainly by the heart atria in response to

A

atrial stretch. ANF acts on the kidney to increase sodium excretion and GFR, to antagonize renal vasoconstriction, and to inhibit renin secretion.

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19
Q

When blood sodium levels and pressure are increased, ANP is secreted from the heart. It binds to its receptor in the

A

kidney and blood vessels, and promotes salt excretion, lowers blood volume and relaxes the vessel.

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20
Q

Is ANP released when blood pressure is high or low?

A

When blood sodium levels and pressure are increased, ANP is secreted from the heart. It binds to its receptor in the kidney and blood vessels, and promotes salt excretion which leads to , lowers blood volume and relaxes the vessel.

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21
Q

can all lead to an electrolyte imbalance.

A

Dehydration; overhydration; certain medications; history of heart, kidney, or liver disorders; and incorrect intravenous fluids or feedings

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22
Q

ØHypovolemia occurs whe

A

n there is a decrease in blood volume within the body due to loss of body fluids or blood.

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23
Q

can lead to hypovolemia.

A

ØExcessive sweating, large burns, diuretics, inadequate fluid intake, and increased urination

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24
Q

third spacing

A

Third-spacing occurs when too much fluid moves from the intravascular space (blood vessels) into the interstitial or “third” space—the nonfunctional area between cells. This can cause potentially serious problems such as edema, reduced cardiac output, and hypotension.

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25
Q

ØExcessive sweating, large burns, diuretics, inadequate fluid intake, and increased urination can lead to

A

can leadto hypovolemia

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26
Q

ØAt first, hypovolemia causes the

A

nose, mouth, and other mucous membranes to dry out; the skin to lose elasticity; and urine output to decrease.

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27
Q

ØThe body then tries to compensate for volume loss by

A

increasing the heart rate and strength of contractions.

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28
Q

ØBlood vessels are constricted

A

in the extremities to preserve blood flow for the heart, brain, and kidneys.

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29
Q

Dehydration symptoms

A

thirst / dry mouth / less frequent urination / headache / rapid heartbeat / dry skin

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30
Q

If hypovolemia goes untreated, serious symptoms may develop including:

A

Blue discoloration of lips and nail beds
Change in alertness or level of consciousness
Chest pain, tightness, or pressure
Palpitations
No urine production
Tachycardia – increased heart rate
Tachypnea – rapid breathing
Decreased blood pressure
Weak pulse

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31
Q

A client may have no signs of

A

hypovolemia or Hypovolemic shock

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32
Q

hypovolemic shock

A

which is when the body has lost 20 percent or one-fifth of its blood or fluid supply.

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33
Q

Treatment of hypovolemic shock is aimed at

A

controlling fluid or blood loss, replacing those components, and restoring overall circulation in the body.

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34
Q

Hypervolemia, AKA or, is a

A

fluid overload. condition where the body has too much water.

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35
Q

Hypervolemia is commonly caused by problems with

A

the kidneys as they are responsible for balancing the salt and fluid in the body.

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36
Q

The goal of treatment of Hypervolemia is to

A

rid the body of excess fluid.

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37
Q

Parameters of Assessment for excess fluid or hypovolemia? CONFIRM WHICH SHE MEANT

A

Patient history and physical assessment
Fluid intake and output
Daily weights
Laboratory studies

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38
Q

One potential cause of an internal potassium balance shift i

A

sinsulin deficiency.

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39
Q

acidosis is to much acid in blood which means what about pH and hydrogen ions

A

higher concentration of hydrogen ions and so a lower pH - to lower pH move ions out of blood and into cells

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40
Q

So in order to help compensate for an acidosis, hydrogen ions enter cells and potassium ions leave the cells and enter the blood,

A

which might help with the acidosis, but results inhyperkalemia.

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41
Q

Respiratory acidosis isa condition that occurs when the

A

Potassium levels are not affected because Co2 lungs cannot remove all of the carbon dioxide the body produces. This causes body fluids, especially the blood, to become too acidic.A

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42
Q

Fluid Volume Excess Lab Tests

A

Complete Blood Count
Hematocrit

Blood Osmolarity - < 280 mOsm/kg
Serum Electrolytes - decreased
BUN - decreased
Urine Specific Gravity - <1.010

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43
Q

indicators of Hypervolemia/ Fluid Vol. Excess - CONFIRM THIS FROM YOUR READING

A

Blood Osmolarity - < 280 mOsm/kg
Serum Electrolytes - decreased
BUN - decreased
Urine Specific Gravity - <1.010 learn why urine specific gravity is effected and what normal level is

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44
Q

to replace fluids lost in hypovolemia

A

Intravenous Rehydration - Small particles that can easily pass from the bloodstream into cells and tissues

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45
Q

crystalloid solutions.

A

ØSmall particles that can easily pass from the bloodstream into cells and tissues are known as

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46
Q

ØEach crystalloid solution is categorized by its

A

tonicity

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47
Q

tonicity,

A

or ability to make water move in or out of cells via osmosis.

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48
Q

ØHypotonic solutions move water (cells swell)

A

from extracellular space into cells.

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49
Q

ØHypertonic solutions cause water to (cells shrivel - raisin up)

A

leave the cells.

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50
Q

isotonic solutions.

A

ØThere is no movement between extracellular and intracellular fluids in (water + inside and outside cell)

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51
Q

ØPacked red blood cells (RBCs), AKA

A

also known as erythrocytes, can be used to restore blood levels without substantially increasing the client’s overall blood volume.

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52
Q

ØWhole blood contains

A

white cells, red cells, and platelets suspended in blood plasma.

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53
Q

common uses for whole blood

A

Trauma and surgery causing a significant blood loss are common uses for whole blood.

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54
Q

ØThe liquid portion of blood is known as

A

plasma which is

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55
Q

plasma

A

where the platelets and red and white blood cells are suspended as they travel throughout the body.

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56
Q

ØPlatelets, or thrombocytes, sPlatelets are commonly used during organ transplants, cancer treatments, and surgery.

A

top or prevent bleeding.

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57
Q

Blood Transfusions

A

packed RBC’s / whole blood / plasma / platelets or thromboctes

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58
Q

ØIntake

A

simply refers to the amount taken in by a client.

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59
Q

ØOutput is the

A

amount produced by the body of a client.

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60
Q

ØI & O Should be recorded at least

A

every 8 hours or per a facility’s protocol.

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61
Q

ØIntake includes

A

anything the client puts in their mouth, takes in intravenously, or any feeding tubes.

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62
Q

ØOutput includes

A

urine, bowel movements, and vomiting. Wound drainage, etc

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63
Q

Mrs. White is a 78-year-old woman admitted to the hospital with a diagnosis of severe dehydration. The nurse assigned to Mrs. White is asked to collect data related to fluid status. The nurse expects Mrs. White’s blood pressure to be low because of fluid loss. The nurse also finds Mrs. White’s skin turgor to be poor, and the nurse notes that the urine output is scant and dark amber. The nurse asks Mrs. White is she knows what day it is, because severe dehydration may cause confusion. In addition, the nurse initiates taking daily weights because this the most accurate way to monitor fluid balance.

A

Mrs. White is a 78-year-old woman admitted to the hospital with a diagnosis of severe dehydration. The nurse assigned to Mrs. White is asked to collect data related to fluid status. The nurse notes Mrs. White’s blood pressure is low. The nurse also finds Mrs. White’s skin turgor to be poor, and the nurse notes that the urine output is scant and dark amber. The nurse asks Mrs. White is she knows what day it is, because severe dehydration may cause confusion. In addition, the nurse initiates taking daily weights because this the most accurate way to monitor fluid balance.

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64
Q

Risk Factors for fluid loss

A

Pathophysiology underlying acute and chronic illnesses
Abnormal losses of body fluids
Burns
Trauma
Surgery
Therapies that disrupt fluid and electrolyte balance

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65
Q

Data Analysis Related to Imbalances

A

Excess fluid volume
Deficient fluid volume
Risk for imbalanced fluid volume

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66
Q

Electrolytes Are Responsible for:

A

Balancing the amount of water in the body.
Balancing the body’s pH (acid/base) level.
Moving waste out of body cells.
Moving nutrients into body cells.
Allowing the body’s muscles, heart, nerves, and brain to function properly.

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67
Q

Electrolytes - Minerals in the body that can

A

conduct electricity.

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68
Q

where are electrolytes found

A

Found in urine, blood, tissues, as well as other body fluids.

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69
Q

electrolytes include

A

Include potassium, sodium, calcium, and magnesium (chloride, phosphorus).

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70
Q

while naturally occuring in the body, electrolytes can also be found in

A

ound in food, drinks, and supplements.

71
Q

Normal Electrolyte Values

A

Potassium (K+)
3.5 – 5.0 mEq/L
Sodium (Na+)
136-145 mEq/L
Calcium (Ca2+)
9.0-10.5 mg/dL
Magnesium (Mg2+)
1.3-2.1 mg/dL
Chloride (Cl-)
98 – 106 mEq/L
Phosphorus (P-)
3 – 4.5 mg/dL

72
Q

ØThe electrolyte sodium supports the

A

sodium function of nerves and muscles, helps maintain a normal blood pressure, and regulates the body’s fluid balance, and acid-base balance.

73
Q

ØLow sodium levels are called

A

hyponatremia.

74
Q

ØHigh sodium levels are called

A

hypernatremia.

75
Q

ØThe electrolyte potassium helps w/

A

potassium nerve and muscle cell function while playing an important role in the muscle cells in the heart. support transmission electrical impulses body’s nerves / muscles.
K+ * Major role conduction nerve cells w/in heart.

76
Q

ØLow potassium levels are called

A

hypokalemia.

77
Q

ØHigh potassium levels are known as

A

hyperkalemia.

78
Q

ØCalcium helps the body maintain

A

strong bones and is mostly stored in teeth and bones to support their hardness. Also helps muscles move, nerves to carry messages between the brain and body, and blood vessels to move blood throughout the body. / blood clotting

79
Q

Low calcium levels are called

A

hypocalcemia.

80
Q

High calcium levels are called

A

hypercalcemia.

81
Q

ØHypoparathyroidism,

A

low parathyroid hormone levels,

82
Q

ØHypoparathyroidism,aka low pth

A

can lead to hypocalcemia / . When PTH secretion is insufficient, hypocalcemia develops.

83
Q

ØHypercalcemia is most commonly caused by

A

overactive parathyroid glands, or hyperparathyroidism. Hyperparathyroidism is a condition in which one or more of your parathyroid glands become overactive and release (secrete) too much parathyroid hormone (PTH). This causes the levels of calcium in your blood to rise, a condition known as hypercalcemia.

84
Q

ØMagnesium’s role in the body is to

A

assist in the regulation of nerve and muscle function, blood pressure and blood sugar levels; as well as making bone, protein, and DNA.

85
Q

ØLow magnesium levels are known as

A

hypomagnesemia.

86
Q

High levels are called

A

hypermagnesemia.

87
Q

what is intended function of potassium

A

helps with nerve and muscle cell function while playing an important role in the muscle cells in the heart. / potassium nerve and muscle cell function while playing an important role in the muscle cells in the heart. support transmission electrical impulses body’s nerves / muscles.
K+ * Major role conduction nerve cells w/in heart.

88
Q

hypokalemia level

A

Anything lower than 3 mEq/L (3 mmol/L) may be considered severe hypokalemia

89
Q

hyperkalemia level

A

Hyperkalemia is defined as a serum or plasma potassium level above the upper limits of normal, usually greater than 5.0 mEq/L to 5.5 mEq/L.

90
Q

normal range for potassium

A

Potassium (K+)
3.5 – 5.0 mEq/L

91
Q

what are the risk factors for hypokalemia

A

FLUID SHIFT FROM ECF TO ICF / ALKALOSIS / WATER INTOXICATION / CARDIAC DYSRYTHMIASDiarrhea.
Vomiting.
Excess sweating.
Poor diet.
both severe hypokalemia and severe hyperkalemia can lead to paralysis, cardiac arrhythmias, and cardiac arrest. Hyperkalemia, generally carries a higher risk of morbidity and mortality if left untreated. Severe hypokalemia may also cause respiratory failure, constipation and ileus.
Taking certain medicines, such as diuretics or beta-2-adrenergenic agonists.
Poorly-controlled diabetes.
Alcohol use disorder or withdrawal.
Eating disorders.

92
Q

what are the risk factors for hyperkalemia

A

o Potassium level above ERR 3.5 to 5 mEq/L.
.ACE INHIBITOS / NSAIDS / POTASSIUM SPARING DIURECTICS / RAPID INFUSION OF POTASSIUM CONTAIN IV SOLUTIONS / KIDNEY DISEASE / ADDISONS DISEAS (ADRENAL INSUFFICIENCY)/ ACIDOSIS / HYPERICEMIA / HYPERCSTSBOLISMAlcohol use (excessive)
Chronic kidney disease.
Diabetic ketoacidosis.
Diarrhea.
Diuretics (water retention relievers)
Excessive laxative use.
Excessive sweating.
Folic acid deficiency.

93
Q

what are the expected findings of hypokalemia

A

Severe muscle weakness or rhabdomyolysis. Cardiac arrhythmias and ECG abnormalities. Kidney abnormalities. Glucose intolerance /ORTHOSTATIC HYPOTENSION (fall risk) PARESTHESIA / SHALLOW RESPIRATIONS / THREADY / WEAK / IREGGULAR PULSE / HYPOREFLEXIA / HYPOACTIVE BOWEL SOUNDS

94
Q

rhabdomyolysis

A

Rhabdomyolysis (often called rhabdo) is a serious medical condition that can be fatal or result in permanent disability. Rhabdo occurs when damaged muscle tissue releases its proteins and electrolytes into the blood. These substances can damage the heart and kidneys and cause permanent disability or even death

95
Q

what are the expected findings of hyperkalemia

A

muscle weakness, URINE ABNORMALITIES / RESPIRATORY DISTRESS / DECREASED CARDIAC CONTRACTILITY (LOW hr / lOW bp) fatigue, and depression. O respiratory muscle weakness
Hyperkalemia symptoms include:
Abdominal (belly) pain and diarrhea.
Chest pain.
Heart palpitations or arrhythmia (irregular, fast or fluttering heartbeat).
Muscle weakness or numbness in limbs.
Nausea and vomiting.

96
Q

priority nursing focue hypokalemia

A

Because hypokalemia affects the transmission of cardiac impulses, the client is at risk for developing cardiac arrhythmias. Cardiac monitoring has the highest priority . Hypokalemia can lead to clinically significant life-threatening arrhythmia. TPOTASSIUM ‘ SODIUM OPPOSITE EFFECTS Place the patient on a high-potassium diet. If increasing dietary potassium is insufficient to treat moderate hypokalemia, provide oral potassium supplements. A patient who has severe hypokalemia or who can’t take oral supplements may need I.V. potassium replacement therapy.

97
Q

priority nursing focue hyperkalemia

A

Nursing Interventions for Hyperkalemia · Monitor cardiac, respiratory, neuromuscular, renal, and GI status · Stop IV potassium if running and hold any PO … Calcium therapy will stabilize the cardiac response to hyperkalemia and should be initiated first in the setting of cardiac toxicity. Calcium does not alter the serum concentration of potassium but is a first-line therapy in hyperkalemia-related arrhythmias and ECG changes.

98
Q

what is intended function of sodium

A

supports the function of nerves and muscles, helps maintain a normal blood pressure, and regulates the body’s fluid balance, and acid-base balance.

99
Q

hyponatremia level

A

Hyponatremia occurs when the sodium in your blood falls below 135 mEq/L.

100
Q

hypernatremia level

A

Doctors diagnose hypernatremia when the concentration of sodium in blood serum is higher than 145 milliequivalents per liter (mEq/l)

101
Q

normal range for sodium

A

Sodium (Na+)
136-145 mEq/L

102
Q

what are the risk factors for hyponatremia

A

Certain medications. …
Heart, kidney and liver problems. …
Syndrome of inappropriate anti-diuretic hormone (SIADH). …
Chronic, severe vomiting or diarrhea and other causes of dehydration. …
Drinking too much water. …
Hormonal changes.

103
Q

what are the risk factors for hypernatremia

A

Advanced age.
Mental or physical impairment.
Uncontrolled diabetes (solute diuresis)
Underlying polyuria disorders.
Diuretic therapy.
Residency in nursing home, inadequate nursing care.
Hospitalization. [22, 32]

104
Q

what are the expected findings of hyponatremia

A

Nausea and vomiting. ORTHOSTATIC HYPOTENSION / SEZURES / STOMACH CRAMPING / TAACHYCARIDA
Headache.
Confusion.
Loss of energy, drowsiness and fatigue.
Restlessness and irritability.
Muscle weakness, spasms or cramps.
Seizures.
Coma.

105
Q

what are the expected findings of hypernatremia

A

Muscle weakness. INCREASED BP / INCREASED FLUID RETENTION / EDEMA AGITATION / THIRST / DECREASED URINE OUTPUT
Restlessness.
Extreme thirst.
Confusion.
Lethargy.
Irritability.
Seizures.
Unconsciousness.

106
Q

priority nursing focue hyponatremia

A

In a patient who is hypovolemic and hyponatremic, the priority is to restore adequate circulating volume. In particular, restoring adequate circulating volume takes priority over any concerns that the hyponatremia might be corrected too rapidly and lead to osmotic demyelination syndrome.

107
Q

priority nursing focue hypernatremia

A

Hypernatremia is treated by replacing fluids. In all but the mildest cases, dilute fluids (containing water and a small amount of sodium in carefully adjusted concentrations) are given intravenously. The sodium level in blood is reduced slowly because reducing the level too rapidly can cause permanent brain damage
slowly lower sodium levels

108
Q

what is intended function of calcium

A

helps the body maintain strong bones and is mostly stored in teeth and bones to support their hardness. Calcium also helps muscles move, nerves to carry messages between the brain and body, and blood vessels to move blood throughout the body.

109
Q

hypocalcemia level

A

total serum (blood) calcium concentration is less than 8.8 mg/dL.

110
Q

hypercalcemia level

A

hypercalcemia is defined as a serum calcium level greater than 10.5 mg/dL (>2.5 mmol/L)

111
Q

normal range calcium

A

Calcium (Ca2+)
9.0-10.5 mg/dL

112
Q

what are the risk factors for hypocalcemia

A

Low levels of calcium cause the muscles to contract more easily, leading to increased deep tendon reflexes. Vitamin D deficiency.
A parathyroid disorder or parathyroid gland surgery.
Thyroid removal surgery (thyroidectomy).
A family history of genetic conditions such as certain genetic mutations, genetic vitamin D disorder or DiGeorge syndrome.

113
Q

what are the risk factors for hypercalcemia

A

Parathyroid problems.
Certain cancers.
Too much calcium in the diet.
Excess vitamin D and/or vitamin A.
Certain medicines—such as lithium, diuretics, and antacids with calcium.
Certain inherited conditions.
Kidney disease or failure.

114
Q

what are the expected findings of hypocalcemia

A

neuromuscular irritability. Patients often complain of numbness and tingling in their fingertips, toes, and the perioral region. Paresthesias of the extremities may occur, along with fatigue and anxiety. Muscle cramps can be very painful and progress to carpal spasm or tetany

115
Q

tetany

A

a condition marked by intermittent muscular spasms, caused by malfunction of the parathyroid glands and a consequent deficiency of calcium

116
Q

what are the expected findings of hypercalcemia

A

Hypercalcemia can cause stomach upset, nausea, vomiting and constipation. Bones and muscles. In most cases, the excess calcium in your blood was leached from your bones, which weakens them. This can cause bone pain and muscle weakness

117
Q

priority nursing focue hyponcalcemia

A

dminister IV calcium as ordered (ex: 10% calcium gluconate)…. give slowly as ordered (be on cardiac monitor and watch for cardiac dysrhythmias). Assess for infiltration or phlebitis because it can cause tissue sloughing (best to give via a central line)

118
Q

priority nursing focus hypercalcemia

A

Initial therapy of severe hypercalcemia includes the simultaneous administration of intravenous (IV) isotonic saline, subcutaneous calcitonin, and a bisphosphonate (typically, IV zoledronic acid [ZA]) (table 1). Isotonic saline – Most patients with severe hypercalcemia have marked intravascular volume depletion

119
Q

what is intended function of magnesium

A

role in the body is to assist in the regulation of nerve and muscle function, blood pressure and blood sugar levels; as well as making bone, protein, and DNA.

120
Q

hypomagnesemia. level

A

(less than 1.46 mg/dL) in the blood.

121
Q

hypermagnesemia level

A

(<3 mEq/L, 3.6 mg/dL, or 1.5 mmol/L)

122
Q

normal range magnesium

A

Magnesium (Mg2+)
1.3-2.1 mg/dL

123
Q

what are the risk factors for hypomagnesemia.

A

alcoholism, congestive heart failure, diabetes, chronic diarrhea, hypokalemia, hypocalcemia, and malnutrition (strength of recommendation: C, based on expert opinion, physiology, and case series).

124
Q

what are the risk factors for hypermagnesemia.

A

acute or chronic kidney disease. In these individuals, some conditions, including proton pump inhibitors, malnourishment, and alcoholism, can increase the risk of hypermagnesemia. Hypothyroidism and especially cortico-adrenal insufficiency, are other recognized causes.DIABETIC KETOACIDOSIS

125
Q

what are the expected findings of hypomagnesemia.

A

Clinical manifestations include anorexia, nausea, vomiting, lethargy, weakness, personality change, tetany (eg, positive Trousseau or Chvostek sign or spontaneous carpopedal spasm, hyperreflexia), and tremor and muscle fasciculations.

126
Q

what are the expected findings of hypercalcemia

A

stomach upset, nausea, vomiting and constipation. Bones and muscles. In most cases, the excess calcium in your blood was leached from your bones, which weakens them. This can cause bone pain and muscle weakness.

127
Q

priority nursing focus hypomagnesemia.

A

Monitor cardiac, GI, respiratory, neuro status. …SEIZURE PRECAUTIONS
May administer potassium supplements due to hypokalemia (hard to get magnesium level up if potassium level is down)
Administering calcium supplements (oral calcium supplements w/ Vitamin-D or 10% Calcium Gluconate)

128
Q

priority nursing focue hypermagnesemia.

A

DIURETICS / AVOID LAXATIVES / ANTACIDS / HEMODYIALYSISNursing interventions for patients with hypermagnesemia or at risk for this imbalance include the following: Teach patients to avoid magnesium-rich foods, especially green, leafy vegetables; whole grains; and nuts. Monitor serum magnesium, potassium, calcium, and phosphate levels

129
Q

neutral pH is what? a figure expressing the acidity or alkalinity of a solution

A

7 (pure water)

130
Q

Acid is

A

1 (gastric acid) -6 (milk)

131
Q

Base is what

A

8 (egg) -14 (concentrated solutions of alkalis (ex bleach / ammonia are bases)

132
Q

Buffers for pH Regulation

A

The blood
The lungs
The kidneys

133
Q

Acid-Base Balance

A

ØIs the correct balance of acidic and basic (alkaline) compounds in the blood.

134
Q

ØAcidosis occurs

A

when the levels of acid in the blood are too high.

135
Q

ØAlkalosis occurs

A

when the blood becomes too alkaline.

136
Q

Normal Arterial Blood Gas Values (test to measure for acid base components and pressure of gasses in blood

A

pH: 7.35-7.45
PaCO²: 35-45 mm Hg
HCO³-: 21-28 mEq/L

137
Q

•pH: ( figure expressing the acidity or alkalinity of a solution)

A

7.35-7.45

138
Q

7.45 =

A

Alkalosis

139
Q

7.35 =

A

Acidosis

140
Q

•PaCO²: (PARTIAL PRESSURE CARBON DIOXIDE)

A

35-45 mm Hg

141
Q

45 mm Hg =

A

Acidosis

142
Q

35 mm Hg =

A

Alkalosis

143
Q

•HCO³-: BICARBONATE

A

21-28 mEq/L

144
Q

28 mEq/L =

A

Alkalosis

145
Q

21 mEq/L =

A

Acidosis

146
Q

Alkalosis

A

isexcessive blood alkalinity caused by an overabundance of bicarbonate in the blood or a loss of acid from the blood(metabolic alkalosis), or by a low level of carbon dioxide in the blood that results from rapid or deep breathing (respiratory alkalosis).

147
Q

Acidosis

A

Acidosisoccurs when acid builds up or when bicarbonate (a base) is lost. Classified as either respiratory or metabolic acidosis.Respiratory acidosisdevelops when there is too much carbon dioxide (an acid) in the body.

148
Q

four major ways excess acid can accumulate in the body

A

increased acid production,
decreased elimination of acids
elimination of acids
increased elimination of base,

149
Q

metabolic acidosis.

A

The buildup of acid in the body due to kidney disease or kidney failureis called metabolic acidosis. When your body fluids contain too much acid, it means that your body is either not getting rid of enough acid, is making too much acid, or cannot balance the acid in your body.

150
Q

Common Causes of Metabolic Acidosis (HCO3-: <22 mEq/L)

A

Kidney disease
Lactic acidosis
Diabetic acidosis –
Severe dehydration
Severe diarrhea

151
Q

why is sever diarrhea a Common Causes of Metabolic Acidosis (HCO3-: <22 mEq/L)

A

due to loss of too much sodium bicarbonate

152
Q

compensation. Withmetabolic acidosis,(HCO3-: <22 mEq/L)

A

respiratory system is the main mode of compensation. The process begins when chemoreceptors in the brain sense a high concentration of hydrogen ions, which stimulates an increase in respirations, or hyperventilation, which increases the rate at which CO2 is eliminated from the body.

153
Q

lactic acidosis,

A

increased acid production,
caused by decreasedtissue perfusionand resulting anaerobic metabolism

154
Q

Common Causes of Metabolic Alkalosis(HCO3-: >26 mEq/L)

A

Loss of potassium or sodium from the body quickly
Ingestion of bicarbonate
Alcohol abuse

155
Q

Loss of potassium or sodium from the body quickly - conditions can cause

A

*Diuretic overuse
*Excess vomiting
*Antacids
*Laxatives

156
Q

Diabetic acidosis – AKA Diabetiketoacidosis (DKA)

A

ketones that are acidic build up when diabetes is uncontrolled

157
Q

diabetic ketoacidosis,

A

increased acid production,
extreme hyperglycemia and an excessive breakdown offatty acidsin people withdiabetes. It can also be caused by increased ingestion of acids, like methanol,salicylates, or ethylene or propylene glycol.

158
Q

kussmaul respirations

A

if underlying cause is diabetic ketoacidosis - rapid, deep respirations will be present. Compensation can’t completely correct the pH imbalance, and it won’t fix the underlying cause of it either

159
Q

Common Cause of Respiratory Alkalosis (PaCO2: <35 mm Hg)

A

•Respiratory alkalosis occurs when the carbon dioxide levels in the body drop too low and may be a result of breathing too fast or too deep.

160
Q

•Respiratory alkalosis occurs (PaCO2: <35 mm Hg)

A

when the carbon dioxide levels in the body drop too low and may be a result of breathing too fast or too deep.

161
Q

respiratory alkalosis - common cause

A

Hyperventilation, or over breathingd ue to the action of deep or rapid breathing ridding the body of too much carbon dioxide.

162
Q

Respiratory acidosis(PaCO2 > 45 mm Hg )

A

Respiratory acidosis isa condition that occurs when the lungs cannot remove all of the carbon dioxide the body produces. This causes body fluids, especially the blood, to become too acidic.

163
Q

Respiratory Acidosis PaCO2: >45 mmHg - Common Causes of

A

Airway diseases such as COPD and asthma
Diseases that affect the chest and breathing ability such as scoliosis
Diseases of the lung tissues
Medicines that suppress breathing such as narcotics
Severe obesity
Obstructive sleep apnea

164
Q

Anaerobic metabolism,

A

which can be defined asATP production without oxygen (or in the absence of oxygen),

165
Q

renal failure

A

decreased elimination of acids

166
Q

MUDPILES,

A

M stands for methanol; U for uremia, which happens in renal failure; D for diabetic ketoacidosis, P for propylene glycol; I for iron tablets and isoniazid, which can cause acidosis with an overdose; L for lactic acidosis; E for ethylene glycol; and finally, S for salicylates.

167
Q

Hyperventilation, or over breathing,

A

is a common cause of respiratory alkalosis

168
Q

Hyperventilation, or over breathing, a common cause of respiratory alkalosis

A

due to the action of deep or rapid breathing ridding the body of too much carbon dioxide.

169
Q

respiratory acidosis occurs.

A

•When the lungs cannot remove enough carbon dioxide from the body,

170
Q

DATA ANALYSIS RELATED TO ACID IMBALANCES

A

Excess fluid volume
Deficient fluid volume
Risk for imbalanced fluid volume

171
Q

Plan (Objective/Goal): The Patient will…..

A

Maintain approximate fluid intake and output balance (2,500-mL intake and output over 3 days).
Maintain urine specific gravity within normal range (1.010-1.030).
Practice self-care behaviors to promote balance.
WHAT DO THESE THINGS MEAN??

172
Q

Implementation

A

Dietary modifications
Modifications of fluid intake
Medication administration
IV therapy
Blood and blood products replacement
TPN
Decrease patient anxiety as needed
Appropriate patient and family teaching

173
Q

Administering Medications/Therapies

A

Mineral–electrolyte preparations
Diuretics
Intravenous therapy
Oxygen

174
Q

Evaluation

A

Maintain approximate fluid intake and output balance (2,500-mL intake and output over 3 days). Goal met

Maintain urine specific gravity within normal range (1.010-1.030). Goal met

Practice self-care behaviors to promote balance. Goal met

NUR 113 (8 decks)

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