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Pathophysiology > Quiz 1 - Electrolyte imbalance > Flashcards

Quiz 1 - Electrolyte imbalance Flashcards

1
Q

Normal Range: 135-145

A

Sodium

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2
Q

Kidneys chief regulator of fluid and electrolytes, exerts what kind of pressure?

A

Osmotic pressure

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3
Q

______ Stimulates Na+ reabsorption (secreted by adrenal cortex under control of Angiotensin II) and K+ excretion

A

ALDOSTERONE: (hormone secreted by adrenal cortex in response to the renin-angiotensin aldosterone cycle and stimulates… )

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4
Q

______: Hydrochlorothiazide (HCTZ) blocks Na+ reabsorption – does not retain sodium, exits in urine with excess fluid

A

Diuretics

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5
Q

Estrogen ____ reabsorption of water and sodium

A

Increases

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6
Q

Where does aldosterone cause sodium reabsorption?

A

Proximal Convoluted Tubule

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7
Q

Aldosterone stimulate sodium reabsorption by….

A

when we need greater blood volume, we retain sodium which draws water in bloodstream which increase our blood volume that is circulating so in heart failure patient it’s not good bc not enough blood flow is being pumped from heart to kidneys so we have release of renin conversion of angio 1 to angio 2 and release of aldosterone and we reabsorb that sodium and water now that failing heart has more fluid and volume to pump

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8
Q

____: Amount reabsorbed varies according to body’s need

A

Potassium

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9
Q

Normal range: 3.5-5 mEq/L

A

Potassium

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10
Q

Why must potassium be kept within normal range?

A

Disruption of cardiac conduction, Irritable cardiac cells, major life threatening dysrhythmias and lead to flat line

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11
Q

What gets reabsorbed in proximal convoluted tubule? (potassium)

A

We will see that depending on serum potassium level, amount that is reabsorbed in PCT will vary so if we have high potassium then we might reabsorb less and get rid of more potassium. So if we have a low serum potassium, PCT will hang onto more potassium

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12
Q

Foods high in potassium

A

Potato, potato skins, oranges, bananas, dried fruit, certain salt substitutes, cantaloupes, raisins, lentils

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13
Q

Patients in in stage renal disease lose ability to balance of potassium. Chronic renal failure will have prob with _____ bc they take in a quite bit of potassium but not good urine output to secrete potassium out

A

Hyperkalemia

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14
Q

______ are responsible for excreting more than 90% of the total daily K+ intake

A

Kidneys

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15
Q

Hypokalemia EKG

A

T wave becomes flattened and we begin to see U wave

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16
Q

Patient with a flat T wave, and a U wave. Patient states ”my legs are cramping” and then nurse has given a diuretic to get rid of fluid. Patient receiving diuretic may suffer _____

A

Hypokalemia

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17
Q

Muscle cramping, weakness, nausea

A

Hypokalemia

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18
Q

What will the nurse do with abnormal EKG waves and cramping?

A

Assess, documents, notify doctor, lab values, serum potassium, expect low potassium

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19
Q

_____ should be administered only after adequate urine flow has been established

A

Potassium

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20
Q

_____ is NEVER administered by IV push; IV K+ must be administered DILUTED using an INFUSION PUMP-

A

Potassium

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21
Q

Why is potassium never administered by IV push?

A

Do not want to give patient too much potassium

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22
Q

Never syringe or iv port, if so putting patient in cardiac arrest and they could die

A

TRUE

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23
Q

False high potassium

A

pseudohyperkalemia

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24
Q

Use of a tight tournequit around an exercising extremity while drawing blood

A

pseudohyperkalemia

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25
Q

Drawing blood above a site where K+ is infusing or patient exercising that extremity

A

pseudohyperkalemia

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26
Q

If patient receiving iv fluids with potassium in those IV fluids and draw blood in same extremity near site

A

pseudohyperkalemia

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27
Q

Addison disease causes _____

A

Hyperkalemia

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28
Q

Renal disease - Can’t excrete potassium

A

Hyperkalemia

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29
Q

Damage to cell/trauma, burn, lot of blood transfusion. antibiotic like PNC that has potassium, crushing injury

A

Hyperkalemia, potassium leaves cells and goes to the bloodstream

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30
Q

_____ is the major intracellular electrolyte

A

Potassium

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31
Q

How do we know patient has hyperkalemia?

A

Complain of paraesthesia, irritability, diarrhea, muscle weakness, peaked peaked T waves, shortened Q T intervals

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32
Q
  • Dialysis (draw off high potassium from blood),
  • IV glucose amp D50 followed by regular insulin.
  • insulin will carry glucose into the cells and also grabs potassium and carries it into the cells
A

Lowering Potassium

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33
Q

Does not really lower the potassium but it stabilizes the heart and keeps it contracted regularly because the high potassium can decrease activity of the heart. This medicine protects the heart.

A

Calcium Gluconate

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34
Q

As potassium levels go up, patients tend to go through _____ acidosis

A

Metabolic

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35
Q

Treatment for metabolic acidosis and hyperkalemia?

A

Sodium Bicarbonate

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36
Q

High potassium can result due to increase use of diuretic, = causes to get rid of excess fluid and cause potassium fluids go up

A

Potassium spearing diuretic (Aldactone-spironolactim)

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37
Q

Digoxin toxicity may have issues with potassium, either high or low

A

True

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38
Q

NSAID (ibuprofen, advil) cause _____

A

Hyperkalemia

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39
Q

ACE inhibitors (captopril, lisinopril) cause ____

A

Hyperkalemia

40
Q

K+ sparing diuretics (spironolactone) cause ____

A

Hyperkalemia

41
Q

Normal Range: 8.5-10.2

A

Calcium

42
Q

Exerts sedative action on nerve cells
Keep nerve cells quiet so they can do their job
If not enough calcium, nerves become irritable

A

Calcium

43
Q

Plays key role in transmission of nerve impulses

A

Calcium

44
Q

Regulates muscle contraction, and relaxation of heart rhythm

A

Calcium

45
Q

Necessary for blood coagulation

A

Calcium

So if not enough calcium, then you may issues with clotting and bleeding

46
Q

Dairy products, green leafy vegetables –kale, spinach, salmon, sardines, broccoli

A

Foods high in calcium

47
Q

Common in Renal patients due to elevated phosphorous = can’t excrete phosphorus… so…

A

Hypocaclemia

48
Q

Ca+ and Phosphorous have an INVERSE relation

As phosphorous goes up, calcium goes down

A

True

49
Q

Tetany- increased neural excitability (twitching), tingling (lips, side of face) all the way to SEIZURES

A

S/S of Hypocalcemia

50
Q

+ CHVOSTEK’S & + TROUSSEAU’S

A

Hypocalcemia

51
Q

Cardiac dysrhythmias

A

Hypocalcemia

52
Q

______ glands watch calcium levels in the blood and when calcium levels drop

A

Parathyroid

53
Q

______ gland is on alert && says “woah there’s not enough calcium in the blood, we have a problem, our patient has tetany then it says we gotta get calcium from somewhere-bone” (Hypocalcemia)

A

Parathryroid

54
Q

Parathryoid gland release _____ hormone and it causes calcium to be pulled from the bone (Hypocalcemia)

A

Paratharmone

55
Q

When calcium levels drop in renal patients due to phosphorous being too high, patients in renal failure can’t secrete phosphours

A

True

56
Q

When you tap on the trigeminal nerve (5), the mouth will pull up toward where you are tapping, tapping of nerve moves mouth up (Hypocalcemia)

A

Positive Chvostek’s

57
Q

When blood cuff is put on arm and the hand draws up into a claw like because we have exerted pressure on nerves that are already excitable, twitching and drawing up of the hand (Hypocalcemia)

A

Positive Trousseaus’s

58
Q

Correlate serum Ca+ with serum albumin

A

True

59
Q

Medical emergency requiring IV calcium

-Give slowly to avoid bradycardia that could lead to cardiac arrest

A

Treatment of Hypocalcemia

60
Q

Monitor for seizures/ provide safe environment

Neurological damage

A

Treatment of Hypocalcemia

61
Q

Airway management

A

Treatment of Hypocalcemia

62
Q

______ are major route for phosphorous excretion

A

Kidneys

63
Q

Normal level: 2.5-4.5mg/dl

A

Phosphorous

64
Q

Necessary for muscle function, RBC production, nerve conduction, metabolism of carbohydrates, protein, and fat

A

Phosphorous

65
Q

Too high level of phosphorous

A

Hyperphosphatemia

66
Q

What causes hypocalcemia?

A

Hyperphosphatemia & Low Active Vitamin D

67
Q

Renal function help activate and metabolize vitamin D therefore patient with renal failure will not have active vitamin D

A

True

68
Q

What happens to a patient with hypocalcemia?

A

Phosphorous levels will increase, calcium level will decrease. Parathyroid gland will produce parathormone which will cause bone to release calcium and phosphate but most important calcium, calcium will be released to the blood.

69
Q

In a hypocalcemia patient, Kidney will also try to reabsorb calcium but remember renal failure patient’s can’t reabsorb so we don’t see that happening much

A

True

70
Q

If calcium is being pulled out the bone, patients will have _____

A

osteoporosis

71
Q

Renal Osteodystrophy/Osteoporosis: Patients with chronic renal failure will not have have stable bones

A

Hyperphosphatemia

72
Q

Very susceptible to fracture

A

Hyperphosphatemia

73
Q

Rare painful syndrome of calcification of the small blood vessels located within the fatty tissue and deeper layers of the skin, blood clots, and the death of skin cells due to too little blood flow. (Hyperphosphatemia)

A

Calciphylaxis

74
Q

Calcium deposited in sites throughout body where you normally wouldn’t have calcium is called _____

A

Calciphylaxis

75
Q

High phosphorous levels will have inverse relationship = low calcium = parahtryoid will secrete parathormone will get calcium out of bone and cause bones to be weak and more likely to have fractures, will have hard things under skin like pebbles and skin will become irritated and sores will develop due to calcium rupturing through the skin (Calciphylaxis)

A

True

76
Q

Overtime bc patients have poor reabsorption of calcium in bones, you will actually see the bones in the digits of the hand become harder to define, less calcium in the bones, bones are thinning, areas where you will see almost nothing due to ___

A

Lack of reabsorption of calcium in the bone bc its going out into the bloodsteam

77
Q

Horrible sores back of legs, inner thigh, bellys, wounds are hard to treat, can become infected, patients often do not survive

A

Calciphylaxis

78
Q

Hyperphosphatemia: too high of a phosphorous bc can’t be excreted, patient not having good renal function, no urine output so can’t get rid of phosphorous

A

True

79
Q

Parathyroidectomy

A

Remove parathyroid gland because that will stop the pulling of calcium out of the bone

80
Q

Phosphate binders: Ex. Phoslo

A

w/ every meal patient will take a phosphate binder, these are big chalky like capsules. Phoslo binds the phosphorous in the gut and prevents phosphorous from being absorbed into the blood stream, binds high phosphorous foods in the GI tract and excrete via stool

81
Q

Foods high in phosphorous

A

Hard cheeses, nuts, whole grains, dried fruits & vegetables, dairy products

82
Q

Parahyroidectomy, phosphate binders, limit foods high in phosphorous

A

Treatments of hyperphosphatemia

83
Q

Renal excretion of _____ keeps body’s level in check

A

Magnesium

84
Q

Necessary for intracellular enzyme activity, carbohydrate & protein metabolism, neuromuscular function (nerve conduction and muscle contraction) particularly the heart

A

Magnesium

85
Q

After MI may have irritability and dysrhythmias so will give patients _____

A

Magnesium

86
Q

Diminished excitability of muscle cells- sluggish

A

Increase in magneisum

87
Q

Increased neuromuscular irritability

A

Decreased magnesium

88
Q

Magnesium and potassium are like sisters

A

True

89
Q

Cardiac patients – If can’t get serum potassium levels up, magnesium will be given so if you have magnesium up then potassium will go up as well, they like sisters, same effects, too much magnesium will shut down the heart, too much potassium will shut down the heart, too little magneisum will cause heart to be irritable and dysrhythmia, too little potassium dysrhythmia as well

A

True

90
Q

Most common cause of hypermagnasemia

A

Renal failure

91
Q

Why is renal failure the most common cause of hypermangasemia?

A

Bc can’t excrete cus they got no urine output so hang up to magnesium

92
Q

Hypermagnasemia patients need to avoid medication high in magnesium such as ___ __ _____

A

Milk of magnesia

93
Q

Muscle weakness, lethargy, drowsiness, loss of reflexes-tapping of the knee-nothing happens, facial flushing, decreased blood pressure due to peripheral vasodilation

A

S/S of hypermagnasemia

94
Q

Hemodialysis: draw off the magnesium
IV calcium/ magnesium: protect heart
Avoid OTC medications
Ventilatory support

A

Treatment for hypermagnasemia

95
Q

90% of Na+ in filtrate (what goes into bowmans capsule, through tuft capillaries into proximal convoluted tubule) is reabsorbed

A

True

96
Q

Heparin causes ___

A

Hyperkalemia

Pathophysiology (4 decks)

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