S2L3: Metabolic Conditions - Fluid & Electrolyte Imbalance Flashcards
Give 3 causes of dehydration
Poor intake
Excess output
Profuse sweating
Vomiting
Diarrhea
Diuretics
Give 3 Clinical Manifestations of Dehydration
Poor skin turgor
Dry mucous membranes
Headache
Irritability
Postural Hypotension
Incoordination
Lethargy
Disorientation
Dehydration may lead to: (2)
uremia and hypovolemic shock
Identify: Excess of body fluids with expansion of interstitial fluid volume
EDEMA
Give 3 Causes of edema
Heart failure, kidney disease, premenstrual retention, pregnancy, heat stress, venous insufficiency
Protein-losing kidney disease, starvation, malnutrition
Inflammation, allergic reactions, malignancy, tissue injury, burns, liver cirrhosis
Obstruction of lymphatic flow
Give 3 Clinical Manifestations of Edema
Bipedal edema
Weight gain
Headache
Blurred vision
Muscle cramps
Twitches
N Level of Potassium
3.5 - 5.5 mEq/L
Give 3 Causes of hypokalemia
Diarrhea, vomiting, metabolic alkalosis, renal tubular disease, alkalosis, diuretic use
Give 3 Manifestations of hypokalemia
Muscle weakness, aches, fatigue, cardiac arrhythmias (ST segment depression) abdominal distention, nausea and vomiting
Give 3 Causes of hyperkalemia
Acute renal failure, metabolic acidosis, diabetic ketoacidosis, sickle cell anemia, SLE
Give 2 Manifestations of hyperkalemia
Muscle weakness, arrhythmias (Tall T wave, prolonged P-R interval and QRS duration)
N Level of Na
135 - 146 mEq/L
Sodium is usually located in:
A. Interstitial fluid
B. CSF
C. Blood
D. Lymphatic Fluids
C
Identify: substance that keeps fluids in the body balanced
sodium
Give 3 causes of Hyponatremia
Water intoxication
Tumors
Endocrine tumors
Give 3 Manifestations of hyponatremia
Confusion, decreased mental alertness, convulsions, signs of increased ICP, cerebral hemorrhages, poor motor coordination, sleepiness, anorexia
Give 3 causes of Hypernatremia
Water deficits, with dehydration, insufficient water intake
Give 3 manifestations of Hypernatremia
Pitting edema, excessive weight gain, pulmonary edema with dyspnea, hypertension, tachycardia, agitation, restlessness, convulsions
What is the normal level of calcium
8.4 - 10.4 mg/dL
Give 3 causes of hypocalcemia
Reduced albumin, hyperphosphatemia, hypoparathyroidism, malabsorption of calcium and vitamin D, alkalosis, acute pancreatitis
Give 3 manifestations of hypocalcemia
muscle cramps, tetany, spasms, paresthesia, anxiety, irritability, twitching convulsion, arrhythmias, hypotension
Give 3 causes of hypercalcemia
Hyperparathyroidism, tumors, hyperthyroidism, vitamin A intoxication
Give 3 manifestations of hypercalcemia
Fatigue, depression, mental confusion, nausea/vomiting, increased urination, occasional cardiac arrythmias
Resisting membrane potential of a neuron is _ mv
-70 mv
Modified T or F
Resisting membrane potential
is determined by the uneven distribution of ions. There is more potassium ions outside the neuron & more sodium inside
A. First statement true, second statement false
B. Second statement true, first statement false
C. Both statements are true
D. Both statements are false
A
More potassium ions inside the neuron
More sodium outside
During depolarization, sodium needs to go inside the cell through a channel. When you want this process to seize, calcium blocks the channel so it stops the sodium influx and depolarization.
A. First statement true, second statement false
B. Second statement true, first statement false
C. Both statements are true
D. Both statements are false
C
In hypercalcemia, the channel is constantly open. It is hard for neuron to repolarize
A. First statement true, second statement false
B. Second statement true, first statement false
C. Both statements are true
D. Both statements are false
D
Channel is constantly blocked
Hard for neuron to depolarize
In hypocalcemia, the sodium channel is constantly open. There is a constant influx of calcium ions
A. First statement true, second statement false
B. Second statement true, first statement false
C. Both statements are true
D. Both statements are false
A
Constant influx of sodium ions
In hypocalcemia, resting membrane potential ↑ from -70mv. Neurons will be hypoexcitable
A. First statement true, second statement false
B. Second statement true, first statement false
C. Both statements are true
D. Both statements are false
A
In hypocalcemia, there is a (+) Chvostek sign & (-) Trousseau sign. The pt may present c anxiety since nerve cells in the brain are constantly firing.
A. First statement true, second statement false
B. Second statement true, first statement false
C. Both statements are true
D. Both statements are false
B
(+) Chvostek sign
(+) Trousseau sign
N Level of Magnesium is _ mg/dL
1.8- 2,4 mg/dL
Give 3 causes of hypomagnesemia
Hemodialysis, blood transfusion, chronic renal disease, hepatic cirrhosis, chronic pancreatitis, hypoparathyroidism, malabsorption syndromes, severe burns, excess loss of body fluids
Give 3 Manifestations of hypomagnesemia
Hyperirritability, confusion, leg and foot cramps
Give 3 causes of hypermagnesemia
Renal failure, diabetic acidosis, hypothyroidism, Addison’s disease, dehydration, use of antacids
Give 3 manifestations of hypermagnesemia
Hyporeflexia, muscle weakness, drowsiness, lethargy, confusion, bradycardia, hypotension
Magnesium is important for _ _ _
protein synthesis, nerve and muscle function, energy production
Problems in magnesium leads to _ _ _
dec BP, heart disease and type 2 diabetes
Magnesium also regulates _ and adjusts _
immune system, blood glucose levels
Symptoms of hypermagnesemia develop with levels more than _ meq/L
4
An average adult has approx. _g of magnesium in the body
25
Half of the magnesium is found in the bones. The other half is found in the cells.
A. First statement true, second statement false
B. Second statement true, first statement false
C. Both statements are true
D. Both statements are false
C
Magnesium is a common negatively charged ion in the cell, 2nd to K. Approx 1% is found in the extracellular space
A. First statement true, second statement false
B. Second statement true, first statement false
C. Both statements are true
D. Both statements are false
B
Hypomagnesemia levels: < _ mg/dL _ mol/L
Normal levels: 1.7-2.2 mg/dL; Hypomagnesemia levels: < 1.7 mg/dL 0.70 mol/L
Give 3 sx of hypomagnesemia
Sx: tremor, nystagmus, seizures, cardiac arrest
Give 3 causes of hypomagnesemia
Causes: alcoholism, starvation, diarrhea, inc urinary loss, poor absorption from intestines
Causes of hypomagnesemia are alcoholism, starvation, diarrhea, inc urinary loss, poor absorption from intestines. These sx can be present without deficiency in magnesium and vice versa
A. First statement true, second statement false
B. Second statement true, first statement false
C. Both statements are true
D. Both statements are false
C
Identify: 2nd most abundant electrolyte after sodium
Chloride
N Level of Chloride: _ mEq/L
98- 107
Chloride helps w regulation of body fluids, regulation of electrolyte balance, preservation of electrical neutrality, and acid-base status. Abnormal chloride levels are not usually d/t metabolic acidosis & alkalosis
A. First statement true, second statement false
B. Second statement true, first statement false
C. Both statements are true
D. Both statements are false
A
usually due to metabolic acidosis & alkalosis
Hypochloremia frequently accompanies hypernatremia. Laxatives increase motility of stool while diuretics increase excretion
A. First statement true, second statement false
B. Second statement true, first statement false
C. Both statements are true
D. Both statements are false
B
Hypochloremia frequently accompanies hyponatremia.
Give 3 causes of hypochloremia
Congestive heart failure, prolonged diarrhea/vomiting, chronic lung disease, metabolic alkalosis, laxative use, diuretics, corticosteroids, bicarbonates
Give 3 manifestations of hypochloremia
Fluid loss, dehydration, weakness, fatigue, difficulty breathing, diarrhea/vomiting
Give 3 causes of hyperchloremia
Kidney problem, diabetes, severe dehydration, increased saline solution (p surgery), ingestion of salt water, inc dietary salt, respiratory alkalosis
Give 3 manifestations of hyperchloremia
Fatigue, muscle weakness, excessive thirst, dry mucous membranes, high BP
Hyperchloremia is > _ meq/L of chloride
106
Give 3 sx of Hyperchloremia
Edematous
Rapid, blowing respirations to remove acid build-up through lungs
Typically in metabolic acidosis
Decreasing level of consciousness (LOC)
In hyperchloremia, urine output is closely monitored since pt is treated with diuretics. The pt would need close monitoring of heart since it is bradycardic.
A. First statement true, second statement false
B. Second statement true, first statement false
C. Both statements are true
D. Both statements are false
A
tachycardic
In hyperchloremia, the goal is to get the urine out of the system. When BP is elevated, diuretics are used for fluid retention & to ↓ BP
A. First statement true, second statement false
B. Second statement true, first statement false
C. Both statements are true
D. Both statements are false
A
BP is elevated, diuretics are used to eliminate fluid & to ↓ BP
Give 3 nursing actions for hyperchloremia
Monitor HR, BP, respirations
Administer diuretics
Skin care
Decrease sodium, & fluid intake
Hypochloremia has <_ meq/L of chloride
95
Give 3 sx of hypochloremia
Rigid extremities (tetany)
Slight tremors/twitching
Tetany can lead to seizures
Slow, shallow respirations (metabolic alkalosis)
If hypochloremia is severe, it can lead to inc in blood pressure, respiratory & cardiac problems. When BP is elevated, diuretics are used to eliminate fluid & to ↓ BP
A. First statement true, second statement false
B. Second statement true, first statement false
C. Both statements are true
D. Both statements are false
B
dec in BP
Give 3 nursing actions for hypochloremia
Replace Na+: can be done orally via sodium-containing foods, salt tablets
Monitoring VS, intake & output are critical
Safety: need assistance in ambulation d/t tremors & decreased BP from sitting → standing position
Normal level of Phosphate
3-4.5 mg/dL
Modified T/F
A. Phosphate has direct relationship with calcium
B. Hence, s/sx of hyperphosphatemia = S/sx of hypokalemia and s/sx of hypophosphatemia = s/sx of hyperkalemia
FT
Has inverse relationship with calcium
Which of the following is not a function of phosphate?
A) Helps to repair bones and teeth
B) Helps in nerve function and muscle contractility
C) Essential in RNA and DNA degradation
D) Activation of enzymes as part of ATP - primary source of energy
C) Essential in RNA and DNA degradation
Essential in RNA and DNA synthesis
T/F:
Low phosphate levels are usually associated with malignancy and hyperparathyroidism (HyperPTH).
True
Modified T/F:
A. High phosphate levels are d/t chronic kidney diseases
B. Pts with kidney problems uses phosphate-releasing medications
False
phosphate-binding medications
Which condition is associated with the following manifestations?
Muscle weakness, fatigue, bone fractures and pain, irritability, and slowed growth in children.
A) Hypophosphatemia
B) Hyperphosphatemia
A) Hypophosphatemia
Which condition is associated with the following manifestations?
Numbness, confusion, loss of appetite, and tooth decay or late baby teeth.
A) Hypophosphatemia
B) Hyperphosphatemia
A) Hypophosphatemia
Which condition is associated with the following manifestations?
Muscle cramps, bone and joint pain, weak bones, rashes, and itchy skin.
A) Hypophosphatemia
B) Hyperphosphatemia
B) Hyperphosphatemia
Which condition is associated with the following manifestations?
Numbness and tingling around the mouth.
A) Hypophosphatemia
B) Hyperphosphatemia
B) Hyperphosphatemia
Which condition is associated with the following manifestations?
Muscle and cell damage, high vitamin D levels, and diabetic ketoacidosis are common causes.
A) Hypophosphatemia
B) Hyperphosphatemia
B) Hyperphosphatemia
Which condition is associated with the following manifestations?
Genetic factors, hospitalized individuals (especially in the ICU) due to fluid loss, and alcoholism are potential causes.
A) Hypophosphatemia
B) Hyperphosphatemia
A) Hypophosphatemia
Which condition is associated with the following manifestations?
Kidney problem, hypoparathyroidism and infections are potential causes.
A) Hypophosphatemia
B) Hyperphosphatemia
B) Hyperphosphatemia
Which condition is associated with the following manifestations?
Faconi syndrome, hyperparathyroidism, chronic diarrhea,and vit D deficiency are potential causes.
A) Hypophosphatemia
B) Hyperphosphatemia
A) Hypophosphatemia
Which condition is associated with the following manifestations?
Severe burns and diabetic ketoacidosis deficiency are potential causes.
A) Hypophosphatemia
B) Hyperphosphatemia
A) Hypophosphatemia
T/F
Diabetic ketoacidosis is potential cause of Hypophosphatemia AND Hyperphosphatemia
True
Modified T/F:
A. Normal pH levels are around 7.35-7.45
B. Hydrogen ions are measured in pH
TT
Identify if the description correspond toMetabolic Acidosis or Alkalosis
The blood is too acidic.
A) Metabolic Acidosis
B) Metabolic Alkalosis
A) Metabolic Acidosis
Identify if the description correspond toMetabolic Acidosis or Alkalosis
Life-threatening condition that requires immediate treatment.
A) Metabolic Acidosis
B) Metabolic Alkalosis
A) Metabolic Acidosis
This is diabetic ketoacidosis
Identify if the description correspond toMetabolic Acidosis or Alkalosis
May eventually lead to stupor or coma.
A) Metabolic Acidosis
B) Metabolic Alkalosis
A) Metabolic Acidosis
Identify if the description correspond toMetabolic Acidosis or Alkalosis
Manifestations include hyperventilation and deep respirations.
A) Metabolic Acidosis
B) Metabolic Alkalosis
A) Metabolic Acidosis
Identify if the description correspond toMetabolic Acidosis or Alkalosis
Manifestations include depressed respirations and dysrhythmias.
A) Metabolic Acidosis
B) Metabolic Alkalosis
B) Metabolic Alkalosis
Identify if the description correspond toMetabolic Acidosis or Alkalosis
Common causes include excess vomiting and excess diuretic use.
A) Metabolic Acidosis
B) Metabolic Alkalosis
B) Metabolic Alkalosis
Identify if the description correspond toMetabolic Acidosis or Alkalosis
Manifestations include irritability, agitation, and confusion.
A) Metabolic Acidosis
B) Metabolic Alkalosis
B) Metabolic Alkalosis
Identify if the description correspond toMetabolic Acidosis or Alkalosis
Causes include excess diuretics and hypokalemia.
A) Metabolic Acidosis
B) Metabolic Alkalosis
B) Metabolic Alkalosis
Identify if the description correspond toMetabolic Acidosis or Alkalosis
Causes Diabetes, renal insufficiency, and diarrhea
A) Metabolic Acidosis
B) Metabolic Alkalosis
A) Metabolic Acidosis
Identify if the description correspond toMetabolic Acidosis or Alkalosis
Manifestations include weakness,
muscular twitches, malaise.
A) Metabolic Acidosis
B) Metabolic Alkalosis
A) Metabolic Acidosis
Identify if the description correspond toMetabolic Acidosis or Alkalosis
Manifestations include nausea, vomiting, diarrhea, and headache
A) Metabolic Acidosis
B) Metabolic Alkalosis
A) Metabolic Acidosis
Identify if the description correspond toMetabolic Acidosis or Alkalosis
Manifestations include dry skin and poor skin turgor
A) Metabolic Acidosis
B) Metabolic Alkalosis
A) Metabolic Acidosis
Identify if the description correspond toMetabolic Acidosis or Alkalosis
Common causes include peptic ulcer disease and excessive intake of antacids.
A) Metabolic Acidosis
B) Metabolic Alkalosis
B) Metabolic Alkalosis
Identify if the description correspond toMetabolic Acidosis or Alkalosis
Manifestations include hypoventilation, prolonged vomiting, weakness, muscle twitching and coma (death)
A) Metabolic Acidosis
B) Metabolic Alkalosis
B) Metabolic Alkalosis
Modified T/F
A. A pH level below 7.35 indicates alkalosis.
B. A ph level above 7.45 indicates acidosis
FF
○ pH level <7.35 = acidosis
○ pH level >7.45 = alkalosis
T/F:
he pH level measures only hydrogen ions and indicates whether the pH level is normal, acidic, or basic.
True
In the equation CO2 + H2O ⇌ H2CO3 ⇌ HCO3 + H+
what is carbonic acid?
H2CO3
In the equation CO2 + H2O ⇌ H2CO3 ⇌ HCO3 + H+
what is bicarbonate ion?
HCO3
Modified T/F:
A. Respiratory acidosis is characterized by an increase in carbon dioxide levels and a decrease in pH.
B. Respiratory alkalosis is characterized by a decrease in carbon dioxide levels and an increase in pH.
TT
Modified T/F:
A. Metabolic acidosis can occur due to a decrease in bicarbonate levels, resulting in a decrease in pH.
B. Metabolic alkalosis can occur due to a decrease in bicarbonate levels, resulting in a decrease in pH.
TF
Metabolic alkalosis can happen if there is
**increase in bicarbonate **or if there is decrease pH
