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Pathophysiology > Week 1 (ch. 2 Fluid, electrolyte, and acid-base imbalances) > Flashcards

Week 1 (ch. 2 Fluid, electrolyte, and acid-base imbalances) Flashcards

1
Q

Hydrostatic pressure

A

Increases filtration by pushing fluids and solutes out of capillaries

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2
Q

Osmotic pressure

A

Pressure caused by solution passing through semi-permeable membrane, the pulling force or attracting force

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3
Q

Arteriolar end of capillary (fluid movement through this)

A

Blood hydrostatic pressure (BP) exceeds the interstitial hydrostatic pressure and plasma colloid osmotic pressure = fluid moves out from capillary into the interstitial space

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4
Q

Fluid movement / capillary exchange: venous end of capillary

A

Bloods hydrostatic pressure is decreased and osmotic pressure is higher = flui is pulled back (shift) into capillary

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5
Q

Causes of edema - increased capillary hydrostatic pressure

A
  1. Increased capillary hydrostatic pressure - pressure prevents the return of fluid from interstitial to venous OR forces amounts out of the capillary. Due to increased blood volume from kidney failure, pregnancy, CHF, or administration of excess fluids
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6
Q

Cause of edema - loss of plasma proteins

A

Causes a decrease in plasma osmotic pressure allowing more fluid to leave capillary and less fluid to return at the venous end. Due to kidney disease, liver disease, malnutrition/malabsorbtion, burn victims

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7
Q

Cause of edema - obstruction of lymphatic circulation

A

Fluid and protien can not be returned to general circulation causing local edema. Due to tumor or infection damage of lymph node or lymph node removal

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8
Q

Cause of edema - increased capillary permeability

A

Chemical mediators released from cells after tissue injury increasing fluid movement into interstitial area typically localized. Due to inflammatory response or infection

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9
Q

third spacing - fluid deficit and fluid excess: what is it?

A

Fluid shifts from the blood to a body cavity or tissue - causes the fluid that was shifted to no longer be circulating fluid

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10
Q

What does third spacing lead to?

A

Fluid deficit in the vascular compartment with a fluid excess in the interstitial space

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11
Q

How is third spacing detected?

A

Lab tests of hematocrit and electrolyte concentrations

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12
Q

When might you see third spacing?

A

Burn or peritonitis (inflammatory infection of the peritoneal cavity)

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13
Q

What does sodium primarily exist as?

A

Sodium chloride or sodium bicarbonate

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14
Q

How are sodium levels controlled?

A

Mostly by kidney through aldosterone

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15
Q

What is Na essential in?

A

Nerve impulses and muscle contraction

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16
Q

Hyponatremia levels

A

Less than 135

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17
Q

What is the role of K

A

Assist in regulation of intracellular fluid volumes

  • role in metabolic processes
  • nerve conduction and contractions of all muscles
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18
Q

What promotes the movement of k into the cell

A

Insulin

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19
Q

What shifts k out of the cell and into the extra cellular environment?

A

Acidosis

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20
Q

What shift k into the cell

A

Alkalosis

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21
Q

Hyponatremia causes

A

Direct loss of na or too much water in extra cellular environment

  • excess sweating, vomiting, diarrhea
  • certain diuretics with low na diet
  • hormone imbalance
  • early chronic renal failure
  • excessive water intake
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22
Q

Hyponaturemia effects

A
  • impairs nerve conduction and results in fluid imbalance
  • fatigue, muscle cramps, abd. Discomfort, N/V
  • decreased osmotic pressure in ECF leading to fluid shift into cells resulting in hypovolemia
  • brain cells swell causing confusing, HA, weakness, seizures
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23
Q

Hypernatremia causes

A 
Too much na 
Insufficient ADH
Loss of thirst mechanism 
Water diarrhea 
Hyperventilation
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24
Q

Hypernatremia effect

A

Fluid shift
Weakness
Agitation
Firm subcutaneous tissue
Increased thirst with dry mucous membranes
Decreases urine d/t ADH secretion/increased urging d/t lack of ADH

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25
Q

Hypokalemia causes

A 
Excessive fluid loss
Diuresis from diuretic meds
Excessive aldosterone or glucocorticoids 
Decreased dietary intake 
Diabetic ketoacidosis
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26
Q

Hypokalemia effects

A 
Cardiac dysthymia 
Fatigue, muscle weakness
Paresthesias (pins and needles)
Decreased appetite / nausea
- shallow respirations (severe)
- polyuria and renal impairment (severe)
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27
Q

Hyperkalemia cause

A 
Renal failure
Aldosterone deficit 
Potassium-sparing diuretics meds
Tissue damage causing leaking of extracellular
Acidosis
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28
Q

Hyperkalemia effects

A

Dysthymia
Cardiac arrest
Muscle weakness progressing to paralysis
Fatigue, nausea, and parasthesias

29
Q

What is Ca controlled by

A

PTH and calcitonin

30
Q

How is Ca influenced by vitamin D and Phosphate

A

Vitamin D is injected from UV rays, activated in kidneys and promotes Ca movement to the blood

Reciprocal relationship with phosphate

31
Q

Does alkalosis or acidosis lead to hypocalcemia

A

Alkalosis

32
Q

Functions of Ca

A

Structural strength for bones

  • stability of nerve membranes
  • muscle contractions
  • needed for metabolic processes and enzyme reactions (blood clotting)
33
Q

What is the appropriate lab value for Ca

A

2.2-5 mmol/ L

34
Q

Hypocalcemia causes

A 
Hypoparathyroidism (decreased PTH)
Malabsorption syndrome
Deficient serum albumin
Increased pH (alkalosis) 
Renal failure
35
Q

Hypocalcemia effects

A

Skeletal muscle spasms d/t increased irritability of nerves

  • muscle twitching, hyperactive reflexes
  • Chvostek sign, tetany, laryngospasm, abdominal cramps

Weaker muscle contraction of the heart
- arrythmias, lower BP

36
Q

Hypercalcemia causes

A

Uncontrolled release of calcium ion-neoplasms

Hyperthyroidism (increased PTH)

Immobility (demineralization of bones)

Increased intake

Milk-alkali syndrome

37
Q

Hypercalcemia effects

A

Decrease neuromuscular activity
- muscle weakness, loss of tone, lethargy, personality change
Interferes with ADH in kidneys
- polyuria
Cardiac contractions increase — dysthymia
Effect on bone — decreased density leading to fractures OR bone strength maintained

Kidney stone formation

38
Q

Magnesium serum level

A

1.6 - 2 mg / dL

39
Q

Causes of hypomagnesemia

A

Diuretics, diabetic ketoacidosis, hyeraldosteronism

40
Q

Hypomagnesemia effects

A 
Neuromuscular hyperirritability
Tremors
Chorea 
Insomnia
Personality changes 
Increase HR
41
Q

Hypermagnesemia causes

A 
Renal failure
Administering magnesium (maternity)
42
Q

Hypermagnesemia effects

A

Depressed neuromuscular function, decreased reflexes, lethargy, cardiac arrythmias

43
Q

Hypophosphatemia causes

A

Malabsorption syndrome, diarrhea, excessive use of anti-acids, alkalosis, hyperparathyroidism

44
Q

Hypophosphatemia effects

A

Tremors, weak reflexes, paresthesias, confusion, anorexia, dysphagia, blood cell functions

45
Q

Hyperphosphatemia causes

A

Renal failure
Tissue damage
Chemo

46
Q

Hyperphosphatemia effects

A

Muscle twitching, hyperactive reflexes, arrhythmia

47
Q

Hypochloremia causes

A

Excessive sweating

Associated with alkalosis

48
Q

Hypochloremia effects

A

N/v, diarrhea, muscle twitching, confusion, sleepiness

49
Q

Hyperchloremia cause

A

Too much intake of sodium chloride

Hypernatremia

50
Q

Hyperchloremia effects

A

Edema

Weight gain

51
Q

What is the bodies normal pH

A

7.35 - 7.45

52
Q

At what levels will death occur for the pH values

A

Less than 6.8

Higher than 7.8

53
Q

What controls the serum pH

A

Buffer pairs - respond immediately
Respiratory system - alter carbon dioxide (carbon acid) by changing respiratory rate
Kidneys - slowest but most effective

54
Q

Control of serum pH: Buffer system

A

Several present in blood

  • combination of weak acid and its alkaline salt
  • reaction to acids/alkali added to blood to neutralize - maintaining constant pH
55
Q

What are the 4 major pairs of the buffer system

A

Sodium bicarbonate - carbonic acid system
Phosphate system
Hemoglobin system
Protein system

56
Q

Control of serum pH: respiratory system

A

If carbon dioxide or hydrogen levels increase, then the respiratory control system is stimulated to increase the respiratory rate which rids more acid from the body. If the body is alkalotic, the respiratory decreased the respiratory rate, increase acid levels.

57
Q

Control of serum pH: renal system

A
  • may reduce body’s acid by exchanging hydrogen for sodium through aldosterone, removes the hydrogen by combining with ammonia
  • provides bicarbonate ion
  • kidneys compensate for metabolic conditions and dietary intake
58
Q

Acidosis

A

Decrease in pH, increase in H ion

59
Q

Alkalosis

A

Increase in pH, decrease in H ions

60
Q

What are the 4 basic types of acid-base imbalance?

A
  • respiratory acidosis
  • respiratory alkalosis
  • metabolic acidosis
  • metabolic alkalosis
61
Q

Acid-base imbalance: compensation

A

When the serum pH is normal
- one system compensation to fix the imbalance because caused by the other system
Ex. Respiratory disorder causes acidosis so the kidneys compensate to rid more acid

  • time limited, patient must be monitored closely
62
Q

Acid-base imbalance: decompensation

A

When the serum pH is abnormal

  • this means the respiratory or renal system can buffer to maintain balance
  • intervention is essential to maintain homeostasis
63
Q

Explain acidosis: value, effects

A

PH < 7.35

Impair nervous system, headache, lethargy, weakness, confusion leads to coma and death

Deep rapid breathing

64
Q

Respiratory acidosis: what happens and what are the causes

A

Increase in CO2

Pneumonia, aspiration, chest injury, meds that depress resp. Control center (opiates)

COPD

65
Q

Metabolic acidosis: what is it and what are the causes

A

Decrease in bicarbonate

Excessive loss (diarrhea)
Increased use to buffer increased acids
Renal failure/disease

66
Q

Alkalosis: what is the value and what are the effects

A

< 7.45
Increased irritability of nervous system, restlessness, muscle twitching, tingling, numbness, eventually leads to tetany, seizures, and coma

67
Q

Respiratory alkalosis: what is it and what are its causes

A

Results from hyperventilation

- anxiety, fear, overdose aspirin, head injury, brain stem tumor causing hyperventilation

68
Q

Metabolic alkalosis: what is it and what are its causes

A

Increase in bicarbonate

Follows loss of hydrochloric acid from stomach

  • early states of vomiting, drainage of stomach
  • hypokalemia
  • excessive ingestion of antacids
69
Q

Treatments of acid-base imbalances

A

A. Deficits are reversed by adding fluid/electrolyte that has the deficit
B. Excess is removed though diuretics to increase excretion through kidneys
C. Levels are monitored closely
D. Some cases, diet changes can accomplish the correction

Pathophysiology (11 decks)

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