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WEEK 13 Flashcards

1
Q

four main electrolytes discussed in class

A

potassium
calcium
magnesium
sodium

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1
Q

electrolytes

A

Minerals in the body that conduct electricity.

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2
Q

electrolyte responsibilities

A

Maintaining the balance of water in the body
Balancing the blood pH (acid–base) level
Moving nutrients into the cells
Moving wastes out of the cells
Maintaining proper function of the body’s muscles, heart, nerves, and brain)

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3
Q

average weight of water in person

A

one-half or two thirds

For males this equates to 60% of weight, for women about 54%, and for babies and young children approximately 70%.

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4
Q

why is it critical to maintain balance of water in the body

A

It is critical to maintain the balance of water in the body to prevent hypovolemia, dehydration, tachycardia, tachypnea, confusion, headache, kidney stones, and numerous other medical complications.

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5
Q

where does water loss in the body primarily occur

A

Water loss in the body primarily occurs through excretion of urine from the kidneys.

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6
Q

what situations can increase water loss

A

Situations such as prolonged vomiting, severe diarrhea, and profuse sweating can greatly increase water loss as well.

When a person is unable to drink enough fluids to compensate for the excess water loss, dehydration or hypovolemia can occur.

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7
Q

hypovolemia

A

Decrease in blood volume due to body fluid or blood loss.

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8
Q

expected range of serum osmolality

A

285-295 mOsm/kg

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9
Q

three main fluid compartments

A

intercellular space- There are three main fluid compartments, with the largest being the intracellular space, which holds 67% of the body’s water.

extracellular space- comprise the interstitial space, which contains 25% of the body’s water

intravascular space- which holds the remaining 8% of body water

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10
Q

thirst response

A

vasopressin is released from the posterior pituitary gland, which is an antidireutic horomone, which tells the kidneys to stop secreting urine and therefore helps the body have more fluid

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11
Q

factors that can contribute to fluid and electrolyte imbalances

A

including dehydration; hypovolemia; overhydration; certain medications; heart, kidney, or liver disorders; and incorrect intravenous fluids or feedings

Conditions such as profuse sweating, vomiting, and diarrhea also result in increased water loss that may disturb fluid and electrolyte balances in the body

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12
Q

expected ranges for postassium

A

3.5-5.1 mEq/L

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13
Q

expected ranges for sodium

A

135-145 mEg/L

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14
Q

calcium expected ranges

A

9-10.5 mg/dL

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15
Q

magnesium expected ranges

A

1.3-2.1 mEq/L

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16
Q

diffusion

A

is the movement of solutes, such as electrolytes, from an area of high concentration (such as within a cell) to an area of low concentration (such as the intravascular area

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17
Q

what is the body’s largest intracellular electrolyte

A

postassium

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18
Q

kidney potassium excretion

A

90%

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19
Q

potassium’s major role

A

Potassium also plays a major role in the conduction of nerve cells within the heart. The body maintains potassium levels within a narrow range. Intake occurs through food, drinks, and supplements.

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20
Q

RDA for daily intake of potassium

A

3,400 mg for adult males and 2,600 mg for adult females.

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21
Q

hypokalemia

A

potassium levels fall below 3.5 mEq/dL

Critical values occur at less than 3 mEq/L for adults and less than 2.5 mEq/L for newborns.

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22
Q

hypokalemia causes

A

Medications
Certain cardiac conditions
Gastrointestinal losses
Metabolic alkalosis
Decreased oral intake of potassium
Excessive alcohol use
Chronic kidney disease
Diabetic ketoacidosis
Excessive sweating
Folic acid deficiency

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23
Q

what is the most common cause of hypokalemia

A

loss of potassium from the kidneys or gastrointestinal tract.

Potassium-wasting diuretics (loop, thiazide, and osmotic) are the medications that most commonly result in hypokalemia through urinary loss.

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24
potassium is what?
HIGH ALERT medication cannot give IV without diluting it or will kill client
25
hyperkalemia causes
over 5 mEq/L but is critical when it reaches 6.1 Renal failure Dehydration Diabetes mellitus Medications Trauma Excess intake of potassium Burns Transfusions of packed red blood cells Acidosis Sepsis
26
most common cause of hyperkalemia
renal failure treat with hemodialysis some of the time
27
A nurse is reviewing the medical history of a client who is experiencing hyperkalemia. Which of the following findings put the client at a higher risk for hyperkalemia? (Select all that apply.)
use of potassium supplements kidney failure
28
sodium
body’s most common extracellular electrolyte regulates normal BP and other stuff
29
RDA for sodium
The RDA for sodium is less than 2,300 mg per day, or approximately 1 teaspoon. Most Americans get more sodium than they actually need
30
hyponatremia causes
less than 136 mEq/L but critical at 120 mEq/L Medications Chronic or severe vomiting or diarrhea Drinking excess amounts of water Excess alcohol intake Heart, kidney, and liver problems Severe burns
31
most common cause of hypontremia
Excess water in the body—rather than a lack of sodium—is the most common cause of hyponatremia, as the presence of too much water dilutes the sodium level
32
hypernatremia causes
greater than 145 mEq/L but critical at 160 mEq/L Loss of body water Medications Gastroenteritis Vomiting Prolonged suction Burns Excessive sweating Chronic kidney disease Diabetes Impaired thirst response
33
what is most common cause of hypernatremia
loss of body water Dehydration is diagnosed most often in infants and older adults due to their inability to communicate the thirst response or diminished thirst response (in older adults).
34
A nurse is caring for a client who has hyponatremia. Which of the following findings or interventions should the nurse expect? (Select all that apply.)
Sodium level of 127 mEq/L Client reporting headache and fatigue A prescription for a urine sodium test
35
calcium
most abundant mineral in the body and has multiple functions While calcium is found in the blood and cells, 99% of it is stored in the bones and teeth. Calcium plays a role in the following activities: mineralization of bone, muscle contraction, nerve transmission, clotting of blood, hormone secretion, and normal functioning of the heart.
36
RDA for vitamin D
Absorption of calcium by the intestines depends on an adequate supply of vitamin D. The RDA for vitamin D is 600 international units (IU) for adults and 800 IU for older adults. Excretion of calcium occurs through the kidneys, and is controlled by the action of parathyroid hormone.
37
hypocalcemia causes
below 9 mg/dL and ionized levels are less than 4.5 mg/dL Medications that decrease the body’s absorption of calcium Inadequate amount of vitamin D Hormonal changes (menopause) Hypoparathyroidism Renal disease Multiple blood transfusions Electrolyte imbalances of magnesium or phosphate Sepsis Low albumin levels
38
hypoparathyroidism
Body produces low levels of parathyroid hormone (PTH). causes hypocalcemia
39
hypercalcemia causes
greater than 10.5 mg/dL and critical levels at 13 mg/dL Cancer Hyperparathyroidism Vitamin D toxicity Medications Renal failure
40
most common cause of hypercalcemia
hyperparathyroidism and cancer Both of these conditions result in excessive calcium being drawn from the bones and into the bloodstream. In hyperparathyroidism, the parathyroid glands secrete excessive amount of the hormone PTH. The elevated PTH levels in the body then lead to increased absorption of calcium by the intestines, increased reabsorption by the kidneys, and increased bone resorption—a process that ultimately leads to excessive levels of calcium in the blood.
41
meds that cause hypocalcemia
stimulant laxatives
42
magnesium
body’s second most common intracellular electrolyte As with calcium, much of the body’s store of magnesium, 50% to 60%, is located in the bones. Magnesium’s role in the body is to assist in the regulation of nerve and muscle function, maintain blood pressure and serum glucose levels, support bone and teeth health, and synthesize protein, DNA, and RNA. Intake of magnesium occurs through digestion of whole foods
43
RDA for magnesium
The RDA for daily intake of magnesium depends on age and sex. Adult males require 400 to 420 mg/day and adult women need 310 to 320 mg/day.
44
hypomagnesemia causes
less than 1.3 mEq/L and critical is 0.5 mEq/L Medications Decreased intake Decreased absorption by the intestines (Crohn’s disease, celiac disease) Increased excretion by the gastrointestinal tract (diarrhea, pancreatitis) Increased excretion by the kidneys Excessive alcohol use Diabetes mellitus type 2 Undernutrition Severe burns Electrolyte imbalances (hypokalemia, hypocalcemia)
45
what is IV magnesium
high alert medication Doses should be double-checked with another nurse and the concentration of the medication should be validated. IV administration of magnesium can cause flushing, sweating, and potentially respiratory depression if the medication is administered too quickly. Decreases in the client’s level of consciousness can occur if the client is also receiving a CNS depressant medication. Monitor urine output in clients who have impaired renal function.
46
hypermagnesemia causes
greater than 2.1 mEq/L Kidney disease (acute and chronic) Excessive intake Medications Trauma Acidotic states Hypothyroidism Chronic alcohol use disorder
47
most common cause of hypermagnesemia
acute or chronic kidney disease, as the impaired kidneys fail to excrete enough magnesium through the urine.
48
hypermagnesemia levels greater than 12 mg/dL cause?
severe reactions such as muscle flaccid paralysis, decreased respiratory rate, hypotension, bradycardia, and dysrhythmias. If the imbalance is not corrected, seizures, coma, cardiac arrest, and death can occur.
49
what are three distinct imbalances that can threaten homeostasis
dehydration, hypovolemia, and hypervolemia.
50
hypervolemia
Fluid overload, the body has too much water.
51
what happens in dehydration with urine
the urine gravity will be high if you are dehydrated
52
hypovolemia causes
Blood loss Gastrointestinal losses Severe burns Third spacing Excessive sweating Fever Medications Trauma
53
hypovolemic shock
If the circulating volume lost becomes greater than 20% of the total volume, hypovolemic shock can occur. If not reversed, this lack of perfusion to the vital organs can lead to multiple organ failure, in which the lungs, kidney, brain, and heart experience tissue death.
54
reasons why older clients are at most risk for dehydration
Diminished thirst response Decline in total body fluid Decreased kidney function Underlying health conditions Medications
55
IV access: what should tourniquet be applied at above the site of access
The tourniquet should be applied 5 to 10 cm above the selected site. The nurse should assess the client’s pulse distal to the tourniquet to confirm that the tourniquet is not applied too tightly.
56
types of solutions to treat fluid imbalances
crystalloid solutions and colloidal solutions.
57
colloidal solutions
treat fluid imbalances Intravenous solutions that contain large molecules unable to pass through capillary membranes.
58
crystalloid solutions
treat fluid imbalances Crystalloids are fluids that contain solutes such as electrolytes or dextrose. These solutes readily dissolve in a solvent such as water and can diffuse through cell membranes.
59
what are crystalloid solutions classified
based on their osmolality hypotonic- A solution that has fewer solutes than cell components and results in fluid moving into the cell. isotonic- A solution that has the same number of solutes than cell components and results in NO fluid movement into or our of the cell. hypertonic-A solution that has more solutes than are present within the cell and results in fluid movement out of the cell.
60
hypotonic crystalloid IV solution
less than 250 mOsm/L Extracellular fluid has fewer solutes than fluid in cells Water moves from extracellular space into cells Treats hypernatremia and diabetic ketoacidosis. Monitor for hypotension. Contraindicated in clients with burns, liver disease, increased intracranial pressure, and trauma.
61
example of hypotonic crystalloid IV solution
0.45% Sodium chloride (0.45% NaCl)
62
hypertonic crystalloid IV solution
greater than 375 mOsm/L Extracellular fluid has more solutes than within the cells Water leaves the cells and interstitial fluid moves into the plasma
63
examples of hypertonic crystalloid IV solutions
3% Sodium chloride Dextrose 5% in 0.45% sodium chloride solution (D51/2NS) Dextrose 5% in 0.9% sodium chloride solution (D5NS) Dextrose 5% in lactated Ringer’s solution (D5LR) Dextrose 10% in water (D10W) Hypertonic solutions may be contraindicated in cases of cardiac or renal disease.
64
isotonic crystalloid IV solution
250-375 mOsm/L No movement of water between extracellular and intracellular fluids, as osmolarity is the same Causes expansion of the extracellular fluid
65
examples of isotonic crystalloid IV solution
0.9% Sodium chloride solution (NaCl) most commonly used IV fluid
66
whole blood
Combination of red cells, white cells, and platelets in blood plasma. this is what you usually donate when just donating blood at a blood drive i.e.
67
shelf life of whole blood
Whole blood has a shelf life of 21 to 35 days and is rarely used outside of severe traumatic injury
68
two components whole blood is divided into
cells and a liquid called plasma The cellular portion of blood contains red cells, white cells, and platelets and accounts for approximately 40% of the blood volume. The plasma makes up the remaining 60% of the volume.
69
thrombocytes
Also known as platelets; responsible for blood clotting.
70
RBCs
Red blood cells (RBCs), or erythrocytes, account for 45% of the cellular portion of whole blood. There are about 1 billion red blood cells in two to three drops of blood
71
plasma
Plasma, the liquid portion of blood, constitutes about 55% of whole blood. It consists mostly of water. In addition to transporting the cells, plasma helps maintain blood pressure and volume.
72
four basic blood types
A, B, AB, O
73
antigens
The various blood types are identified by the presence or absence of antigens, which can cause an immune response if they are unfamiliar to the body. Since a mismatch of antigens can trigger a patient’s immune system to attack transfused blood, safe blood transfusions depend on careful blood typing and cross-matching.
74
Rh factor
Protein of the blood type represented as (+) if present and (-) if absent.
75
Blood Types: Universal Donor and Recipient
Universal donor blood type: O– Universal recipient blood type: AB+
76
most common acute transfusion reactions
include acute hemolytic reactions, which occur when the blood transfused is not compatible with the blood of the client; febrile non-hemolytic transfusion reactions; allergic reactions, which can range from mild to anaphylactic; transfusion-related acute lung injury (TRALI), which results in edema of the lung tissues and airways; and transfusion-associated circulatory overload (TACO), which is often the result of too-rapid administration of blood products.
77
pH scale
0 is strongly acidic 7 is considered neutral 14 strongly aklaline
78
expected reference range for the pH of human blood
7.35-7.45 death occuring at less than 6.9 or greater than 7.8
79
acid-base balance
The homeostasis of acidic and basic (alkaline) compounds in the blood to maintain a blood pH of between 7.35 and 7.45.
80
acidosis
Levels of acid in the blood are too high, a pH of less than 7.35.
81
alkalosis
The blood is too alkaline, a pH of greater than 7.45.
82
metabolic acidosis
When the blood in the body is too acidic, with an HCO3- less than 21 and a pH less than 7.35.
83
metabolic alkalosis
Blood in the body is too alkaline, with an HCO3- greater than 28 and a pH greater than 7.45
84
respiratory acidosis
A buildup of carbon dioxide in the lungs and the body fluids, which results in a PaCO2 greater than 45 and a pH less than 7.35.
85
respiratory alkalosis
Low carbon dioxide levels in the body, with a PaCO2 less than 35 and a pH greater than 7.45.
86
what can cause respiratory alkalosis
hyperventilation, such as pain, anxiety, severe stress, pregnancy, sepsis, infection, trauma or fever
87
nonspecific immunity
Nonspecific immunity refers to neutrophils and macrophages and their work as phagocytes. Phagocytes eat and destroy microorganisms, thereby helping to protect the body from harm. Both neutrophils and macrophages are released during the inflammatory response
88
specific immunity
Specific immunity refers to the work of antibodies (also called immunoglobulins) and lymphocytes. Antibodies bind to infectious agents and call to the white blood cells and complement to destroy them.
89
stages of infection
Incubation: An infection enters host and begins to multiply. Prodromal: The client begins having symptoms. Acute illness: Manifestations of the specific infectious disease process are obvious and may become severe. Decline: Manifestations begin to wane as the degree of infectious disease decreases. Convalescence: The client returns to a normal or a “new normal” state of health.
90
pathogens
bacteria-most common type (staph, E-coli) viruses-use host to reproduce (HIV, hep, herpes zoster) fungi-molds and yeasts (candida albicans) prions-protein particles that can cause infection (jakob disease) parasites- organisms that live on and often cause harm to host
91
types of parasites
protoza (malaria) helminths (worms) flukes (schistosomes) arthropods (lice, mites, ticks)
92
general expected findings for infection
chills sore throat fatigue, malaise nausea and vomiting
93
sepsis
A systemic inflammatory response syndrome resulting from the body’s response to a serious infection, usually bacterial (peritonitis, meningitis, pneumonia, wound infections, urinary tract infections) can lead to organ failure

Fundamentals (20 decks)

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