Week 3 Flashcards

1
Q

BP control (neuro-hormonal regulation)

A
  1. baroreceptors reflex & sympathetic NS
  2. RAAS (⇡ BP by ⇡BV, ⇡ vasoconstriction)
  3. ADH = vasopressin (⇡ BP by ⇡BV, ⇡ vasoconstriction)
  4. kidneys - long term control of BP thru regulating BV
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2
Q

osmolality

A
  • pulling power of a solution for H2O

- determined by concentration of solutes

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3
Q

which organ has the thirst mechanism?

A

hypothalamus

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4
Q

ADH = vasopressin

A
  • released by pituitary gland
  • function:
    1. regulate fluid balance by retaining H20
    2. concentrate or dilute urine from collecting ducts
    3. vasoconstriction - constrict arteriole smooth muscle
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5
Q

Diabetes (meaning)

A

large amount of urination

  • mellitus - sweet (↓ insulin production)
  • insipidus - tastes like water (↓ ADH production)
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6
Q

↓ of ADH (diabetes insipidus)

A
  • ⇡loss of urine –> diluted urine - dehydration
  • s/sx = cells shrink – change in mental status
    Lab? - hypernatremia
    Rx = DDAVP (replace ADH)
  • fluid replacement, monitor I&O, weight
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7
Q

⇡of ADH (SIADH - syndrome of inappropriate ADH)

A
  • ↓ loss of urine –> concentrated urine - retain H20
  • s/sx = cells swell = change in mental status
    Rx - Na+ replacement
  • fluid restriction, weight
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8
Q

Fluid Volume Excess (FVE)

A

Proportionate ⇡of H20 & Na+
Fluid overload, overhydration, pulmonary edema (drowning), hypervolemia (too much volume in blood), pitting edema
Caused by: HF, CKD, cirrhosis, malnutrition
NI: fluid restriction, Na+ intake, diuretic
Monitor: I/Os, daily wt, TED stockings

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9
Q

Edema

A

too much fluid w/in interstitial
- pulmonary edema = in lungs/alveoli
- pleural effusion = in pleural space
- ascites = fluid in peritoneal cavity
- periphery = pitting edema
Causes: HF, cirrhosis, renal failure, malnutrition
Rx: diuretic, TED stockings, elevate legs, SCD

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10
Q

Fluid Volume Deficit (FVD)

A
  • dehydration, hypovolemia
  • if not treated, can go into hypovolemic shock
    causes: proportionate ↓ of Na+ & H20
    Rx: anti-diuretic
    Labs: keep eye out for hypokalemia (affects heart)
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11
Q

S/Sx of FVD

A
  • flat jugular vein
  • change in mental status
  • ⇡ pulse, but thready; ↓ BP
  • dry mouth, constipation
  • tenting of skin; wt loss
    Rx: give fluids
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12
Q

isotonic fluids

A
0.9% normal saline (NS)
lactated ringers (LR) - contain Na+, Cl-, K+, Ca++
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13
Q

hypotonic IV solutions

A
  • D5W

- 0.45% NS

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14
Q

hypertonic IV solutions

A
  • 3% NS

- dangerous

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15
Q

Na+ balance

A

135 - 145 mEq/L

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16
Q

hyponatremia - Na+ level?

A

Na+

17
Q

hypernatremia - Na+ level?

A

> 145 mEq/L
Causes: ↓ in H20 intake – defect in thirst mechanism; if unconscious - unable to drink; dehydration
S/Sx: cells shrink, change in mental status, muscle twitching
Rx: Na+ restriction, IV hypotonic (0.45% NS or D5W)

18
Q

Normal Potassium (K+) levels?

A

3.5 - 5.0 mEq/L
↓ or ⇡ will affect heart rhythm
essential for transmission & conduction of nerve impulses & muscle contraction

19
Q

hypokalemia - levels?

A

K+

20
Q

hyperkalemia - levels?

A

K+> 5.0 mEq/L
Causes: renal failure; movement of K+ from ICF to ECF as result of burn injury, crash injury
S/Sx - change in EKG, muscle weakness
Rx: kayexalate sorbital – binds to K+ in GI tract & excreted in stool (K+ & glucose move together); dialysis if in renal failure.

21
Q

Oncotic pressure

A

Pressure caused by protein

Pulls H20 into space

22
Q

Hydrostatic pressure

A

Pressure of blood pushing through veins pushes H20 out.

23
Q

BMP

A

Basic metabolic panel

Checks electrolyte balance

24
Q

Calcium levels - normal

A

8.5 - 10.5 mg/dL

25
Q

Hormones that regulate Ca++ in blood

A

parathyroid hormone (PTH) - to ⇡ Ca++ levels in blood

  • rls calcium from bone
  • ↓ Ca elimination by kidneys

calcitonin - ↓ Ca++ in serum
- inhibits release of Ca++ from bone

26
Q

Hypomagnesemia

A
27
Q

Hypermagnesemia

A

Mg >2.7 mg/dL
Causes: renal insufficiency, excessive intake of Mg-containing antacids
S/Sx: dysrhythmias, muscle weakness
Rx: dialysis, diuretic

28
Q

Magnesium balance

A

1.8 - 3.0 mg/dL
Tends to move with Ca++
Kidneys regulate
essential to ATP reactions

29
Q

Hypomagnesemia

A
30
Q

Hypermagnesemia

A

Mg >2.7 mg/dL
Causes: renal insufficiency, excessive intake of Mg-containing antacids
S/Sx: dysrhythmias, muscle weakness
Rx: dialysis, diuretic

31
Q

ABG normal level: pH

A
  1. 35 - 7.45

7. 45 - alkalosis

32
Q

ABG normal level: PaCO2

A

Partial Pressure of Carbon Dioxide
35 - 45
45 - acid (acidosis)

33
Q

ABG normal level: HC03

A

bicarbonate ion
22-26
26 - base (alkalosis)