Fluid and Electrolytes/Acid Base Flashcards

1
Q

movement of fluid through a membrane from an area of higher hydrostatic pressure to a lower pressure

A

filtration

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2
Q

movement of solutes across a membrane from an area of higher concentration to an area of lower concentration

A

diffusion

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3
Q

movement of water only through a selectively permeable membrane to achieve an equilibrium of osmolarity

A

osmosis

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4
Q

normal osmolarity for the body

A

270-300 mOsm

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5
Q

obligatory urine output

A

400-600mL/day of urine. any less means toxic waste is retained in the body.

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6
Q

secreted when the plasma sodium levels are low

A

aldosterone

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7
Q

effect of aldosterone

A

causes kidneys to reabsorb water and sodium

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8
Q

what happens to potassium when sodium is absorbed?

A

potassium is excreted

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9
Q

secreted when blood osmolarity rises

A

Antidiuretic hormone/vasopressin

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10
Q

effect of ADH

A

causes water to be reabsorbed and retained to lower blood osmolarity

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11
Q

secreted when the heart muscles stretch

A

natriuretic peptides

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12
Q

effect of natriuretic peptides

A

excretion of water and sodium- lowering blood osmolarity and volume

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13
Q

actions of angiotensin II

A
  • systemic vasoconstriction
  • decreased urinary output
  • secretion of aldosterone
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14
Q

what is the goal of the RAAS pathway?

A

raise blood pressure and increase/maintain organ perfusion

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15
Q

how much fluid should a dehydrated patient get per hour?

A

60-120 ml/hr

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16
Q

what are the two most important things to monitor during rehydration therapy?

A

urine output and pulse rate and quality

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17
Q

what is the best indicator of fluid overload and retention?

A

rapid weight gain

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18
Q

what are the two physiological changes at the cellular level in hyponatremia?

A

decreased cell membrane depolarization and cellular swelling

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19
Q

what is the normal range of calcium?

A

9-10.5 mEq/L

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20
Q

what is calcium’s role in the body?

A

bones, blood, and beats.

bone and dental health, cardiac rhythm, muscle and nerve function, and blood clotting

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21
Q

what is the normal range for magnesium?

A

1.8- 2.6 mEq/L

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22
Q

What are physical signs of dehydration?

A

Rapid, weak pulses. Hypotension/orthostatic hypotension. Decreased turgor. Dry mucous membranes. Flat neck veins. Decreased urine output/concentrated urine.

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23
Q

What happens to the labs of a patient with dehydration?

A

They will be elevated because there is water loss which increases blood concentration

24
Q

`What is a safety concern for a client with dehydration?

A

falls due to confusion, muscle weakness, and orthostatic hypotension

25
Q

What are physical signs of fluid overload?

A

Rapid, bounding pulse. Elevated BP. Dependent edema. Distended neck veins. Crackles in lungs. Rapid weight gain.

26
Q

What are important interventions for fluid overload?

A

Daily weights, strict I and Os, sodium and water restriction. Skin assessments to prevent breakdown.

27
Q

What are the functions of sodium in the body?

A

Controls fluid movement, nerve impulse conduction, and muscle contractions

28
Q

What are some causes of hyponatremia?

A

Prolonged diuretic use, excessive vomiting, diarrhea, sweating. Kidney disease, NPO.

29
Q

Signs and symptoms of hyponatremia

A

Confusion, seizures, decreased DTR, muscle weakness, rapid weak pulse.

30
Q

What are causes of hypernatremia?

A

Kidney failure, excessive intake, tube feedings without free water.

31
Q

Signs and symptoms of hypernatremia

A

Agitation, risk for seizures, muscle twitching, decreased urine output.

32
Q

What are functions of potassium in the body?

A

Nerve impulse conduction and muscle contraction

33
Q

What are causes of hypokalemia?

A

Diuretics, diarrhea/vomiting, too much water

34
Q

Signs and symptoms of hypokalemia

A

Muscle weakness, heart arrythmias, decreased peristalsis

35
Q

What are important interventions for a patient with hypokalemia?

A

Fall precautions due to muscle weakness and respiratory monitoring also due to muscle weakness

36
Q

What electrolyte can never be given by IV push?

A

Potassium because it can cause cardiac arrest

37
Q

What is important to note about administration of potassium?

A

It is a severe tissue irritant and can cause necrosis of tissues

38
Q

What are causes of hyperkalemia?

A

Potassium-sparing diuretics, kidney failure, excessive salt substitute intake, trauma to cells

39
Q

What does hyperkalemia do at the cellular level?

A

Increases cell membrane excitability and makes it irritable

40
Q

Signs and symptoms of hyperkalemia

A

Cardiac dysrhythmias, muscle twitching, irritability

41
Q

What is sodium polystyrene sulfonate?

A

Drug used for hyperkalemia. Binds to K+ in the GI tract

42
Q

What is the effect of hyperkalemia on the heart?

A

It decreases cardiac contractility: decreased HR, BP

43
Q

What are causes of hypocalcemia?

A

inadequate intake of calcium or vitamin D, parathyroid issues/surgery

44
Q

What are signs and symptoms of hypocalcemia?

A

Muscle spasms, tingling, cardiac arrythmias, osteoporosis, Trousseau and Chvostek signs

45
Q

What is Chvostek’s sign?

A

Facial muscle response when the side of the face is tapped

46
Q

What is Trousseau’s sign?

A

Palmar flexion when a blood pressure cuff is applied to the arm.

47
Q

Safety considerations for a patient with hypocalcemia?

A

Fall risk and risk of fractures due to low bone density

48
Q

What are causes of hypercalcemia?

A

Thiazide diuretics, kidney failure, excessive intake, hyperparathyroidism

49
Q

Signs and symptoms of hypercalcemia?

A

Increased risk of blood clots, decreased BP and HR, muscle weakness, increased risk of kidney stones

50
Q

What hormone is released when calcium is low?

A

Parathyroid hormone

51
Q

What hormone is released when calcium is high?

A

Thyrocalcitonin

52
Q

What hormone is typically the opposite of calcium?

A

Phosphorous

53
Q

What electrolyte values typically go up and down together?

A

Magnesium and calcium (Callie and Maggie)

54
Q

What are the causes of hypomagnesemia?

A

Loop/thiazide diuretics, malnutrition

55
Q

Signs and symptoms of hypomagnesemia?

A

Cardiac dysrhythmias, hypertension, muscle contractions/twitching, confused/agitated, risk of seizures

56
Q

What are causes of hypermagnesemia?

A

Renal failure, antacids

57
Q

Signs and symptoms of hypermagnesemia?

A

Decreased HR and BP, drowsy/lethargic, muscle weakness/respiratory failure