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Concepts Exam 2 > Fluids and Electrolytes > Flashcards

Fluids and Electrolytes Flashcards

1
Q

Functions of water in the body?

A

Transporting nutrients to cells and wastes from cells

Transporting hormones, enzymes, blood platelets, and blood

Facilitating cellular metabolism and proper cellular chemical functioning

Acting as a solvent for electrolytes and non-electrolytes

Helping maintain normal body temperature

Facilitating digestion and promoting elimination

Acting as a tissue lubricant

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2
Q

What is the total body fluid?

A

50-60% of body weight

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3
Q

How much of our body weight comes from cell fluid or intracellular fluid?

A

35-40% of body weight

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4
Q

How much of our body weight comes from extra cellular fluid?

A

15 to 20% if body weight

5% from plasma (intravascular)
10-15% from interstitial fluid

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5
Q

Define osmosis

A

Water passes from an area of lesser solute concentration to greater concentration until equilibrium is established

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6
Q

Define diffusion

A

Tendency of solutes to move freely throughout a solvent (downhill)

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7
Q

Define active transport

A

Requires energy for movement of substances through the cell membrane from the lesser solute concentration to the higher solute concentration

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8
Q

Define capillary filtration

A

Passage of fluid through a permeable membrane from the area of higher to lower pressure

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9
Q

Define isotonic

A

Fluid has the same osmolarity as plasma

Cells neither shrink nor swell with fluid movement.

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10
Q

Define hypotonic

A

Fluid has fewer solutes than plasma

Osmotic pressure draws water into the cells from the ECF and the cell swells

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11
Q

What is hypertonic?

A

Fluid has more solutes than plasma

Draws water out of the cells, and into the more highly concentrated ECF and the cell shrinks

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12
Q

What are some examples of isotonic IV fluids?

A

0.9% normal saline

Ringers lactate

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13
Q

What are some examples of hypotonic IV fluids?

A

0.45% NS

D5W (because dextrose is used up by the body leaving behind only water)

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14
Q

What are some examples of hypertonic IV fluids?

A

3% saline

D5NS (normal saline)

D10W

D5LR

D50

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15
Q

Chief function of sodium?

A

Controls and regulates volume of body fluids

Brain!

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16
Q

Chief function of potassium

A

Chief regulator of cellular enzyme activity and water content

Heart

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17
Q

Chief function of calcium

A

Nerve impulses, blood clotting, muscle contraction, B12 absorption

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18
Q

Chief function of magnesium

A

Metabolism of carbohydrates and proteins, vital actions involving enzymes

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19
Q

Chief function of chloride

A

Maintains osmotic pressure in blood, produces hydrochloric acid

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20
Q

Chief function of bicarbonate

A

Bodies primary buffer system

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21
Q

Chief function of phosphate

A

Involved in important chemical reactions in the body, cell division, and hereditary traits

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22
Q

Reference values for sodium?

A

Adult: 135-145 mmol/L

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23
Q

Panic values for sodium

A

<125 or > 150 mmol/L

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24
Q

What are some important functions of sodium?

A

Major cation in the extracellular fluid

Helps to maintain body fluid, is responsible for conduction of neuromuscular impulses, is involved in enzyme activity

Important in acid base balance

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25
Q

What is hyponatremia and how could you get it?

A

Less than 135 mmol/L

Results from excessive loss of sodium or an excessive gain of water, diuretic therapy, excessive drinking of water, endocrine disorders

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26
Q

What are symptoms of hyponatremia and what are the treatments?

A

Symptoms: headache, N&V, confusion, muscle twitching, tremors, weakness, irritability

Treatment: receive oral sodium, supplementation, restrict fluid intake

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27
Q

What is hypernatremia and how can you get it?

A

Sodium higher than 145 mmol/L

Too much sodium in diet, severe insensible water losses that are not replaced, severe vomiting

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28
Q

Symptoms and treatment of hypernatremia

A

Symptoms: extreme thirst, restlessness, or agitation, anorexia, N&V, dry sticky tongue and oral mucosa, disorientation, hyperactive reflexes, oliguria and anuria, lethargy

Treatment: prescribed oral/IV therapy and sodium restricted diet

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29
Q

Reference values for potassium

A

Adult: 3.5- 5.3 mmol/L

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30
Q

Panic values for potassium

A

< 2.5 and > 7.0 mmol/L

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31
Q

Symptoms and treatment for hypokalemia

A

< 3.5 mmol/L

Symptoms: muscle weakness or leg cramps, paresthesia, fatigue

Cardiac irregularities, G.I. complaints, EKG changes, decreased reflexes

Treatment: oral supplements of potassium, IV potassium chloride

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32
Q

Causes for hyperkalemia?

A

> 5.0 mmol/L

Reduced excretion by the kidneys, oliguria due to shock or severe dehydration, potassium sparing diuretics

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33
Q

Symptoms and treatment for hyperkalemia

A

Symptoms: irritability, paresthesia and numbness in extremities, skeletal muscle weakness, cardiac arrhythmias

Treat treatment: kayexalate (a cation exchange resin, orally or by enema)

34
Q

Reference values for calcium

A

Adult: 8.6 - 10 mg/dL

35
Q

Panic values for calcium

A

<6.0 and > 14.0 mg/dL

36
Q

Normal ionized calcium levels

A

4.5-5.5 mg/dL

37
Q

Panic levels for ionized calcium?

A

<2.8 and > 7 mg/dL

38
Q

What are some important roles for calcium

A

Major component of bones and teeth

Role in transmitting nerve impulses

Regulates muscle contractions

39
Q

What are the three components of calcium

A

Protein bound 47%

Ionized (free) 43%

Complex 10%

40
Q

How can you get hypocalcemia?

A

Results from abnormalities of parathyroid hormone (PTH) secretion or from inadequate dietary intake or excessive losses of bound, ionized (unbound), or total body calcium

41
Q

What are symptoms and treatments for hypocalcemia?

A

Symptoms: muscle cramps, or tremors, tetany, positive Trousseau’s sign, positive Chvostek’s sign, irritability and anxiety, seizures, arrhythmias, angina, bradycardia, and hypotension

Treatment: calcium supplements orally
or IV Calcium gluconate or calcium chloride.

42
Q

How do you get hypercalcemia?

A

Results from increased intestinal absorption of calcium, renal abnormalities can interfere with calcium secretion and excretion, patients with metastatic cancer are especially high risk

43
Q

Symptoms and treatments of hypercalcemia?

A

Symptoms: lethargy, muscle weakness or flaccidity, hyporeflexia and decreased muscle tone, polyuria, polydipsia, arrhythmias and cardiac arrest

Treatment: adequate hydration (IV fluids/oral intake), biphosphonates, ambulation

44
Q

Reference values for magnesium

A

Adults: 1.5-2.5 mg/dL

45
Q

Panic values for magnesium

A

<1.2 and > 4.9 mg/dL

46
Q

Important roles for magnesium

A

Second most abundant cation after potassium

Helps maintain normal nerve and muscle functions

Required for the heart to beat normally

Plays a role in almost all chemical processes in the body

47
Q

How do you get hypomagnesemia?

A

Excessive losses from G.I. and kidneys, chronic alcoholism, and medications

48
Q

Symptoms and treatments for hypomagnesemia

A

Symptoms: neuromuscular irritability, weakness, tremors, dizziness, cardiac irritation, mood changes, tetany, and convulsions

Treatment: oral magnesium, IV magnesium, rich magnesium diet

49
Q

How could you get hypermagnesemia

A

Renal failure, adrenal insufficiency, and excessive intake, sepsis, magnesium containing medications

50
Q

Symptoms and treatments of hypermagnesemia?

A

Symptoms: feeling of warm/ flushing, hypotension, SOB, drowsiness, and hypoactive reflexes

Treatment: IV calcium gluconate, Lasix, glucose and insulin

51
Q

Reference values for phosphorus?

A

2.5- 4.5 mg/dL

52
Q

Panic value for phosphorus?

A

< 1.5 mg/dL

53
Q

Important roles for phosphorus

A

Second most abundant mineral in the body after calcium

Extremely important in building strong bones and teeth

Needed for repair of all tissues/cells in the body

Plays an essential role in how the body stores and uses energy

54
Q

Symptoms and treatments for hypophosphetemia?

A

Symptoms: altered mental status, cardiac arrhythmia, dyspnea, and heart failure

Treatment: oral phosphates, IV phosphates, control the intake through diet

55
Q

Symptoms and treatments for hyperphosphatemia?

A

Symptoms: tingling around the mouth, fingertips, delirium, numbness, and muscle cramps

Treatment: control the intake through diet, acetazolamide

56
Q

What is phosphorus inversely proportional with?

A

Calcium

57
Q

What can cause hyperphosphatemia?

A

Exercise, excessive enema usage, hypoparathyroidism, and dehydration

58
Q

Reference values for chloride

A

97-107 mEq/L

59
Q

Panic values for chloride?

A

<80 and > 115 mEq/L

60
Q

Some roles of chloride

A

Major ECF anion

Acts with sodium to maintain osmotic pressure

Major component of interstitial and lymph fluid- gastric and pancreatic juices, sweat, bile and saliva

61
Q

How can you get hypocholremia?

A

Over hydration, SIADH, severe vomiting, gastric suction, Addisons disease

62
Q

Symptoms and treatment of hypochloremia

A

Symptoms: hyperexcitability of muscles, hyperactive DTRs, tetany, muscle cramps

Treatment: oral sodium chloride, IV normal saline.

63
Q

How can you get hyperchloremia?

A

Head trauma, dehydration, mineralocorticoid deficiency, increased sweating, laxative abuse

64
Q

Symptoms and treatment for hyperchloremia

A

Symptoms: tachypnea, lethargy, altered mentation, weakness, extreme thirst

Treatment: depends on the cause. Hydration, stopping medications that contribute to increased chloride, correcting metabolic acidosis

65
Q

What are liver function tests?

A

Bilirubin

SGOT/AST

SGPT/ALT

66
Q

What are the renal function tests?

A

BUN

Creatinine

67
Q

What are the lipid profile tests?

A

Total cholesterol

Triglycerides

LDL

HDL

68
Q

What tests are in the coagulation panel?

A

PT: prothrombin time

INR

PTT: partial thromboplastin time

69
Q

What is AST/SGOT testing?

A

Aspartate aminotransferase

Found everywhere in the body!

70
Q

What is ALT/ SGPT testing for?

A

Alanine aminotransferase

Found primarily in the liver

71
Q

Normal value for total cholesterol and triglycerides

A

Total cholesterol: <200

Triglycerides: <150

72
Q

Normal values for LDL and HDL

A

LDL: <100

HDL: >40

73
Q

What does it mean when both BUN and creatinine go up?

A

Kidney dysfunction.. but unfortunately they will not be outside the normal range until 60% of total kidney function is lost

74
Q

What does it mean if BUN is elevated but creatinine is normal?

A

Dehydration

75
Q

What does it mean when BUN is lowered but they have a normal creatinine

A

Overhydration

76
Q

What test do we use if you’re on heparin?

A

PTT

77
Q

What test would we use if you have afib?

A

INR.. especially if they are on warfarin (coumadin)

78
Q

What is Hct testing for?

A

% of total blood volume that is RBC

Approx 3 x Hgb

79
Q

What is Hgb testing for?

A

Oxygen carrying capacity of blood

80
Q

What is leukocytosis

A

WBC > 11,000

Infection, inflammation, tissue necrosis

Sepsis: WBC is extremely high

Could also end in “philia”

81
Q

What is leukopenia?

A

WBC < 4,500

Bone marrow failure following chemo/radiation, immune compromised, autoimmune disease, overwhelming infections

Most common cause though is cancer and having chemo

82
Q

When you’re bleeding internally or dehydrated how does that change your vitals?

A

Heart rate will go up, bodies trying to pump more blood

Concepts Exam 2 (8 decks)

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