Fluid and electrolyte balance and disturbances Flashcards

1
Q

K+ is the major determinant what r/t cell excitability

A

RMP

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2
Q

Ca++ is the major determinant of what r/t cell excitability

A

threshold potential

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3
Q

Normal Ionic balance:

what is the normal rmp? and what controls it

A

-90

K+

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4
Q

Normal Ionic balance:

what is the normal threshold? and what controls it

A

-60

Ca++

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5
Q

point to the RMP

A
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6
Q

Normal Ionic balance:

clearify

Muscle rmp is -90

Nerve is -70

A

just so i dont get confused

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7
Q

Normal Ionic balance:

point to the Threshold line

A
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8
Q

Normal Ionic balance:

what one is HYPOkalemia

A
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9
Q

Normal Ionic balance:

explain how you know it is hypokalemia and what it all means.

A
  • RMP HYPERpolarized (more negative)
  • making it LESS excitable
    • Moves away from threshold
  • ​​More of a stimulus if needed to exert an action
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10
Q

Normal Ionic balance:

Point to HYPERkalemia

A
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11
Q

Normal Ionic balance:

explain how you know it is hyperkalemia and what it all means.

A
  • HYPOpolarized (less negative/closer to 0)
  • RMP moves closer the threshold
    • MORE excitable
  • Less of a stimulus is needed to evoke a response
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12
Q

Normal Ionic balance:

what the hell can cause D? and what is going on?

A
  • the RMP has past the threshold
  • Cardioplegia solution
  • Hyperkalemia
  • Na+ channel snaps open
    • causes absolut refractory period b/c Na+ channels can’t fire
  • K+ levles = 15-40 mEq
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13
Q

Normal Ionic balance:

point to Hyper calcemia

A
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14
Q

Normal Ionic balance:

explain how you know it is hypercalemia and what it all means.

A
  • Threshold is hypopolarzed
    • moves closer to 0
  • ​​Decreased excitability
    • bigger gap b/t rmp and threshold
  • More stimulus is needed to elict a response
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15
Q

Normal Ionic balance:

what the hell if F showing?

A
  • hyperkalemia treated with Ca++
  • the RMP is hypopolarized (hyperkalemia)
  • the threshold is increased to decrease the excitability
    • threshold increased
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16
Q

Normal Ionic balance:

what is G showing explain how you know and what it all means.

A
  • first a nerve cell b/c it says so and the RMP is at -70 (normal for nerve cell)
  • hypocalcemia is shown
    • threshold is decreased
  • Increased excitability
    • smaller gap between RMP and Threshold
  • Smaller stimulus will be neede to elict a response
17
Q

can s/s of hypocalcemia be elicited when the pt is hyperventilated?

A

yes, hyperventilation can cause resp alkolosis. ionzied Ca++ decreases

18
Q

therapies and mechanisms for treating HYPERkalemia:

what is the fastest treatment, but does not correct the hyperkalemia

A

Give Ca++

19
Q

therapies and mechanisms for treating HYPERkalemia:

why administer HCO3-

A

H+ concentraions in the plasma decrease and metabolic alkolosis ensues.

H+ shifts out of cell to to buffer the alkolosis and in exchane K+ shfts into the cell

20
Q

therapies and mechanisms for treating HYPERkalemia:

what does hyperventilation do?

A

H+ concentration in plasma decreases causing resp alkolosis occurs.

H+ shifts out of the cell to buffer the alkolosis and in exchange K+ shifts into the cell

21
Q

for each 10mmHg decrease in PaCO2 serum K+ decreaseshow much?

A

0.5 mEq/L

22
Q

therapies and mechanisms for treating HYPERkalemia:

what does giving insulin-glucose do?

A

insulin stimulates Na+K+ pump, drives K+ into the cells

Insulin also opens glucose channels

Glucose is administered along with insulin to prevent hypogylcemia

23
Q

therapies and mechanisms for treating HYPERkalemia:

what do Beta-2 agonist do?

A

stimulates Na+K+ pump, drives K+ into the cells

24
Q

insulin stimulates Na+K+ pump, drives K+ into the cells

2 additional treatments

A

kayexalate

Dialysis