fluid, electrolyte and acid- base homeostasis Pt.2 chapter 6 Flashcards

1
Q

cations

A

positively charged electrolytes

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2
Q

anions

A

negatively charged electrolytes

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3
Q

electrolytes balance plays a role in

A
  • muscle and neural activity

- acid-base and fluid balance

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4
Q

sodium normal range

A

135- 145 mEq/l

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5
Q

sodium role and function

A
  • controls serum osmolarity and water balance
  • facilitates muscles and nerve impulses
  • regular fluid balance
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6
Q

sodium intake and output

A
  • main sources is deitary
  • processed/packaged foods
  • salt/ seasonings
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7
Q

sodium output

A
  • excreted through the kidneys and gastrointestinal tract

- perspiration

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8
Q

hypernatremia

A

sodium > 145 mEq/l

- sodium osmolarity increases, resulting in fluid shifts

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9
Q

hypernatremia causes

A
  • excessive intake: dietary na, hypertonic iv solutions, cushings syndrome, corticosteroids use
  • deficient water: insufficient intake, third spacing, excessive output
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10
Q

hypernatremia clinical manifestations

A
  • thirst
  • irritability
  • weakness
  • headache
  • edema
  • decreased urine output
  • seizures
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11
Q

hypernatremia diagnosis

A
  • serium NA level

- urinalysis

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12
Q

hypernatremia treatment

A
  • NA restriction
  • fluid replacement: oral and hypotonic solutions
  • diuretcs
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13
Q

hyponatremia

A

sodium < 135 mEq/l

- serium osmolarity decreases

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14
Q

hyponatremia causes

A

deficient sodium

  • too much: diuretics, Gi loss (V/d), diaphoresis
  • not enough in: Na restricting

excessive water

  • too much in: hypotonic solutions, oral hydration
  • not enough out: renal failure, heart failure, SIADH
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15
Q

hyponatremia clinical maifestations

A
  • GI upset
  • lethargy
  • confusion
  • decrease deep tendon reflexes
  • muscle weakness
  • seizures
  • coma
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16
Q

hyponatremia diagnosis

A
  • serum Na level

- urinalysis

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17
Q

hyponatremia treatment

A
  • fluid restriction

- increase dietary Na

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18
Q

potassium

A

normal range 3.5- 5.0 mEq/l

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19
Q

potassium role/function

A
  • nerve and muscle impulses assisting with skeletal contraction
  • cardiac muscle contraction and electrical conductivity
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20
Q

potassium intake/output

A

intake:
- main source is dietary: meats, fruits, veggies, beans

output:
- excreted through the kidneys and gastrointestinal tract

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21
Q

hyperkalemia

A

potassium > 5 mEq/l

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22
Q

hyperkalemia causes

A
  • deficient excretion: renal/ liver failure, medications
  • excessive intake: oral K supplements, rapid IV administration
  • lot of older adults defficent
  • check inf they are on a diuretic
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23
Q

hyperkalemia clinical manifestations

A
  • paraesthesia
  • muscle weakness
  • respiratory depression
  • EKG CHANGES ( dysrthmias) need to shock them
  • cardiac arrest
  • abdominal cramping
24
Q

hyperkalemia diagnosis

A
  • serum k levels

- EKG

25
Q

hyperkalemia treatment

A
  • decrease intake
  • hold supplements
  • medications: diruects, kayexalate, insulin
  • telemetry monitoring (continuous way to monitor EKG)
26
Q

hypokalemia

A

potasium < 3.5 mEq/l

27
Q

hypokalemia causes

A

excessive loss
- vomiting, diarrhea, nasogastric suctioning, laxatives, potassium- losing diuretics

deficient intake
- malnutrition, extreme dieting, and alcoholism

increased shift into the cell
- insulin excess: too much K+ into the blood and out of cell

28
Q

hypokalemia clinical manifestations

A
  • muscle weakness
  • decrease bowel sounds
  • illeus
  • dysrhythmias
  • EKG changes
  • cardiac arrest
29
Q

hypokalemia diagnosis

A

serum K

30
Q

hypokalemia treatment

A
  • replacement: oral, intravenous
31
Q

Calcium

A

4-5 mEQL

32
Q

calcium role function

A
  • formation/structur bone and teeth
  • blood clotting
  • nerve transmission and muscle contraction
33
Q

calcium intake and output

A

intake:
- main source is dietary intake (vitamin D aids absorption) absorbed through the gastrointestinal tract (small intestine)

output
- excreted in urine and stool

34
Q

hypercalcemia

A

> 5 mEq/l

35
Q

hypercalcemia causes:

A

increased intake or release
- calcium antacids and supplements, cancer, immobilization, corticosteroids, vitamin D deficiency

deficit excretion
- renal failure, thiazide diuretics, and hyperparathyroidism

36
Q

hypercalcemia clinical manifestations

A
  • confusion
  • muscle weakness
  • decreased deep tendon reflexes
  • lethargy
  • increased HR & BP
  • decreased Gi motility
37
Q

hypercalcemia diagnosis

A

serum calcium

38
Q

hypercalcemia treatment

A

identify and manage underlying caused

  • increase mobility: strength bone
  • calcitonin: meds that helps pull calcium out of blood
  • intravenous fluids: diluate
  • diuretics: pulls Na and K+ good not really CA
39
Q

hypocalcemia

A

calcium < 4 mEq/l

40
Q

hypocalcemia causes

A
  • excessive losses: hypoparathyroidism, renal failure, laxatives, diarrhea, and other medications
  • deficient intake: decreased dietary intake, alcoholism, and absorption disorders
41
Q

hypocalcemia clinical manifestations

A
  • confusion
  • irritability
  • paresthesia
  • increased deep tendon reflexes
  • increased GI motility
  • trousseau’s sign (hand drop-down)
  • chvostek’s sign (face twitch)
42
Q

hypocalcemia diagnosis

A

serum calcium

43
Q

hypocalcemia treatment

A
  • calcium replacement

- vitamin D

44
Q

magnesium

A

normal range: 1.8-2.5 mEq/l

45
Q

magnesium role/function

A
  • muscle and nerve function
  • cardiac rhythm
  • immune function
46
Q

magnesium intake/output

A

intake: main source is deitary intake
output: excreted through the kidneys and gastrointestinal system

47
Q

hypermagnesemia

A

magnesium > 2.5 mEq/l

48
Q

hypermagnesemia causes

A

to little out
- renal failure

too much in
- excessive laxative and antacid use

49
Q

hypermagnesemia clinical manifestations

A
  • similar to hypercalacemia
50
Q

hypermagnesemia diagnosis

A

serum magnesium

51
Q

hypermagnesemia treatment

A
  • diuretics, dialysis, and intravenous calcium
52
Q

hypomagnesemia

A

magnesium < 1.8 mEq/l

53
Q

hypomagnesemia causes

A

too little in

  • inadequate intake
  • alcoholism
  • malnutrition

too much out

  • diarrhea
  • diuretics
54
Q

hypomagnesemia clinical manifestations

A
  • similar to hypocalcemia
55
Q

hypomagnesemia diagnosis and treament

A

diagnosis: serum mag

treatment
- magnesium replacement: oral of IV

56
Q

acid-base balance

A
  • measured by PH: normal serum- 7.35-.7.45
  • body fluids, kidneys, and lungs help maintain balance
  • subtle changes can cause serious effects
57
Q

acid-base balance

A
  • cellular buffers- 1st line: acts as a sponge to soak up extra hydron ions if there are too many (acidic) or release hydrogen ions if not enough (alkaline)
  • lungs- 2nd
  • acidic- lungs blow off additional CO2, rapid breaths
  • alkaline conserve CO2 via shallow breaths
  • kidneys- slow response
  • regular of bicarbonate