ABGs/electrolytes/fluids Flashcards
(138 cards)
1
Q
What is the pH of a patient in acute overdose with metabolic acidosis?
A
Around 7.3, with low bicarbonate and high anion gap.
2
Q
What effect does hyperkalemia have on the ECG?
A
Tall, peaked T-waves and widened PR, QRS intervals.
3
Q
What electrolyte imbalance causes Torsades de Pointes?
A
Hypomagnesemia.
4
Q
What is a common ECG finding in hypercalcemia?
A
Shortened QT interval.
5
Q
What is the treatment for hyperkalemia?
A
Calcium gluconate, sodium bicarbonate, and insulin with glucose.
6
Q
What is the relationship between potassium and the U wave?
A
A prominent U wave is often seen in hypokalemia.
7
Q
What is the most common cause of respiratory acidosis?
A
Chronic obstructive pulmonary disease (COPD).
8
Q
What are common causes of metabolic alkalosis?
A
Vomiting, diuretics, and loss of chloride.
9
Q
How do the kidneys compensate in metabolic acidosis?
A
By increasing excretion of H+ and reabsorbing bicarbonate.
10
Q
What is the role of hemoglobin in acid-base buffering?
A
Hemoglobin acts as a buffer by binding H+ in red blood cells.
11
Q
What does the anion gap calculate?
A
The difference between measured cations and anions in the blood.
12
Q
What condition might cause a normal anion gap metabolic acidosis?
A
Diarrhea or renal tubular acidosis.
13
Q
What are the effects of magnesium on cardiac rhythm?
A
Magnesium deficiency can lead to arrhythmias, including Torsades.
14
Q
What ECG finding is characteristic of hypokalemia?
A
Prominent U waves and prolonged QT interval.
15
Q
What is the primary effect of acidosis on the body?
A
Depressed cardiac function, decreased contractility.
16
Q
What is the key feature of respiratory alkalosis?
A
Decreased pCO2, often due to hyperventilation.
17
Q
What is the treatment for metabolic acidosis with an elevated anion gap?
A
Administer sodium bicarbonate and address the underlying cause.
18
Q
How does the respiratory system compensate for metabolic alkalosis?
A
By decreasing respiratory rate to retain CO2.
19
Q
What does a negative Base Excess indicate?
A
It suggests a state of metabolic acidosis.
20
Q
What is the relationship between pCO2 and pH?
A
An increase in pCO2 causes a decrease in pH (acidosis).
21
Q
What effect does hypocalcemia have on the ECG?
A
Prolonged QT interval.
22
Q
What is the typical treatment for severe hyperkalemia?
A
Calcium gluconate, insulin, and sodium bicarbonate.
23
Q
What is the impact of hypercalcemia on the heart?
A
Shortened QT interval and potential arrhythmias.
24
Q
How does potassium affect the T wave?
A
In hyperkalemia, T waves become peaked and narrow.
25
What are the common causes of metabolic acidosis?
Renal failure, diabetic ketoacidosis, and lactic acidosis.
26
What are the key signs of respiratory acidosis?
Decreased pH and increased pCO2.
27
What compensates for respiratory alkalosis?
The kidneys decrease bicarbonate to compensate.
28
What is the effect of Torsades de Pointes on the ECG?
A polymorphic ventricular tachycardia with a twisting pattern.
29
What is the normal serum potassium level?
3.5-5.0 mEq/L
30
How does the body compensate for acidosis?
By increasing respiration to 'blow off' CO2.
31
What is a common cause of high anion gap metabolic acidosis?
Diabetic ketoacidosis or lactic acidosis.
32
What does a high base deficit indicate?
A significant metabolic acidosis with low bicarbonate.
33
What is the effect of acidosis on potassium levels?
Acidosis leads to hyperkalemia as H+ moves into cells and K+ exits.
34
What condition might cause hyperkalemia?
Acute kidney injury or massive tissue breakdown.
35
How does sodium bicarbonate affect acidosis?
It neutralizes H+ ions and increases bicarbonate to restore pH.
36
What changes are seen in the ECG with hyperkalemia?
Peaked T-waves, widened PR and QRS intervals.
37
What is the role of carbonic anhydrase in acid-base balance?
It catalyzes the conversion of CO2 to bicarbonate in red blood cells.
38
How does metabolic alkalosis affect potassium?
It often leads to hypokalemia due to renal potassium wasting.
39
What compensates for metabolic alkalosis?
The respiratory system decreases pCO2 by hyperventilation.
40
What is the primary cause of respiratory acidosis?
Hypoventilation, leading to CO2 retention.
41
What electrolyte imbalance can cause bradycardia?
Hyperkalemia and hypokalemia can both affect heart rate.
42
What electrolyte change occurs in prolonged vomiting?
Hypokalemia and metabolic alkalosis.
43
What is the impact of dehydration on acid-base balance?
It can cause metabolic acidosis due to decreased renal perfusion.
44
How does respiratory acidosis affect oxygen saturation?
It may decrease oxygenation due to CO2 retention.
45
What does an increased anion gap suggest?
The presence of unmeasured anions in the blood, such as lactate.
46
What is the effect of hyperventilation on blood pH?
It causes respiratory alkalosis due to excessive CO2 loss.
47
What is a common cause of hypocalcemia?
Hypoparathyroidism or vitamin D deficiency.
48
What is the treatment for severe metabolic acidosis?
Administration of sodium bicarbonate and correction of underlying cause.
49
How does the body compensate for hyperventilation?
By decreasing bicarbonate retention through the kidneys.
50
What ECG changes are seen in hypokalemia?
Prominent U-waves and flattened T-waves.
51
What are the typical signs of an electrolyte imbalance?
Arrhythmias, muscle weakness, and changes in ECG.
52
What compensates for metabolic acidosis?
The respiratory system increases ventilation to decrease CO2.
53
What is the effect of magnesium on the heart?
Magnesium deficiency can cause arrhythmias and Torsades.
54
How does hyperkalemia affect the cardiac conduction system?
It can cause delays and abnormal conduction in the heart.
55
What is the treatment for hypomagnesemia?
Magnesium sulfate supplementation.
56
What is the relationship between bicarbonate and pCO2?
Bicarbonate acts as a buffer to compensate for changes in pCO2.
57
What is the normal value for base excess?
Between -2 and +2 mEq/L.
58
What condition is associated with low pCO2?
Respiratory alkalosis caused by hyperventilation.
59
What is the impact of hyperkalemia on the heart?
It can cause ventricular arrhythmias and arrest.
60
What does metabolic alkalosis cause in the body?
A decrease in H+ and an increase in bicarbonate.
61
What is the compensatory response to metabolic acidosis?
Increased respiratory rate to expel CO2.
62
How does hypercalcemia affect myocardial contractility?
It increases myocardial contractility and may cause arrhythmias.
63
What is the key feature of an anion gap greater than 12?
It is indicative of metabolic acidosis caused by unmeasured anions.
64
What does a pCO2 of 60 mmHg indicate?
Respiratory acidosis, with CO2 retention causing decreased pH.
65
What is the treatment for an overdose causing metabolic acidosis?
Sodium bicarbonate and addressing the underlying cause.
66
What causes a positive T-wave in hyperkalemia?
A rapid increase in serum potassium causes the T-wave to become peaked.
67
What is the pH range for normal blood?
7.35 to 7.45.
68
What is Respiratory Acidosis?
Acidosis caused by CO2 retention, reflected by increased pCO2.
69
What causes Respiratory Alkalosis?
Alkalosis due to excessive loss of CO2, reflected by decreased pCO2.
70
What is the role of HCO3 in buffering?
HCO3 buffers H+ to maintain pH balance in the blood.
71
How does metabolic acidosis affect bicarbonate?
Metabolic acidosis results in a decrease in bicarbonate (HCO3).
72
What does a high anion gap indicate?
It suggests the presence of unmeasured anions like lactate or ketones.
73
What is the normal range for bicarbonate (HCO3)?
22-28 mEq/L.
74
What condition might cause mixed acidosis and alkalosis?
Diabetic Ketoacidosis (DKA) with compensation.
75
What does the term 'Base Excess' refer to?
A measure of metabolic acidosis or alkalosis; negative values indicate acidosis.
76
What compensates for respiratory acidosis?
The kidneys increase bicarbonate retention to compensate.
77
What are the three primary minerals discussed?
Calcium, phosphate, and magnesium
## Footnote
These minerals are essential for various bodily functions.
78
What condition is characterized by low calcium levels?
Hypocalcemia
## Footnote
This condition can result from excessive loss or inadequate intake.
79
What are the presentations of hypocalcemia?
Symptoms may include muscle spasms, tingling, and seizures
## Footnote
Specific presentations can vary based on severity.
80
What is the treatment for hypocalcemia?
Calcium supplementation and addressing the underlying cause
## Footnote
Treatment may vary depending on the severity and cause.
81
What condition is characterized by high calcium levels?
Hypercalcemia
## Footnote
This can occur due to high intake or inadequate output.
82
What are the presentations of hypercalcemia?
Symptoms may include nausea, vomiting, and confusion
## Footnote
The severity of symptoms can vary widely.
83
What is the treatment for hypercalcemia?
Hydration, medications to lower calcium levels
## Footnote
Treatment is often tailored to the underlying cause.
84
What is the function of phosphate in the body?
Energy production, bone mineralization, and cell function
## Footnote
Phosphate is crucial for ATP production.
85
What condition is characterized by low phosphate levels?
Hypophosphatemia
## Footnote
This condition can result from excessive loss or inadequate intake.
86
What are the presentations of hypophosphatemia?
Weakness, bone pain, and respiratory failure
## Footnote
Symptoms may vary based on severity.
87
What is the treatment for hypophosphatemia?
Phosphate supplementation and addressing the cause
## Footnote
Treatment strategies depend on the underlying issue.
88
What condition is characterized by high phosphate levels?
Hyperphosphatemia
## Footnote
This can occur due to inadequate output or high intake.
89
What are the presentations of hyperphosphatemia?
Itching, bone and joint pain, and calcification of tissues
## Footnote
Symptoms may be more pronounced in chronic cases.
90
What is the treatment for hyperphosphatemia?
Dietary restrictions and phosphate binders
## Footnote
Treatment may involve managing underlying kidney issues.
91
What is the role of magnesium in the body?
Muscle function, nerve transmission, and energy production
## Footnote
Magnesium is a cofactor in many enzymatic reactions.
92
What condition is characterized by low magnesium levels?
Hypomagnesemia
## Footnote
This can be caused by inadequate intake or excessive loss.
93
Who is at high risk for hypomagnesemia?
Individuals with gastrointestinal disease, diabetes, or chronic alcoholism
## Footnote
Certain medications can also increase risk.
94
What are the presentations of hypomagnesemia?
Muscle cramps, seizures, and arrhythmias
## Footnote
Symptoms can be severe and life-threatening.
95
What is the treatment for hypomagnesemia?
Magnesium supplementation and addressing the underlying cause
## Footnote
Treatment may vary based on severity and cause.
96
What condition is characterized by high magnesium levels?
Hypermagnesemia
## Footnote
This can occur due to renal failure or excessive intake.
97
What are the presentations of hypermagnesemia?
Nausea, vomiting, hypotension, and respiratory depression
## Footnote
Severe cases can lead to cardiac arrest.
98
What is the treatment for hypermagnesemia?
Discontinuation of magnesium intake and hydration
## Footnote
Severe cases may require dialysis.
99
What is the definition of Extracellular fluid?
Fluid found outside of cells in the body.
## Footnote
This fluid plays a crucial role in maintaining homeostasis and transporting nutrients and waste.
100
What does ECFVD stand for?
Extracellular fluid volume deficit.
## Footnote
This condition indicates a decrease in the volume of extracellular fluid in the body.
101
What is the priority of fluid and electrolyte problems?
Volume, pH, Potassium, Calcium, Magnesium, Sodium, Chloride.
## Footnote
These elements are essential to assess in the management of fluid and electrolyte imbalances.
102
What should the rate of correction for fluid imbalances mirror?
The rate of imbalance.
## Footnote
Rapid correction of fluid imbalances can lead to adverse outcomes.
103
What are the categories of fluid balance disorders?
Disorders of Electrolyte Balance.
## Footnote
These disorders can significantly impact the body's overall fluid balance.
104
What are common etiologies of fluid loss leading to ECFVD?
* Dehydration
* Hemorrhage
* Gastrointestinal losses
* Renal losses
* Skin losses
## Footnote
Identifying the etiology is crucial for appropriate treatment.
105
What are signs and symptoms of fluid loss?
* Thirst
* Decreased urine output
* Dry mucous membranes
* Hypotension
## Footnote
These can vary based on the severity of the fluid loss.
106
What is the initial treatment of fluid loss?
Rehydration, typically with IV fluids.
## Footnote
The choice of fluid type may depend on the underlying cause of fluid loss.
107
What does ECFVe stand for?
Extracellular fluid volume excess.
## Footnote
This condition indicates an increase in the volume of extracellular fluid.
108
What is a common cause of volume overload in ECFVe?
* Renal disease
* Impaired blood flow to the kidneys
* Liver failure
* Cardiovascular disorders (CHF)
## Footnote
These conditions often lead to sodium retention and fluid overload.
109
What are early findings in fluid excess?
* Weight gain
* Edema
* Hypertension
## Footnote
Early identification can help in managing fluid excess effectively.
110
What are late findings in fluid excess?
* Shortness of breath
* Jugular venous distension
* Pulmonary edema
## Footnote
These findings indicate more severe fluid overload and require prompt treatment.
111
What is the definition of ECFVS?
Extracellular fluid volume shift (Third-Spacing).
## Footnote
This condition refers to the abnormal accumulation of fluid in body compartments.
112
What are the consequences of third-spacing?
* Reduced effective blood volume
* Edema
* Impaired tissue perfusion
## Footnote
Third-spacing can complicate fluid management strategies.
113
What are common clinical manifestations of ECFVS?
* Swelling
* Weight gain
* Decreased urine output
## Footnote
These symptoms result from fluid accumulation in interstitial spaces.
114
What does ICFVE stand for?
Intracellular fluid volume excess.
## Footnote
This condition indicates an increase in the volume of fluid within cells.
115
What is a common etiology of ICFVE?
SIADH (Syndrome of Inappropriate Antidiuretic Hormone secretion).
## Footnote
This condition leads to excess water retention and dilution of electrolytes.
116
What is a neurological presentation of ICFVE?
* Confusion
* Seizures
* Coma
## Footnote
These symptoms can arise due to cerebral edema caused by excess intracellular fluid.
117
What is the treatment for ICFVE?
Fluid restriction and addressing the underlying cause.
## Footnote
Treatment may vary based on the severity and cause of the fluid excess.
118
What are the priorities in Fluid and Electrolyte Management?
Volume, pH, Potassium, Calcium, Magnesium, Sodium, Chloride
## Footnote
This order indicates the sequence in which problems should be corrected.
119
What is hypokalemia?
A condition characterized by low potassium levels in the blood
## Footnote
Hypokalemia can lead to various health issues if not addressed.
120
What are the common etiologies of hypokalemia?
Gastrointestinal losses, renal losses, certain medications
## Footnote
These factors can significantly contribute to the development of hypokalemia.
121
What are the typical presentations of hypokalemia?
Muscle weakness, cramping, fatigue, arrhythmias
## Footnote
Symptoms can vary in severity depending on the degree of potassium deficiency.
122
What ECG changes are associated with hypokalemia?
U waves, flattened T waves, ST segment depression
## Footnote
These changes can indicate the cardiac effects of low potassium levels.
123
What is the treatment for hypokalemia?
Potassium replacement, addressing underlying causes
## Footnote
Treatment can be oral or intravenous depending on severity.
124
What is hyperkalemia?
A condition characterized by high potassium levels in the blood
## Footnote
Hyperkalemia can be life-threatening if not managed promptly.
125
What are the common etiologies of hyperkalemia?
Renal failure, medications, tissue breakdown
## Footnote
Certain drugs like ACE inhibitors and potassium-sparing diuretics can also cause hyperkalemia.
126
What are the typical presentations of hyperkalemia?
Muscle weakness, fatigue, palpitations, arrhythmias
## Footnote
Symptoms may escalate quickly and require urgent intervention.
127
What ECG changes are associated with hyperkalemia?
Peaked T waves, widened QRS complexes, ventricular fibrillation
## Footnote
These changes are critical indicators of severe hyperkalemia.
128
What is the treatment for hyperkalemia?
Calcium gluconate, insulin with glucose, diuretics, dialysis
## Footnote
The choice of treatment depends on the severity and underlying cause.
129
What is sodium's role in the body?
Regulation of fluid balance, nerve function, muscle contraction
## Footnote
Sodium is a key electrolyte in maintaining homeostasis.
130
What is hyponatremia?
A condition characterized by low sodium levels in the blood
## Footnote
Hyponatremia can be classified into hypervolemic, euvolemic, and hypovolemic types.
131
What are the hypervolemic etiologies of hyponatremia?
Heart failure, liver cirrhosis, nephrotic syndrome
## Footnote
These conditions lead to fluid retention and dilution of sodium.
132
What are the hypovolemic etiologies of hyponatremia?
Vomiting, diarrhea, diuretic use
## Footnote
These causes lead to a loss of both water and sodium, but sodium loss is more significant.
133
What are the typical presentations of hyponatremia?
Nausea, headache, confusion, seizures
## Footnote
Severity of symptoms correlates with the rapidity of sodium decline.
134
What is the treatment for hyponatremia?
Fluid restriction, sodium replacement, addressing underlying causes
## Footnote
Treatment must be approached cautiously to avoid rapid correction.
135
What is hypernatremia?
A condition characterized by high sodium levels in the blood
## Footnote
Hypernatremia often results from water loss or excessive sodium intake.
136
What are the etiologies of hypernatremia?
Dehydration, diabetes insipidus, excessive salt intake
## Footnote
Each of these conditions can lead to an imbalance in sodium levels.
137
What are the typical presentations of hypernatremia?
Thirst, dry mucous membranes, confusion, seizures
## Footnote
Symptoms can escalate rapidly and indicate severe dehydration.
138
What is the treatment for hypernatremia?
Fluid replacement, addressing underlying causes
## Footnote
Treatment should be gradual to prevent cerebral edema.
