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Med Surg > Chapter 10 > Flashcards

Chapter 10 Flashcards

electrolyte functions and imbalances

1
Q

water constitutes about ____ percent of the adult male body and _____ percent of the adult female body

A

60, 50

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2
Q

older adults average about _____ percent of water for total body weight

A

45

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3
Q

average fluid intake and output over a 24 hour period is about _____ mL

A

2400

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4
Q

average daily urine output is between _____ and _____ mL in adults

A

1200, 1500

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5
Q

about _____ mL of urine daily is required to excrete metabolic wastes produced by the body

A

500

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6
Q

substances that dissociate in a solution to form ions are called _____

A

electrolytes

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7
Q

_____ are positively charged electrolytes

A

cations

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8
Q

_____ are negatively charged electrolytes

A

anions

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9
Q

_____ _____ is fluid found in the spaces between body cells

A

interstitial fluid

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10
Q

_____ _____, also called _____, is found within arteries, veins and capillaries

A

intravascular fluid, plasma

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11
Q

_____ _____ includes urine, perspiration, pleural fluid, etc.

A

transcellular fluid

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12
Q

ICF contains high levels of _____, _____, _____, _____ and _____

A

magnesium, potassium, phosphate, glucose, oxygen

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13
Q

ECF principally contains _____, _____, and _____

A

sodium, chloride, bicarbonate

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14
Q

conventional lab values for sodium

A

135-145

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15
Q

conventional lab values for chloride

A

95-105

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16
Q

conventional lab values for bicarbonate

A

22-26

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17
Q

conventional lab values for calcium

A

4.5-5.5

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18
Q

conventional lab values for potassium

A

3.5-5.0

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19
Q

conventional lab values for phosphate

A

1.7-2.6

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20
Q

conventional lab values for magnesium

A

1.5-2.5

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21
Q

conventional lab values for serum osmolality

A

280-300

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22
Q

_____ is the process by which water moves across a selectively permeable membrane from lower to higher solute concentration

A

osmosis

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23
Q

osmosis continues until the solute concentration on both sides is _____

A

balanced

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24
Q

the concentration of a solution is called _____

A

osmolality

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25
Q

osmolality of ECF depends on chiefly on _____ concentration

A

sodium

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26
Q

serum osmolality can be estimated by _____ serum sodium concentration

A

doubling

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27
Q

the _____ _____ is the power of a solution to draw water across a membrane

A

osmotic pressure

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28
Q

_____ refers to the effect of a solution’s osmotic pressure on water movement across cell membranes

A

tonicity

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29
Q

_____ solutions have the same concentration as solutes in plasma

A

isotonic

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30
Q

_____ solutions have a greater concentration of solutes in plasma

A

hypertonic

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31
Q

_____ solutions have a lower concentration of solutes in plasma

A

hypotonic

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32
Q

in hypertonic solutions, water is _____ _____ of cells, causing them to _____

A

drawn out, shrink

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33
Q

in hypotonic solutions, water is _____ _____ cells, causing them to _____

A

moved into, swell

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34
Q

the process by which solute molecules move from an area of high solute concentration to an area of low concentration until balanced is called _____

A

diffusion

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35
Q

_____ _____ refers to the random movement of particles through a solution, such as when milk spreads through coffee

A

simple diffusion

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36
Q

_____ _____ allows water soluble molecules, such as glucose and amino acids, to diffuse across cell membranes

A

facilitated diffusion

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37
Q

the process by which water and solutes move from an area of high to low hydrostatic pressure is called _____

A

filtration

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38
Q

_____ _____ allows molecules to move across cell and epithelial membranes against a concentration gradient

A

active transport

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39
Q

active transport uses _____ for energy to move molecules, such as with the _______ - _______ pump

A

ATP, sodium potassium

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40
Q

report urinary output of less than _____ mL per hour

A

30

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41
Q

the thirst center is located in the _____

A

hypothalamus

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42
Q

the _____ are primarily responsible for regulating _____ _____ and _____ ______ in the body

A

kidneys, fluid volume, electrolyte balance

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43
Q

about _____ mL of urine is normally produced over a 24-hour period

A

1500

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44
Q

_____ _____ or _____ regulates water excretion from the kidneys

A

antidiuretic hormone, vasopressin

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45
Q

_____ _____ _____ is a hormone released by atrial muscle cells in response to distention from fluid overload

A

atrial natriuretic peptide

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46
Q

two good places to check for skin turgor on elderly clients are over the _____ and the _____ _____ of the thigh

A

sternum, inner aspect

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47
Q

the most common cause of FVD is excessive loss of _____ _____

A

GI fluids

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48
Q

decreased circulating blood volume is called _____

A

hypovolemia

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49
Q

shift of fluid into the interstitial space is called _____ _____

A

second spacing

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50
Q

shift of fluid into the transcellular space is called _____ _____

A

third spacing

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51
Q

_____ _____ _____ or _____ _____ _____ can trigger third spacing

A

increased vascular permeability, decreased protein levels

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52
Q

a good indicator of FVD is _____ _____ _____

A

rapid weight loss

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53
Q

a drop of more than _____ mmHg in systolic BP when changing from lying to standing can indicate FVD

A

15

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54
Q

3 common manifestations of FVD include _____, _____, and _____ _____ _____

A

tachycardia, vasoconstriction, decreased urine output

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55
Q

_____ electrolyte solutions, such as _____ _____ or _____ _____, are used to expand plasma volume in hypotensive patients or replace abnormal losses

A

isotonic, normal saline, Ringer solution

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56
Q

_____ _____ _____ _____ saline or _____ percent sodium chloride is given to provide water to treat total body water deficits

A

five percent dextrose in, 0.45

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57
Q

adequate fluid intake is considered to be _____ mL

A

1500

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58
Q

excess intravascular fluid is called _____

A

hypervolemia

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59
Q

_____ refers to excess interstitial fluid

A

edema

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60
Q

_____ refers to causes induced by effects of treatment

A

iatrogenic

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61
Q

these drinks should be avoided when dehydrated, as they increase urine output and general fluid loss

A

coffee, alcohol, tea

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62
Q

class of diuretics that inhibits reabsorption of sodium chloride on the ascending loop of Henle

A

loop

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63
Q

class of diuretics that decrease absorption of potassium, sodium chloride and water on the distal tubule

A

thiazide-type

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64
Q

class of diuretics that inhibit sodium-potassium exchange in the distal tubule

A

potassium-sparing

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65
Q

inadequate intake of potassium, excessive renal loss (often secondary to drugs), excessive GI loss (diarrhea, ileostomy drainage) and transcellular shifts from ECF to ICF (metabolic alkalosis, treatment of diabetic ketoacidosis with insulin) can cause _____

A

hypokalemia

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66
Q

respiratory arrest, poliguria, dilute urine, dysrhythmias, decreased bowel sounds, cardiac arrest, and leg cramps are all symptoms of _____

A

hypokalemia

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67
Q

impaired renal excretion of potassium, rapid IV administration, the use of salt substitutes, and acidosis can all cause _____

A

hyperkalemia

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68
Q

colic, muscle twitching/tremors, bradycardia, and muscle weakness in lower extremities are all symptoms of _____

A

hyperkalemia

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69
Q

the loss of excess aldosterone through _____ can lead to hypokalemia

A

hyperaldosteronism

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70
Q

the _____ are the main source of potassium excretion

A

kidneys

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71
Q

transcellular potassium shifts from ECF to ICF typically occur in _____ _____ or the treatment of _____ _____ with _____

A

metabolic alkalosis, diabetic ketoacidosis, insulin

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72
Q

hypokalemia affects the transmission of _____ _____

A

nerve impulses

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73
Q

_____ _____ is affected by hypokalemia, suppressing the insulin needed to synthesize glycogen

A

carbohydrate metabolism

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74
Q

the state of _____ is often associated with hypokalemia, which requires a test of ABGs

A

alkalosis

75
Q

serum tests on _____, _____, _____, _____, and _____ are ran when testing for hypokalemia

A

potassium, sodium, calcium, bicarbonate, magnesium

76
Q

renal function studies that include ______ ______ and ______ are often run to test for hypokalemia

A

serum creatinine, BUN

77
Q

when experiencing _____, cell membrane potential is affected, including a slowing of the heart rate, possible heart blocks and cardiac arrest, along with general weakening of cardiac/skeletal muscles

A

hyperkalemia

78
Q

a minimum of _____ mEq/day of potassium must be taken to replace urinary losses

A

40-50

79
Q

the primary intracellular cation is _____

A

potassium

80
Q

low levels of _____ and _____ may increase the effects of hyperkalemia

A

calcium, sodium

81
Q

the use of _____ is a last ditch effort to manage hyperkalemia due to its invasiveness

A

dialysis

82
Q

high levels of _____ may increase the effects of hyperkalemia

A

magnesium

83
Q

low sodium levels are referred to as _____

A

hyponatremia

84
Q

high levels of sodium are referred to as ______

A

hypernatremia

85
Q

the ______ are the primary regulators of sodium balance in the body

A

kidneys

86
Q

decreased serum osmolality, increased muscle weakness, hyperreflexia, muscle cramps/weakness, anorexia, cerebral/cellular edema, and coma are all symptoms of _____

A

hyponatremia

87
Q

increased serum osmolality, oliguria, tachycardia, dehydration, increased thirst, and dry skin/poor skin turgor are all symptoms of _____

A

hypernatremia

88
Q

this electrolyte maintains neuromuscular activity and is the primary regulator of volume, osmolality and distribution of ECF

A

sodium

89
Q

sodium intake of about _____ mg a day is sufficient for meeting the body’s needs

A

500

90
Q

most potassium in the body is found in the _____

A

ICF

91
Q

the hormone _____ helps regulate potassium elimination by the kidneys

A

aldosterone

92
Q

lunch meat, bacon, cheese, dry cereal, canned soup, popcorn, ketchup, pickles and seafood are all foods high in ______

A

sodium

93
Q

bananas, oranges, avocados, spinach, potatoes, tomatoes, meat, seafood, milk and yogurt are all foods high in _____

A

potassium

94
Q

_____ plays a vital role in cell metabolism and cardiac/neuromuscular function, such as nerve impulses and maintenance of normal cardiac rhythms

A

potassium

95
Q

excess loss of sodium through the kidneys (diuretics, adrenal insufficiency), GI tract (vomiting, diarrhea), or skin (sweating, loss of skin surface) can lead to _____

A

hyponatremia

96
Q

excess water loss or excess sodium ingestion can lead to _____

A

hypernatremia

97
Q

_____ and/or ______ supplements are given to prevent/treat hypokalemia

A

oral, parenteral

98
Q

_____ potentiates digitalis effects and increases resistance to certain antidysrhythmics

A

hypokalemia

99
Q

_____ and _____ promote potassium uptake by the cells, shifting potassium out of ECF.

A

insulin, glucose

100
Q

_____ increases the risk of digitalis toxicity

A

calcium

101
Q

_____ is the most plentiful electrolyte in ECF

A

sodium

102
Q

Excess sodium loss can occur through the _____, _____ _____, or _____

A

kidneys, GI tract, skin

103
Q

A _____ _____ _____ is obtained to evaluate sodium excretion

A

24-hour urine specimen

104
Q

_____ _____ or _____ _____ (0.9% NaCl) solution may be administered to manage hyponatremia

A

isotonic Ringer, isotonic saline

105
Q

______ diuretics (e.g., furosemide) may be administered to patients who have hyponatremia with normal or excess ECF volume

A

loop

106
Q

the release of ______ and the ______ mechanism both protect against hypernatremia

A

ADH, thirst

107
Q

Hypotonic IV fluids such as _____ percent NaCl solution or 5% _____ _____ _____ (which is isotonic when administered, but becomes hypotonic and provides pure water when the glucose is metabolized) may be administered to correct hypernatremia

A

0.45, dextrose in water

108
Q

the primary regulator of water intake is _____

A

thirst

109
Q

vomiting/diarrhea, hot environment, hemorrhage, diuretics, and significant GI losses can all cause _____

A

FVD

110
Q

FVD can lead to _____ and _____ _____

A

hypovolemia, third spacing

111
Q

rapid weight loss, tachycardia, decreased skin turgor, and decreased systolic blood pressure are symptoms of _____

A

FVD

112
Q

one should monitor for fluid overload and no liver response in patients with liver failure when giving _____ solutions

A

isotonic

113
Q

one should monitor for circulatory overload and IV site inflammation when giving _____ solutions

A

hypertonic

114
Q

one should monitor for inflammation at the IV site and serum sodium levels when giving _____ solutions

A

hypotonic

115
Q

hypertonic solutions must be given through a _____ line to minimize site inflammation

A

central

116
Q

CHF, excessive sodium intake, adrenal gland disorders, liver cirrhosis an excess ADH/aldosterone due to stress can lead to _____

A

FVE

117
Q

with FVE, serum hematocrit and hemoglobin often _____

A

decrease

118
Q

only about _____ percent of ingested calcium is absorbed into the blood

A

20

119
Q

stabilizing cell membrane, regulating muscle contractions/relaxation, maintaining cardiac function and blood clotting are all processes managed by ionized ______

A

calcium

120
Q

serum calcium levels are regulated by _____, _____, and _____

A

PTH, calcitonin, calcitriol

121
Q

_____ stimulates the effects of PTH by further enhancing the calcium release from bones, absorption into the intestines and reabsorption into the kidneys

A

calcitriol

122
Q

_____ inhibits the movement of calcium out of bone, reduces intestinal absorption and promotes kidney excretion of calcium

A

calcitonin

123
Q

during the state of _____, more calcium binds with protein, making less available in its ionized, active form

A

alkalosis

124
Q

during the state of _____, calcium is released from protein, making more of it available in its ionized form

A

acidosis

125
Q

when albumin levels fall, total plasma calcium _____

A

declines

126
Q

the state of low levels of calcium is called _____

A

hypocalcemia

127
Q

the state of high levels of calcium is called _____

A

hypercalcemia

128
Q

tetany/convulsions, numbness/tingling around the mouth, hands and feet, muscle spasms, decreased cardiac output, hypotension, positive Chvostek/Trousseau signs, and bone pain/fractures are all symptoms of _____

A

hypocalcemia

129
Q

people who have undergone parathyroidectomies, bariatric surgeries (decreased food intake/malabsorption), lactose intolerance, have alcoholism (reduces intestinal absoprtion), and older women going through menopause (decreased estrogen) are all at risk for _____

A

hypocalcemia

130
Q

constipation, increased blood pressure, lethargy, muscle weakness, increased thirst, increased urine output, lethargy, AV block, negative Trousseau/Chvostek signs are all symptoms of _____

A

hypercalcemia

131
Q

people who experience hypoparathyroidism and acute pancreatitis are at risk for _____

A

hypocalcemia

132
Q

During _____, the amount of ionized calcium may remain normal even though the total calcium level is low

A

hypoalbuminemia

133
Q

hypocalcemia is often associated with _____

A

hypomagnesemia

134
Q

_____ and _____ share an inverse relationship

A

phosphate, calcium

135
Q

the electrolyte imbalances of _____ and _____ can cause hypocalcemia

A

hypomagnesemia, hyperphosphatemia

136
Q

inadequate _____ _____ can decrease calcium absorption and contribute to hypocalcemia

A

vitamin D

137
Q

When blood is administered faster than the liver can metabolize the citrate, it can bind with and temporarily remove ionized _____ from circulation.

A

calcium

138
Q

along with drugs that lower serum magnesium levels, _____ _____, _____, and _____ can increase the risk for hypocalcemia

A

loop diuretics, anticonvulsants, phosphates

139
Q

involuntary contraction of muscles is called _____

A

tetany

140
Q

contraction of the facial muscles produced by tapping the facial nerve in front the ear is called _____ _____

A

Chvostek sign

141
Q

carpal spasms produced by inflating a blood pressure cuff on the upper arm to above systolic blood pressure for 2 to 5 minutes is called _____ _____

A

Trousseau sign

142
Q

the two most common calcium IV preparations include calcium _____ and ______

A

chloride, gluconate

143
Q

oral calcium preparations include calcium _____, _____, and _____

A

carbonate, gluconate, lactate

144
Q

dairy products, canned salmon, broccoli, spinach, and tofu are all foods high in _____

A

calcium

145
Q

the two most common causes of hypercalcemia are _____ _____ and _____

A

bone resorption, malignancies

146
Q

excess PTH produced by hyperparathyroidism releases calcium from the bones, causing increased calcium absorption in the _____ and retention of calcium in the _____

A

intestines, kidneys

147
Q

prolonged _____ and lack of _____ _____ can cause increased resoprtion of bone with calcium release into ECF

A

immobility, weight bearing

148
Q

excess vitamin D use, milk ingestion and overuse of calcium-containing antacids can all cause increased _____ _____ of calcium

A

intestinal absorption

149
Q

_____ _____ and drugs such as _____ _____ and _____ can intefere with calcium elimination by kidneys

A

renal failure, thiazide diuretics, lithium

150
Q

mental status can be altered by high _____ levels

A

calcium

151
Q

loop diuretics such as _____ promote elimination of excess calcium

A

furosemide

152
Q

rapid reveresal of hypercalcemia can be accomplished by use of _____ and _____ phosphate

A

sodium, potassium

153
Q

IV _____ inhibits the bone resorption of calcium

A

plicamycin

154
Q

____ compete with vitamin D, inhibit GI absorption of calcium, bone resorption, and increase urinary calcium excretion

A

glucocortisoids

155
Q

_____ _____ restores vascular volume and promotes renal excretion of calcium in hypercalcemic patients

A

isotonic saline

156
Q

acidic drinks such as _____ and _____ juice reduce the risk of calcium salt build-up into kidney stones

A

prune, cranberry

157
Q

green vegetables, grains, bananas, citrus fruits, meats, chocolate, and seafood are all food high in ______

A

magnesium

158
Q

_____ is vital to various enzyme reactions and synthesis of proteins and nucleic acids

A

magnesium

159
Q

magnesium is essential for _____ _____ and _____ _____

A

neuromuscular transmission, cardiovascular function

160
Q

the state of having low levels of magnesium is called _____

A

hypomagnesemia

161
Q

the state of having high levels of magnesium is called _____

A

hypermagnesemia

162
Q

loss of GI fluids (diarrhea, ileostomy), alcoholism, protein-calorie malnutrition/starvation, kidney disease and diabetic ketoacidosis are risk factors for _____

A

hypomagnesemia

163
Q

magnesium deficiency is often seen alongside low _____ and _____ levels

A

potassium, calcium

164
Q

severe hypomagnesium is strongly linked with low serum _____ levels as both are associated with renal and GI losses

A

calcium

165
Q

similar to hypercalcemia, _____ increases the risk of digoxin toxicity

A

hypomagnesemia

166
Q

positive Bobinski/Trousseau/Chvostek signs, nystagmus, and hypertension are all signs of _____

A

hypomagnesemia

167
Q

negative Bobinski/Trousseau/Chvostek, depressed CNS, hypotension, cardiac dysrhythmias/arrest are all signs of _____

A

hypermagnesemia

168
Q

parenteral _____ _____ can treat hypomagnesemia

A

magnesium sulfate

169
Q

_____ is often seen in adults with renal failure or general functional decline

A

hypermagnesemia

170
Q

_____ or _____ _____ can both be used to remove excess magnesium

A

hemodialysis, peritoneal dialysis

171
Q

the IV _____ _____ can be administered to reverse neuromuscular/cardiac effects of hypermagnesemia

A

calcium gluconate

172
Q

the primary intracellular anion is _____

A

phosphate

173
Q

_____ is responsible for ATP production and electrolyte transport, red blood cell function, oxygen tissue delivery, maintaining acid-base balance, and fat/carb/protein metabolism

A

phosphate

174
Q

an inverse relationship exists between phosphorus and _____

A

calcium

175
Q

the state of low phosphorus is called _____

A

hypophosphatemia

176
Q

the state of high phosphorus is called _____

A

hyperphosphatemia

177
Q

a shift of phosphate into the intracellular space is the most common cause of _____

A

hypophosphatemia

178
Q

intention tremors, confusion//stupor, joint stiffness, impaired white blood cell function and seizures are all symptoms of _____

A

hypophosphatemia

179
Q

_____, _____ _____, _____, and _____ _____ can all contribute to hypophosphatemia

A

alcoholism, respiratory alkalosis, hyperventilation, diabetic ketoacidosis

180
Q

_____ _____ is the primary cause of impaired excretion

A

renal failure

181
Q

excess _____ _____ increases phosphate absorption and can contribute to hyperphosphatemia

A

vitamin D

182
Q

disruptions of mechanism that regulate _____ levels can lead to hyperphosphatemia

A

calcium

183
Q

excess phosphorus will often combine with another electrolyte during hyperphostemia, contributing to the state of _______

A

hypocalcemia

Med Surg (1 decks)

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