Chapter 10 Flashcards
electrolyte functions and imbalances (183 cards)
1
Q
water constitutes about ____ percent of the adult male body and _____ percent of the adult female body
A
60, 50
2
Q
older adults average about _____ percent of water for total body weight
A
45
3
Q
average fluid intake and output over a 24 hour period is about _____ mL
A
2400
4
Q
average daily urine output is between _____ and _____ mL in adults
A
1200, 1500
5
Q
about _____ mL of urine daily is required to excrete metabolic wastes produced by the body
A
500
6
Q
substances that dissociate in a solution to form ions are called _____
A
electrolytes
7
Q
_____ are positively charged electrolytes
A
cations
8
Q
_____ are negatively charged electrolytes
A
anions
9
Q
_____ _____ is fluid found in the spaces between body cells
A
interstitial fluid
10
Q
_____ _____, also called _____, is found within arteries, veins and capillaries
A
intravascular fluid, plasma
11
Q
_____ _____ includes urine, perspiration, pleural fluid, etc.
A
transcellular fluid
12
Q
ICF contains high levels of _____, _____, _____, _____ and _____
A
magnesium, potassium, phosphate, glucose, oxygen
13
Q
ECF principally contains _____, _____, and _____
A
sodium, chloride, bicarbonate
14
Q
conventional lab values for sodium
A
135-145
15
Q
conventional lab values for chloride
A
95-105
16
Q
conventional lab values for bicarbonate
A
22-26
17
Q
conventional lab values for calcium
A
4.5-5.5
18
Q
conventional lab values for potassium
A
3.5-5.0
19
Q
conventional lab values for phosphate
A
1.7-2.6
20
Q
conventional lab values for magnesium
A
1.5-2.5
21
Q
conventional lab values for serum osmolality
A
280-300
22
Q
_____ is the process by which water moves across a selectively permeable membrane from lower to higher solute concentration
A
osmosis
23
Q
osmosis continues until the solute concentration on both sides is _____
A
balanced
24
Q
the concentration of a solution is called _____
A
osmolality
25
osmolality of ECF depends on chiefly on _____ concentration
sodium
26
serum osmolality can be estimated by _____ serum sodium concentration
doubling
27
the _____ _____ is the power of a solution to draw water across a membrane
osmotic pressure
28
_____ refers to the effect of a solution's osmotic pressure on water movement across cell membranes
tonicity
29
_____ solutions have the same concentration as solutes in plasma
isotonic
30
_____ solutions have a greater concentration of solutes in plasma
hypertonic
31
_____ solutions have a lower concentration of solutes in plasma
hypotonic
32
in hypertonic solutions, water is _____ _____ of cells, causing them to _____
drawn out, shrink
33
in hypotonic solutions, water is _____ _____ cells, causing them to _____
moved into, swell
34
the process by which solute molecules move from an area of high solute concentration to an area of low concentration until balanced is called _____
diffusion
35
_____ _____ refers to the random movement of particles through a solution, such as when milk spreads through coffee
simple diffusion
36
_____ _____ allows water soluble molecules, such as glucose and amino acids, to diffuse across cell membranes
facilitated diffusion
37
the process by which water and solutes move from an area of high to low hydrostatic pressure is called _____
filtration
38
_____ _____ allows molecules to move across cell and epithelial membranes against a concentration gradient
active transport
39
active transport uses _____ for energy to move molecules, such as with the _______ - _______ pump
ATP, sodium potassium
40
report urinary output of less than _____ mL per hour
30
41
the thirst center is located in the _____
hypothalamus
42
the _____ are primarily responsible for regulating _____ _____ and _____ ______ in the body
kidneys, fluid volume, electrolyte balance
43
about _____ mL of urine is normally produced over a 24-hour period
1500
44
_____ _____ or _____ regulates water excretion from the kidneys
antidiuretic hormone, vasopressin
45
_____ _____ _____ is a hormone released by atrial muscle cells in response to distention from fluid overload
atrial natriuretic peptide
46
two good places to check for skin turgor on elderly clients are over the _____ and the _____ _____ of the thigh
sternum, inner aspect
47
the most common cause of FVD is excessive loss of _____ _____
GI fluids
48
decreased circulating blood volume is called _____
hypovolemia
49
shift of fluid into the interstitial space is called _____ _____
second spacing
50
shift of fluid into the transcellular space is called _____ _____
third spacing
51
_____ _____ _____ or _____ _____ _____ can trigger third spacing
increased vascular permeability, decreased protein levels
52
a good indicator of FVD is _____ _____ _____
rapid weight loss
53
a drop of more than _____ mmHg in systolic BP when changing from lying to standing can indicate FVD
15
54
3 common manifestations of FVD include _____, _____, and _____ _____ _____
tachycardia, vasoconstriction, decreased urine output
55
_____ electrolyte solutions, such as _____ _____ or _____ _____, are used to expand plasma volume in hypotensive patients or replace abnormal losses
isotonic, normal saline, Ringer solution
56
_____ _____ _____ _____ saline or _____ percent sodium chloride is given to provide water to treat total body water deficits
five percent dextrose in, 0.45
57
adequate fluid intake is considered to be _____ mL
1500
58
excess intravascular fluid is called _____
hypervolemia
59
_____ refers to excess interstitial fluid
edema
60
_____ refers to causes induced by effects of treatment
iatrogenic
61
these drinks should be avoided when dehydrated, as they increase urine output and general fluid loss
coffee, alcohol, tea
62
class of diuretics that inhibits reabsorption of sodium chloride on the ascending loop of Henle
loop
63
class of diuretics that decrease absorption of potassium, sodium chloride and water on the distal tubule
thiazide-type
64
class of diuretics that inhibit sodium-potassium exchange in the distal tubule
potassium-sparing
65
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 _____
hypokalemia
66
respiratory arrest, poliguria, dilute urine, dysrhythmias, decreased bowel sounds, cardiac arrest, and leg cramps are all symptoms of _____
hypokalemia
67
impaired renal excretion of potassium, rapid IV administration, the use of salt substitutes, and acidosis can all cause _____
hyperkalemia
68
colic, muscle twitching/tremors, bradycardia, and muscle weakness in lower extremities are all symptoms of _____
hyperkalemia
69
the loss of excess aldosterone through _____ can lead to hypokalemia
hyperaldosteronism
70
the _____ are the main source of potassium excretion
kidneys
71
transcellular potassium shifts from ECF to ICF typically occur in _____ _____ or the treatment of _____ _____ with _____
metabolic alkalosis, diabetic ketoacidosis, insulin
72
hypokalemia affects the transmission of _____ _____
nerve impulses
73
_____ _____ is affected by hypokalemia, suppressing the insulin needed to synthesize glycogen
carbohydrate metabolism
74
the state of _____ is often associated with hypokalemia, which requires a test of ABGs
alkalosis
75
serum tests on _____, _____, _____, _____, and _____ are ran when testing for hypokalemia
potassium, sodium, calcium, bicarbonate, magnesium
76
renal function studies that include ______ ______ and ______ are often run to test for hypokalemia
serum creatinine, BUN
77
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
hyperkalemia
78
a minimum of _____ mEq/day of potassium must be taken to replace urinary losses
40-50
79
the primary intracellular cation is _____
potassium
80
low levels of _____ and _____ may increase the effects of hyperkalemia
calcium, sodium
81
the use of _____ is a last ditch effort to manage hyperkalemia due to its invasiveness
dialysis
82
high levels of _____ may increase the effects of hyperkalemia
magnesium
83
low sodium levels are referred to as _____
hyponatremia
84
high levels of sodium are referred to as ______
hypernatremia
85
the ______ are the primary regulators of sodium balance in the body
kidneys
86
decreased serum osmolality, increased muscle weakness, hyperreflexia, muscle cramps/weakness, anorexia, cerebral/cellular edema, and coma are all symptoms of _____
hyponatremia
87
increased serum osmolality, oliguria, tachycardia, dehydration, increased thirst, and dry skin/poor skin turgor are all symptoms of _____
hypernatremia
88
this electrolyte maintains neuromuscular activity and is the primary regulator of volume, osmolality and distribution of ECF
sodium
89
sodium intake of about _____ mg a day is sufficient for meeting the body's needs
500
90
most potassium in the body is found in the _____
ICF
91
the hormone _____ helps regulate potassium elimination by the kidneys
aldosterone
92
lunch meat, bacon, cheese, dry cereal, canned soup, popcorn, ketchup, pickles and seafood are all foods high in ______
sodium
93
bananas, oranges, avocados, spinach, potatoes, tomatoes, meat, seafood, milk and yogurt are all foods high in _____
potassium
94
_____ plays a vital role in cell metabolism and cardiac/neuromuscular function, such as nerve impulses and maintenance of normal cardiac rhythms
potassium
95
excess loss of sodium through the kidneys (diuretics, adrenal insufficiency), GI tract (vomiting, diarrhea), or skin (sweating, loss of skin surface) can lead to _____
hyponatremia
96
excess water loss or excess sodium ingestion can lead to _____
hypernatremia
97
_____ and/or ______ supplements are given to prevent/treat hypokalemia
oral, parenteral
98
_____ potentiates digitalis effects and increases resistance to certain antidysrhythmics
hypokalemia
99
_____ and _____ promote potassium uptake by the cells, shifting potassium out of ECF.
insulin, glucose
100
_____ increases the risk of digitalis toxicity
calcium
101
_____ is the most plentiful electrolyte in ECF
sodium
102
Excess sodium loss can occur through the _____, _____ _____, or _____
kidneys, GI tract, skin
103
A _____ _____ _____ is obtained to evaluate sodium excretion
24-hour urine specimen
104
_____ _____ or _____ _____ (0.9% NaCl) solution may be administered to manage hyponatremia
isotonic Ringer, isotonic saline
105
______ diuretics (e.g., furosemide) may be administered to patients who have hyponatremia with normal or excess ECF volume
loop
106
the release of ______ and the ______ mechanism both protect against hypernatremia
ADH, thirst
107
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
0.45, dextrose in water
108
the primary regulator of water intake is _____
thirst
109
vomiting/diarrhea, hot environment, hemorrhage, diuretics, and significant GI losses can all cause _____
FVD
110
FVD can lead to _____ and _____ _____
hypovolemia, third spacing
111
rapid weight loss, tachycardia, decreased skin turgor, and decreased systolic blood pressure are symptoms of _____
FVD
112
one should monitor for fluid overload and no liver response in patients with liver failure when giving _____ solutions
isotonic
113
one should monitor for circulatory overload and IV site inflammation when giving _____ solutions
hypertonic
114
one should monitor for inflammation at the IV site and serum sodium levels when giving _____ solutions
hypotonic
115
hypertonic solutions must be given through a _____ line to minimize site inflammation
central
116
CHF, excessive sodium intake, adrenal gland disorders, liver cirrhosis an excess ADH/aldosterone due to stress can lead to _____
FVE
117
with FVE, serum hematocrit and hemoglobin often _____
decrease
118
only about _____ percent of ingested calcium is absorbed into the blood
20
119
stabilizing cell membrane, regulating muscle contractions/relaxation, maintaining cardiac function and blood clotting are all processes managed by ionized ______
calcium
120
serum calcium levels are regulated by _____, _____, and _____
PTH, calcitonin, calcitriol
121
_____ stimulates the effects of PTH by further enhancing the calcium release from bones, absorption into the intestines and reabsorption into the kidneys
calcitriol
122
_____ inhibits the movement of calcium out of bone, reduces intestinal absorption and promotes kidney excretion of calcium
calcitonin
123
during the state of _____, more calcium binds with protein, making less available in its ionized, active form
alkalosis
124
during the state of _____, calcium is released from protein, making more of it available in its ionized form
acidosis
125
when albumin levels fall, total plasma calcium _____
declines
126
the state of low levels of calcium is called _____
hypocalcemia
127
the state of high levels of calcium is called _____
hypercalcemia
128
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 _____
hypocalcemia
129
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 _____
hypocalcemia
130
constipation, increased blood pressure, lethargy, muscle weakness, increased thirst, increased urine output, lethargy, AV block, negative Trousseau/Chvostek signs are all symptoms of _____
hypercalcemia
131
people who experience hypoparathyroidism and acute pancreatitis are at risk for _____
hypocalcemia
132
During _____, the amount of ionized calcium may remain normal even though the total calcium level is low
hypoalbuminemia
133
hypocalcemia is often associated with _____
hypomagnesemia
134
_____ and _____ share an inverse relationship
phosphate, calcium
135
the electrolyte imbalances of _____ and _____ can cause hypocalcemia
hypomagnesemia, hyperphosphatemia
136
inadequate _____ _____ can decrease calcium absorption and contribute to hypocalcemia
vitamin D
137
When blood is administered faster than the liver can metabolize the citrate, it can bind with and temporarily remove ionized _____ from circulation.
calcium
138
along with drugs that lower serum magnesium levels, _____ _____, _____, and _____ can increase the risk for hypocalcemia
loop diuretics, anticonvulsants, phosphates
139
involuntary contraction of muscles is called _____
tetany
140
contraction of the facial muscles produced by tapping the facial nerve in front the ear is called _____ _____
Chvostek sign
141
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 _____ _____
Trousseau sign
142
the two most common calcium IV preparations include calcium _____ and ______
chloride, gluconate
143
oral calcium preparations include calcium _____, _____, and _____
carbonate, gluconate, lactate
144
dairy products, canned salmon, broccoli, spinach, and tofu are all foods high in _____
calcium
145
the two most common causes of hypercalcemia are _____ _____ and _____
bone resorption, malignancies
146
excess PTH produced by hyperparathyroidism releases calcium from the bones, causing increased calcium absorption in the _____ and retention of calcium in the _____
intestines, kidneys
147
prolonged _____ and lack of _____ _____ can cause increased resoprtion of bone with calcium release into ECF
immobility, weight bearing
148
excess vitamin D use, milk ingestion and overuse of calcium-containing antacids can all cause increased _____ _____ of calcium
intestinal absorption
149
_____ _____ and drugs such as _____ _____ and _____ can intefere with calcium elimination by kidneys
renal failure, thiazide diuretics, lithium
150
mental status can be altered by high _____ levels
calcium
151
loop diuretics such as _____ promote elimination of excess calcium
furosemide
152
rapid reveresal of hypercalcemia can be accomplished by use of _____ and _____ phosphate
sodium, potassium
153
IV _____ inhibits the bone resorption of calcium
plicamycin
154
____ compete with vitamin D, inhibit GI absorption of calcium, bone resorption, and increase urinary calcium excretion
glucocortisoids
155
_____ _____ restores vascular volume and promotes renal excretion of calcium in hypercalcemic patients
isotonic saline
156
acidic drinks such as _____ and _____ juice reduce the risk of calcium salt build-up into kidney stones
prune, cranberry
157
green vegetables, grains, bananas, citrus fruits, meats, chocolate, and seafood are all food high in ______
magnesium
158
_____ is vital to various enzyme reactions and synthesis of proteins and nucleic acids
magnesium
159
magnesium is essential for _____ _____ and _____ _____
neuromuscular transmission, cardiovascular function
160
the state of having low levels of magnesium is called _____
hypomagnesemia
161
the state of having high levels of magnesium is called _____
hypermagnesemia
162
loss of GI fluids (diarrhea, ileostomy), alcoholism, protein-calorie malnutrition/starvation, kidney disease and diabetic ketoacidosis are risk factors for _____
hypomagnesemia
163
magnesium deficiency is often seen alongside low _____ and _____ levels
potassium, calcium
164
severe hypomagnesium is strongly linked with low serum _____ levels as both are associated with renal and GI losses
calcium
165
similar to hypercalcemia, _____ increases the risk of digoxin toxicity
hypomagnesemia
166
positive Bobinski/Trousseau/Chvostek signs, nystagmus, and hypertension are all signs of _____
hypomagnesemia
167
negative Bobinski/Trousseau/Chvostek, depressed CNS, hypotension, cardiac dysrhythmias/arrest are all signs of _____
hypermagnesemia
168
parenteral _____ _____ can treat hypomagnesemia
magnesium sulfate
169
_____ is often seen in adults with renal failure or general functional decline
hypermagnesemia
170
_____ or _____ _____ can both be used to remove excess magnesium
hemodialysis, peritoneal dialysis
171
the IV _____ _____ can be administered to reverse neuromuscular/cardiac effects of hypermagnesemia
calcium gluconate
172
the primary intracellular anion is _____
phosphate
173
_____ is responsible for ATP production and electrolyte transport, red blood cell function, oxygen tissue delivery, maintaining acid-base balance, and fat/carb/protein metabolism
phosphate
174
an inverse relationship exists between phosphorus and _____
calcium
175
the state of low phosphorus is called _____
hypophosphatemia
176
the state of high phosphorus is called _____
hyperphosphatemia
177
a shift of phosphate into the intracellular space is the most common cause of _____
hypophosphatemia
178
intention tremors, confusion//stupor, joint stiffness, impaired white blood cell function and seizures are all symptoms of _____
hypophosphatemia
179
_____, _____ _____, _____, and _____ _____ can all contribute to hypophosphatemia
alcoholism, respiratory alkalosis, hyperventilation, diabetic ketoacidosis
180
_____ _____ is the primary cause of impaired excretion
renal failure
181
excess _____ _____ increases phosphate absorption and can contribute to hyperphosphatemia
vitamin D
182
disruptions of mechanism that regulate _____ levels can lead to hyperphosphatemia
calcium
183
excess phosphorus will often combine with another electrolyte during hyperphostemia, contributing to the state of _______
hypocalcemia
