Chapter 8 Flashcards
1
Q
hydrostatic pressure
A
due to fluid volume, greater the fluid volume in a compartment the greater the hydrostatic pressure
2
Q
osmotic pressue
A
due to the number of dissolved particles in solution (electrolytes and proteins).
- the greater the number of dissolved particles the greater the osmotic pressure
3
Q
colloid osmotic pressure
A
osmotic pressure due to proteins
4
Q
isotonic solutiom
A
no net movement of water
5
Q
hypotonic solution
A
water moves in the cell - cell swells
6
Q
hypertonic solution
A
water moves out of cell - cell shrinks
7
Q
transudative edema
A
increased hydrostatic pressure/low oncotic pressure; high in fluid, low in protein (heart failure, nephrotic syndrome, cirrhosis)
8
Q
exudative
A
inflammation; high in fluid and protein
9
Q
Causes for transudative edema:
A
- Increased capillary pressure
- Decreased osmotic/oncotic pressure
- Lymphatic obstruction
10
Q
Causes for exudative edema:
A
Increased capillary permeability
11
Q
hormones that regulate water balance
A
- ADH
- Aldosterone
- ANP
- Renin Angiotensin system
12
Q
ADH (antidiuretic)
A
increases water reabsorption by kidney (against urination)
13
Q
aldosterone
A
tells the kidney to hold on to sodium and excrete potassium
14
Q
ANP (atrial naturetic peptide)
A
increases the amount of sodium and water the kidney excretes, natriuresis and diuresis
15
Q
Neurogenic diabetes insipidus
A
No ADH
16
Q
Nephrogenc diabetes insipidus
A
No receptors for ADH
17
Q
syndrome of inappropriate ADH (SIADH)
A
too much ADH - holding on to too much fluid - high blood volume
18
Q
causes of hypovalemia
A
- Diarrhea
- Vomiting
- Excessive sweating
- Excessive urine loss
- GI suction
19
Q
s/s of hypovolemia
A
- Increased thirst
- Weak pulse
- Increased heart rate
- Decreased blood pressure
- Decreased urine output
- Decreased skin turgor
- Increased hematocrit
- Dry mucous membranes
- Sunken eyes
20
Q
treatment of hypovolemia
A
Fluid replacement
21
Q
what causes hypervolemia
A
- Increased sodium followed by increased water
- Renal failure
- Heart failure
- Liver failure
22
Q
S/S of hypervolemia
A
- Weight gain
- Edema
- Distended neck veins
- Bound pulse, increased BP
- Decreased hematocrit
23
Q
treatment of hypervolemia
A
- sodium restriction
- diuretics
24
Q
potassium wasting diuretics
A
- lasix
- hydrochlorothiazide
25
what electrolyte imbalance do potassium wasting diuretics cause
- low potassium
26
potassium sparing diuretics
- aldactone
- spironolactone
27
what electrolyte imbalance does potassium sparing diuretics cause
- high potassium
28
normal level of sodium
135 - 145 mEq/L
29
hyponaturemia level
<135 mEq/L
- fluid shift from ICF -- ECF
- hypotonic
30
hypernatremia level
>145 mEq/L
- water deficit
- Na+ administration
31
causes of Hyponatremia
- Excessive sweating
- Diarrhea
- Certain diuretics
- Insufficient aldosterone
- Decreased renal function/failure
- Excessive ADH secretion – - SIADH
- Excessive water intake
- Diluting baby formula
32
S/S of hyponatremia
- Muscle cramps
- fatigue/weakness
- Nausea/vomiting
- Decreased osmotic pressure – cell shift – cell swelling
- Confusion
- Seizures
- headache/lethargy
33
treatment of hyponatremia
- Limiting water intake
- Discontinuing medication
- Adminstration of IV saline
- Hypertonic saline with a diuretic
34
Hypernatremia causes
- Insufficient ADH
- lost of thirst mechanism/inability to communicate (dehydration)
- watery diarrhea
- excessive aldosterone
- impaired ability of kidney to conserve water
- high osmotic tube feeding w/o sufficient water
35
S/S Hypernatremia
- Increased thirst increased
- ADH secretion (expect if caused by lack of ADH
- Dry skin and mucous membranes
- Decreased skin turgor
- Decreased salivation
- Difficulty swallowing
- Confusion
36
treatment of hypernatremia
- Treat underlying cause
- If the underlying cause is diuretics: stop.
- If it is that their body are not responding to ADH: stop giving ADH
- Fluid replacement: if due to fluid loss
37
Potassium normal levels
3.5 to 5.0 mEq/L
38
hypokalemia causes
- Inadequate intake
- Diuresis associated with certain diuretics (lasix and hydrochlorothiazide)
- Excessive aldosterone
- Treatment of diabetic ketoacidosis with insulin (increase intracellular shift)
- Beta2 adrenergic agonists (intracellular shift)
- Metabolic alkalosis (excessive loss)
39
S/S hypokalemia
- Muscle weakness
- Fatigue/weakness
- Paresthesia (tingling of fingers)
- Cardiac arrhythmias
- Decrease ability of excitable cells to develop an AP (action potential)
40
causes hyperkalemia
- Renal failure (Kidneys job to get rid of excessive potassium)
- Decreased aldosterone
- Potassium sparing diuretics
- Prolonged acidosis (Potassium shifts out of the cells)
- Tissue injury (More potassium inside the cell then out)
- Rapid rate of administration of K+ (If you administer potassium too
41
S/S hyperkalemia
- Impaired neuromuscular function:
- Excitable cells do not repolarize
- Cardiac arrhythmias
- Muscle weakness
- Paresthesia
- Increase the ability to excitable cells (hyperreflexia) to develop an AP (action potential)
42
normal calcium levels
8.5 to 10.5 mg/dL
43
Hypocalcemia causes
- Hypoparathyroidism (PTH = Increases the parathyroid hormone, meaning you are not absorbing it)
- Malabsorption
- Vitamin D deficiency/resistance
- Elevated serum phosphate
- Increased serum pH (alkalosis): increased binding of calcium to protein
- Renal failure
- Increased urinary loss
44
S/S hypocalcemia
- Increased excitability of nerve
- Hyperactive reflexes
- Weak heart rate contractions
- Cardiac arrhythmias
- Blood pressure drops
45
causes of hypercalcemia
- Hyperparathyroidism
- Increased intake of vitamin D or excess dietary calcium
- Malignant bone tumors
- Bronchogenic tumors = secrete PTH
- Demineralization of bone due to immobility or bone tumors
- Acidosis
46
S/S hypercalcemia
- Hyporeflexia: depressed neuromuscular activity
- Loss of muscle tone
- Polyuria due to decreased function of ADH in kidneys
- Cardiac contraction increases in strength
- Bone pain
- Renal stones
47
normal phosphorus levels
2.5 - 4.5 mg/dL
48
causes of hypophosphatemia
- Malabsorption
- Excessive use of antacids
- Hyperparathyroidism
- Prolonged hyperventilation
- Refeeding syndrome
49
S/S hypophosphatemia
- Blood cells function less effectively
- Increased bleeding
- Impaired neurological function
- Tremors
- Confusion
- Paresthesias
- Dysphagia
- Anorexia
- Hyporeflexia
50
causes of hyperphosphatemia
renal failure
51
S/S
- Blood cells function less effectively
- Increased bleeding
- Impaired neurological function
- Tremors
- Confusion
- Paresthesias
- Dysphagia
- Anorexia
- Hyporeflexia
52
Normal level of magnesium
1.3 - 2.1 mEq/L
53
causes of hypomagnesemia
- Limited intake and excessive loss (intestinal or renal), shifting between compartments
- Malnutrition
- Starvation
- Prolonged nasogastric suctioning
- Decreased absorption
- Diarrhea
- Diabetes ketoacidosis = increased renal loss
- Hyperparathyroidism = increased renal loss
- Loop diuretics = increased renal loss
- Insulin = Shifts Mg into cells
54
causes of hypermagnesemia
- Renal insufficiency
- Magnesium containing medications including laxatives, antacids
55
S/S hypomagnesemia
- Hyperreflexia = increases activity of neuromuscular junction = hyperactive deep tendon reflexes
- Paresthesia
- Positive Chvostek or Trousseau signs
- Muscle twitching
- ECG changes
56
S/S of hypermagnesemia
- Decrease PTH secretion
- Decrease neuromuscular junction activity = muscle weakness = hyporeflexia
- Blocks calcium channel = effect on heart
- Decreased BP
57
what are electrolyte imbalances from hyperaldosteronism
- hypokalemia
- hypernatremia
58
S/S hyperaldosteronism
- Muscle weakness
- Cramps
- Paresthesia
- Hypertension
- Cardiac arrhythmias
- Palpitations
- Polyuria
- Polydipsia
- Nocturia
- Fatigue
- Headache
59
what are electrolyte imbalances of hypoaldosteronism
- hyperkalemia
- hyponatremia
60
S/S of hypoaldosteronism
- Muscle weakness
- Fatigue
- Hypotension
- Dizziness
- Cardiac arrhythmias
- Dehydration
- Nausea
- Confusion
61
Why do cancer patients treated with chemotherapy develop leukopenia
chemotherapy targets rapidly dividing cells, including both cancerous and healthy cells. Since bone marrow stem cells, which produce white blood cells (WBCs), are among the fastest-dividing cells in the body, they are highly susceptible to chemotherapy's effects. As a result, WBC production decreases, leading to leukopenia.
62
Consequences of Leukopenia:
- increased infection risk
- delayed heaing
- fever and sepsis
- treatment interruptions
63
What is the physiological active form of calcium
ionized calcium
64
What happened to the physiological active form of calcium during acidosis and
Why?
Acidosis (Low pH, High H⁺) → More Ionized Calcium (↑ Ca²⁺)
Why?
Extra H⁺ binds to albumin, kicking calcium off, so more free Ca²⁺ is available.
65
What happened to the physiological active form of calcium during alkalosis and
Why?
Alkalosis (High pH, Low H⁺) → Less Ionized Calcium (↓ Ca²⁺)
Why?
Less H⁺ means more calcium binds to albumin, so less free Ca²⁺ is available.
66
Name all the electrolyte imbalances you would expect to see in a patient suffering from
kidney failure.
- low Na
- high K
- low Ca
- high PO4
- high Mg
- high H
67
What happens to potassium in acidosis
Acidosis (Low pH, More H⁺) → High K⁺ in Blood (Hyperkalemia)
H⁺ moves into cells, pushing K⁺ out into the blood.
68
