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Adult health 2 > Exam 1: Fluid and Electrolytes imbalance > Flashcards

Exam 1: Fluid and Electrolytes imbalance Flashcards

(64 cards)

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1
Q

Total body fluid depends on what 4 things

A

muscle mass
electrolytes
body fat
age

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2
Q

In the newborn infant more than half of total body fluid is ________

A

extracellular

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3
Q

For adults what is the % of TBW for each:

Intracellular
Extracellular
Interstitial
Intravascular
Transcellular

A

66%
34%: extracellular
– 75%
–25%
–1%

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4
Q

Serum levels indicate _______ concentration

A

extracellular

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5
Q

Osmolality/osmolarity

A

measurement of number of particles in a solution or the concentration of the solution

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6
Q

Normal osmolarity

A

275-290 mOsm/kg

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7
Q

Osmolality and osmolarity are regulated by

A

ADH release

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8
Q

Osmolality (concentration of solutes in water) exert osmotic pressure causing…

A

osmosis

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9
Q

_____: measurement of osmotic pressure of a solution–osmalality

A

tonicity

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10
Q

Isotonic

A

same osmolality of serum blood

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11
Q

hypertonic

A

osmolality higher than that of serum, causing ICF to shrink

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12
Q

hypotonic

A

osmolality lower than that of serum, causing ICF to swell

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13
Q

__________ pressure: pulling pressure exerted by proteins colloids in the blood

A

colloid oncotic pressure

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14
Q

Colloid oncotic pressure ____ or ____ fluid from the interstitial

A

pulls/absorbs

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15
Q

_________ pressure: created by the weight of fluid pressing against the wall of blood vessels

A

hydrostatic

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16
Q

hydrostatic pressure forces molecules through a

A

capillary membrane

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17
Q

_________ movement of water and solutes from highly hydrostatic pressure to low hydrostatic pressure

A

filtration

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18
Q

What factors regulate water in the body

A

ADH and thirst

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19
Q

ADH is stimulated by ____________ or ________ and cause increased water resorption in the kidney tubules

A

decreased blood volume or increased serum osmolality

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20
Q

What is ANP

A

amino acid peptide synthesized, stored, and released by atria cells

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21
Q

What does ANP do to blood pressure

A

decreases blood pressure and volume

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22
Q

T/F isotonic fluid deficit (hypovolemia) has a proportional loss of both sodium and water from ICF?

A

yes but there will be no change in osmolality –> no fluid shift

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23
Q

isotonic fluid excess can cause ECF to become

A

hypotonic

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24
Q

What is the most predominant electrolyte in the ECF??

A

sodium

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25
What is sodiums normal level
135 to 145
26
sodium imbalance is usually associated with parallel changes in water ____ or _____
loss or gain
27
Sodium is important for what
transmission of nerve impulses and muscle contraction
28
Hypernatremia etiology
water loss is greater than sodium loss
29
Hypernatremia clinical presentation
dehydration, thirst, dry mucous membranes, decrease LOC, seizures
30
Hypernatremia treatment
free water boluses hypotonic fluid replacement treat cause if due to excessive Na, diuretics
31
Hyponatremia etiology
excessvie water intake (SIADH
32
hyponatremia clinical presentation
s/s fluid overload, neuro impairment, changes in LOC, muscle weakness, seizures
33
Sodium loss can be caused by
GI loss, diuretics, diaphoresis
34
Treatment for hyponatremia
excessive water: fluid restrict, diuretics sodium deficits: replace sodium
35
What is the main cation in ICF
potassium
36
What is potassium responsible for
transmission of nerve fibers Contraction of skeletal, smooth, and cardiac muscles
37
Hyperkalemia treatment
glucose and insulin sodium bicarb calcium chloride kayexalate (not fast) sorbitol treat cause (e.g. dialysis)
38
S/S of hyperkalemia GI CNS Muscles Cardiac Urine
GI: N/V/diarrhea CNS: numbness, paresthesias Muscles: irritability (early) and weakness (late) --> flaccid paralysis Cardiac: ventricular fibrillation and cardiac arrest Urine: oliguria --> anuria
39
S/S of hypokalemia GI CNS Muscles Cardiac Kidneys
GI: anorexia, N/V, abdominal distention --> paralytic ileus CNS: lethargy, diminished deep tendon reflex, confusion, mental depression Muscles: weakness --> flaccid paralysis, weakened respiratory muscles --> respiratory arrest Cardiovascular system: decrease in standing BP, ECG changes, Cardiac arrest, Myocardial damage Kidney's: decreased capacity to concentrate waste --> water loss --> thirst --> kidney damage
40
Treatment of hypokalemia
Potassium replacement and treat the cause
41
Normal calcium levels
9.0-10.2 mg/dL
42
What 3 things regulate Ca
PTH Vitamin D Calcitonin
43
What is calcium responsible for doing
transmission of nerve impulses contraction of cardiac muscles formation of bones and teeth coagulation process
44
Calcium is bound to _____ so if that is low, calcium is generally low as well
albumin
45
S/S of hypocalcemia GI CNS Muscles Cardiac Bones
GI increased peristalsis --> N/V/D CNS: tingling --> convulsions Muscles: spasms --> tetany Cardiac: dysrhythmias --> cardiac arrest Bones: osteoporosis
46
What can cause hypocalcemia
decreased ionized calcium: large tranfussion with citrated blood excess loss: kidney disease, draining fistulas inadequate intake decreased GI and bone absorption: decreased vit d, PTH; increased mg, calcitonin
47
What are the treatments for hypocalcemia
calcium replacement: IV 10% calcium gluconate or cholride slowly Vitamin D replacement oral calcium for chronic treat cause
48
What are 2 signs of low calcium
trousseau sign chvostek sign
49
Trousseau sign: how can you check for it what is a positive signs of it
you can check while monitoring vital signs --> triggered by placing a BP cuff on an arm and inflating it to a pressure greater than systolic BP for 2 to 3 minutes If you have it, your arm muscles will activate involuntarily and have flexion of the wrist, thumb, and joints with extension of the fingers
50
Chvostek signs
abnormal twitching of muscles that are activated by the facial nerve --> when it is tapped in front of the ear, the muscles on the same side will contract
51
What are causes of hypercalemia
loss from bones: metastases, multiple myeloma, immobilization excess intake increase in factors causing mobilization from bone: increased PTH, Vit D
52
S/S of hypercalcemia Kidneys CNS Muscles Cardiac Bones
Kidneys: stones --> damage CNS: decreased reflex --> lethargy --> coma Bones: pain --> osteoporosis --> fractures muscles: fatigue --> decreased GI motility Cardiac: depressed activity --> dysrhythmias --> cardiac arrest
53
What is the treatment for hypercalcemia
Normal saline infusions corticosteroids to decrease GI absorption mithramycin phosphate administration treat cause
54
What does your body look like with hypercalcemia?
slow movements
55
What is a normal magnesium level
1.3-2.2
56
What does magnesium do
contract myocardium and influence transportation of Na/K across cells
57
S/S hypomagnesemia mental changes CNS Muscles Cardiac
mental: agitation, depression, confusion CNS: convulsions, paresthesias, tremor, ataxia Muscles: cramps, spasticity, tetany Cardiac: tachy, hypotension, dysrhytmias
58
Causes of hypomagnesemia
decreased in impaired absorption: alcohol withdrawal, hypercalcemia, diarrhea Excessive excretion: increased aldosterone, conditions with large losses of urine
59
Treatment of hypomagnesemia
magnesium replacement treat the cause (hypomagnesemia caused dig toxicity)
60
What is a rule of thumb when replacing K and Mg
don't replace potassium until you replace magnesium first
61
What are causes of hypermagnesemia
increased in decreased out: renal failure, adrenocortical insufficiency
62
S/S hypermagnesemia Muscle CNS Cardaic
Muscle: weakness, paralysis, hyporeflexia, resp paralysis CNS: drowsiness, confusion, coma Cardaic: hypotension, flushing, T-wave changes, brady
63
Treatment of hypermagnesemia
fluids dialysis calcium gluconate treat underlying cause
64

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