Exam #4 Flashcards by JANETH Martinez

What 2 hormones and glands regulate calcium
What is needed for Ca+ absorption
How does it work

Thyroid secretes calcitonin when Ca+ is too high to increase resorption in bones and decrease absorption in kidneys and intestines
Parathyroid hormone: stimulates the renal conversion of vitamin D into calcitriol which increases calcium and phosphorus release from the bones and increases reabsorption from intestine and kidneys (excretes phosphorus in the process)
Vitamin D is needed for calcium absorption and Mg+ (for PT to secrete PTH)

How well did you know this?

Not at all

Perfectly

How is calcium in the body
What does calcium do for the body (3)

99% of calcium is found in the bones (1% in plasma and body cells)

Serum calcium= free ionized + albumin bound (bound to albumin and phosphorus)
Free ionized calcium is biologically active and is used for
Nerve impulse transmission, muscle and myocardial contractions, cross linking of fibrin threads (clot formation)

How well did you know this?

Not at all

Perfectly

Hypocalcemia causes (8)

Vitamin D deficiency/ impaired absorption (need calcitriol to absorb Ca+)
Kidney disease (need kidneys to convert Vit D to calcitriol)
Hypoparathyroidism (d/t cancer/ neck surgery)
Hypoalbuminemia (Ca+ is bound to albumin in bone)
Hyperphosphatemia (calcium is excreted d/t increase relationship
Hypomagnesmia (my is needed for PT gland to release PTH)
Diuretics (excrete electrolytes)
Chronic alcohol use (malnutrition)

How well did you know this?

Not at all

Perfectly

Hypocalcemia symptoms (4) and nursing implications (5)

SYMPTOMS: Hyperreflexia
Tetany (Chvostek/ trousseau)
Numbness and tingling extremities and around the mouth
Cardiac dysrhythmias

Nursing implications
Increase vitamin D and Ca+ intake
Monitor post op thyroid/ neck surgery
Hold diuretics
Assess sensation, reflexes, cardiac rhythm
Monitor vitamin D, calcium, Phosphorus, mg+ and albumin (possibly PTH)

How well did you know this?

Not at all

Perfectly

Hypercalcemia
Causes 3
Symptoms 4
NI 6

Hyperparathyroidism
Cancer with bone metastasis and other cancers
Excess Ca+ intake and antacids (made of Ca+)

Symptoms:
Hypoflexia
Muscle weakness
Lethargy, confusion, cardiac dysrhythmias
Kidney stones

NI:
maintain adequate hydration
Low Ca+ diet
Increase weigh bearing exercises
Assess mentation, reflexes and cardiac rhythm
Filter urine if needed
Monitor Ca+

How well did you know this?

Not at all

Perfectly

Phosphate
What kind of electrolyte is it
What hormone/ gland regulates it?
What is required for balance of this electrolyte
Source

Primary anion found in the ICF
PTH maintains serum phosphate levels and balance
If PTH is low, phosphate excretion is low
Balance requires adequate renal function
Attained from intake of food

How well did you know this?

Not at all

Perfectly

Phosphate functions 4

85% bound with calcium in teeth and bones
Helps convert carbs, proteins and fat into energy
Essential for muscle function RBCs and nervous system
Acid bas buffering system

How well did you know this?

Not at all

Perfectly

Hypophosphatemia causes 5

Inadequate intake/ malabsorption issues
Chronic diarrhea
Vitamin D deficiency
Increased use of phosphate binding anti acids (mg, albumin and calcium)
Hyperparathyroidism

How well did you know this?

Not at all

Perfectly

Hypophosphatemia symptoms

Similar to hypercalcemia
Confusion
Muscle weakness
Respiratory muscle weakness
Cardiac dysrhythmias

How well did you know this?

Not at all

Perfectly

Hyperphosphatemia causes 3

Renal failure
Hypoparathyroidism
Chronic use of phosphate enemas

How well did you know this?

Not at all

Perfectly

Symptoms of Hyperphosphatemia 4

Hyperreflexia
Tetany (Chvostek/ trousseau)
Numbness and tingling to extremities and around the mouth
Cardiac dysrhythmias
(Similar to Hypocalcemia)

How well did you know this?

Not at all

Perfectly

BUN
What function does it indicate
What causes elevated levels and decreased levels 3 each

Measures the amount of urea nitrogen in the blood
Indication of kidney and liver function

Elevated: d/t increase protein intake, kidneys disease, dehydration

Decreased levels: liver disease, low protein diet, fluid volume excess

How well did you know this?

Not at all

Perfectly

Creatinine
What does it measure/ indicate
Elevated levels d/t 4, low levels d/t 1

Waste product from protein digestion and normal muscle breakdown
Sensitive indicator of kidney function (excreted only by kidneys)

Elevated d/t: kidney damage, MI, high protein intake dehydration
Decreased d/t: low protein intake

How well did you know this?

Not at all

Perfectly

Magnesium functions: 6

Transmission of nerve impulses
Needed for PTH secretion
Needed to maintain K+ levels via renal channels (membrane potential)
Regulation of insulin secretion by pancreatic cells
Stimulate glucose uptake from skeletal muscle
Muscle contraction and relaxation

How well did you know this?

Not at all

Perfectly

3 causes of Hypomagnesmia

Chronic alcoholism
Inadequate intake/ diarrhea
Diuretics

How well did you know this?

Not at all

Perfectly

Symptoms of Hypomagnesmia 4+

Resemble Hypocalcemia
Urinary excretion of K+
Decreased insulin sensitivity and secretion
Increased BP, HR and dysrhythmias

How well did you know this?

Not at all

Perfectly

Causes of hypermagnesemia 2

Renal failure
IV/PO and Mg containing meds

How well did you know this?

Not at all

Perfectly

Hypermagnesmia symptoms 4

Resembles hypercalcemia
Lethargy
Muscle weakness
Dininished deep tendon reflexes
Decrease BP and HR
Decreases heart condition

How well did you know this?

Not at all

Perfectly

Causes of hypoglycemia (3)

Insufficient food intake
Excessive physical exertion
Hypoglycemic agents

How well did you know this?

Not at all

Perfectly

Hyperglycemia causes 5

Study These Flashcards

Excessive glucose intake
Insulin deficiency
Emotional. Physical stressors
Corticosteroid use
Parenteral therapy

Hypoglycemia signs and symptoms 8

Study These Flashcards

Shakey
Sweaty
Dizzy
Confused and difficulty speaking
Hungry
Weak or tired
Headache
Nervous or upset

Symptoms of high blood sugar 6

Study These Flashcards

Very thirst
Need to pee often
Very hungry
Sleepy
Blurry vision
Infections or injuries heal more slowly

Symptoms of anemia (low hemoglobin and hematocrit)9

Study These Flashcards

Fatigue
Weakness,
Pale skin
SOB
Dizziness
Lightheadedness
Irregular HR
Chest pains
Headache

Purposes for parenteral therapy 3

Study These Flashcards

resuscitation
Replacement
Maintenance

Hypertonic, isotonic and hypotonic solutions number of average osmolality

375, 290, 250

Do isotonic fluids affect blood pressure?

Yes, they will have a higher blood pressure d/t increased intravascular volume

When could isotonic solutions be used 6

Resuscitation (NS), replacement, increased volume, maintenance Mild hyponatremia, hypercalcemia (NOT LR b/c it has calcium)

When to use LR 2 Where is lactate metabolized When is it contraindicated

Replacement and maintenance (SURGERY) In the liver into HCO3 No not use if pt has liver disease or alkalosis

Precautions for Hypervolemia cause by isotonic fluids 3

Pulmonary edema Hemodilution Peripheral edema

When to use hypotonic fluids 2

Hypernetremia Hyperosmolar hyperglycemia (to dilute solute concentration in the blood

Which solution starts as isotonic and becomes hypotonic When to use it

5% dextrose Becomes isotonic when metabolized (water shifts from ECF to ICF Hypernatremia

What should use assess for/ be aware of when administering hypotonic solutions 3

Increased cerebral swelling (cerebral edema) May worsen hypovolemia/ hypotension Assess urine output

When to use hypertonic fluids 4

Severe hyponatremia, expand intravascular volume, cerebral edema, maintain/ replace electrolytes

What to be cautious of with hypertonic solutions 3

Risk for foluid voluem overload Caution in cardiac or renal patients Administer short term (Pulmonary edema)

What does albumin do ( it is a colloid)

Increase colloidal oncotic pressure (pulling force) draws fluid from the interstitial to intravascular space Used mostly in the ICU as a plasma volume expander

When is albumin used 3

Fluid volume deficit ( to increase BP) Low albumin levels (low albumin levels leads to decrease oncotic pressure and can lead to fluid leaking out of the blood vessel and causing edema) For patients who cannot tolerate large infusion

What to be careful with for albumin 2

Assess for pulmonary edema and do not use if pt has HF (Fluid volume overload)

What pressure cause edema 3

increase venous hydrostatic pressure (hf, iv fluids) Decreased plasma oncotic pressure (low plasma protein) Increased interstitial oncotic pressure (accumulation of protein in the interstitial space)

What symptoms would be present with edema 6

Peripheral edema Increased BP Polyuria Weight gain Crackles is lungs and Dyspnea (SOB)

What to assess with edema 6

Extremities Lungs and heart sounds Blood pressure I&O Urine color quantity and concentration Labs

What is third spacing

Fluid accumulation in non- functional areas between cells

What are the causes of third spacing 4

Liver disease Burns, trauma and sepsis

Signs and symptoms of third spacing 3

Hypotension Edema Low urine output

What is the body’s reaction to dehydration (Receptors and hormones secreted)

Osmoreceptors arestimulates by increased osmolality Osmoreceptors should signal thirst to hypothalamus Osmoreceptors signal posterior pituitary to secrete antidieutic hormone (vasopressin) ADH increases H20 reabsorption in the DCT and CD

Causes of dehydration 3

Increased plasma osmolality Excessive fluid loss Lack of ADP production

Signs and symptoms of dehydration 7

Tachycardia, Orthostatic hypotension Thirst Dry mucous membranes Poor skin turgor Oliguria Weight loss

What to assess for dehydration 5

Skin turgor and mucous membranes Intake and output Urine quantity and color Specific gravity Labs

How often should you assess urine output

6-8 hours

Exam #4 Flashcards

(48 cards)