fluid and electrolyte basics

Question 1

hypertonic

Answer 1

higher particles outside cells

water leaves cell and the cell shrinks

Question 2

hypotonic

Answer 2

higher particles inside cell

water moves in and cells expand

Question 3

water regulation

Answer 3

distal convoluted tubule

Question 4

particle regulation

Answer 4

proximal convoluted tubule

Question 5

aldosterone

Answer 5

regulates na up take

every sodium reabsorbed, one k is released

Question 6

atrial natriuetic factor

Answer 6

released by heart when the atria expand

blocks na reabsorption and promotes loss of water

Question 7

antidiuretic hormone

Answer 7

draws water back in

Question 8

increased water

Answer 8

increased osmolarity

Question 9

where is ADH released from

Answer 9

posterior pituitary

Question 10

dehydration

Answer 10

decrease water intake

excessive losses

Question 11

Diabetes inspidus

Answer 11

no bg in urine it is adh

Question 12

diabetes mellitus

Answer 12

body attempting to excrete the sugar

Question 13

dehydratoin

Answer 13

decrease in total body water but na is at a normal level
water is pulled from cells and thirst drive is activated
can cause relative hypernatremia

Question 14

water intoxication

Answer 14

dilutes ECF

Rarely develops becauae of efficiecy of the kidney

Question 15

Water intoxication can be caused by

Answer 15

SIADH when hypothalamus is affected

Question 16

water intoxication can cause what?

Answer 16

relative hyponatremia

Question 17

is na loss> water loss

Answer 17

hypotonic

Question 18

if water loss< na loss

Answer 18

hypertonic

Question 19

diarrhea

Answer 19

isotonic depletioon

Question 20

intense perspiration

Answer 20

hypertonic depletion relative increase in na

Question 21

renal na loss

Answer 21

hypotonic depletion
decreased ecf
increased icf volume
decrease na (decreased na so the water in increased)

Question 22

normal saline solution

Answer 22

isotonic expansion

increase ecf no affect on sodium or icf

Question 23

hypertonic infusion

Answer 23

hypertonic expansion
increased icf
decreased ecf
increased icf

Question 24

water intoxication

Answer 24

hypotonic expansion
increase icf volume
increase icf volume
relative decrease in Na

Question 25

sequestrian states

Answer 25

rapid blood loss or burn and inflammatory exudate

Question 26

volume excess

Answer 26

renal water and na retention as well as na retention renal failure, chf, and nephrotic syndrome hypersecretion of aldosterone (tumor)

Question 27

decrease plasma volume = _____ hematocrit

Answer 27

increased

Question 28

hypertonic plasma on brain

Answer 28

cns cells shrink- weakness, irrability, seizures, occurs rapidly then there can be cerebral hemorrhage

Question 29

hypotonic plasma on brain

Answer 29

cns cells swell- cerebral edema, ha/maliase/vomiting seizures and coma if it progresses

Question 30

causes of hyponatremia

Answer 30

``` result of fluid loss not enough intake usually relative can be due to renal deficits decreased aldosterone matched by water loss to produce isotonic ECF ```

Question 31

hypernatremia

Answer 31

excess na arises when water loss> na loss condition is relative true condition is rare and can result from NaCl excess administration

Question 32

potassium and sodium

Answer 32

potassium is really high in cells and low in the blood | sodium is really high in the blood and low in the cell

Question 33

potassium affects

Answer 33

neuromuscular activity

Question 34

loss of potassium and aldosterone

Answer 34

keeps an na so it has to excrete a potassium

Question 35

hypokalemia

Answer 35

result of total body deficit shift of k from ECF to ICF (d/t insulin, glucose, and many drugs, alkalosis (shifts k into cells)) inadequate dietary intake- elderly, gi disturbances, nausea

Question 36

hypokalemia

Answer 36

``` result of vomiting heavy perspiration chronic diarrhea gi fistula/restriction kidney tubular defect hypersecretion of aldosterone diuretics improper administration of iv fluids ```

Question 37

signs and symptoms of hypokalemia

Answer 37

weakness, muscle twitches, depresses reflexes loss of neuromuscular tone vomiting

Question 38

ekg changes with hypokalemia

Answer 38

twave- hearts attempt to compensate d/t decreased action potentail

Question 39

hyperkalemia

Answer 39

excess k can be life threatening due to: aldosterone deficiency K retention renal failure excessive IV fluids excessive trauma crushing injuries (cells break down and release k)

Question 40

blood transfusions and hyperkalemia

Answer 40

hemolytic event can release stored k in the rbcs

Question 41

ekg changes with hyperkalemia

Answer 41

st segment depressed t wave increases p wave lost

Question 42

calcium concentration

Answer 42

more common in ECF rather than ICF

Question 43

PTH

Answer 43

increase GI absorption and renal retention of Ca PTH mobilizes ca from bone calcitonin, promotes Ca excretion to prevent excess

Question 44

hypercalcemia

Answer 44

``` result of hyper parathyroidis or hypothyroid ca retention renal disease excessive vit d intake tumors that secrete pth hypophospatemia Ca retention liked to PO excretion ```

Question 45

s/s of hypercalcemia

Answer 45

nausea/cramping/diarrhea (increased GI motility), nephrolithiasis

Question 46

causes of hypocalcemia

Answer 46

reduced PTH peritoneal inflammation excessive calcitonin inadequate calcium absorption