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Adult Health Exam 1 > Fluid And Electrolytes > Flashcards

Fluid And Electrolytes Flashcards

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1
Q

What are the primary ECF ions?

There are two

A

Sodium and Chloride

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2
Q

What are the primary ICF ions?

There are two. P&P

A

Potassium and Phosphate?

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3
Q

What are the ways of movement for facilitation?

There are four; eight advanced

A

Diffusion (Passive and Facilitated), Active Transport, Osmotic, Pressure (Hydrostatic and Oncotic)

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4
Q

(T/F) The cell swells during hypotonic ECF

A

True

Think opposite; hypotonic causes swelling, hyper causes shrinking

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5
Q

(T/F) The cell swells for hypertonic ECF?

A

False, the cell shrinks

Think opposite, hypertonic causes shrinking and hypo causes swelling

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6
Q

What is Hydrostatic Pressure? What is an example

A

PUSHES force of fluid against cell wall. Ex: Blood pressure

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7
Q

What is oncotic pressure?

A

PULL force of proteins, attracting water from one space to another

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8
Q

(T/F) The first spacing is normal ICF and ECF

A

True

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9
Q

What and where is second spacing? Give an example of what second spacing would look like.

A

Abnormal increase located in INTERSTITIAL FLUID. Example: edema

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10
Q

What and where is third spacing? Give an example.

A

Excess fluid in NON-FUNCTION spaces around CELLS. Example is ascites and edema from burns.

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11
Q

(T/F) It is easy to move third spacing fluid back to ICF or plasma

A

False, fluid is trapped and difficult to move back to ICF or plasma.

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12
Q

What are the three processes that help keep water and electrolyte balance?

There are four

A

Intake and Absorption
Distribution
Output

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13
Q

(T/F) The antidiuretic hormone (ADH) regulates water excretion only

A

True, the ADH encourages kidneys to hold onto water

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14
Q

(T/F) The RAAS system (Renin-Angiotensin-ALDOSTERONE-System) regulates water and sodium.

A

True, Aldosterone encourages kidneys to hold onto water and sodium

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15
Q

What is the difference between dehydration and hypovolemia?

Hint: What cation moves with water?

A

Dehydration is loss of water alone while hypovolemia is loss of water and sodium

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16
Q

What causes hypovolemia?

There are four causes

A

Abnormal loss, Inadequate intake, Shift from plasma to interstitial fluid, Third Spacing

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17
Q

What are interventions for hypovolemia?

There are two

A

Replace water and electrolytes with options like isotonic fluids and blood transfusions.

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18
Q

(T/F) 1kg of weight equals 1 liter of fluid retention

A

True, this is why it’s important to do daily weights for patients with fluid imbalances.

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19
Q

What is the lab value for Hct?

Equals ten by adding and then multiplying

A

37-52%

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20
Q

What is the lab value for BUN?

This is not Urine Specific Gravity; it is a whole number

A

10-20mg/dL

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21
Q

What is the lab value for Urine Specific Gravity:

A

1.010-1.025

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22
Q

What is the normal range for sodium?

A

136-145 mEq/L

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23
Q

(T/F) Water follows sodium

A

True, this is why sodium imbalances are closely related to water imbalances

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24
Q

What are the causes for hypernatremia?

There are two

A

Low water intake, excess water loss

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25
What are some symptoms associated with hypernatremia? | FRIED and SALTED acronyms
Fever (low grade) Restlessness and agitation Increased fluid retention Edema (peripheral and pitting) Dry mouth Skin flushed Altered LOC and confusion Low urinary output Thirst Elevated Blood pressure Decreased energy
26
What is the management for hypernatremia? | There are five things to manage it ## Footnote Think what you want to do to manage excess sodium
Water deficit (replace isotonic fluids) Sodium excess: replace with sodium free fluids Sodium restrictions Monitor lab levels **Safety (seizure precautions)**
27
What causes hyponatremia? | There are two causes
Loss of sodium-rich fluids (ex: wounds, diarrhea, vomiting), and water excess
28
What are symptoms of hypocalcemia? | Acronyms: SALT LOSS
Stupor/coma Anorexia Lethargy Tendon reflexes go down Limp muscles Orthostatic Hypotension Seizures Stomach Cramping
29
What is management for hyponatremia? | There are five
Isotonic or sodium containing fluids PO intake Water excess: restrict fluids Monitor labs Monitor I&Os
30
What is the range for hyponatremia?
Less than (<) 136
31
What is the range for hypernatremia?
More than (>) 145
32
What is the normal range for potassium?
3.5-5.0 mEq/L
33
What is the function for potassium? | There are two
Neuromusclar and **cardiac**
34
(T/F) Potassium is inversely related to sodium regulation
True; When sodium goes up, potassium goes down and vice-versa.
35
What is the range for hyperkalemia?
More than (>) 5.0 | If the range is 3.5-5.0, then anything above it is hyper.
36
What are the causes for hyperkalemia? | There are four
Impaired ouput (ex: **kidney failure**) Increased intake Shift from ICF to ECF Certain medications (ex: Digoxin, Propranolol, Hydrocholride)
37
What are the clinical manifestations for hyperkalemia? | There are eight
Cell excitability Electrocardiac changes Dysrhythmia Muscle cramps; tetany numbness/tingling Diarrhea, cramping, vomiting
38
What are managements for hyperkalemia? | There are five
Stop potassium intake Increase potassium excretion (ex: **diuretics**) Calcium gluconate--reverses effects on cardiac **Cardiac monitoring** Labs: CMP ## Footnote Bold is what might be on a case-study like question (my suspcions alone)
39
What is the range for hypokalemia?
Less than(<) 3.6 | Range for potassium is 3.6-5.0
40
What are causes for hypokalemia? | There are three
Potassium loss (GI, Renal, low Magnesium) Decreased intake Shift from ECF to ICF
41
What are clinical manifestations for hypokalemia? | There are five
Impaired muscle contractions Electrocardiac changes Dysrhythmias Weakness Parethesias (numbness/tingling)
42
What are managements for hypokalemia? | There are four
PO/IV potassium chloride (KC1) Potassium rich foods **Cardiac monitoring** Monitor labs (CMP) ## Footnote Safety: Never crush or give KCL pills and IV push respectively. If given IV, slow push with monitoring
43
What does diuretics do to sodium and water?
Reduces sodium and water reabsorption; water and sodium loss.
44
What is the normal range for calcium?
9.0-10.5 mg/dL
45
What does calcium contribute to?
**BONES**, muscle contraction (including the heart)
46
What controls calcium regulation? | There are two
The parathyroid horomone (PTH) and Calcitonin ## Footnote So if you lose your thyroid your calcium can go out of wack.
47
(T/F) The Thyroid gland will relase calcintonin to cause a fall in blood calcium levels
True
48
(T/F) The thyroid will relase the parathyroid hormone (PTH) to cause a rise in blood calcium levels
True
49
What are the causes for calcium imbalances? | There are four
**Hyperparathyroidism** Cancer Tumors Bone breakdown ## Footnote Remember, PTH causes a rise in calcium, so if you're getting an excess of the hormone your calcium will rise
50
What is the range for hypercalcemia?
More than (>) 10.5 | Range is 9.0-10.5
51
What are clincial manifestations for hypercalcemia? | There are two important ones, two kinda important ones
**Sedative** symptoms Fatigue, **weakness**, confusion, seizures, coma *Bone pain* Dysrhythmias Kidney stones Nausea, vomiting, *anorexia* *Increased BP* ## Footnote Bold is what I think can turn up, italics are possibiltiies (50/50)
52
What are the symptoms of hypercalcemia based on rhyme "bones, stones, groans, and psychiatric overtones"
Bones--abnormal bone remodeling and fracture risk Stones--kidney stones! Groans--abdominal cramping, nausea, ileus, constipation Psychiatric overtones--Lethargy, depressed mood, psychosis, cognitive dsyfunction
53
What are managements for hypercalcemia? | There are five, one important
Weight-bearing activity **Hydration (3-4L)** Biphosphonates *Calcitonin (injection)* Dialysis ## Footnote Hydration to dilute water. Calcitonin brings your calcium levels down.
54
What is the range for hypocalcemia?
Less than (<) 9.0 ## Footnote Range is 9.0-10.5
55
What are the causes for hypocalcemia? | There are three
Low PTH (Parathyroid removal, radiation) Chronic alcohol use Diarrhea
56
What are clinial manifestations for hypocalcemia? ## Footnote There are six, three important
Nerve **excitability** **Tetany** **Chvostek sign** **Trousseau sign** Numbness/tingling (extremities and circumoral) Cardiac changes
57
What is the difference between tetany and Trousseau sign?
Tetany is muscle contractions, Trousseau sign is a carpopedal spasm that can be a sign of latent tetany
58
What is management for hypocalcemia? | There are five, two important
*Diet (Vitamin D)* Supplements *Calcium Gluconate (IV)* Post-surgical management Monitor labs (CMP) ## Footnote Vitamin D helps with absorption of calcium
59
What is the normal range for phosphorous?
3.0-4.5
60
(T/F) Phosphorous has a inverse relationship with calcium
True ## Footnote Balanced with PTH and kidneys
61
What is the range for hyperphosphatemia?
Greater than (>) 4.5
62
What are causes for hyperphosphatemia? | There are four
Kidney injury/disease Laxatives/enemas Shift from ICF to ECF **Hypoparathyroidism** ## Footnote Inverse relationship with calcium, if the PCT is down then phosphorus goes up.
63
What are clinical manifestations of hyperphosphatemia? | There are four
Same as symptoms of hypocalcemia (nerve **excitability**, tetany, paresthesias) Soft tissue calcium deposits
64
What are the managements for hyperphosphatemia? | One important one, four total
Treat underlying cause Dietary restrictions **Calcium carbonate (Tums)** Hemodialysis
65
What is the range for hypophosphatemia?
Less than (<) 3.0 | Range is 3.0-4.6
66
What are the causes for hypophosphatemia? | There are three, eight advanced
Decreased absorption (malnourishment, high use of certain antacids, **diarrhea, chronic alcohol use** Increased excretion (diarrhea) ECF to ICF shift (**respiratory alkalosis**)
67
What are the clinical manifestations of hypophosphatemia?
Central Nervous System (CNS) depression **Weakness** Pain *Respiratory or heart failure* Rickets/osteomalacia
68
What is the management for hypophosphatemia?
Diet or supplements IV phosphate Monitor labs (CMP)
69
What is the normal range for magnesium imbalance?
1.3-2.1 mEq/L
70
What does magnesium contribute to?
Muscle contractions/relaxations Neuro function
71
(T/F) Magnesium has a close parallel relationship with calcium
True, when calcium rises so does magnesium and vice versa
72
What is magnesium regulated by? | There are two
GI and Kidneys
73
What is the range for hypermagnesium?
Greater than (>) 2.1
74
What are the causes of hypermagnesium? | There are three
Increased intake Renal problems Magnesium-containing medications
75
What are the clincial manifestations of hypermagnesium? | There are ten
Decreased BP and HR Facial flushing Nausea/vomiting Lethargy Muscle paralysis, **weakness**, decreased deep tendon reflexes (DTR) Coma Cardiac or respiratory arrest
76
What are the managements for hypermagensium? | There are five
Dietary limitations Increase fluids Diuretics Dialysis Calcium Gluconate (for cardiac muscle)
77
What are the range for hypomagnesium?
Less than (<) 1.3
78
What are the causes for hypomagnesium? | There's five
Diet GI or renal loss Chronic alcohol use Meds: diuretics, proton pump inhibitors (PPIs), some antibiotics Pancreatitis
79
What are the clinial manifestations for hypomagnesium? | There are 10
Same as hypocalcemia Cramps, tremors, **tetany**, increased DTR Chvostek, Trousseau Confusion, vertigo, seizures Dsyrhytmias
80
What are the managements for hypomagnesium?
Treat cause Diet/supplements IV magnesium
81
What are the two fluid imbalances that have symptoms of tetany, Chovestsk, and Trosseau?
Hypocalcemia Hypomagnesium

Adult Health Exam 1 (3 decks)

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