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hlsc 222 midterm 1 > Fluid electrolyte- Acid base imbalances - midterm 1 > Flashcards

Fluid electrolyte- Acid base imbalances - midterm 1 Flashcards

1
Q

Chloride is inversely proportionate too? it is also regulated through the (blank) through the secretion of?

A

-Proportionate to HC03-

-regulated through the kidneys through the secretion of ADH

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2
Q

What is metabolic alkalosis?

A

Too much bicarbonate ion (HCO3-) / not enough acid
pH > 7.45
HCO3 > 26 mEq/L

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3
Q

Management for hypovolemia?

A

↑fluid replacement,
isotonic fluids - IV Normal Saline
Monitor VS, Ins/Outs, weight

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4
Q

Why is PH important? What is it needed for?

A

Needed to maintain membrane potential integrity (maintain the speed of enzyme reactions and regulated speed of nerve impulse conduction and muscle fibre contraction)

Membrane excitability, the enzyme systems, and all chemical reactions depend on the pH being in that range of 7.35-7.45
Acid releases H+ ion, Base receives H+ ion

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5
Q

Causes of hypernatremia?

A

Excess water loss or sodium intake (thinking eating slaty bar food)
Diabetes Insipidus
Heat Stroke

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6
Q

Management for hypernatremia?

A

Hypotonic IV solution,
sodium restrictions,
diuretics

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7
Q

What is kussmaul breathing? What does it result in?

A

Kussmaul breathing = hyperventilation – hyperventilation results in alkalosis so the respiratory system is trying to shift towards alkalosis

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8
Q

What is Hyponatremia?

A

The volume of fluid the cell stays the same, hyponatremia is a decrease of Na+ serum levels in the cell

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9
Q

Hypertonic Vs hypotonic Vs Isotonic solutions?

A

Isotonic – concentration equivalent to 0.9% NaCl– normal saline solution – no shrinking or swelling

Hypertonic – concentration > 0.9% NaCl ECF – cells shrink

Hypotonic – concentration < 0.9% NaCl ECF – cells expand

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10
Q

ECF has a higher concentration of? ICF has a higher concentration of?

A

ECF has a higher concentration of sodium and chloride and a smaller amount of potassium

ICF has a higher concentration of potassium and a smaller concentration of sodium and chloride

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11
Q

Signs and symptoms of hypernatremia?

A

Thirst,
seizures,
dry mucous membranes

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12
Q

Signs and symptoms hypokalemia?

A

ECG changes,
ventricular dysrhythmias,
leg cramps,
lethargy

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13
Q

Management of hyperklemia?

A

Increase fluids,
calcium gluconate,
insulin,
bicarb,
dialysis

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14
Q

Causes of metabolic alkalosis?

A

Excess loss of acid:
Vomiting, gastric suction
↑Aldosterone

Excessive intake of base:
Antacid overdose

Vomiting or the loss of chloride stimulates the retention of bicarbonate
Too much aldosterone results in bicarbonate retention

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15
Q

What is hyperkalemia?

A

Potassium levels > 5.0mmol/L

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16
Q

Causes of hypervolemia? What kind of response is it?

A

Excess fluid intake
Increased fluid retention
Secondary response to increased sodium content

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17
Q

Signs and symptoms of hyponaterima?

A

Dry skin,
↑urine output,
cramping, headache,
seizures

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18
Q

Causes for respiratory alkalosis?

A

Hypoxemia : low O2 in the blood
Pulmonary disease
Heart failure, anemia
High altitudes :lower pressure, we are going to dry and breath more and deeper but we are actually just blowing all of our CO2 off

Hyperventilation
Fever, anxiety

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19
Q

If the problem is a metabolic issue which system will trigger the buffer effect?

A

Respiratory system will trigger the buffer effect

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20
Q

How do the kidneys handle nonvolatile gases?

A

3rd line defence system

Sulfuric, phosphoric, and other organic acids

Eliminated by the renal tubules

Need to be exceeded via kidneys

Not fast SLOW (hours to days)

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21
Q

High concentration of hydrogen yield a?

A

Low PH (acidic substances)

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22
Q

Where sodium goes?

A

Water follows

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23
Q

What is kussmaul breathing? What does it result in?

A

Kussmaul breathing = hyperventilation – hyperventilation results in alkalosis so the respiratory system is trying to shift towards alkalosis

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24
Q

Causes of hypokalemia?

A

GI losses
Malnutrition
Diuretics
Alkalosis

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25
Q

What causes hypovolemia?

A

Excess fluid loss
Hemorrhage
Decreased intake
Third spacing

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26
Q

Causes of hyperklemia?

A

Increased intake
Renal dysfunction
Tissue trauma
Acidosis
Medications

27
Q

To maintain the body’s normal PH (7.35 - 7.45) the H+ must be?

A

H+ must be neutralized by buffers and excreted via the lungs or kidneys

28
Q

What causes metabolic acidosis?

A

Causes – excessive loss of HCO3- or too much H+
Renal failure
Diarrhea

Ecess production of non-volatile acids
Diabetic ketoacidosis

29
Q

What is hyperventilating? Signs and symptoms?

A

-Resp acidosis

-Hyperventilating - not filling lungs with enough oxygen - not looking at what the rep rate is - we look at O2 stats
Very much so like hypoxia

Signs and Symptoms:
Headache, blurred vision, restlessness, disorientation, tremors
Start with an increased respiratory rate – eventually depressed as the respiratory center adapts to the increased CO2 (COPD)

30
Q

Respiratory acidosis or alkalosis is caused by?

A

Caused by the lungs

31
Q

Management of hypervolemia?

A

Fluid/sodium restrictions, diuretics
Monitor VS, Ins/Outs, Weight

32
Q

What is metabolic acidosis?

A

Not enough bicarbonate ion (HCO3-) / too much acid
pH < 7.35
HCO3 < 22 mEq/L

33
Q

Low PH state causes? High PH state causes?

A

pH – low – acidosis you would be in a state of acidemia

pH – high alkalosis in a state of alkalemia

34
Q

Management of hyponatermia?

A

Water restriction,
sodium replacement, hypertonic IV solution

35
Q

Causes and symptoms of respiratory acidosis?

A

Causes:
Depression of respiratory center, paralysis of respiratory muscles, drug overdose causing depressed ventilation

Decreased gas exchange in alveoli – pneumonia, pulmonary edema, emphysema, asthma, bronchitis

Slow / shallow breathing
(Head injury, spinal cord injury, drug overdose)

Decreased gas exchange in alveoli (Pneumonia, emphysema)

36
Q

Capillary hydrostatic pressure Vs Capillary Osmotic pressure?

A

There is a high hydrostatic pressure in the capillary (fluid is trying to move out) at the same time there is an osmotic pressure in the capillary trying to pull fluid in (hydrostatic pressure is higher so fluid moves out into the intracellular space)

At the venous end due to the dilution caused by the extra fluid from the arteriol end, the hydrostatic pressure is unchanged (it is our BP), but the oncotic pressure is greater due to the tissues being diluted – so fluid will move back in to the capillary.

37
Q

If the lungs are functioning properly it is a (blank) situation, if the lungs are not functioning properly it is a (blank) situation)

A

IF LUNGS NOT FUNCTION PROPERLY = RESPIRATORY
PROBLEM

IF LUNGS ARE FUNCTION PROPERLY IT IS A METABOLIC ISSUE

38
Q

When we are over processing we will go into a?

A

acidic state

39
Q

what is Respiratory acidosis?

A

Too much CO2
PCO2 > 45 mm Hg
pH < 7.35

Alveolar hypoventilation – excess CO2 in blood

40
Q

Increasing and decreasing respiratory rate in metabolic issue will

A

Increasing the respiratory rate will remove more carbon dioxide from the body – formula will shift to the right H+ will decrease = raise pH

Decreasing the respiratory rate will retain CO2 – formula will shift to the left – H+ will increase = lower pH

41
Q

Signs and symptoms of metabolic alkalosis?

A

Weakness, muscle cramps, hyperactive reflexes, tetany (involuntary contraction of muscles), convulsion, atrial tachycardia, confusion

42
Q

Causes of hyponaterima?

A

Water excess (ADH)
Fluid loss
Renal disease
Diuretics

43
Q

What is respiratory alkalosis?

A

Too little carbon dioxide - hyperventilating Ph is going to be high because our CO2 is being blown off

44
Q

Metabolic acidosis or alkalosis is caused by?

A

Caused by anything except the lungs

45
Q

Ph will go (blank) in metabolic acidosis?

A

pH will go low

46
Q

Management of hypokalemia?

A

Increased diet intake,
correct acid base balance
Monitor renal function

47
Q

How does the regulation of chloride through ADH secretion work? What does it cause?

A

Regulated by secretion of ADH
↑ Plasma osmolality – occurs with water deficit or sodium excess in relation to TBW
- Hypothalamic increases thirst & increases water reabsorption

↓ circulating blood volume caused by vomiting, diarrhea, or excessive sweating leads to decrease in blood pressure

48
Q

How does the renal system control PH?

A

Excreting or conserving acid: H+ and/or
Conserving or excreting base: bicarbonate (HCO3-)

49
Q

Hydrostatic pressure?

A

Hydrostatic pressure - pressure exerted existing within a liquid at rest with respect to its surroundings

Pressure that blood exerts in capillaries is blood pressure – as fluid is pushed into the interstitial area – interstitial fluid increases and therefore interstitial hydrostatic pressure also increases

Hydrostatic pressure refers to thepressure that any fluid in a confined space exerts

50
Q

Signs and symptoms of hypervolemia?

A

Weight gain,
SOBOE,
orthopnea,
crackles,
wheeze,
cough,
↓BP,
weak pulse,
pitting edema

51
Q

Water follows?

A

Sodium

52
Q

An imbalance of one electrolyte often produces an?

A

An imbalance in another electrolyte

53
Q

Signs and symptoms of hypovolemia?

A

Weight loss,
dilute urine,
dizzy,
↓skin turgor,
thirst,
confusion,
nausea, ↑temp

54
Q

In Respiratory Acidosis and Alkalosis what will try to compensate?

A

Kidneys will try to compensate

55
Q

In metabolic acidosis and alkalosis what will try to compensate?

A

Lungs will try to compensate

56
Q

What is hypernatremia?

A

The volume of fluid in the cell stays the same, hypernaterima is excess serum Na+ in the cell

Na+ serum > 15mmol/L

57
Q

We consider chloride as a major ion in our? What kind of motion is it?

A

Major anion in our ECF

Passive motion

58
Q

What is respiratory alkalosis?

A

Too little carbon dioxide - hyperventilating Ph is going to be high because our CO2 is being blown off

59
Q

What is metabolic alkalosis?

A

Too much bicarbonate ion (HCO3-) / not enough acid
pH > 7.45
HCO3 > 26 mEq/L

60
Q

Signs and symptoms of metabolic acidosis? What does it cause?

A

Headache (lethargy - confision, decreased BP, hyperkalemia, muscle twitching, warm flushed skin, nausea, vomiting, diarrhea

High serum K+ - Metabolic acidosis causes potassium to move from cells to extracellular fluid

61
Q

Signs and symptoms of Hyperklemia?

A

Cardiac dysrhythmia,
irregular pulses,
hyperactive bowels

62
Q

Respiratory system exerts CO2 by?

A

Respiratory system excretes CO2 by increasing or decreasing ventilation rate

Increase release of CO2 by increasing our respiratory rate

Decrease release of CO2 by decreasing our respiratory rate

63
Q

What is the pressure at the arterial and venous end of the capillaries?

A

At the arterial end, capillary hydrostatic pressure is higher than capillary oncotic pressure so water flows out of capillary

At the venous end, the pressures are reversed so water flows back into the capillary

hlsc 222 midterm 1 (6 decks)

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