Fluid Lytes Part 2 Flashcards
1
Q
How much Hydrogen ion does the body produce in a day?
A
50-100 mEq
2
Q
True or False: Does Cellular Metabolism produce Oxygen?
A
False Cellular Metabolism produce CO2
3
Q
True or False: Does the body produce more acid than Base?
A
True
4
Q
When does Acid-Base balance exist?
A
When the Net rate at which the body produces acids or bases equals the rate which acids or bases produces.
5
Q
What is normal levels for ECF?
A
7.4
6
Q
Blood pH level range?
A
7.35-7.45
7
Q
What numbers are classified as Acidosis (academia)?
A
7.35
8
Q
What levels are considered to be Alkalosis (Alkalemia)?
A
7.45
9
Q
Acid is what?
A
Contains H+ ion that can be released in solution
10
Q
What is considered a strong acid in the body?
A
Hydrochloric Acid releases all H+
11
Q
What is considered a weak acid in the body?
A
Carbonic acid releases some H+
12
Q
How is bicarbonate created?
A
H2CO3 releases H+ to form HCO3
13
Q
What is a Chemical Buffer?
A
Combine with acid or bases to control pH
14
Q
True or False: Does a Buffer system take up H+ or release H+ as conditions change?
A
True
15
Q
What is the ratio of Bicarbonate to Carbonic acid?
A
20:1
16
Q
How can the body pH be changed via respiration?
A
Changing rate and depth of breathing
17
Q
How can the body retain carbonic acid?
A
By blowing off CO2
18
Q
PaCo2 normal levels?
A
35-45 mmHg
19
Q
What are the function for kidneys related to acid-base within the body?
A
Eliminate large amount of acid
excrete base
conserve and produce bicarb ions
Most effective regulator of pH
20
Q
What would happen if the the pH of ECF decreases?
A
kidneys will eliminate more acid and retain or produce more bicarbonate.
21
Q
Why happens if the pH increases in blood?
A
kidneys retain H+ and excrete HCO3
22
Q
What are the normal levels of Bicarbonate?
A
22-26 mEq/L
23
Q
How long does it take for buffers to take affect within the body?
A
Buffers functions almost instantaneously
24
Q
How long does it take for respiratory buffers to take affect?
A
Minutes to hours
25
What is metabolic alkalosis?
Loss of H+, Na, K and CL
26
What is metabolic acidosis?
Loss of intestinal bicarbonate, Na, Cl, K
27
How is thirst generated?
increase in plasma osmolarity or decrease in blood volume regulates fluid intake also xerostomia
28
What are some psychological factors for fluid intake?
Depression, confusion
29
Diaphoresis
Fever, excessive exercise
30
Diuretics
Prescribed to excrete excess water and Na but -K andMg loss occurs
31
What factors could affect F&E?
Cardiac Failure, Liver Failure, Respiratory Failure
32
How does Cardiac Failure affect F&E?
decreased b/p, aldosterone and ADH stimulated equals water retention
33
How does Liver Failure affect F&E?
Decreased production of albumin
| Decreased Colloid Osmotic Pressure
34
How does Respiratory Failure affect F&E?
Loss of compensatory mechanism to decrease H+ equals CO2 retained equals respiratory acidosis
35
Surgery affects F&E how ?
NPO status, increased insensible loss, Hyperkalemia from cellular destruction, hypokalemia as urine excretion
36
Water and electrolytes loss or gained in proportion
Isotonic
37
Loss or gain of water only
Osmolar
38
Severity of Dehydration is measured based by weight loss. What are the percentage of weight that must be lost?
5% mild
10% severe
15% life threatening
39
What is Third Spacing
Fluid leaves vascular area and remains in interstitial fluids and transcellular compartments
40
What is the Etiology of Thirs Space fluid shift?
Increased fluid volume
increased capillary hydrostatic pressure
hyponatremia
increased tissue permeability
41
What are some intervention for F&E?
```
Assess for clinical signs for FVD
Monitor weight
VS
I&O
Specific gravity > 1.025
lab finding
measures for skin breakdown
```
42
Hypervolemia
Increase in interstitial or vascular volume
43
True or False: Does the body retain both water and Na in same proportions?
True
44
Having Increased fluid volume also increases what?
Increased hydrostatic pressure
45
If your body has fluid volume excess. How would your pulse respond respond?
Pulse would be bounding and Tachy
46
What are some Symptoms of excess fluid volume?
Bounding pulse, Increased B/P, pitting edema: Feet, ankles lower legs, distended neck veins
Polyuria, possible decreased urine output, pulmonary edema, Respiratory patterns changed
47
What would a treatment be for a person with Fluid Volume Excess?
Fluid and Na restrictions
48
What places on the body would be apparent with a person with FVE?
around the eyes and dependent tissues where hydrostatic pressure is high
49
What interventions would you as a nurse perform for a person with FVE?
monitor weight daily and VS, assess for edema
Assess breath sounds, I&O (intake greater than output)
place in Fowler position, Restrict fluid (IF ORDERED)
Restrict dietary Na (IF ORDERED), prevent skin breakdown
50
When does water or osmolarity imbalance occur?
When water intake or decrease is excessive
51
How would you be able to determine if a patient has water imbalance?
Check or estimate serum osmolarity
52
If Na and electrolytes are left behind and only water is lost, what increases?
Osmolarity
53
If water is drawn from ICF, where does it go and what occurs?
goest to ECF space and Cells shrink
54
An increase in water loss without Na loss if referred to as?
Hyperventilation
55
What are normal serum osmolarity
>300 Mosm/L
56
as cells shrinks in the brain what begins to occurs?
Confusion, agitation, convulsions coma and possibly death
57
normal Serum Na levels?
>145 mEq/L
58
An increase in water intake in excess of electrolytes results in what?
Low Na, Low Osmolarity
59
What are some symptoms of excess water?
Lethargy, irritability, confusion, personality changes, seizures, death, anorexia, nausea, vomiting, muscle weakness and cramping.
60
What would a treatment be for water excess?
ECF volume replacement of Na to decrease neurological changes
61
If you want to analyze blood gas what would you look at first?
pH
62
Respiratory acidosis
Primary excess of carbonic acid in ECF
63
Respiratory alkalosis
Primary deficit of carbonic acid in ECF
64
Metabolic acidosis
Proportionate deficit of bicarbonate in ECF
65
Metabolic alkalosis
Primary excess of bicarbonate in ECF
66
When does Acid-Base imbalances occur?
When carbonic acid or bicarbonate levels become disproportionate
67
What is levels are considered to respiratory acidosis?
low pH 45 mmHg
68
As the pH drops below normal ranges during Respiratory Acidosis. What are the kidneys doing?
Compensating by retaining more HCO3 in an attempt to raise the pH.
69
If the kidneys begins to excrete H+ during Respiratory acidosis. Is the urine Acidic or Alkaline?
Acidic. H+ is acidic
70
How would a person who is suffering form respiratory acidosis be able to promote the release of CO2?
breathe deeply, Turn, CDB, Semi-Fowlers postion
71
Carbonic acid excess
Increased blood levels of CO2 above 45mmHg (Hypercarbia)
72
What is a chronic condition for respiratory acidosis?
Depression of respiratory center in brain that controls breathing rate
Paralysis of respiratory or chest muscles
emphysema - COPD
73
What would be acute conditions of Respiratory acidosis?
Adult respiratory distress syndrome
| pulmonary edema, pneumothorax, pneumonia, narcotic overdose, asthma mechanical ventilation.
74
Respiratory Alkalosis levels?
elevated pH>7.45 or higher. PaCO2
75
When does respiratory alkalosis occurs?
Increased rate or depth of ventilation. due to pain and anxiety, pulmonary disease, ventilator settings too high or too fast, hypoxia: fever encephalitis, high altitudes, salicylate poisoning (aspirin poisoning)
76
What is the primary cause of respiratory alkalosis?
Hyperventialtion
77
How does the kidneys compensate for Respiratory alkalosis?
Excreting HCO3 and retaining H+
Urine becomes more alkaline
Treatment is aimed at eliminating cause
78
What is the goal for respiratory alkalosis?
To increase CO2 in body, slow breathing
79
What would a treatment be for Respiratory alkalosis?
Treat underlying cause, Breathe into a paper bag
80
Levels for Metabolic acidosis?
ph
81
During metabolic acidosis the body rapidly excrete what?
bicarbonate or the inability to retain it
82
During metabolic acidosis what system compensate?
Respiratory system
83
What is the cause of metabolic acidosis?
Loss of HCO3 from diarrhea, Lack of exertion of H= ions: renal failure
Overproduction of hydrogen ions: diabetic ketoacidosis, starvation, fever
84
During metabolic acidosis. What are the lungs attempting to do and Why?
Blow off CO2 deep and rapidly to lower CO2 in the body
85
When kussmaul respiration be used?
Diabetics
86
What are the kidneys during metabolic acidosis?
Excrete H+ and urine becomes more acidic. May take days or weeks.
87
True or False: If a pt has renal damage during metabolic acidosis. Will the patient be able to excrete H+.
False
88
pH levels for Metabolic alkalosis?
pH >7.45 PaCO2 normal or increased HCO3 increased
89
What is a cause of Metabolic alkalosis?
Ingestion of large amounts of HCO3 or loss of acid by prolonged vomiting, NG functioning, some diuretics, antacids.
90
True or False: Breathing occurs rapidly and deep to retain CO2?
False: Breathing becomes slow and shallow to retain CO2
91
What are the kidneys during when metabolic alkalosis occur?
retain H+ or excrete HCO3 so urine becomes more alkaline
92
What are risk factors for imbalances?
Pathophysiology underlying acute and chronic illnesses, abnormal losses of body fluids, burns, trauma, surgery, therapies that disrupt fluid and electorate balance.
93
If a pt losses 1Kg of body weight how much water can we assume that was lost of a pt had water retention?
1L of fluid
94
What objective Data would you assess for patients for fluids and electrolytes?
Plasma Electrolytes, BUN and creatinine, CBC - Hematocrit, Plasma Osmolarity, ABG, Urine Osmolarity, Urine specific gravity, Urine pH
95
What would be some Nursing diagnosis for for Fluid Volume?
Deficient Fluid Volume, Risk for Deficient fluid volume, Excess Fluid Volume, Risk for imbalanced fluid volume
96
What would some expected outcomes be for a pt who is recovering from fluid imbalance?
maintain fluid I&O balance 2500 ml over 3 days. Maintain urine specific gravity WNL 1.010 - 1.025. Practice self care behavior
97
IF pH and PaCO2 move in opposite direction what is this. Respiratory or metabolic?
Respiratory problem
98
If pH and HCO3 go down but PaCO2 remains steady what problem is this?
Metabolic acidosis
99
If pH goes up and PaCO2 goes down but HCO3 remains steady. What problem is this?
Respiratory Alkalosis
100
If both pH and HCO3 go up and PaCO2 remains steady. What problem is this?
Metabolic Alkalosis
101
If Pogoes down and PaCO2 goes up but HCO3 remains steady> What problem si this
Respiratory acidosis
102
Normal levels of HCO3?
22-26mEq/L
