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Concepts Exam 2 > Fluids and Electrolytes > Flashcards

Fluids and Electrolytes Flashcards

1
Q

Functions of water in the body?

A

Transporting nutrients to cells and wastes from cells

Transporting hormones, enzymes, blood platelets, and blood

Facilitating cellular metabolism and proper cellular chemical functioning

Acting as a solvent for electrolytes and non-electrolytes

Helping maintain normal body temperature

Facilitating digestion and promoting elimination

Acting as a tissue lubricant

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2
Q

What is the total body fluid?

A

50-60% of body weight

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3
Q

How much of our body weight comes from cell fluid or intracellular fluid?

A

35-40% of body weight

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4
Q

How much of our body weight comes from extra cellular fluid?

A

15 to 20% if body weight

5% from plasma (intravascular)
10-15% from interstitial fluid

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5
Q

Define osmosis

A

Water passes from an area of lesser solute concentration to greater concentration until equilibrium is established

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6
Q

Define diffusion

A

Tendency of solutes to move freely throughout a solvent (downhill)

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7
Q

Define active transport

A

Requires energy for movement of substances through the cell membrane from the lesser solute concentration to the higher solute concentration

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8
Q

Define capillary filtration

A

Passage of fluid through a permeable membrane from the area of higher to lower pressure

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9
Q

Define isotonic

A

Fluid has the same osmolarity as plasma

Cells neither shrink nor swell with fluid movement.

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10
Q

Define hypotonic

A

Fluid has fewer solutes than plasma

Osmotic pressure draws water into the cells from the ECF and the cell swells

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11
Q

What is hypertonic?

A

Fluid has more solutes than plasma

Draws water out of the cells, and into the more highly concentrated ECF and the cell shrinks

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12
Q

What are some examples of isotonic IV fluids?

A

0.9% normal saline

Ringers lactate

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13
Q

What are some examples of hypotonic IV fluids?

A

0.45% NS

D5W (because dextrose is used up by the body leaving behind only water)

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14
Q

What are some examples of hypertonic IV fluids?

A

3% saline

D5NS (normal saline)

D10W

D5LR

D50

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15
Q

Chief function of sodium?

A

Controls and regulates volume of body fluids

Brain!

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16
Q

Chief function of potassium

A

Chief regulator of cellular enzyme activity and water content

Heart

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17
Q

Chief function of calcium

A

Nerve impulses, blood clotting, muscle contraction, B12 absorption

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18
Q

Chief function of magnesium

A

Metabolism of carbohydrates and proteins, vital actions involving enzymes

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19
Q

Chief function of chloride

A

Maintains osmotic pressure in blood, produces hydrochloric acid

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20
Q

Chief function of bicarbonate

A

Bodies primary buffer system

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21
Q

Chief function of phosphate

A

Involved in important chemical reactions in the body, cell division, and hereditary traits

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22
Q

Reference values for sodium?

A

Adult: 135-145 mmol/L

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23
Q

Panic values for sodium

A

<125 or > 150 mmol/L

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24
Q

What are some important functions of sodium?

A

Major cation in the extracellular fluid

Helps to maintain body fluid, is responsible for conduction of neuromuscular impulses, is involved in enzyme activity

Important in acid base balance

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25
What is hyponatremia and how could you get it?
Less than 135 mmol/L Results from excessive loss of sodium or an excessive gain of water, diuretic therapy, excessive drinking of water, endocrine disorders
26
What are symptoms of hyponatremia and what are the treatments?
Symptoms: headache, N&V, confusion, muscle twitching, tremors, weakness, irritability Treatment: receive oral sodium, supplementation, restrict fluid intake
27
What is hypernatremia and how can you get it?
Sodium higher than 145 mmol/L Too much sodium in diet, severe insensible water losses that are not replaced, severe vomiting
28
Symptoms and treatment of hypernatremia
Symptoms: extreme thirst, restlessness, or agitation, anorexia, N&V, dry sticky tongue and oral mucosa, disorientation, hyperactive reflexes, oliguria and anuria, lethargy Treatment: prescribed oral/IV therapy and sodium restricted diet
29
Reference values for potassium
Adult: 3.5- 5.3 mmol/L
30
Panic values for potassium
< 2.5 and > 7.0 mmol/L
31
Symptoms and treatment for hypokalemia
< 3.5 mmol/L Symptoms: muscle weakness or leg cramps, paresthesia, fatigue Cardiac irregularities, G.I. complaints, EKG changes, decreased reflexes Treatment: oral supplements of potassium, IV potassium chloride
32
Causes for hyperkalemia?
> 5.0 mmol/L Reduced excretion by the kidneys, oliguria due to shock or severe dehydration, potassium sparing diuretics
33
Symptoms and treatment for hyperkalemia
Symptoms: irritability, paresthesia and numbness in extremities, skeletal muscle weakness, cardiac arrhythmias Treat treatment: kayexalate (a cation exchange resin, orally or by enema)
34
Reference values for calcium
Adult: 8.6 - 10 mg/dL
35
Panic values for calcium
<6.0 and > 14.0 mg/dL
36
Normal ionized calcium levels
4.5-5.5 mg/dL
37
Panic levels for ionized calcium?
<2.8 and > 7 mg/dL
38
What are some important roles for calcium
Major component of bones and teeth Role in transmitting nerve impulses Regulates muscle contractions
39
What are the three components of calcium
Protein bound 47% Ionized (free) 43% Complex 10%
40
How can you get hypocalcemia?
Results from abnormalities of parathyroid hormone (PTH) secretion or from inadequate dietary intake or excessive losses of bound, ionized (unbound), or total body calcium
41
What are symptoms and treatments for hypocalcemia?
Symptoms: muscle cramps, or tremors, tetany, positive Trousseau’s sign, positive Chvostek’s sign, irritability and anxiety, seizures, arrhythmias, angina, bradycardia, and hypotension Treatment: calcium supplements orally or IV Calcium gluconate or calcium chloride.
42
How do you get hypercalcemia?
Results from increased intestinal absorption of calcium, renal abnormalities can interfere with calcium secretion and excretion, patients with metastatic cancer are especially high risk
43
Symptoms and treatments of hypercalcemia?
Symptoms: lethargy, muscle weakness or flaccidity, hyporeflexia and decreased muscle tone, polyuria, polydipsia, arrhythmias and cardiac arrest Treatment: adequate hydration (IV fluids/oral intake), biphosphonates, ambulation
44
Reference values for magnesium
Adults: 1.5-2.5 mg/dL
45
Panic values for magnesium
<1.2 and > 4.9 mg/dL
46
Important roles for magnesium
Second most abundant cation after potassium Helps maintain normal nerve and muscle functions Required for the heart to beat normally Plays a role in almost all chemical processes in the body
47
How do you get hypomagnesemia?
Excessive losses from G.I. and kidneys, chronic alcoholism, and medications
48
Symptoms and treatments for hypomagnesemia
Symptoms: neuromuscular irritability, weakness, tremors, dizziness, cardiac irritation, mood changes, tetany, and convulsions Treatment: oral magnesium, IV magnesium, rich magnesium diet
49
How could you get hypermagnesemia
Renal failure, adrenal insufficiency, and excessive intake, sepsis, magnesium containing medications
50
Symptoms and treatments of hypermagnesemia?
Symptoms: feeling of warm/ flushing, hypotension, SOB, drowsiness, and hypoactive reflexes Treatment: IV calcium gluconate, Lasix, glucose and insulin
51
Reference values for phosphorus?
2.5- 4.5 mg/dL
52
Panic value for phosphorus?
< 1.5 mg/dL
53
Important roles for phosphorus
Second most abundant mineral in the body after calcium Extremely important in building strong bones and teeth Needed for repair of all tissues/cells in the body Plays an essential role in how the body stores and uses energy
54
Symptoms and treatments for hypophosphetemia?
Symptoms: altered mental status, cardiac arrhythmia, dyspnea, and heart failure Treatment: oral phosphates, IV phosphates, control the intake through diet
55
Symptoms and treatments for hyperphosphatemia?
Symptoms: tingling around the mouth, fingertips, delirium, numbness, and muscle cramps Treatment: control the intake through diet, acetazolamide
56
What is phosphorus inversely proportional with?
Calcium
57
What can cause hyperphosphatemia?
Exercise, excessive enema usage, hypoparathyroidism, and dehydration
58
Reference values for chloride
97-107 mEq/L
59
Panic values for chloride?
<80 and > 115 mEq/L
60
Some roles of chloride
Major ECF anion Acts with sodium to maintain osmotic pressure Major component of interstitial and lymph fluid- gastric and pancreatic juices, sweat, bile and saliva
61
How can you get hypocholremia?
Over hydration, SIADH, severe vomiting, gastric suction, Addisons disease
62
Symptoms and treatment of hypochloremia
Symptoms: hyperexcitability of muscles, hyperactive DTRs, tetany, muscle cramps Treatment: oral sodium chloride, IV normal saline.
63
How can you get hyperchloremia?
Head trauma, dehydration, mineralocorticoid deficiency, increased sweating, laxative abuse
64
Symptoms and treatment for hyperchloremia
Symptoms: tachypnea, lethargy, altered mentation, weakness, extreme thirst Treatment: depends on the cause. Hydration, stopping medications that contribute to increased chloride, correcting metabolic acidosis
65
What are liver function tests?
Bilirubin SGOT/AST SGPT/ALT
66
What are the renal function tests?
BUN Creatinine
67
What are the lipid profile tests?
Total cholesterol Triglycerides LDL HDL
68
What tests are in the coagulation panel?
PT: prothrombin time INR PTT: partial thromboplastin time
69
What is AST/SGOT testing?
Aspartate aminotransferase Found everywhere in the body!
70
What is ALT/ SGPT testing for?
Alanine aminotransferase Found primarily in the liver
71
Normal value for total cholesterol and triglycerides
Total cholesterol: <200 Triglycerides: <150
72
Normal values for LDL and HDL
LDL: <100 HDL: >40
73
What does it mean when both BUN and creatinine go up?
Kidney dysfunction.. but unfortunately they will not be outside the normal range until 60% of total kidney function is lost
74
What does it mean if BUN is elevated but creatinine is normal?
Dehydration
75
What does it mean when BUN is lowered but they have a normal creatinine
Overhydration
76
What test do we use if you’re on heparin?
PTT
77
What test would we use if you have afib?
INR.. especially if they are on warfarin (coumadin)
78
What is Hct testing for?
% of total blood volume that is RBC Approx 3 x Hgb
79
What is Hgb testing for?
Oxygen carrying capacity of blood
80
What is leukocytosis
WBC > 11,000 Infection, inflammation, tissue necrosis Sepsis: WBC is extremely high Could also end in “philia”
81
What is leukopenia?
WBC < 4,500 Bone marrow failure following chemo/radiation, immune compromised, autoimmune disease, overwhelming infections Most common cause though is cancer and having chemo
82
When you’re bleeding internally or dehydrated how does that change your vitals?
Heart rate will go up, bodies trying to pump more blood

Concepts Exam 2 (8 decks)

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