Packet 10 - Fluid Balance (2)

Question 1

One of the major divalent cations in the body. Influences membrane potential and permeability, and is necessary for contraction of all muscle types.

a. ) Sodium
b. ) Calcium
c. ) Potassium

Answer 1

Calcium

One of the major divalent cations in the body. Influences membrane potential and permeability, and is necessary for contraction of all muscle types.

Question 2

Helps regulate intracellular osmolality. Helps maintain resting membrane potential and generate action potentials in nerve and muscle tissue. Involved in regulating acid/base balance.

a. ) Sodium
b. ) Calcium
c. ) Potassium

Answer 2

Potassium

Helps regulate intracellular osmolality.

Helps maintain resting membrane potential and generate action potentials in nerve and muscle tissue.

Involved in regulating acid/base balance.

Question 3

Regulates extracellular and vascular volume (r/t effect on osmolality). Helps maintain resting membrane potential and generate action potentials in nerve and muscle tissue. (Mostly extracellular)

a. ) Sodium
b. ) Calcium
c. ) Potassium

Answer 3

Sodium

Regulates extracellular and vascular volume (r/t effect on osmolality)

Helps maintain resting membrane potential and generate action potentials in nerve and muscle tissue.

Question 4

Transcompartmental shifts (release of intracellular K related to burns, crush injuries, extreme exercise, or other types of cell damage).

a. ) Hyponatremia b.) Hypernatremia
c. ) Hypokalemia d.) Hyperkalemia
e. ) Hypocalcemia f.) Hypercalcemia

Answer 4

Hyperkalemia

increase in serum levels

P/C Factors:

• Decrease in elimination
  
  • Renal failure
  • Aldosterone deficiency
  • K-sparing diuretics
• Excessive intake
  
  • Oral or IV
• Transcompartmental shifts
  
  • release of intracellular K related to burns, crush injuries, extreme exercise, other types of cell damage

Question 5

Results in decreased membrane excitability (harder to generate action potentials).

a. ) Hyponatremia b.) Hypernatremia
c. ) Hypokalemia d.) Hyperkalemia
e. ) Hypocalcemia f.) Hypercalcemia

Answer 5

Hypokalemia

decrease in serum levels

P/C Factors:

• Inadequate intake
• Excessive loss
  
  • Renal (i.e. diuretic therapy, excessive aldosterone or glucocorticoids)
  • GI (i.e. vomiting, diarrhea)
  • Skin (i.e. heavy sweating, burns)
• Transcompartmental shifts
  
  • from extracellular to intracellular, r/t pH changes

Question 6

Acute form causes decreased membrane excitability (muscle weakness, flaccid muscles, cardiac dysrhythmias, constipation, and stoopor. Chronic form causes kidney stones.

a. ) Hyponatremia b.) Hypernatremia
c. ) Hypokalemia d.) Hyperkalemia
e. ) Hypocalcemia f.) Hypercalcemia

Answer 6

Hypercalcemia

increase in serum levels

Acute form:

• Decreased membrane excitability (too much of the membrane stabilizer
  
  • muscle weakness
  • flaccid muscles (no reflexes, no muscle tone, flabby muscles)
  • cardiac dysrhythmias
  • constipation (no peristalsis)
  • stoopor (extreme lethargy)

Chronic form:

• kidney stones

P/C Factors:

• increased bone resorption
  
  • excess parathyroid hormone
  • prolonged immobility
  • some cancers
• increase in intestinal absorption
  
  • excess vitamin D₃
  • excess dietary calcium

Question 7

Excessive water intake in relation to output.

a. ) Hyponatremia b.) Hypernatremia
c. ) Hypokalemia d.) Hyperkalemia
e. ) Hypocalcemia f.) Hypercalcemia

Answer 7

Hyponatremia

Decrease in serum sodium

P/C factors:

• increase in sodium/water loss, accompanied by replacement with sodium-free fluid.
  
  • Skin (i.e. excessive sweating, burns)
  • GI loss (i.e. vomiting, diarrhea, tap water enemas)
  • Renal (i.e. aggressive diuretic therapy)
• Excessive water intake in relation to output (dilutional hyponatremia)
  
  • Psychogenic polydipsia
  • increased intake + impaired elimination
    
    • kidney disease and increase in ADH levels

Question 8

S/S include alkalosis, muscle weakness, decreased peristalsis (constipation → paralytic ileus), cardiac disrhythmias, and polyuria.

a. ) Hyponatremia b.) Hypernatremia
c. ) Hypokalemia d.) Hyperkalemia
e. ) Hypocalcemia f.) Hypercalcemia

Answer 8

Hypokalemia

decrease in serum levels

P/C Factors:

• Inadequate intake
• Excessive loss
  
  • Renal (i.e. diuretic therapy, excessive aldosterone or glucocorticoids)
  • GI (i.e. vomiting, diarrhea)
  • Skin (i.e. heavy sweating, burns)
• Transcompartmental shifts
  
  • from extracellular to intracellular, r/t pH changes

Question 9

If severe, cells can only depolarize and cannot repolarize (cardiac arrest).

a. ) Hyponatremia b.) Hypernatremia
c. ) Hypokalemia d.) Hyperkalemia
e. ) Hypocalcemia f.) Hypercalcemia

Answer 9

Hyperkalemia

increase in serum levels

P/C Factors:

• Decrease in elimination
  
  • Renal failure
  • Aldosterone deficiency
  • K-sparing diuretics
• Excessive intake
  
  • Oral or IV
• Transcompartmental shifts
  
  • release of intracellular K related to burns, crush injuries, extreme exercise, other types of cell damage

Question 10

Transcompartmental shifts (from extracellular to intracellular related to pH changes).

a. ) Hyponatremia b.) Hypernatremia
c. ) Hypokalemia d.) Hyperkalemia
e. ) Hypocalcemia f.) Hypercalcemia

Answer 10

Hypokalemia

decrease in serum levels

P/C Factors:

• Inadequate intake
• Excessive loss
  
  • Renal (i.e. diuretic therapy, excessive aldosterone or glucocorticoids)
  • GI (i.e. vomiting, diarrhea)
  • Skin (i.e. heavy sweating, burns)
• Transcompartmental shifts
  
  • from extracellular to intracellular, r/t pH changes

Question 11

Results in increased membrane excitability (too easy to generate action potentials).

a. ) Hyponatremia b.) Hypernatremia
c. ) Hypokalemia d.) Hyperkalemia
e. ) Hypocalcemia f.) Hypercalcemia

Answer 11

Hyperkalemia

increase in serum levels

P/C Factors:

• Decrease in elimination
  
  • Renal failure
  • Aldosterone deficiency
  • K-sparing diuretics
• Excessive intake
  
  • Oral or IV
• Transcompartmental shifts
  
  • release of intracellular K related to burns, crush injuries, extreme exercise, other types of cell damage

Question 12

S/S include intercellular dehydration (dry skin, dry mucous membranes, and no tears).

a. ) Hyponatremia b.) Hypernatremia
c. ) Hypokalemia d.) Hyperkalemia
e. ) Hypocalcemia f.) Hypercalcemia

Answer 12

Hypernatremia

increase in serum sodium

P/C Factors:

• Excess water loss
  
  • Renal (i.e. polyuria)
  • GI (i.e. watery diarrhea)
  • Skin (i.e. increase in sweating)
• Decreased water intake
  
  • Thirst defect or inability to drink
• Excessive sodium intake
  
  • Oral or IV administration, near-drowning in salt water

Question 13

Acute form causes increased membrane excitability (paresthesia, seizures, cardiac dysrhythmias, tetany [muscle spasms/twitching]), and Laryngospasms (airway obstruction). Chronic form results in osteoporosis.

a. ) Hyponatremia b.) Hypernatremia
c. ) Hypokalemia d.) Hyperkalemia
e. ) Hypocalcemia f.) Hypercalcemia

Answer 13

Hypocalcemia

decrease in serum levels

Acute form:

• increased membrane excitability (too little of the membrane stabilizer).
  
  • paresthesia
  • seizures
  • cardiac dysrhythmias
  • tetany (muscle spasms/twitching)
  • Laryngospasms (airway obstruction).

Chronic form:

• osteoporosis.

P/C Factors:

• Decrease in intestinal absorption
  
  • decrease in vitamin D₃ malabsorption
• Decrease in ability to mobilize from bone
  
  • related to altered parathyroid function
• Abnormal renal loss
  
  • renal failure
• increase in protein binding
  
  • alkaline pH

Question 14

If mild, the person experiences tingling (paresthesia) and increased peristalsis (diarrhea).

a. ) Hyponatremia b.) Hypernatremia
c. ) Hypokalemia d.) Hyperkalemia
e. ) Hypocalcemia f.) Hypercalcemia

Answer 14

Hyperkalemia

increase in serum levels

P/C Factors:

• Decrease in elimination
  
  • Renal failure
  • Aldosterone deficiency
  • K-sparing diuretics
• Excessive intake
  
  • Oral or IV
• Transcompartmental shifts
  
  • release of intracellular K related to burns, crush injuries, extreme exercise, other types of cell damage

Question 15

ECF is hypotonic causing fluid to move into the cells (swelling of body cells). Notice first when brain cells start to swell (neurological symptoms: lethargy, headache, nausea and vomiting, motor weakness, confusion, seizures, or coma).

a. ) Hyponatremia b.) Hypernatremia
c. ) Hypokalemia d.) Hyperkalemia
e. ) Hypocalcemia f.) Hypercalcemia

Answer 15

Hyponatremia

Decrease in serum sodium

P/C factors:

• increase in sodium/water loss, accompanied by replacement with sodium-free fluid.
  
  • Skin (i.e. excessive sweating, burns)
  • GI loss (i.e. vomiting, diarrhea, tap water enemas)
  • Renal (i.e. aggressive diuretic therapy)
• Excessive water intake in relation to output (dilutional hyponatremia)
  
  • Psychogenic polydipsia
  • increased intake + impaired elimination
    
    • kidney disease and increase in ADH levels

Question 16

ECF is hypertonic causing fluid to move out of the cells (intracellular dehydration). S/S include dry skin, dry mucous membranes, no tears, little saliva. Begin to notice when the brain cells shrink or swell.

a. ) Hyponatremia b.) Hypernatremia
c. ) Hypokalemia d.) Hyperkalemia
e. ) Hypocalcemia f.) Hypercalcemia

Answer 16

Hypernatremia

increase in serum sodium

P/C Factors:

• Excess water loss
  
  • Renal (i.e. polyuria)
  • GI (i.e. watery diarrhea)
  • Skin (i.e. increase in sweating)
• Decreased water intake
  
  • Thirst defect or inability to drink
• Excessive sodium intake
  
  • Oral or IV administration, near-drowning in salt water

Question 17

Increase in sodium/water loss, accompanied by replacement with sodium-free fluid.

a. ) Hyponatremia b.) Hypernatremia
c. ) Hypokalemia d.) Hyperkalemia
e. ) Hypocalcemia f.) Hypercalcemia

Answer 17

Hyponatremia

Decrease in serum sodium

P/C factors:

• increase in sodium/water loss, accompanied by replacement with sodium-free fluid.
  
  • Skin (i.e. excessive sweating, burns)
  • GI loss (i.e. vomiting, diarrhea, tap water enemas)
  • Renal (i.e. aggressive diuretic therapy)
• Excessive water intake in relation to output (dilutional hyponatremia)
  
  • Psychogenic polydipsia
  • increased intake + impaired elimination
    
    • kidney disease and increase in ADH levels