Patho Exam 1: REV Flashcards Preview

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Flashcards in Patho Exam 1: REV Deck (111):
1

Acidosis/Alkalosis

ROME

  • Respirotaroy Opposite
    • pH up PCO2 down= Alkalosis
    • pH down PCO2 up= Acidosis
  • Metabolic Equal
    • pH up HCO3 up = Alkalosis
    • pH down HCO3 down = Acidosis

2

Hypothalamus Functions

TAN HATS

  • Thirst & Water balance
  • Adenohypophysis
  • Neurohypophysis
  • Hunger & Satiety
  • Autonomic regulation
  • Temperature Reg
  • Sexual urges & emotions

3

Causes/ R/T of Hyperkalemia

MACHINE

  • Meds
  • Acidosis
  • Cellular destruction
  • Hypoaldosteronism (hemolysis)
  • Intake, excessive
  • Nephrons, renal failure
  • Excretion, impaired

4

Signs (AEB) Hyperkalemia

MURDER

  • Muscle weakness
  • Urine, oliguria, anuria
  • Respiratory distress
  • Decreased cardiac contractility
  • EKG Changes, Peaked T Waves
  • Reflexes, hyper, or hypo

5

Signs (AEB) Hypokalemia

6L's

  1. Lethargy
  2. Lethat cardiac arrhthymia
  3. Leg cramps
  4. Limp Muscles
  5. Low, shallow respirations
  6. Less stool (constipation)

6

R/T Hypokalemia

GRAPHIC IDEA

  • GI losses
  • Renal
  • Aldosterone
  • PEriodic paralysis
  • Insulin Excess
  • Cushing;s Syndrome
  • Insufficient intake
  • Diuretics
  • Elevated beta adrenergic activity
  • Alkalosis

7

Signs (AEB) of Hypernatremia

FRIED

  • Fever
  • Restless
  • Increase BP
  • Edema
  • Decreased Urinary Output

8

How much of the body fluid is intracellular

2/3

9

How much of the bod fluid is extracellular

1/3

10

What are the 2 components of extracellular compartment?

  1. interstitial
  2. intravascular

11

How does water move across membranes

freely

12

What is the major ECF cation

Sodium

13

What is the major ICF cation

potassium

14

a hormone that is secreted when sodium levels are depressed.

aldosterone

15

This hormone gets secreted when potassium is increased

adosterone

16

this is a result of an underlying disorder

hyperchloremia (elevated serum chlorine),

17

What is the usual cause of hyperchloremia

an increase in sodium and a deficit of bicarbonate

18

Are there symptoms of hyperchloremia

no

19

This is an outcome of serious burns, vomiting, or diarrhea

hypornatremia

20

When does hyperkalemia often occur

acidosis

21

This often occurs w/ acidosis. Hydrogen is taken up in the cell. It is exchanged for potassium and serum potassium rises.

Hyperkalemia

22

What would aldosterone cause for your potassium levels

hypokalemia

23

A patient has deep and rapid respirations. Laboratory tests reveal decreased pH and bicarbonate. This patient is experiencing:

metabolic acidosis

24

A common cause of the increased filtration of fluid from capillaries and lymph into surrounding tissues (edema) includes:

  1. inc hydrostatic pressure
  2. dec plasma oncotic pressure.
  3. inc capillary membrane permeability.
  4. lymphatic obstruction

25

What is the process called where carbon dioxide (CO2) is exchanged for oxygen?

Respiration

26

This is the mechanical movement of gas or air into and out of the lungs

Ventilation

27

This is actual blood flow and oxygen delivery.

Circulation

28

Which muscles has a major role in respiration?

  1. External intercostal
  2. Diaphragm

29

characterized by a slightly increased ventilatory rate, very large tidal volumes, and no expiratory pause

Kussmaul respiration (hyperpnea)

30

This iss the selective bulbous enlargement of the end of a digit (finger or toe). It is commonly associated with diseases that cause chronic hypoxemia, such as bronchiectasis, cystic fibrosis, pulmonary fibrosis, lung abscess, and congenital heart disease

clubbing

31

Conditions that can cause of hypercapnia? x4

  1. Disease of the medulla
  2. Large airway obstruction
  3. Thoracic cage abnormalities
  4. Depression of the respiratory center

32

hypocapnia characteristics

  • severe anxiety
  • Results in respiratory alkalosis
  • PaCO2 less than 36 mm Hg

33

RUB MUB

Respiratory Uses Bicarb

Metabolic Uses Breathing

34

When your acid bases are fully compensated, what is normal

pH

35

When your acid bases are partially compensated

pH will still be off balance, but something is still trying to correct it

36

Who is Sodium's buddy

Chloride

37

Who pares with Calcium but is always inversed

phosphate

38

 This is in both intercellular space and extracellular

Bicarb

Phosphate

39

ICF includes

  • Potassium
  • Magnesuium

40

ECF includes:

  • Sodium
  • Chloride
  • Calcium
  • Phosphate

41

Calcium Normal Value

8.5-10.5

42

Potassium Normal Value

3.5-5

43

Sodium Normal Value

135-145

44

Chloride Normal Value

95-105

45

Magnesium Normal Value

1.5-2.0

46

Phosphate Normal Value

1.6-2.6

47

Why does sodium interact with calcium?

to maintain muscle contraction

48

Signs of Hyponatremia

SALT LOSS

 

  • Stupor/Coma
  • Anorexia
  • Lethargy
  • Tendon Reflexes Decreased
  • Limp Muscles
  • Orthostatic Hypotenion
  • Seizures/headaches
  • Stomach Cramping

49

Signs of HypoCalcemia

CATS

  • Convulsions
  • Arrhythmias
  • Tetany
  • Spasma/Stridor

50

Hypernatremia Etiology

MODEL

  • Medications/Meals
  • Osmotic Diuretics
  • Diabetes Insipidus
  • Excessive Water Loss
  • Low Water Intake

51

a condition marked by intermittent muscular spasms, caused by malfunction of the parathyroid glands and a consequent deficiency of calcium.

Tetany

52

intravascular water is

blood

53

Children vs Adult Water Retention

  • 70% kids
  • 45% older adults
  • prone to dehydration

54

What are non electrolytes

  • most organic molecules
  • do not dissociate in water
  • carry NO net electrical charge
  • (example: protein, glucose)

55

What are electrolytes

  • dissociate in water to ions
  • inorganic salts, acids, bases, some bases
  • more osmotic pwr (attract water)

56

Functions of electroylyes

  • regulate nerve/muscle function
  • hemodynamically stable
  • stay hydrated
  • manage pH
  • blood pressure
  • damaged tissue repair

57

relating to the flow of blood within the organs and tissues of the body

hemodynamic

58

How do we maintain homeostasis

  • movement of fluids & electrolytes
  • fluid intake and fluid output
  • hormonal regulation
  • adh, Adosterone, Renin, Angiotensin, Natriuretic Peptides

59

What changes the hydrostatic pressure

force of the weight of water molecules pressing against the confining walls.

60

What are the results of hydrostatic pressure

  • movement from an area of Greater pressure to lower pressure
  • makes cell wall more permeable

61

Exerted by proteins, notably albumin, in a blood vessel's plasma (blood/liquid) that usually tends to pull water into the circulatory system.

  • Oncotic pressure
  • (egg white, dense less permeable)
  • keep fluid in

62

fluid getting backed up in the tissue

edema

63

hydrostatic pressure=

osmotic/oncotic pressure (not inflamed)

64

3 Classification of Osmolarity

  • isotonic (same as blood)
  • hypotonic (water, more inside)
  • hypertonic (gatorade, more outside)

65

Normal serum osmolarity

280-295 mOsm/L

66

What directions to solutes diffuse?

high to low

67

What direction does osmosis move?

towards higher concentration

68

Moves both water and small solutes from high pressure to low pressure

Filtration

69

What are 7 mechanisms for fluid balance

  1. hypothalamic,
  2. pituitary
  3. Adrenal cortex (on top of kidneys)
  4. Kidneys
  5. Heart
  6. GI Tract
  7. Insensible water loss

70

These hormones regulate body fluid x4

  • Renin Angiotensin
  • Aldosterone
  • Natriuretic Peptides
  • Antidiuretic hormone (keep water)

71

RAAS stimulates

Angiotensinogen (renin)> Angiotensin I (enzyme) > Angiotenin II > potent vasoconstrictor, stimulates aldosterone secretion

ex: ace inhibitor (decreases BP), low sodium

72

hormones secreted by your heart in response to BP and blood volume that stretch heart tissues

NP- Natriuretic Peptides

73

When does ADH respond

  • to serum osmolaltiy,
  • fever,
  • pain,
  • stress,
  • opiods
  • (LOW BLOOD VOLUME)

74

It is better to be lacking fluid than

osmolarity

75

With a decrease in ADH release, urine will be more

dilute

76

Types of fluid volume imbalances

  • deficit
  • excess
  • shift
  • ECF it is accompanied by changes in the serum sodium levels

77

What is 3rd spacing

  • constantly leaking out
  • not easily exchanged with ECF

78

Cations have a positive or negative charge?

positive

79

What is the major cation in the blood

Sodium (Na+)

extracellular

80

What regulates potassium

 

  • aldosterone.
  • Increase aldosterone increase excretion of potassium
  • everytime you pee lose potassium
  • Na+ & K go opposite one another

81

Hypoxia Signs & Symptoms

RAT BED

Early Signs:

  • Restlessness
  • Anxiety
  • Tachycardia/Tachypnea

Late Signs:

  • Bradycardia
  • Extreme Restlessness
  • Dyspnea

82

the patient who is vomiting will lose a significant amount of gastric acid and be at an increased risk for

metabolic alkalosis

83

gastric secretions are rich in

hydrochloric acid

84


You are caring for a patient admitted with a diagnosis of chronic obstructive pulmonary disease (COPD) who has the following arterial blood gas results: pH 7.33, PaO2 47 mm Hg, PaCO2 60 mm Hg, HCO3 32 mEq/L, and O2 saturation of 92%. What is the correct interpretation of these results?
 

Partially compensated respiratory acidosis

85

You are caring for a patient receiving calcium carbonate for the treatment of osteopenia. Which serum laboratory result would you identify as an adverse effect related to this therapy?

Phosphorus falling to 2.1 mg/dL

86

contraindicated during episodes of hypokalemia because these medications cause the kidneys to excrete sodium and potassium

Loop Diuretics

87

Which nursing intervention is most appropriate when caring for a patient with dehydration?

Monitor daily weight and intake and output.

88

When planning care for a patient with dehydration related to nausea and vomiting, the nurse would anticipate which fluid shift to occur because of the fluid volume deficit?

Fluid movement from the interstitial space into the blood vessels

89

Magnesium food containing products

  • chocolate
  • nuts
  • peanut butter
  • banana

90

Used to remove excess magnesium in the blood

renal dialysis

91

The patient is admitted with metabolic acidosis. Which system is not functioning normally?

Kidney

92

The dehydrated patient is receiving a hypertonic solution. What assessments must be done to avoid risk factors of these solutions

  • Lung sounds
  • Blood Pressure
  • Serum sodium level

93

What is a compensatory mechanism for metabolic acidosis

hyperventilation (allow to continue)

94

During sepsis, the formation of lactic acid is common during this process?

metabolic acidosis

95

Recspiratory acidosis Examples:

  • hypoventilation, increase PCO2
  • Compensation: Kidneys Reabsorb Bicarb

96

Metabolic Acidosis Examples

  • Lactic Acidosis
  • Renal Failure
  • Ketones
  • Ammonium intoxication
  • Compensation: Hyperventilation to eliminate CO2

97

How does Respiratory alkalosis compensate?

Kidneys excrete HCO3

98

Causes for Metabolic Alkalosis

  • Emesis
  • diuretics
  • retention of HCO3 medication,
  • Hyperaldosteronism

99

How does the body compensate for metabolic alkalosis?

  • Respiratory cts not stimulated
  • Hypoventilation
  • CO2 retention

100

Respiratory Acidosis Retains

Bicarb

101

Metabolic Acidosis Increases

Ventilation

102

Hyperventilating decrease PC02 causing what to happen to pH

Rise (respiratory alkalosis)

103

Normal Value for PCO2

35-45

104

Normal Value for HCO3

22-26

105

Normal Value for PO2

80-100

106

Base Excess: -2 - +2

  • Always negative w/ metabolic acidosis
  • awalys positive w/ metabolic alkalosis

107

Nursing Interventions for Metabolic Alkalosis

  • monitor ABG levels
  • monitor hypokalemia
  • monitor hypocalcemia
  • I/Os

108

Risk Factors Metabolic Acidosis

  • hyperchloremia
  • lactic acidosis
  • renal failure
  • severe diarhea

109

How close should intake an output be

roughly equal (2000 mL/day)

110

this is required for blood clotting

calcium

111

a protein whose presence in the blood promotes aldosterone secretion and tends to raise blood pressure.

Angiotensin