Patho Exam 1: REV Flashcards
1
Q
Acidosis/Alkalosis
ROME
A
-
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
Q
Hypothalamus Functions
A
TAN HATS
- Thirst & Water balance
- Adenohypophysis
- Neurohypophysis
- Hunger & Satiety
- Autonomic regulation
- Temperature Reg
- Sexual urges & emotions
3
Q
Causes/ R/T of Hyperkalemia
A
MACHINE
- Meds
- Acidosis
- Cellular destruction
- Hypoaldosteronism (hemolysis)
- Intake, excessive
- Nephrons, renal failure
- Excretion, impaired
4
Q
Signs (AEB) Hyperkalemia
A
MURDER
- Muscle weakness
- Urine, oliguria, anuria
- Respiratory distress
- Decreased cardiac contractility
- EKG Changes, Peaked T Waves
- Reflexes, hyper, or hypo
5
Q
Signs (AEB) Hypokalemia
A
6L’s
- Lethargy
- Lethat cardiac arrhthymia
- Leg cramps
- Limp Muscles
- Low, shallow respirations
- Less stool (constipation)
6
Q
R/T Hypokalemia
A
GRAPHIC IDEA
- GI losses
- Renal
- Aldosterone
- PEriodic paralysis
- Insulin Excess
- Cushing;s Syndrome
- Insufficient intake
- Diuretics
- Elevated beta adrenergic activity
- Alkalosis
7
Q
Signs (AEB) of Hypernatremia
A
FRIED
- Fever
- Restless
- Increase BP
- Edema
- Decreased Urinary Output
8
Q
How much of the body fluid is intracellular
A
2/3
9
Q
How much of the bod fluid is extracellular
A
1/3
10
Q
What are the 2 components of extracellular compartment?
A
- interstitial
- intravascular
11
Q
How does water move across membranes
A
freely
12
Q
What is the major ECF cation
A
Sodium
13
Q
What is the major ICF cation
A
potassium
14
Q
a hormone that is secreted when sodium levels are depressed.
A
aldosterone
15
Q
This hormone gets secreted when potassium is increased
A
adosterone
16
Q
this is a result of an underlying disorder
A
hyperchloremia (elevated serum chlorine),
17
Q
What is the usual cause of hyperchloremia
A
an increase in sodium and a deficit of bicarbonate
18
Q
Are there symptoms of hyperchloremia
A
no
19
Q
This is an outcome of serious burns, vomiting, or diarrhea
A
hypornatremia
20
Q
When does hyperkalemia often occur
A
acidosis
21
Q
This often occurs w/ acidosis. Hydrogen is taken up in the cell. It is exchanged for potassium and serum potassium rises.
A
Hyperkalemia
22
Q
What would aldosterone cause for your potassium levels
A
hypokalemia
23
Q
A patient has deep and rapid respirations. Laboratory tests reveal decreased pH and bicarbonate. This patient is experiencing:
A
metabolic acidosis
24
Q
A common cause of the increased filtration of fluid from capillaries and lymph into surrounding tissues (edema) includes:
A
- inc hydrostatic pressure
- dec plasma oncotic pressure.
- inc capillary membrane permeability.
- 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 c*ongenital 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
* **S**tupor/Coma
* **A**norexia
* **L**ethargy
* **T**endon Reflexes Decreased
* **L**imp Muscles
* **O**rthostatic Hypotenion
* **S**eizures/headaches
* **S**tomach Cramping
49
Signs of HypoCalcemia
CATS
* **C**onvulsions
* **A**rrhythmias
* **T**etany
* **S**pasma/**Stridor**
50
Hypernatremia Etiology
MODEL
* **M**edications/Meals
* **O**smotic Diuretics
* **D**iabetes Insipidus
* **E**xcessive Water Loss
* **L**ow 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
* **R**enin Angiotensin
* **A**ldosterone
* **N**atriuretic Peptides
* **A**nti**_d_**iuretic **_h_**ormone *(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:
* **R**estlessness
* **A**nxiety
* **T**achycardia/Tachypnea
Late Signs:
* **B**radycardia
* **E**xtreme Restlessness
* **D**yspnea
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 **Alkalosi**s
* Emesis
* diuretics
* retention of HCO3 medication,
* **Hyper**aldosteronism
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 **hypo**kalemia
* monitor **hypo**calcemia
* I/Os
108
Risk Factors Metabolic Acidosis
* **hyper**chloremia
* 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
