S2L3: Metabolic Conditions - Fluid & Electrolyte Imbalance Flashcards by MindMed Official

Give 3 causes of dehydration

Poor intake
Excess output
Profuse sweating
Vomiting
Diarrhea
Diuretics

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Give 3 Clinical Manifestations of Dehydration

Poor skin turgor
Dry mucous membranes
Headache
Irritability
Postural Hypotension
Incoordination
Lethargy
Disorientation

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Dehydration may lead to: (2)

uremia and hypovolemic shock

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Identify: Excess of body fluids with expansion of interstitial fluid volume

EDEMA

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Give 3 Causes of edema

Heart failure, kidney disease, premenstrual retention, pregnancy, heat stress, venous insufficiency
Protein-losing kidney disease, starvation, malnutrition
Inflammation, allergic reactions, malignancy, tissue injury, burns, liver cirrhosis
Obstruction of lymphatic flow

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Give 3 Clinical Manifestations of Edema

Bipedal edema
Weight gain
Headache
Blurred vision
Muscle cramps
Twitches

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N Level of Potassium

3.5 - 5.5 mEq/L

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Give 3 Causes of hypokalemia

Diarrhea, vomiting, metabolic alkalosis, renal tubular disease, alkalosis, diuretic use

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Give 3 Manifestations of hypokalemia

Muscle weakness, aches, fatigue, cardiac arrhythmias (ST segment depression) abdominal distention, nausea and vomiting

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Give 3 Causes of hyperkalemia

Acute renal failure, metabolic acidosis, diabetic ketoacidosis, sickle cell anemia, SLE

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Give 2 Manifestations of hyperkalemia

Muscle weakness, arrhythmias (Tall T wave, prolonged P-R interval and QRS duration)

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N Level of Na

135 - 146 mEq/L

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Sodium is usually located in:
A. Interstitial fluid
B. CSF
C. Blood
D. Lymphatic Fluids

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Identify: substance that keeps fluids in the body balanced

sodium

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Give 3 causes of Hyponatremia

Water intoxication
Tumors
Endocrine tumors

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Give 3 Manifestations of hyponatremia

Confusion, decreased mental alertness, convulsions, signs of increased ICP, cerebral hemorrhages, poor motor coordination, sleepiness, anorexia

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Give 3 causes of Hypernatremia

Water deficits, with dehydration, insufficient water intake

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Give 3 manifestations of Hypernatremia

Pitting edema, excessive weight gain, pulmonary edema with dyspnea, hypertension, tachycardia, agitation, restlessness, convulsions

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What is the normal level of calcium

8.4 - 10.4 mg/dL

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Give 3 causes of hypocalcemia

Reduced albumin, hyperphosphatemia, hypoparathyroidism, malabsorption of calcium and vitamin D, alkalosis, acute pancreatitis

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Give 3 manifestations of hypocalcemia

muscle cramps, tetany, spasms, paresthesia, anxiety, irritability, twitching convulsion, arrhythmias, hypotension

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Give 3 causes of hypercalcemia

Hyperparathyroidism, tumors, hyperthyroidism, vitamin A intoxication

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Give 3 manifestations of hypercalcemia

Fatigue, depression, mental confusion, nausea/vomiting, increased urination, occasional cardiac arrythmias

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Resisting membrane potential of a neuron is _ mv

-70 mv

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Modified T or F Resisting membrane potential is determined by the uneven distribution of ions. There is more potassium ions outside the neuron & more sodium inside A. First statement true, second statement false B. Second statement true, first statement false C. Both statements are true D. Both statements are false

A More potassium ions inside the neuron More sodium outside

During depolarization, sodium needs to go inside the cell through a channel. When you want this process to seize, calcium blocks the channel so it stops the sodium influx and depolarization. A. First statement true, second statement false B. Second statement true, first statement false C. Both statements are true D. Both statements are false

In hypercalcemia, the channel is constantly open. It is hard for neuron to repolarize A. First statement true, second statement false B. Second statement true, first statement false C. Both statements are true D. Both statements are false

D Channel is constantly blocked Hard for neuron to depolarize

In hypocalcemia, the sodium channel is constantly open. There is a constant influx of calcium ions A. First statement true, second statement false B. Second statement true, first statement false C. Both statements are true D. Both statements are false

A Constant influx of sodium ions

In hypocalcemia, resting membrane potential ↑ from -70mv. Neurons will be hypoexcitable A. First statement true, second statement false B. Second statement true, first statement false C. Both statements are true D. Both statements are false

In hypocalcemia, there is a (+) Chvostek sign & (-) Trousseau sign. The pt may present c anxiety since nerve cells in the brain are constantly firing. A. First statement true, second statement false B. Second statement true, first statement false C. Both statements are true D. Both statements are false

B (+) Chvostek sign (+) Trousseau sign

N Level of Magnesium is _ mg/dL

1.8- 2,4 mg/dL

Give 3 causes of hypomagnesemia

Hemodialysis, blood transfusion, chronic renal disease, hepatic cirrhosis, chronic pancreatitis, hypoparathyroidism, malabsorption syndromes, severe burns, excess loss of body fluids

Give 3 Manifestations of hypomagnesemia

Hyperirritability, confusion, leg and foot cramps

Give 3 causes of hypermagnesemia

Renal failure, diabetic acidosis, hypothyroidism, Addison's disease, dehydration, use of antacids

Give 3 manifestations of hypermagnesemia

Hyporeflexia, muscle weakness, drowsiness, lethargy, confusion, bradycardia, hypotension

Magnesium is important for _ _ _

protein synthesis, nerve and muscle function, energy production

Problems in magnesium leads to _ _ _

dec BP, heart disease and type 2 diabetes

Magnesium also regulates _ and adjusts _

immune system, blood glucose levels

Symptoms of hypermagnesemia develop with levels more than _ meq/L

An average adult has approx. _g of magnesium in the body

Half of the magnesium is found in the bones. The other half is found in the cells. A. First statement true, second statement false B. Second statement true, first statement false C. Both statements are true D. Both statements are false

Magnesium is a common negatively charged ion in the cell, 2nd to K. Approx 1% is found in the extracellular space A. First statement true, second statement false B. Second statement true, first statement false C. Both statements are true D. Both statements are false

Hypomagnesemia levels: < _ mg/dL _ mol/L

Normal levels: 1.7-2.2 mg/dL; Hypomagnesemia levels: < 1.7 mg/dL 0.70 mol/L

Give 3 sx of hypomagnesemia

Sx: tremor, nystagmus, seizures, cardiac arrest

Give 3 causes of hypomagnesemia

Causes: alcoholism, starvation, diarrhea, inc urinary loss, poor absorption from intestines

Causes of hypomagnesemia are alcoholism, starvation, diarrhea, inc urinary loss, poor absorption from intestines. These sx can be present without deficiency in magnesium and vice versa A. First statement true, second statement false B. Second statement true, first statement false C. Both statements are true D. Both statements are false

Identify: 2nd most abundant electrolyte after sodium

Chloride

N Level of Chloride: _ mEq/L

98- 107

Chloride helps w regulation of body fluids, regulation of electrolyte balance, preservation of electrical neutrality, and acid-base status. Abnormal chloride levels are not usually d/t metabolic acidosis & alkalosis A. First statement true, second statement false B. Second statement true, first statement false C. Both statements are true D. Both statements are false

A usually due to metabolic acidosis & alkalosis

Hypochloremia frequently accompanies hypernatremia. Laxatives increase motility of stool while diuretics increase excretion A. First statement true, second statement false B. Second statement true, first statement false C. Both statements are true D. Both statements are false

B Hypochloremia frequently accompanies hyponatremia.

Give 3 causes of hypochloremia

Congestive heart failure, prolonged diarrhea/vomiting, chronic lung disease, metabolic alkalosis, laxative use, diuretics, corticosteroids, bicarbonates

Give 3 manifestations of hypochloremia

Fluid loss, dehydration, weakness, fatigue, difficulty breathing, diarrhea/vomiting

Give 3 causes of hyperchloremia

Kidney problem, diabetes, severe dehydration, increased saline solution (p surgery), ingestion of salt water, inc dietary salt, respiratory alkalosis

Give 3 manifestations of hyperchloremia

Fatigue, muscle weakness, excessive thirst, dry mucous membranes, high BP

Hyperchloremia is > _ meq/L of chloride

106

Give 3 sx of Hyperchloremia

Edematous Rapid, blowing respirations to remove acid build-up through lungs Typically in metabolic acidosis Decreasing level of consciousness (LOC)

In hyperchloremia, urine output is closely monitored since pt is treated with diuretics. The pt would need close monitoring of heart since it is bradycardic. A. First statement true, second statement false B. Second statement true, first statement false C. Both statements are true D. Both statements are false

A tachycardic

In hyperchloremia, the goal is to get the urine out of the system. When BP is elevated, diuretics are used for fluid retention & to ↓ BP A. First statement true, second statement false B. Second statement true, first statement false C. Both statements are true D. Both statements are false

A BP is elevated, diuretics are used to eliminate fluid & to ↓ BP

Give 3 nursing actions for hyperchloremia

Monitor HR, BP, respirations Administer diuretics Skin care Decrease sodium, & fluid intake

Hypochloremia has <_ meq/L of chloride

Give 3 sx of hypochloremia

Rigid extremities (tetany) Slight tremors/twitching Tetany can lead to seizures Slow, shallow respirations (metabolic alkalosis)

If hypochloremia is severe, it can lead to inc in blood pressure, respiratory & cardiac problems. When BP is elevated, diuretics are used to eliminate fluid & to ↓ BP A. First statement true, second statement false B. Second statement true, first statement false C. Both statements are true D. Both statements are false

B dec in BP

Give 3 nursing actions for hypochloremia

Replace Na+: can be done orally via sodium-containing foods, salt tablets Monitoring VS, intake & output are critical Safety: need assistance in ambulation d/t tremors & decreased BP from sitting → standing position

Normal level of Phosphate

3-4.5 mg/dL

# Modified T/F A. Phosphate has direct relationship with calcium B. Hence, s/sx of hyperphosphatemia = S/sx of hypokalemia and s/sx of hypophosphatemia = s/sx of hyperkalemia

FT ## Footnote Has inverse relationship with calcium

Which of the following is not a function of phosphate? A) Helps to repair bones and teeth B) Helps in nerve function and muscle contractility C) Essential in RNA and DNA degradation D) Activation of enzymes as part of ATP - primary source of energy

C) Essential in RNA and DNA degradation ## Footnote Essential in RNA and DNA synthesis

# T/F: Low phosphate levels are usually associated with malignancy and hyperparathyroidism (HyperPTH).

True

# Modified T/F: A. High phosphate levels are d/t chronic kidney diseases B. Pts with kidney problems uses phosphate-releasing medications

False ## Footnote phosphate-binding medications

# Which condition is associated with the following manifestations? Muscle weakness, fatigue, bone fractures and pain, irritability, and slowed growth in children. A) Hypophosphatemia B) Hyperphosphatemia

A) Hypophosphatemia

# Which condition is associated with the following manifestations? Numbness, confusion, loss of appetite, and tooth decay or late baby teeth. A) Hypophosphatemia B) Hyperphosphatemia

A) Hypophosphatemia

# Which condition is associated with the following manifestations? Muscle cramps, bone and joint pain, weak bones, rashes, and itchy skin. A) Hypophosphatemia B) Hyperphosphatemia

B) Hyperphosphatemia

# Which condition is associated with the following manifestations? Numbness and tingling around the mouth. A) Hypophosphatemia B) Hyperphosphatemia

B) Hyperphosphatemia

# Which condition is associated with the following manifestations? Muscle and cell damage, high vitamin D levels, and diabetic ketoacidosis are common causes. A) Hypophosphatemia B) Hyperphosphatemia

B) Hyperphosphatemia

# Which condition is associated with the following manifestations? Genetic factors, hospitalized individuals (especially in the ICU) due to fluid loss, and alcoholism are potential causes. A) Hypophosphatemia B) Hyperphosphatemia

A) Hypophosphatemia

# Which condition is associated with the following manifestations? Kidney problem, hypoparathyroidism and infections are potential causes. A) Hypophosphatemia B) Hyperphosphatemia

B) Hyperphosphatemia

# Which condition is associated with the following manifestations? Faconi syndrome, hyperparathyroidism, chronic diarrhea,and vit D deficiency are potential causes. A) Hypophosphatemia B) Hyperphosphatemia

A) Hypophosphatemia

# Which condition is associated with the following manifestations? Severe burns and diabetic ketoacidosis deficiency are potential causes. A) Hypophosphatemia B) Hyperphosphatemia

A) Hypophosphatemia

# T/F Diabetic ketoacidosis is potential cause of Hypophosphatemia AND Hyperphosphatemia

True

# Modified T/F: A. Normal pH levels are around 7.35-7.45 B. Hydrogen ions are measured in pH

# Identify if the description correspond toMetabolic Acidosis or Alkalosis The blood is too acidic. A) Metabolic Acidosis B) Metabolic Alkalosis

A) Metabolic Acidosis

# Identify if the description correspond toMetabolic Acidosis or Alkalosis Life-threatening condition that requires immediate treatment. A) Metabolic Acidosis B) Metabolic Alkalosis

A) Metabolic Acidosis ## Footnote This is diabetic ketoacidosis

# Identify if the description correspond toMetabolic Acidosis or Alkalosis May eventually lead to stupor or coma. A) Metabolic Acidosis B) Metabolic Alkalosis

A) Metabolic Acidosis

# Identify if the description correspond toMetabolic Acidosis or Alkalosis Manifestations include hyperventilation and deep respirations. A) Metabolic Acidosis B) Metabolic Alkalosis

A) Metabolic Acidosis

# Identify if the description correspond toMetabolic Acidosis or Alkalosis Manifestations include depressed respirations and dysrhythmias. A) Metabolic Acidosis B) Metabolic Alkalosis

B) Metabolic Alkalosis

# Identify if the description correspond toMetabolic Acidosis or Alkalosis Common causes include excess vomiting and excess diuretic use. A) Metabolic Acidosis B) Metabolic Alkalosis

B) Metabolic Alkalosis

# Identify if the description correspond toMetabolic Acidosis or Alkalosis Manifestations include irritability, agitation, and confusion. A) Metabolic Acidosis B) Metabolic Alkalosis

B) Metabolic Alkalosis

# Identify if the description correspond toMetabolic Acidosis or Alkalosis Causes include excess diuretics and hypokalemia. A) Metabolic Acidosis B) Metabolic Alkalosis

B) Metabolic Alkalosis

# Identify if the description correspond toMetabolic Acidosis or Alkalosis Causes Diabetes, renal insufficiency, and diarrhea A) Metabolic Acidosis B) Metabolic Alkalosis

A) Metabolic Acidosis

# Identify if the description correspond toMetabolic Acidosis or Alkalosis Manifestations include weakness, muscular twitches, malaise. A) Metabolic Acidosis B) Metabolic Alkalosis

A) Metabolic Acidosis

# Identify if the description correspond toMetabolic Acidosis or Alkalosis Manifestations include nausea, vomiting, diarrhea, and headache A) Metabolic Acidosis B) Metabolic Alkalosis

A) Metabolic Acidosis

# Identify if the description correspond toMetabolic Acidosis or Alkalosis Manifestations include dry skin and poor skin turgor A) Metabolic Acidosis B) Metabolic Alkalosis

A) Metabolic Acidosis

# Identify if the description correspond toMetabolic Acidosis or Alkalosis Common causes include peptic ulcer disease and excessive intake of antacids. A) Metabolic Acidosis B) Metabolic Alkalosis

B) Metabolic Alkalosis

# Identify if the description correspond toMetabolic Acidosis or Alkalosis Manifestations include hypoventilation, prolonged vomiting, weakness, muscle twitching and coma (death) A) Metabolic Acidosis B) Metabolic Alkalosis

B) Metabolic Alkalosis

# Modified T/F A. A pH level below 7.35 indicates alkalosis. B. A ph level above 7.45 indicates acidosis

FF ## Footnote ○ pH level <7.35 = acidosis ○ pH level >7.45 = alkalosis

# T/F: he pH level measures only hydrogen ions and indicates whether the pH level is normal, acidic, or basic.

True

In the equation CO2 + H2O ⇌ H2CO3 ⇌ HCO3 + H+ what is carbonic acid?

H2CO3

In the equation CO2 + H2O ⇌ H2CO3 ⇌ HCO3 + H+ what is bicarbonate ion?

HCO3

# Modified T/F: A. Respiratory acidosis is characterized by an increase in carbon dioxide levels and a decrease in pH. B. Respiratory alkalosis is characterized by a decrease in carbon dioxide levels and an increase in pH.

# Modified T/F: A. Metabolic acidosis can occur due to a decrease in bicarbonate levels, resulting in a decrease in pH. B. Metabolic alkalosis can occur due to a decrease in bicarbonate levels, resulting in a decrease in pH.

TF ## Footnote Metabolic alkalosis can happen if there is **increase in bicarbonate **or if there is decrease pH

S2L3: Metabolic Conditions - Fluid & Electrolyte Imbalance Flashcards

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