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(3) PT in Special Conditions > S2L3: Metabolic Conditions - Fluid & Electrolyte Imbalance > Flashcards

S2L3: Metabolic Conditions - Fluid & Electrolyte Imbalance Flashcards

1
Q

Give 3 causes of dehydration

A

Poor intake
Excess output
Profuse sweating
Vomiting
Diarrhea
Diuretics

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2
Q

Give 3 Clinical Manifestations of Dehydration

A

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

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3
Q

Dehydration may lead to: (2)

A

uremia and hypovolemic shock

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4
Q

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

A

EDEMA

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5
Q

Give 3 Causes of edema

A

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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6
Q

Give 3 Clinical Manifestations of Edema

A

Bipedal edema
Weight gain
Headache
Blurred vision
Muscle cramps
Twitches

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7
Q

N Level of Potassium

A

3.5 - 5.5 mEq/L

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8
Q

Give 3 Causes of hypokalemia

A

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

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9
Q

Give 3 Manifestations of hypokalemia

A

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

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10
Q

Give 3 Causes of hyperkalemia

A

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

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11
Q

Give 2 Manifestations of hyperkalemia

A

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

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12
Q

N Level of Na

A

135 - 146 mEq/L

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13
Q

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

A

C

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14
Q

Identify: substance that keeps fluids in the body balanced

A

sodium

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15
Q

Give 3 causes of Hyponatremia

A

Water intoxication
Tumors
Endocrine tumors

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16
Q

Give 3 Manifestations of hyponatremia

A

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

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17
Q

Give 3 causes of Hypernatremia

A

Water deficits, with dehydration, insufficient water intake

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18
Q

Give 3 manifestations of Hypernatremia

A

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

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19
Q

What is the normal level of calcium

A

8.4 - 10.4 mg/dL

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20
Q

Give 3 causes of hypocalcemia

A

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

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21
Q

Give 3 manifestations of hypocalcemia

A

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

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22
Q

Give 3 causes of hypercalcemia

A

Hyperparathyroidism, tumors, hyperthyroidism, vitamin A intoxication

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23
Q

Give 3 manifestations of hypercalcemia

A

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

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24
Q

Resisting membrane potential of a neuron is _ mv

A

-70 mv

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25
Q

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

A

More potassium ions inside the neuron
More sodium outside

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26
Q

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

A

C

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27
Q

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

A

D

Channel is constantly blocked
Hard for neuron to depolarize

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28
Q

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

A

Constant influx of sodium ions

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29
Q

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

A

A

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30
Q

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

A

B

(+) Chvostek sign
(+) Trousseau sign

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31
Q

N Level of Magnesium is _ mg/dL

A

1.8- 2,4 mg/dL

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32
Q

Give 3 causes of hypomagnesemia

A

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

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33
Q

Give 3 Manifestations of hypomagnesemia

A

Hyperirritability, confusion, leg and foot cramps

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34
Q

Give 3 causes of hypermagnesemia

A

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

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35
Q

Give 3 manifestations of hypermagnesemia

A

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

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36
Q

Magnesium is important for _ _ _

A

protein synthesis, nerve and muscle function, energy production

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37
Q

Problems in magnesium leads to _ _ _

A

dec BP, heart disease and type 2 diabetes

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38
Q

Magnesium also regulates _ and adjusts _

A

immune system, blood glucose levels

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39
Q

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

A

4

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40
Q

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

A

25

41
Q

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

A

C

42
Q

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

A

B

43
Q

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

A

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

44
Q

Give 3 sx of hypomagnesemia

A

Sx: tremor, nystagmus, seizures, cardiac arrest

45
Q

Give 3 causes of hypomagnesemia

A

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

46
Q

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

A

C

47
Q

Identify: 2nd most abundant electrolyte after sodium

A

Chloride

48
Q

N Level of Chloride: _ mEq/L

A

98- 107

49
Q

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

A

usually due to metabolic acidosis & alkalosis

50
Q

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

A

B

Hypochloremia frequently accompanies hyponatremia.

51
Q

Give 3 causes of hypochloremia

A

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

52
Q

Give 3 manifestations of hypochloremia

A

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

53
Q

Give 3 causes of hyperchloremia

A

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

54
Q

Give 3 manifestations of hyperchloremia

A

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

55
Q

Hyperchloremia is > _ meq/L of chloride

A

106

56
Q

Give 3 sx of Hyperchloremia

A

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

57
Q

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

A

tachycardic

58
Q

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

A

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

59
Q

Give 3 nursing actions for hyperchloremia

A

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

60
Q

Hypochloremia has <_ meq/L of chloride

A

95

61
Q

Give 3 sx of hypochloremia

A

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

62
Q

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

A

B

dec in BP

63
Q

Give 3 nursing actions for hypochloremia

A

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

64
Q

Normal level of Phosphate

A

3-4.5 mg/dL

65
Q

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

A

FT

Has inverse relationship with calcium

66
Q

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

A

C) Essential in RNA and DNA degradation

Essential in RNA and DNA synthesis

67
Q

T/F:

Low phosphate levels are usually associated with malignancy and hyperparathyroidism (HyperPTH).

A

True

68
Q

Modified T/F:

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

A

False

phosphate-binding medications

69
Q

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

A) Hypophosphatemia

70
Q

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

A) Hypophosphatemia

71
Q

Which condition is associated with the following manifestations?

Muscle cramps, bone and joint pain, weak bones, rashes, and itchy skin.

A) Hypophosphatemia

B) Hyperphosphatemia

A

B) Hyperphosphatemia

72
Q

Which condition is associated with the following manifestations?

Numbness and tingling around the mouth.

A) Hypophosphatemia

B) Hyperphosphatemia

A

B) Hyperphosphatemia

73
Q

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

A

B) Hyperphosphatemia

74
Q

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

A) Hypophosphatemia

75
Q

Which condition is associated with the following manifestations?

Kidney problem, hypoparathyroidism and infections are potential causes.

A) Hypophosphatemia

B) Hyperphosphatemia

A

B) Hyperphosphatemia

76
Q

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

A) Hypophosphatemia

77
Q

Which condition is associated with the following manifestations?

Severe burns and diabetic ketoacidosis deficiency are potential causes.

A) Hypophosphatemia

B) Hyperphosphatemia

A

A) Hypophosphatemia

78
Q

T/F

Diabetic ketoacidosis is potential cause of Hypophosphatemia AND Hyperphosphatemia

A

True

79
Q

Modified T/F:

A. Normal pH levels are around 7.35-7.45
B. Hydrogen ions are measured in pH

A

TT

80
Q

Identify if the description correspond toMetabolic Acidosis or Alkalosis

The blood is too acidic.

A) Metabolic Acidosis

B) Metabolic Alkalosis

A

A) Metabolic Acidosis

81
Q

Identify if the description correspond toMetabolic Acidosis or Alkalosis

Life-threatening condition that requires immediate treatment.

A) Metabolic Acidosis

B) Metabolic Alkalosis

A

A) Metabolic Acidosis

This is diabetic ketoacidosis

82
Q

Identify if the description correspond toMetabolic Acidosis or Alkalosis

May eventually lead to stupor or coma.

A) Metabolic Acidosis

B) Metabolic Alkalosis

A

A) Metabolic Acidosis

82
Q

Identify if the description correspond toMetabolic Acidosis or Alkalosis

Manifestations include hyperventilation and deep respirations.

A) Metabolic Acidosis

B) Metabolic Alkalosis

A

A) Metabolic Acidosis

83
Q

Identify if the description correspond toMetabolic Acidosis or Alkalosis

Manifestations include depressed respirations and dysrhythmias.

A) Metabolic Acidosis

B) Metabolic Alkalosis

A

B) Metabolic Alkalosis

84
Q

Identify if the description correspond toMetabolic Acidosis or Alkalosis

Common causes include excess vomiting and excess diuretic use.

A) Metabolic Acidosis

B) Metabolic Alkalosis

A

B) Metabolic Alkalosis

84
Q

Identify if the description correspond toMetabolic Acidosis or Alkalosis

Manifestations include irritability, agitation, and confusion.

A) Metabolic Acidosis

B) Metabolic Alkalosis

A

B) Metabolic Alkalosis

85
Q

Identify if the description correspond toMetabolic Acidosis or Alkalosis

Causes include excess diuretics and hypokalemia.

A) Metabolic Acidosis

B) Metabolic Alkalosis

A

B) Metabolic Alkalosis

86
Q

Identify if the description correspond toMetabolic Acidosis or Alkalosis

Causes Diabetes, renal insufficiency, and diarrhea

A) Metabolic Acidosis

B) Metabolic Alkalosis

A

A) Metabolic Acidosis

87
Q

Identify if the description correspond toMetabolic Acidosis or Alkalosis

Manifestations include weakness,
muscular twitches, malaise.

A) Metabolic Acidosis

B) Metabolic Alkalosis

A

A) Metabolic Acidosis

88
Q

Identify if the description correspond toMetabolic Acidosis or Alkalosis

Manifestations include nausea, vomiting, diarrhea, and headache

A) Metabolic Acidosis

B) Metabolic Alkalosis

A

A) Metabolic Acidosis

89
Q

Identify if the description correspond toMetabolic Acidosis or Alkalosis

Manifestations include dry skin and poor skin turgor

A) Metabolic Acidosis

B) Metabolic Alkalosis

A

A) Metabolic Acidosis

90
Q

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

A

B) Metabolic Alkalosis

91
Q

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

A

B) Metabolic Alkalosis

92
Q

Modified T/F

A. A pH level below 7.35 indicates alkalosis.
B. A ph level above 7.45 indicates acidosis

A

FF

○ pH level <7.35 = acidosis
○ pH level >7.45 = alkalosis

93
Q

T/F:

he pH level measures only hydrogen ions and indicates whether the pH level is normal, acidic, or basic.

A

True

94
Q

In the equation CO2 + H2O ⇌ H2CO3 ⇌ HCO3 + H+

what is carbonic acid?

A

H2CO3

95
Q

In the equation CO2 + H2O ⇌ H2CO3 ⇌ HCO3 + H+

what is bicarbonate ion?

A

HCO3

96
Q

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.

A

TT

97
Q

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.

A

TF

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

(3) PT in Special Conditions (40 decks)

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