Sem2Midterm Flashcards
1
Q
What are the three classifications of systems for anti-bitoics?
A
1-By Susceptible organism (broad or narrow spectrum)
2- BY bactericidal vs. bacteriostatic
3- By mechanisms of action
2
Q
What does it mean when a drug is bacteriocidal?
A
It is lethal to the bacteria at clinically achievable concentrations and the bacteria dies
3
Q
What does it mean when a drug is bacteriostatic?
A
This means that the bacterial growth will SLOW, but not die. The host will eventually eliminate the organism through phagocytes
4
Q
What are the 4 antimicrobial mechanisms of action?
A
Cell wall synthesis inhibitor
Protein synthesis inhibitor
DNA synthesis inhibitor
Metabolism Inhibitor (folate antagonist)
5
Q
Why are penicillins and Cephalosporins similar?
A
The both contain the beta-lactam structure
6
Q
Amoxicillin
A
Oral- Broad spectrum- 250mg-500 q8h Gram neg and pos organisms Eliminated through renal system AE: hypersensitivity, diarrhea *take with food* Caution with oral contraceptives
7
Q
What is beta-lactamase?
A
An enzyme that some bacteria produce that breaks down the beta lactam ring in penicillins and cephalosporins
-can be specific
8
Q
What is a beta- lactamase inhibitor ?
A
chemical compound that is to be taken WITH antibiotic so that the break-down of beta lactam is prevented.
9
Q
What is Augmentin made up of?
A
Clauvuanic Acid and amoxicillin
10
Q
What is Unasyn made up of?
A
Ampicillin and sulbactam
11
Q
What is Zosyn made up of?
A
piperacillin and tazobactam
12
Q
Amoxicillin and Clavulanic Acid
A
amniopenicillin and a beta- lactamase inhibitor 250-1000 q8-12hrs
gram neg and pos
Extends to organisms that so produce beta lactamase
ex) H. INfluenza
AE: Hypersensitivity, diarrhea, may take with food
* Cell Wall Synthesis Inhibitor*
13
Q
Piperacillin-Tazobactam
A
Extended Spectrum- 2.25-4.5 g IV q6h (none orally)
Gram pos and neg
AE: HYpersensitivity, diarrhea
Cell Wall Synthesis Inhibitor
14
Q
How are cephalosporins grouped?
A
Into generations based on
1- Effectiveness against different organisms
2- Characteristics
3-Develpment
15
Q
How common is cross sensitivity with PCN and Cephalosporins?
A
5%
16
Q
What is an example of 1st generation cephalosporin?
A
Cephalexin- Keflex
17
Q
What is an example of a 3rd generation cephalosporin?
A
Cefriaxone - Rocephin
18
Q
What are 5 examples of Cell wall synthesis inhibitors?
A
Amoxicillin Amoxicillin + Clavulanic acid Piperacillin + Tazobactam Cephalexin Cefriaxone
19
Q
Cephalexin
A
Oral 250-1000mg Q6-8hr
Gram pos (skin flora)
1st gen
AE: nausea, vomiting, diarrhea - take with food
20
Q
Ceftiaxone
A
IV or IM 250-2g IV/IM Q12-24 hrs 3rd Gen ** BEST FOR step. pneum. and Gonorr Gram pos and neg AE: Hypersensitivity, may increase bleeding
21
Q
What are the contraindications for cefriaxone?
A
Avoid in neonates- may displace bilirubin from albumin binding sites
22
Q
What are 4 ways a protein synthesis inhibitor could work?
A
1-inhibit formation of peptide bond
2- prevents tRNA and mRNA from attatching with ribosome complex
3- Prevent movement of ribosome movement
4- Causes code mRNA to read code wrong
23
Q
Doxycycline
A
IV/PO 100 mg q12hr (tetracyline class)
gram pos and neg –Bacteriostatic- broad
Protein synthesis inhibitor
*BEST FOR chlamydia and tick borne illness
AE: phototoxicity, tooth discoloration, C.Diff
24
Q
What are some considerations to think about with doxycyline?
A
Don’t take with milk, antacids or oral contraceptives
Don’t take if pregnant or under 8
25
Azithromycin
IV/PO- 250mg-500 daily (macrolides)
can cover atypical- mycoplasma, legionella and chlamydia
AE: nausea, vomiting, abd pain, some QT prolonged on EKG
bacteriostatic (cidal in high doses)- broad
26
How does tetracycline/ doxycycline work on protein synthesis inhibition?
interferes with attachment of tRNA to mRNA ribosome complex
27
How does azythromycin work as protein synthesis inhibitor?
reversibly binds to ribosomal subunit
28
Metronidazole
IV/PO 250-750 mg q8-12 hr
bacteriocidal- fiarly narrow- protozoa *systemic amebiasus, trichomonasis, giardiasis
AE: nausea, headache, metallic taste, hypersensitivity
drug interaction with ethanol-tachy, dysnea, vomit, facial flushing
29
What is metronidazole MOA?
inhibits nucleic acid synthesis=cell death
30
What are the two categories of antifungal drugs?
SubQ/ systemic
superficial
31
Fluconazole
IV/PO 200-800mg q24hr member of azole family
fungistatic- damage of membrane
BEST FOR candida infections
AE: nausea, headache, rash, adb pain, (rare=hepatic necrosis)
32
Anticoagulant Medications are used to...?
prevent clots from forming and extension
prevent and treat VTE&PE
Stroke prevention in atrial fib
HIgh risk for VTE
33
Who are at high risk for VTE?
hospitalized patients who are less mobile
Post-op orthopedic surgery
artificial heart vavles
heart failure
34
What is an example of an unfractionated heparin & low-molecular weight heparin?
Heparin and Enoxaparin
35
What is an exmaple of a vitamin K antagonist?
Warfarin- inhibits synthesis of vit k- dependent clotting factors
36
What is an example of a direct thrombin inhibitor?
Dabigatran
37
What is an exmaple of factor Xa inhibitor?
Rivaroxaban
38
What 3 things does thrombin do?
1 catalyze conversion- fibrinogen-->fibrin
2 catalyze conversion - Factor V --> active Va (inhances activity of Xa)
3 catalyze conversion- VIII-->VIIIa (increase activity of IXa in intrinsic pathway)
39
Which pathway is the contact activation pathway?
intrinsic pathway
40
What pathway is the tissue factor pathway?
extrinsic pathway
41
Where do the two pathways connect?
At Xa where prothrombin is turned into thrombin
42
Warfarin can act on which parts of the pathway?
IIa VII, IX, X ( thrombin= IIa)
43
How does unfractionated heparin interfere on the pathway?
since it is longer, it has arms that can wrap around Xa and thrombin at the same time
44
Why does low-molecular weight heparin only bind to Xa and not thrombin?
it is shorter and can only wrap around the xa portion
45
What are side effects of heparin?
BLEEDING- thrombocytopenia
46
You should not give heparin if:
There is active bleeding
They are preparing for a surgery
renal dysfunction -low weight
47
What is the antidote for heparin?
protamine sulfate
48
What does DOAC's stand for?
Direct Acting Oral Anticoagulants
49
What are three examples of DOAC's?
Diabigatran
Rivaroxiban
Apixaban
50
What part of the pathway does Rivaroxiban and Apixaban work on?
Xa
51
What lab test are needed when on Warfarin?
PT- Prothrombin Time
| INR- international normalized ratio
52
What are some vitamin K rich foods?
Avocados, kale, cabbage, kiwi, cucumber, celery, green beans, green pears
** must eat regularly and in moderation**
53
What is the role of erythropoietin?
Helps you make RBC
54
Erythropoientin (Procrit, EPOgen)
SC or IV
used to stimulate RBC formation- renal disease or oncologic/hematologic diseases
Must also have all other things to make RBCs
55
What are essential in RBC formation?
Iron, folic acid, B12, healthy bond marrow
56
What is the best way to treat iron deficiency anemia?
increase iron intake
57
Ferrous Sulfate
GI upset: nausea, heartburn, CONSTIPATION, diarrhea, stool can be dark green or black
TOXIC: in large doses, death common in peds- treat with deferoxamine
Interactions: Decreased with antacids, increased with vit C (but also increased AE)
58
Iron Dextran
parenteral iron product
| AE: anaphylactic reactions (from dextran component), hypotension, circulatory failure, cardiac arrest.
59
VitaminB12 prep cyanocobalamin
purified crystalline form
AE: hypokalemia due to increased erythrocyte production
never given IV must be deep IM or SC
60
Folic Acid
Oral or IV
61
What is the definition of Relative anemia?
Normal total RBC mass, with increased plasma volume
62
What is an example of when someone would have relative anemia?
Pregnancy
63
What is absolute anemia?
decreased in RBC number
64
How are anemias classified?
Size and color
or
decreased RBC production, inherited disorders, destruction or loss
65
When you have a folic acid deficite, what will that result in?
premature cell death
66
When you are iron deficient, what will it result in?
lack of hemoglobin
67
What is aplastic anemia?
bone marrow suppression which leads to decreased production
68
What is claudication?
pain in muscles with exercise, normally due to lack of O2 in tissues
69
Clinical manifestations of anemia are categorized into what 3 groups?
mild, mild to moderate, moderate to severe
70
Why are manifestations divided based on characteristics and not actual numbers?
every body is different and tolerance can play a role, so people may not have the same response
71
What are examples of mild to moderate anemia?
fatigue, generalized weakness, tachy, loss of stamina, exertional dyspnea
72
What are examples of moderate to severe anemia?
```
orthostatic/gen hypotension,
vasoconstriction and palor
tachy, dyspnea
intermittent claudication
night cramps in muscles
headache, lightheadedness and fainting
roaring in ears
```
73
What are some evaluations that would be done for anemia?
hemoglobin/ hematocrit
| bone marrow aspiration
74
What are some treatments for anemia?
Erythropoieten
transfusions
supplements
rest, O2, fluids (sickle cell)
75
What is something to keep in mind about anemia, in relation to chidren?
Sometimes milk can cause underlying problems, such as GI issues and blood loss-anemia
76
What is pica?
The craving to eat non-nutrative or nonfood items
77
What type of anemia is the most common?
Iron deficiency
78
What are some assessment findings for someon with iron deficient anemia?
PIca
fatigue
palor
microcytic, hypochromatic- pale/washed out
79
What is the most common treatment for iron deficient anemia?
oral administration
80
What is the etiology of iron deficiency ?
1- body can't absorb it
2- the requirements for it have increased
3- excessive iron loss/blood loss
4- renal issues
81
What are 3 categories of bleeding disorders?
1- Vascular disorders
2- Platelet disorders
3- Coagulation Disorders
82
vascular purpura is an example of what type of bleeding disorder?
Vascular
83
Thrombocytopenia is an example of what type of bleeding disorder?
Platelet
84
What are some examples of coagulation disorders?
Vit K deficiency
inherited- hemophilia
DIC- disseminated intravascular coagulation
85
What is hemostasis?
The physiologic process that stops bleeding at the site of injury while maintaining normal blood flow elsewhere.
86
What is primary hemostasis?
VAsospasm at site of injury----platelet plug- adhere and clump
3-7 mins
87
What is secondary hemostasis?
coagulation- formation of clot made of fibrin
clotting activation, clotting retraction=firming
can take up to an hour
88
What are the two pathways in the clotting cascade?
intrinsic- blood in contact with altered endothelium
| extrinsic- tissue trauma
89
When assessing skin, what is one important thing to note?
Does it blanch?
90
What is purpura?
patches of patechia
91
What is Ecchymosis?
bruising
92
What is hemarthrosis?
blood in joints
93
What is hematochezia?
blood in stool
94
What is epistaxis?
nose bleed
95
Why would CBCs be taken for a lab value?
to look at platelet numbers and morphology of platelets
96
Why would bleeding time be a test?
evaluate platelet and vascular response
97
What do prothrombin (pt) and INRs test?
the EXTRINSIC pathway of coagulation
98
What does an activated partial thromboplastin time (aPTT) test?
evaluates INTRINSIC pathway of coagulation
99
What are some treatments for bleeding disorders?
```
avoid the cause ie: meds, milk
Steroids- prevents platelet breakdown
IVIG- shirt term- prevents major bleeds
Factor replacement
Platelets
Fresh frozen plasma
```
100
What is thrombocytopenia?
generlized bleeding
101
What is the cause of thrombocytopenia?
decreased production or increased consumption of platelets
102
During an assessment, what would you see if someone had thrombocytopenia?
petechia, purpura, decreased platelet counts, bleeding
103
how do you treat thrombocytopenia?
remove cause
block immune response
blood/platelet transfusion
104
What is a thrombus?
stationary blood clot
| in vessel or chamber of heart
105
What is a thrombus composed of?
Aggregated platelets, clotting factors and fibrin that adhere to vessel wall
106
What is Virchow's Triad composed of?
Epithelial injury (vessel wall injury)
Circulatory Stasis
Hypercoagulable conditions
107
What is DVT?
a thrombus in one of the deep veins
108
What is the Virchow's Triad giving risk factors for?
thrombus
109
What is an example circulatory stasis that can cause DVT?
bed bound, long flights
110
What is an example of hypercoagulability that can cause DVT?
pregnancy, oral contraceptives, chemo, obesity
111
What are examples of epithelial injury that can cause DVT?
trauma, IV, caths, smoking, hypertension, surgery
112
What are the signs of DVT that you would see on a patient in assessment?
edema
pain/tenderness
redness, discoloration
warmth
ultrasound, D-dimer lab
113
What is the treatment for DVT?
a thrombalytic to break down the clot
| Anticoagulant to reduce further clot formation
114
How do you prevent DVTs?
MOVE
Anticoagulants
SCD or compression socks
good hydration
115
What re the 3 things that cells do when presented with a problem?
1-withstand and return to normal
2- adapt
3- die
116
What are two types of reversible cell damage?
Hydropic and cellular accumulations
117
What are 5 types of cell damage that are generally reversible?
```
Atrophy
Hypertrophy
Hyperplasia
Metaplasia
Dysplasia
```
118
What are the two types of cell death?
Necrosis
| Apoptosis
119
What is Hydropic cell damage?
Accumulation of water.-
malfunction of Na-K pump- Na in cell-water follows
*normally first manifestation of most forms of reversible damage
120
What does megaly mean?
generalized swelling of cells for certain organ- enlargement
121
What are three parts to intracellular Accumulations?
1- excessive amounts of normal substances
2- Accumulation of abnormal- produced by cell
3- Accumulation of pigments and particles- unable to degrade
122
What is an example of intracellular accumulation from excessive amounts of normal substances?
Diabetes- body does not break down glucose
| Fatty deposits in liver
123
What is an example of intracellular accumulation from abnormal substances produced by cell?
Stress
124
What is an example of intracellular accumulation from pigments and particles?
Hyperbillirubanemia
125
What is Atrophy and what happens to the cell?
Cells shrink & reduce differentiated function
| -conserves energy for the body
126
What are some examples of why Atrophy would happen?
No use- fractires, bedbound, eschemia, starvation
127
What is Hypertrophy and what does it do to the cells?
Increase in cell size
WITH augmented functional capacity
cells are working harder
** could increase BP which could lead to CHF
128
What are some examples of hypertrophy would happen?
Pregnancy - enlargement of uterus and breasts
129
What is Hyperplasia?
Increase in NUMBER of cells through mitotic division
130
What is Metaplasia?
Replacement of one differentiated cell type with another
| swap out
131
What is an example of when Metaplasia would happen?
Smoking- bronchial mucosa changes
132
What is Dysplasia?
Disorganized appearance of cells because of abnormal variations
133
What are some reasons cell injury occurs?
```
Ischemia
Hypoxia
Infections
Chemical
Physical
```
134
What can Ca overload cause?
apoptosis of cells
135
What are two reasons Ca overload could happen and why?
Hypoxia and Ischemia
| -ATP made-pumps fail- H2O & Na-->excess Ca
136
What are examples of chemical cell injuries?
Free redicals
Heavy metals
Toxic gasses
137
What are some nutritional examples of cell injury?
```
Malnutrition
low iron
increased sodium
obesity
diabetes
```
138
What are some examples of physical and mechanical cell injury?
```
temp changes
abrupt atmoshperic pressure change
Abrasion
Electrical
Radiation
```
139
Whtat are some infectious and immunological examples of cell injury?
Bacteria- endo/exo toxins
Virus
indirect immunologic response
140
What are the clinical manifestations of hyponatremia?
CNS dysfunction
Malaise, anorexia, nausea, vomiting, HA
confusion, lethargy, seizures, coma
fatal cerebral herniation
141
What are clinical manifestations of hypernatremia?
```
Thirst, dry mucous membranes
hypotension, tachy
Oliguria
Muscle irritation
agitation
Confusion, lethargy, seizures, coma, death
```
142
What are the clinical manifestations of Hypokalemia?
```
hyperpolarized smooth and skeletal muscles- less reactive
Abd distension, no bowel sounds
postural hypotension
skeletal musces weakness, paralysis
cardiac dysrhythmia
```
143
What are the clinical manifestations of Hyperkalemia?
hypopolarized smooth/skeletal muscles- can't fire after discharge
intestinal cramping and diarrhea
skeletal muscle weakness, paralysis
cardiac dysrhythmia and arrest
144
What are the clinical manifestations of hypocalcemia?
Increased neurotransmuscular excitability- twitching, cramping, hyperactive reflexes, tetany
seizures, dysrhythmias
145
What are the clinical manifestations of hypercalcemia?
Anorexia, nausea, emesis, constipation, fatigue, muscles weakness, diminished reflexes, HA, confusion, lethargy,
heart block, brady
kidney stones
146
What is ROME?
```
Respiratory= opposite moving numbers
Metabolic= Same moving numbers
```
147
What are the clinical manifestations of respiratory acidosis?
HA, tachy, cardiac dsy
blurred vision, tremors, vertigo, disorientation, lethargy
**INCREASED PaCO2 DECREASED pH
148
What are the clinical manifestations of respiratory alkalosis?
numbness, tingling, feet/hand spasms
confusion, cerebral vasoconstriction
DECREASED PaCO2. INCREASED pH
149
What are clinical manifestations of metabolic acidosis?
```
GI upset- N/V/D
dehydration
lethargy, stupor coma
tachy, dysrhythmia
fruity breath
DECREASED bicorbonate and pH
```
150
What are clinical manifestations of metabolic alkalosis?
```
GI- N/V/D
tingling, tetany, seizures
hypokalemia
bilateral muscles weakness
irritability CNS depression
INCREASE bicarb and pH
```
151
What are the 4 drugs used for treatment of hyperkalemia?
Albuterol
Dextrose 50% injection
Insulin, regular
Kayexalate
152
What is the most common type of potassium supplement?
Potassium chloride
153
What would be a good reason to use potassium phosphate?
If they lack potassium and phosphate
154
Why is potassium given?
most commonly for hypokalemia
155
What are the two forms potassium comes in?
liquid or powder
| ** IV sight can be irritated or painful
156
Potassium side effects
GI: N/V/D abd discomfort
esophagitis
**give with food
157
What levels will you need to watch when giving potassium chloride?
1- serum K levels
2- watch for hyperkalemia
3- watch IV site
158
What are some contraindications for potassium chloride?
Renal dysfunction? **monitor very close!
| watch close for those already taking meds that could increase serum K levels
159
What type of IV can you use for K?
Central or peripheral
** watch close for irritation and pain
can be added to maintenance IV fluid
160
Concentrated potassium...
should never be available on patient care units
161
What are the two approaches for treatment of hyperkalemia?
1- Shift K back into cell
| 2- Increase excretion of K
162
What would you use to stabilize the heart with hyperkalemia?
Calcium IV
163
What would you use to shift K back into the cells?
Insulin and dextrose 50% injection
Sodium bicarb injection
Albuterol inhalation
164
For increasing excretion of K, what are the three options?
using the kidneys- diuretics **always know underlying cause
Fake kidney- hemodialysis
Use gut- Sodium polystyrene
165
What are the two types of IV Calcium?
Calcium gluconate
| Calcium chloride
166
What is the equation of the two types of calcium?
3g Gluconate= 1g Chloride
167
How would you give calcium gluconate?
Peripherally
168
How would you give calcium chloride?
Centrally
169
If you are giving calcium for Hyperkalemia, what rate would you give it?
10-30 mins 2g- immediate
170
If you are giving calcium for hyokalemia/replacement, how fast would you give it?
slow- 1g hr just to keep it in there
171
What does the Na-K ATP pump do?
- Maintains intracellular and extracelluar K concentrations
- Exchanges Na for K in 3:2 ratio
- Enhances movement of K into cells
172
What is required for the ATP pump to work?
Insulin and glucose AKA dextrose
| *must have the insulin to have glucose uptake
173
What would you check for when giving insulin?
CBG levels
174
When giving sodium bicorbonate, what do you need to watch for?
Edema, potassium levels
175
Why would you use sodium bicarb?
for severe metabolic acidosis, hyperkalemia
**this is just a bandaid
- sometimes used for OD
overcorrection happens
176
What are the adverse effects of sodium bicorbonate?
caustic to vasculature, can cause hypokalemia, can cause metabolic alkalosis
177
Albuterol
inhalant- Beta2 agonist
brochodilation
-activates cAMP--> helps move K intracellularly
178
What is a side effect of albuterol?
Tachycardia
179
Kayexalate: sodium polystyrene
resin that exchanges Na for K in gut *NOT absorbed
Oral/Rectal
*not for emergencies, few hour onset
180
What are some serious AE of Kayexalate?
intestinal necrosis/ other serious GI problems
181
What doe magnesium do in the body?
activates intracellular enzymes
binds to mRNA to ribosomes
helps regulate muscle contractility/ blood coag
182
What are the two types of mag replacement? how is it given?
mag sulfate- IV
| mag oxide- Oral, over several days
183
Why would you give mag sulfate?
preeclampsia
migraines
status asthmaticus
hypomagnesemia
184
What is Capillary hydrostatic pressure?
In capillary pushing out into interstitial space
185
What is Capillary Oncotic pressure?
in capillary pulling in water from interstitial space
186
What is Interstitial hydrostatic pressure?
in interstitial space pushing into capillary
187
What is interstitial oncotic pressure?
in interstitial space pulling back from capillary
188
What is the definition of edema and hypervolemia?
excessive accumulation of fluid within interstitial space
189
What are the forces that are involved with edema and hypervolemia?
Increased Capillary Hydrostatic pressure
Increased cap permeability
decreased plasma oncotic pressure
Lymphatic channel obstruction
190
What is an example of why someone would have decreased plasma oncotic pressure?
malnutrition, burns, kidney disease
191
What is an example of why someone would have increased capillary perm?
inflammation or immune response
192
What is an exampe of why someone would have increased cap. hydrostatic pressure?
kidney failure or heart failure
193
What is an example of why someone would have lymphatic channel obstruction?
Removal of lymphs
| inflammatory process
194
What is localized edema?
limited to one site of trauma or with a particular organ system
195
What is generalized edema?
uniformed distribution. normally in dependent areas b/c of gravity
ex/ legs
196
What are some clinical manifestations of edema you would see?
weight increase, swelling, puffiness, limited movement, crackles, respiratory distress, bounding pulse, tachy
197
What are 4 ways to treat Edema?
Treat underlying cause
be supportive and educate
CHange diet- low sodium
Diuretics
198
What is the definition of clinical dehydration and hypovolemia?
too small amount of fluid in extracellular compartment.
| fulids are too concentrated
199
What are three reasons why someone would have hypovolemia?
Fluid loss- burns, emesis, hemorrhage. sweating, diabetes
Reduced intake- altered cog. dependence
Fluid shifts- burns
200
What are some clinical manifestations for hypovolemia?
```
poor skin turger, tachy, hypotension
dry mucous
weight loss, crying with no tears
dark urine/less urine
thirst
```
201
How would you treat hypovolemia?
stop the reason they are losing the fluid
| give fluids- slowly. too fat can cause cerebral hyervolemia
202
What is the normal range of K?
3.5-5.0
203
What is the normal range for sodium?
135-145
204
What is the normal range for Phosphate?
2.5-4.5
205
What is the normal range for magnesium?
1.5-2.5
206
What is the normal range for calcium?
9-11mg/dl 4.5-5.5 mEq/L
207
What are the main roles of Na?
Regulates acid-base balance
Nerve conduction and neuro- muscular function
Maintains water balance
208
What are some reasons people have have hyponatremia?
```
Inappropriate fluid admin
Tap water ememas
Excess of ADH (antiduiretics)
Too many diuretics
Renal disease
```
209
What are some reasons someone would have hypernatremia?
```
Tube feedings
Overuse of salt
No access to water
Emesis
Diarrhea
```
210
What is the role of K in body?
Maintain Electricaly Neutrality
Cardiac muscle contraction
Neuromuscular/ nerve impulses
Acid-base balance
211
What are some reasons that someone would be hypokalemic?
```
NPO
Fasting
Fad diet
Anorexia
Alkolosis
Diuretics, diarrhea, emesis, gastric succ.
```
212
What are some reasons that someone would be hyperkalemic?
```
blood transfusions
acidosis
crushing injury
meds
olguria
```
213
What is the role of Ca in the body?
Blood coag
Nerve impulses
Muscle contractions
Cardiac action potential
214
What are some reasons someone would be hypocalemic>
```
Kidney disease
Diet
Diarrhea
Alkalosis
Pancreatitis- (fatty stools)
```
215
What are some reasons someone would be hypercalemic?
tumors
leukemia
immobilized
diuretics
216
What is the normal range for PaCO2?
36-44 mm Hg
217
What are the normal ranges for HCO3-?
22-26 mm Hg
218
What are some causes of respiratory acidosis?
```
pneumonia
asthma
COPD
chest injury/surgery
meds/drugs
```
219
What are some causes of Respiratory alkalosis?
```
Hyperventilation
anxiety
brainstem injury
panic attacks
crying
acute pain
hypoxemia
```
220
What are some causes of metabolic acidosis?
ketoacidosis, diabetes
burns
circulatory shock
Diarrhea
221
What are some causes of metabolic alkalosis?
```
over use of antacids
hypovolemic
emesis
hypokalemia
diuretics
```
