Unit 2 test Acid-base balance--- Electrolyte -- EOD Flashcards
(67 cards)
1
Q
Facts of Potassium
A
3.5-5.0
Major ICF Cation
Function: some control over ICF osmolarity and volume
regulate protein synthesis , glucose use, and storage
pH balance
nerve conduction
2
Q
Hypernatremia
A
sodium level greater then 145
H20 movement from the ICF to the ECF
ICF = dehydration
Causes: increase in Na intake decreases in Na excretion decrease in H20 intake Increase in water loss
3
Q
Signs and Symptoms of Hypernatremia
A
Thirsty ICF dehydration Lethargy convulsion pulmonary edema hypotension tachycardia restless irritable oliguria seizures coma warm skin dry mucous membranes
4
Q
What is convulsion
A
brain cell dehydration
5
Q
Nursing interventions for hypernatremia
A
Monitor CVA, RESP, Renal, Skin status Monitor I&O if d/t fluid loss- admin IV fluid if d/t inadequate renal exertion- administer diuretics May restrict Na+ intake education
6
Q
Hyponatremia signs and symptoms
A
Na level under 135 too much H20 decrease osmolatiry tachycardia weak rapid thready pulse hypotension orthostatic hypotension nausea and vomiting diarrhea decreased deep tendon reflexes lethargy headache confusion cramps muscle weakness and fatigue
7
Q
Nursing Interventions for Hyponatremia
A
IV fluids - NS or 1/2 NS Osmotic diuretics increase in sodium intake monitor Na levels monitor LOA Safety precautions-- seizures, falls education Monitor I&O Daily weights
8
Q
Causes of Hypocalcemia
A
Hypoparathyroidisim malabsorption-- chrones disease hypersecretion of calcitonin deficient serum albumin increase inn serum pH lack of Vit D-- lactose chronic renal failure
9
Q
Calcium
A
9.0-10.5 Mostly found in ECF 98% stored in bones Works with Vit.D functions: bone and teeth muscle contraction and relaxation blood clotting Regulated by parathyroid hormone increase in blood calcium by stimulation osteoclasis increase GI aborption and renal retention calcitonin
10
Q
Signs and symptoms of Hyperkalemia
A
increase in neromuscular irritability tingling and numbness found in the lips, fingers, and toes restless cardiac dysrthmias -- widen QRS and spiked T wave nausea fatigue little or no urine output decrease in pH acidosis
11
Q
Interventions for hyperkalemia
A
Monitor status Monitor EKG monitor renal function d/c KCL medication prepare dialysis if needed education nutrition
Treatment:
Insulin+ glucose— D5W to counteract low blood sugar levels
Sodium Bicarb
Ca++ counter acts effects on heart
12
Q
Causes of hyperkalemia
A
end stage renal disease aldosterone defect use of K+ sparing diuretic leakage of ICF K+ into ECF insulin defficient uncontrolled DM multiple blood transfusions
13
Q
Causes of hypokalemia
A
diarrhea diuresis w/ diuretic use Increase in aldosterone or glutocosteroids decrease in dietary intake Treatment of DKA w/ insullin Increase in loss of urine increase of K+ into the cells
14
Q
Interventions of hypokalemia
A
Monitor status Monitor EKG administer PO K 1st then IV therapy if needed potassium sparing diuretic saftey nutrition education
15
Q
Normal ABG lab values
A
pH: 7.35-7.45 CO2 35-45 HCO3 22-26 O2 80-100 anion gap 10-14 albumin 4
16
Q
Signs and symptoms of hypokalemia
A
cardiac dysrthmias --> cardiac arrest fatigue and muscle weakness parathesis (sensation anorexia nausea shallow respirations increase in urine output increase in serum pH depressed T wave. forms a U wave
17
Q
hypertonic solution dehydration
A
deficit of fluid is greater than the deficit of electrolytes
fluid shifts out of ICF and into ECF space neurologic
18
Q
Isotonic dehydration
A
Loss of fluid and electrolyte is balanced most of loss is sustained by ECF
Most Common
19
Q
hypotonic dehydration
A
electrolytes deficit is greater then fluid deficit
ECF moves into ICF space
20
Q
signs of dehydration
A
tachycardia weak pulse restless flushed dry skin dry mucous membranes decrease in urine output increase in HCT increased Na Increase in hgb , osmolatiry, and specific gravity
21
Q
Magnesium
A
1.3-2.1
critical for skeletal muscle contraction, cell growth, ATP formation, and carbohydrate metabolism
22
Q
Phosphorus
A
30-4.5
found in bones
activates vitamins and enzymes
assist in cell growth and metabolism
treat with Aluminum Hydroxide
23
Q
Hypercalcemia signs and symptoms, and Interventions
A
depressed neuromuscular activity muscle weakness, loss of muscle lethargy cardiac arrest, bradycardia anorexia nausea interffernece with ADH in the renal loss of absorption of H2O = poyuria
Interventions
Monitor status, ca level, and EKG
24
Q
Causes of hypercalcemia
A
uncontrolled use of ca+ ions from the bones causes by neoplasms (cancer cells) Immobility hypothyroidism renal disease hyperparathyroid hormone Increase in Ca and Vit D Certain drugs
25
SIgns of hypocalcemia
```
Increase neuromuscular stimulation
muscle spasm
muscle cramps
Chvostck sign +
Trosseau sign +
arrhythmias
bradycardia
intestinal cramping
pain
```
26
Common causes of fluid overload
```
excessive fluid replacement
kidney failure
heart failure
long term corticosteroid use
SIADH
pysch disorders w/ polydipsia
water intoxication
```
27
Common causes of dehyrdation
```
hemorrhage
vomit
diarrhea
profuse salivation
fever
hyperventilation
ileostomy
fistulas
burns
wounds
NPO status
GI suction
diabietes incipidus
difficulty swallowing
```
28
Fluid Volume Excess Signs and Symptoms
```
visual changes
renal disease
ADH secretion is decreased
decreased cardiac output
decreased blood flow to kidney s
low hct
low hgb
low osmo
low Specific gravity
headache
moist crackles
edeam
pale
cool
tachycardia
bounding pulse
high BP
high CVP
weight gain
```
29
Common causes of hyponatremia
```
excessive diaphoresis
diuretics
wound drainage
decreased secretion of aldosterone
hyperlipidemia
kidney disease
NPO
low salt diet
hyperglycemia
cirrhosis of liver
SIADH
heart failure
kidney failure
```
30
two most important areas to watch for during dehydration
urine output
| pulse rate
31
Metabolic alkalosis
pH: High
HCO3: High
32
Resp Alkalosis
pH: High
CO2: Low
33
Resp Acidosis
pH: Low
Co2: High
34
Interventions for Metabolic Alkalosis
```
Correct problem
KCL replacement
replace fluid depletion w/ NS or 1/2 NS
intubation if resp related
monitor neuros. seizure precautions
Monitor I&O status
```
35
Interventions for Metabolic Acidosis
Treat the cause
Sodium bicarb infusion
```
IV Fluid and insulin for DKA cases
restoration of fluids and treatment of electrolyte imbalances
administer O2
dialysis for renal failure
Increase cardiac output
treat dysrythmia
```
36
Interventions for Resp Alkalosis
```
sedatives or analagesics
treat the cause
O2 if needed
deep breath
breathe in a bag
relaxation techniques
```
37
Metabolic Acidosis- Causes and S&S
Ph: Low
HCO3: low
Causes: Increase in nonvolatile metabolic acids
decrease in acid secretion by renal
excessive loss of HCO3
DKA, cardiac arrest, diarrhea, antifreeze overdose
```
SIGNS
hyperventilation-- kussmauls resp
CNS depression (Coma)
N/V abdominal pain
dull headache
weakness
fatigue
confusion
High Potassium, Chrloide, and Calcium levels
```
38
What is Respitory Acidosis Causes and S7S
```
pH: Low
CO2: High
Not breathing adqequatley
Causes: acute resp depression
or airway obstruction
chronic COPd
Over-sedation
narcotic overdose
```
```
SIGNS
altered LOC
tachycardic
headache
warm skin
muscle twitching
shallow breathing
pale
cynotic
```
39
Metabolic Acidosis
pH: Low
HCO3: low
40
Acid Base balance lines of defense
1. Chemical and protein buffers; respond quickly
2. Resp Buffers: control levels of H+ ions in blood
3. Renal Buffesrs; Most effective, slower to respond
41
Resp Alkalosis; Causes and S&S
pH: high
CO2: Low
Causes:: hyperventalation of any eitology
pyschogenic (fear and or anxiety)
```
SIGNS
numbness and tingling in toes and fingers
dizzy
seizures
tachypnea
rapid breathing
convulsions
confusion
low o2 possible
```
42
Metaboic Alkalosis Causes and S&S
High pH
High HCO3-- too much bicarb not enough acid
Causes: vomiting, NG tube placement
cushings syndrome
K+ deficiency => due to diarrhea or vomitting
mass blood transfusions
Increased use of diuretics
```
SIGNS ;; related to hypokalemia
numbness and tingling
N/V
diaphoresis
shallow breathing
confusion
hypotensive
headache
dysrytmias
increased QT, sinuc tachy
```
43
Interventions for Resp Acidosis
```
Focus on improving ventalation and O2
maintain patient airway
treat the underlying cause
Drug therapy
Bronchodilators
anti-inflam
mucolytics
O2 therapy
Pulm hygiene
vent support
eleminate excess O2
```
44
Forensic nurse examiner
Victims of rape, child abuse, domestic violence advocate
Develops safety plans
how to escape violent situations
document injuries
45
Traige level ( non-urgent)
```
Could wait several hours if needed
Examples
skin rashes
strains and sprains
"Colds"
simple fractures
```
46
Triage level Emergent
```
"life threatening" 1st level
Examples
Resp distress
Chest pain w/ diaphoresis
active bleed
unstable vitals
```
47
Triage level Urgent
```
Need quick treatment , but not immediate life threatening
Examples
Sever abdominal pain
renal colic
displaced or multiple fractures
soft tissue injuries
pneumonia
```
48
Water body weight for babies, adults, and elderly
babies 70-80%
adults 60%
older adults 45-50%
49
SIADH
```
too much aldosterone
-- not peeing
edema
weight gain
disturbed electrolyte count
```
```
Monitor I&O
diuretic therapy
watch vitals
monitor weight
Hct, Hgb, Na, Osmo, will be decreased
```
50
How is ADH stimulated
when there is a low Na+ level, blood volume, and body fluids are down ( dehydration)
it helps to regulate H2O
51
Isontonic Solution
same concentration of blood
| examples NS, D5W, LR, D5 in 1/4 NS
52
Hypotonic Solution
lower solute concentration then blood; fluid moves out of cells into intersitial
examples: 1/2 NS
53
Hypertonic solution
Higher concentration then blood
moves fluid into cell
examples: D10W, D5NS, D5LR
54
how to measure dehydration levels
adults: mucous membranes
Babies; sunken fontanell
Older adults: Neuro status
55
diabetes incipidus has not enough what
ADH, cannot concentrate urine, you pee alot, drink alot, and can become hpyotensive
56
what type of patients need fluid right away
burns
sever fever
very ill
57
specific gravity of fluid overloaded
will lower then 1.003
58
how much weight gain to notify provider
1-2 lb weight gain in 24hr period and 3 lbs in a week
59
addison's disease is associated with what electrolyte
chloride
60
An increase in sodium can cause a decrease in what
potassium
61
diarrhea equals a low what
potassium level
62
clotting is effected by which electrolyte
calcium; if low can cause an increase in bleeding
63
parathyroid hormone comes when
there is too low of calcium
64
calcitonin will be released when
to keep calcium in the bones
65
an increase in calcium causes an increase in
phosphorus
66
cancer cells mimic what
parathyroid hormone cells
67
Third spacing
accumalation of fluid in the intersitial space
common in cirrhosis patients, renal failure, sepsis patients
