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Pathophysiology > Week 1 (ch. 2 Fluid, electrolyte, and acid-base imbalances) > Flashcards

Week 1 (ch. 2 Fluid, electrolyte, and acid-base imbalances) Flashcards

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1
Q

Hydrostatic pressure

A

Increases filtration by pushing fluids and solutes out of capillaries

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2
Q

Osmotic pressure

A

Pressure caused by solution passing through semi-permeable membrane, the pulling force or attracting force

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3
Q

Arteriolar end of capillary (fluid movement through this)

A

Blood hydrostatic pressure (BP) exceeds the interstitial hydrostatic pressure and plasma colloid osmotic pressure = fluid moves out from capillary into the interstitial space

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4
Q

Fluid movement / capillary exchange: venous end of capillary

A

Bloods hydrostatic pressure is decreased and osmotic pressure is higher = flui is pulled back (shift) into capillary

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5
Q

Causes of edema - increased capillary hydrostatic pressure

A
  1. Increased capillary hydrostatic pressure - pressure prevents the return of fluid from interstitial to venous OR forces amounts out of the capillary. Due to increased blood volume from kidney failure, pregnancy, CHF, or administration of excess fluids
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6
Q

Cause of edema - loss of plasma proteins

A

Causes a decrease in plasma osmotic pressure allowing more fluid to leave capillary and less fluid to return at the venous end. Due to kidney disease, liver disease, malnutrition/malabsorbtion, burn victims

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7
Q

Cause of edema - obstruction of lymphatic circulation

A

Fluid and protien can not be returned to general circulation causing local edema. Due to tumor or infection damage of lymph node or lymph node removal

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8
Q

Cause of edema - increased capillary permeability

A

Chemical mediators released from cells after tissue injury increasing fluid movement into interstitial area typically localized. Due to inflammatory response or infection

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9
Q

third spacing - fluid deficit and fluid excess: what is it?

A

Fluid shifts from the blood to a body cavity or tissue - causes the fluid that was shifted to no longer be circulating fluid

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10
Q

What does third spacing lead to?

A

Fluid deficit in the vascular compartment with a fluid excess in the interstitial space

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11
Q

How is third spacing detected?

A

Lab tests of hematocrit and electrolyte concentrations

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12
Q

When might you see third spacing?

A

Burn or peritonitis (inflammatory infection of the peritoneal cavity)

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13
Q

What does sodium primarily exist as?

A

Sodium chloride or sodium bicarbonate

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14
Q

How are sodium levels controlled?

A

Mostly by kidney through aldosterone

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15
Q

What is Na essential in?

A

Nerve impulses and muscle contraction

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16
Q

Hyponatremia levels

A

Less than 135

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17
Q

What is the role of K

A

Assist in regulation of intracellular fluid volumes

  • role in metabolic processes
  • nerve conduction and contractions of all muscles
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18
Q

What promotes the movement of k into the cell

A

Insulin

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19
Q

What shifts k out of the cell and into the extra cellular environment?

A

Acidosis

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20
Q

What shift k into the cell

A

Alkalosis

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21
Q

Hyponatremia causes

A

Direct loss of na or too much water in extra cellular environment

  • excess sweating, vomiting, diarrhea
  • certain diuretics with low na diet
  • hormone imbalance
  • early chronic renal failure
  • excessive water intake
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22
Q

Hyponaturemia effects

A
  • impairs nerve conduction and results in fluid imbalance
  • fatigue, muscle cramps, abd. Discomfort, N/V
  • decreased osmotic pressure in ECF leading to fluid shift into cells resulting in hypovolemia
  • brain cells swell causing confusing, HA, weakness, seizures
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23
Q

Hypernatremia causes

A 
Too much na 
Insufficient ADH
Loss of thirst mechanism 
Water diarrhea 
Hyperventilation
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24
Q

Hypernatremia effect

A

Fluid shift
Weakness
Agitation
Firm subcutaneous tissue
Increased thirst with dry mucous membranes
Decreases urine d/t ADH secretion/increased urging d/t lack of ADH

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25
Hypokalemia causes
``` Excessive fluid loss Diuresis from diuretic meds Excessive aldosterone or glucocorticoids Decreased dietary intake Diabetic ketoacidosis ```
26
Hypokalemia effects
``` Cardiac dysthymia Fatigue, muscle weakness Paresthesias (pins and needles) Decreased appetite / nausea - shallow respirations (severe) - polyuria and renal impairment (severe) ```
27
Hyperkalemia cause
``` Renal failure Aldosterone deficit Potassium-sparing diuretics meds Tissue damage causing leaking of extracellular Acidosis ```
28
Hyperkalemia effects
Dysthymia Cardiac arrest Muscle weakness progressing to paralysis Fatigue, nausea, and parasthesias
29
What is Ca controlled by
PTH and calcitonin
30
How is Ca influenced by vitamin D and Phosphate
Vitamin D is injected from UV rays, activated in kidneys and promotes Ca movement to the blood Reciprocal relationship with phosphate
31
Does alkalosis or acidosis lead to hypocalcemia
Alkalosis
32
Functions of Ca
Structural strength for bones - stability of nerve membranes - muscle contractions - needed for metabolic processes and enzyme reactions (blood clotting)
33
What is the appropriate lab value for Ca
2.2-5 mmol/ L
34
Hypocalcemia causes
``` Hypoparathyroidism (decreased PTH) Malabsorption syndrome Deficient serum albumin Increased pH (alkalosis) Renal failure ```
35
Hypocalcemia effects
Skeletal muscle spasms d/t increased irritability of nerves - muscle twitching, hyperactive reflexes - Chvostek sign, tetany, laryngospasm, abdominal cramps Weaker muscle contraction of the heart - arrythmias, lower BP
36
Hypercalcemia causes
Uncontrolled release of calcium ion-neoplasms Hyperthyroidism (increased PTH) Immobility (demineralization of bones) Increased intake Milk-alkali syndrome
37
Hypercalcemia effects
Decrease neuromuscular activity - muscle weakness, loss of tone, lethargy, personality change Interferes with ADH in kidneys - polyuria Cardiac contractions increase — dysthymia Effect on bone — decreased density leading to fractures OR bone strength maintained Kidney stone formation
38
Magnesium serum level
1.6 - 2 mg / dL
39
Causes of hypomagnesemia
Diuretics, diabetic ketoacidosis, hyeraldosteronism
40
Hypomagnesemia effects
``` Neuromuscular hyperirritability Tremors Chorea Insomnia Personality changes Increase HR ```
41
Hypermagnesemia causes
``` Renal failure Administering magnesium (maternity) ```
42
Hypermagnesemia effects
Depressed neuromuscular function, decreased reflexes, lethargy, cardiac arrythmias
43
Hypophosphatemia causes
Malabsorption syndrome, diarrhea, excessive use of anti-acids, alkalosis, hyperparathyroidism
44
Hypophosphatemia effects
Tremors, weak reflexes, paresthesias, confusion, anorexia, dysphagia, blood cell functions
45
Hyperphosphatemia causes
Renal failure Tissue damage Chemo
46
Hyperphosphatemia effects
Muscle twitching, hyperactive reflexes, arrhythmia
47
Hypochloremia causes
Excessive sweating | Associated with alkalosis
48
Hypochloremia effects
N/v, diarrhea, muscle twitching, confusion, sleepiness
49
Hyperchloremia cause
Too much intake of sodium chloride | Hypernatremia
50
Hyperchloremia effects
Edema | Weight gain
51
What is the bodies normal pH
7.35 - 7.45
52
At what levels will death occur for the pH values
Less than 6.8 | Higher than 7.8
53
What controls the serum pH
Buffer pairs - respond immediately Respiratory system - alter carbon dioxide (carbon acid) by changing respiratory rate Kidneys - slowest but most effective
54
Control of serum pH: Buffer system
Several present in blood - combination of weak acid and its alkaline salt - reaction to acids/alkali added to blood to neutralize - maintaining constant pH
55
What are the 4 major pairs of the buffer system
Sodium bicarbonate - carbonic acid system Phosphate system Hemoglobin system Protein system
56
Control of serum pH: respiratory system
If carbon dioxide or hydrogen levels increase, then the respiratory control system is stimulated to increase the respiratory rate which rids more acid from the body. If the body is alkalotic, the respiratory decreased the respiratory rate, increase acid levels.
57
Control of serum pH: renal system
- may reduce body’s acid by exchanging hydrogen for sodium through aldosterone, removes the hydrogen by combining with ammonia - provides bicarbonate ion - kidneys compensate for metabolic conditions and dietary intake
58
Acidosis
Decrease in pH, increase in H ion
59
Alkalosis
Increase in pH, decrease in H ions
60
What are the 4 basic types of acid-base imbalance?
- respiratory acidosis - respiratory alkalosis - metabolic acidosis - metabolic alkalosis
61
Acid-base imbalance: compensation
When the serum pH is normal - one system compensation to fix the imbalance because caused by the other system Ex. Respiratory disorder causes acidosis so the kidneys compensate to rid more acid - time limited, patient must be monitored closely
62
Acid-base imbalance: decompensation
When the serum pH is abnormal - this means the respiratory or renal system can buffer to maintain balance - intervention is essential to maintain homeostasis
63
Explain acidosis: value, effects
PH < 7.35 Impair nervous system, headache, lethargy, weakness, confusion leads to coma and death Deep rapid breathing
64
Respiratory acidosis: what happens and what are the causes
Increase in CO2 Pneumonia, aspiration, chest injury, meds that depress resp. Control center (opiates) COPD
65
Metabolic acidosis: what is it and what are the causes
Decrease in bicarbonate Excessive loss (diarrhea) Increased use to buffer increased acids Renal failure/disease
66
Alkalosis: what is the value and what are the effects
< 7.45 Increased irritability of nervous system, restlessness, muscle twitching, tingling, numbness, eventually leads to tetany, seizures, and coma
67
Respiratory alkalosis: what is it and what are its causes
Results from hyperventilation | - anxiety, fear, overdose aspirin, head injury, brain stem tumor causing hyperventilation
68
Metabolic alkalosis: what is it and what are its causes
Increase in bicarbonate Follows loss of hydrochloric acid from stomach - early states of vomiting, drainage of stomach - hypokalemia - excessive ingestion of antacids
69
Treatments of acid-base imbalances
A. Deficits are reversed by adding fluid/electrolyte that has the deficit B. Excess is removed though diuretics to increase excretion through kidneys C. Levels are monitored closely D. Some cases, diet changes can accomplish the correction

Pathophysiology (11 decks)

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