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week 3 Flashcards

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1
Q

value useful to determine cause of acid/base imbalance

A

anion gap

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2
Q

increased intracranial pressure could occur with respiratory ___

A

acidosis

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3
Q

chronic alcohol abuse is the most common cause for ____

A

hypomagnesemia

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4
Q

calcium concentration in the blood is regulated by the ___ ____

A

parathyroid hormone

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5
Q

patients with hyperkalemia should avoid ___ ____

A

salt substitutes

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6
Q

most common cause of hypercalcemia is ___ & ___

A

malignancies & hyperthyroidism

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7
Q

oncotic pressure is osmotic pressure exerted by ____

A

proteins

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8
Q

major anion (-) electrolyte

A

chloride

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9
Q

3 cations (+)

A

potassium
sodium
calcium

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10
Q

calcium & ____ have an inverse relationship

A

phosphorus

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11
Q

sodium (Na+)

A

135-145

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12
Q

Potassium (K+)

A

3.5-5

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13
Q

Calcium (Ca+)

A

8.5-10.5

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14
Q

chloride (Cl-)

A

96-108

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15
Q

Magnesium (Mg+)

A

1.3-3

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16
Q

Phosphorus(P)

A

2.5-4.5

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17
Q

Chloride moves where ____ does

A

sodium

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18
Q

causes of hyponatremia

A

deficient aldosterone
antidepressants
desmopressin
SIADH

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19
Q

Hyponatremia: clinical manifestations

A

depressed and deflated:
poor skin turgor
dry mucous membranes
decreased salvation
anorexia and abd cramping
ortho hypo
increases ICP

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20
Q

Hyponatremia: nursing management

A

I/O
daily weights
mental status assess
fluid restriction
lab values
fall/seizure precautions

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21
Q

Hypernatremia: Clinical manifestations

A

Big and bloated:
thirst
increased temp
tachy
hypotension
change in mental status-disorientation
irritability, restlessness
decreased DTR
seizures
n/v
anorexia

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22
Q

Hypernatremia: Nursing management

A

I/O
LOC
fall/seizure precautions
neuros
PO water

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23
Q

____ drives K+ into cells

A

insulin

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24
Q

Hypokalemia: Actual causes

A

diuretics
GI tract loss
corticosteroids

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25
Hypokalemia: relative causes
alkalosis, TPN, water intox, hyperinsulinism
26
Hypokalemia: clinical manifestations
low and slow: hypotension cardiac arrest respiratory depression fatigue anorexia muscle weakness, cramps, parathesias decreased gastric motility abd distension metabolic alkalosis Flattened T wave, prominent U wave ST depression, prolonged PR interval
27
determine loss of K source- ____ toxicity?
digoxin
28
Hyperkalemia: relative causes
acidosis, tissue damage- cells burst and release K+ decreased insulin production 60% caused by meds
29
Hyperkalemia: Clinical manifestations
tachy then late bradycardia (late sign) abd cramps/ distension hyperactive bowel sounds anxiety/irritability TALL tented t-waves prolonged PR interval & QRS duration absent p waves ST-depression (late sign)
30
Hyperkalemia: last resort medical management
dialysis
31
Hyperkalemia: Medical management
sodium polystyrene (kayexalate) calcium gluconate (protects heart) sodium bicarbonate loop diuretics insulin/dextrose albuterol (drives K+ into cell)
32
Calcium assists with ____ ____
blood clotting
33
If calcium is elevated---> calcitonin released ---> bones ___ Ca+
absorb
34
If calcium is decreased---> PTH released---> bones ___ Ca+
release
35
Hypocalcemia: value
<8.5
36
Hypocalcemia: Causes
hypoparathyroidism kidney injury alkalosis
37
Hypocalcemia: Clinical manifestations
tetany hyperactive DTRs numbness trousseau/chvostek sign seizures abnormal clotting anxiety dyspnea/laryngospasms Prolonged QT interval lengthened ST segment
38
Will have positive Trousseau/Chvostek sign
hyperphosphatemia hypomagnesemia hypocalcemia
39
Hypercalcemia: serum level
>10.5 (rare)
40
Hypercalcemia: Clinical manifestations
polyuria thirst muscle weakness intractable nausea abd cramps constipation diarrhea peptic ulcer bone pain Shortened ST segment and QT interval bradycardia and heart blocks
41
Hypercalcemia: management
furosemide, phosphates calcitonin increase mobility
42
Hypomagnesemia: serum level
<1.3
43
Hypomagnesemia: patho
alcoholism GI losses
44
Hypomagnesemia: Manifestations
Chvostek/Trousseau signs apathy depressed mood psychosis muscle weakness tremors increased tendon reflexes diarrhea nystagmus flat or inverted t waves depressed ST segment widened QRS prolonged PR interval
45
Hypomagnesemia: management
monitor for dysphagia seizure precautions EKG avoid osmotics & loop diuretics
46
Hypermagnesemia: serum level
>3.0 (rarest)
47
Hypermagnesemia: patho
dka
48
Hypermagnesemia: manifestations
hypoactive reflexes drowsiness muscle weakness depressed respirations prolonged PR and QRS peaked t waves CARDIAC ARREST
49
direct antidote for mag toxicity
calcium gluconate
50
Hypophosphatemia: serum level
<2.5
51
Hypophosphatemia: patho
alcoholism respiratory alkalosis dka hyperparathyroidism
52
Hypophosphatemia: manifestations
nystagmus confusion muscle weakness muscle/bone pain increased risk for infection
53
Foods to encourage with Hypophosphatemia
milk fish/poultry whole grains soda
54
Hyperphosphatemia: serum level
>4.5
55
Hyperphosphatemia: causes
acidosis chemo hypoparathyroidism
56
Hyperphosphatemia: manifestations
tetany
57
Hyperphosphatemia: management
calcium-binding antacids (while eating) avoid: hard cheese, sardines, meat, dried fruit
58
hypochloremia: serum level
<96
59
hypochloremia: manifestations
agitation/irritability weakness seizures/coma
60
hypochloremia: causes
dka metabolic alkalosis fever, burns, excessive sweating
61
hyperchloremia: serum level
>108
62
hyperchloremia: causes
head injury hypernatremia dehydration/diarrhea respiratory alkalosis metabolic acidosis
63
hyperchloremia: manifestations
tachypnea lethargy, weakness HTN cognitive changes
64
The sodium potassium pump transports ___ into the ECF
Na
65
the sodium potassium pump contributes to creating ___ transmission and maintaining ___ level in the ICF
electrical; K+

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