Ch 41 Agents Affecting Volume And Ion Content Of Body Fluid

Front 1

Volume contraction

Back 1

is defined as a decrease in total body water; conversely,

For volume contraction, the subcategories are isotonic contraction, hypertonic contraction, and hypotonic contraction

Front 2

volume expansion

Back 2

is defined as an increase in total body water.

Treat volume expansion with diuretics.

Front 3

Isotonic contraction

Back 3

is defined as volume contraction in which sodium and water are lost in isotonic proportions

treat with (0.9%) sodium chloride.

Front 4

Causes of hypertonic contraction include

Back 4

excessive sweating, osmotic diuresis, and feeding excessively concentrated foods to infants.

Treat hypertonic volume contraction with hypotonic (eg, 0.11%) sodium chloride. [Never seen this; usually hypertonic situations are treated with water restriction.]

Front 5

Hypotonic contraction

Back 5

is defined as volume contraction in which loss of sodium exceeds loss of water. Hence both the volume and osmolality of extracellular fluid are reduced.

Treat hypotonic volume contraction with hypertonic (eg, 3%) sodium chloride. [This has to be infused very carefully per a formula; it is never infused quickly].

Front 6

_______ _________is produced by hyperventilation. By hyperventilating, a patient or person will blow off CO2 (carbon dioxide), causing the pH of their blood to rise, causing respiratory alkalosis

Back 6

Respiratory alkalosis

Front 7

_______ ________results from retention of CO2 secondary to hypoventilation.

Back 7

Respiratory acidosis

Front 8

How does metabolic alkalosis occur?

Back 8

is characterized by increases in both the pH and bicarbonate content of plasma

Causes include excessive loss of gastric acid (through vomiting or suctioning) and administration of alkalinizing salts (eg, sodium bicarbonate).

Front 9

How do you treat metabolic alkalosis?

Back 9

Treat metabolic alkalosis with an infusion of sodium chloride plus potassium chloride.

Front 10

When an alkalinizing salt is indicated (in severe cases) in treating metabolic acidosis______ ________ is generally preferred. _____ _______ is only used now when the pH is less than____.

Back 10

sodium bicarbonate

7.1.

Front 11

In treating metabolic acidosis it is important to treat the __________ _____.

Back 11

underlying cause

Front 12

Treat moderate hypokalemia with what?

Back 12

potassium chloride in sustained release tablets.

Front 13

Treat severe hypokalemia with what?.

Back 13

intravenous (IV) potassium chloride. NEVER GIVE IV POTASSIUM CHLORIDE UNDILUTED OR IV PUSH. YOU WILL KILL THE PATIENT

Front 14

What are some of the causes of hyperkalemia?

Back 14

• Hyperkalemia (excessive elevation of serum potassium) can result from a number of causes. These include severe tissue trauma, untreated Addison’s disease, acute acidosis (which draws potassium out of cells), misuse of potassium-sparing diuretics, and overdose with IV potassium

Front 15

Treat hyperkalemia byfirst withdrawingthe potassium source/s and then follow these three steps?

Back 15

(1) infusing a calcium salt to offset the cardiac effects of potassium,

(2) infusing glucose and insulin to promote potassium uptake by cells, and
(3) infusing sodium bicarbonate if acidosis is present. Hyperkalemia will usually be treated by using Kayexalate as this will bind the potassium for excretion out of the body. IV glucose/insulin will only push the potassium back into the cells and won’t really treat the problem.