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88 Cards in this Set
- Front
- Back
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What is what part intracellular and what part extracellular?
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2/3 intra
1/3 extra |
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What is extracellular fluid made up of?
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80 interstitial and 20 blood plasma
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What makes up 90 percent of extracellular cations?
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na
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What is the function of sodium?
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regulate water balance and osmotic forces
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What are the constiuent ions and who do they work with?
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cl and hco3 work with k and ca
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What do cl, hco3,k,and ca do?
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maintain neuromuscular irritability to maintain impulses
regulate acid base balance aid in chemical reactions and cellular transport |
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Why would adh be secreted?
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-because of increase in plasma osmolarity and it holds onto water
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Aldosterone is secreted when?
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-sodium levels are low
-k levels are up -renal perfusion is low |
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Aldosterone conserves what and dumps what?
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conserves na and dumps k
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When is renin released?
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sns stimulation and decreased kidney perfusion
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Renin stimulates what
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angiotensin
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What does angiotensin 2 do?
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stimulates release of aldosterone and causes vasoconstriction
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When would you find an elevated BNP?
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pulmonary hypotension and right ventricular dysfunction and heart failure
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What are the 3 roles of NA?
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neuromusc irritability, acid base balance and cellular reactions
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na cation or anion
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na is a cation
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what is the primary ecf anion and its purpose?
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chloride-electroneutrality
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Na range?
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135-145
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WHAT IS NA REGULATED BY?
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KIDNEYS
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sODIUM IS WHAT IN RENAL CARDIAC AND LIVER DISEASE?
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HIGHER
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WHAT DOES HYPONATREMIA DO?
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DECREASED MEMBRANE EXCITABILITY
CNS MOST SENSITIVE TO CHANGES IN EXCITABILITY LESS NA AVAILABLE TO CROSS MEMBRANE |
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WHAT HAPPENS DURING HYPONATREMIA TO OSMOLARITY?
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HYPOOSMOLARITY..PULLS FLUID FROM INSIDE CELLS TO BALANCE
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WHAT ARE CNS CHANGES DUE TO HYPONATREMIA?
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HEAD ACHE, APPREHENSION, SEIZURES,SWELL OF BRAIN
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WHAT ARE CARDIO CHANGES DUE TO HYPONATREMIA?
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LOW BLOOD PRESSURE, ORTHOSTATIC, RAPID AND THREADY PULSE,
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WHAT ARE SYMPTOMS OF HYPERVOLEMIC HYPONATREMIA?
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LUNG CRACKLES, ALTERED LUNG AND CARDIAC FUNCTION
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WHAT ARE GI SYMPTOMS OF HYPONATREMIA?
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cramping and increased bowel sounds
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what should you do for mild hyponatremia?
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RESTRICT FLUIDS 1000-1500 ML A DAY
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IF NA LESS THAN 125..HOW SHOULD U TREAT IT
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.9 NACL OR LACT RINGERS OR 3* NACL IF LESS THAN 115 AND DIURETIC
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WHAT HAPPENS IF HYPONATREMIA NOT CORRECTED?
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OTHER LYTES GET LOW AND SHOULD RAISE NA SLOWLY
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WHAT ARE THE THREE ROLES OF SODIUM?
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REGULATE OSMOTIC FORCES
ACID BASE BALANCE AND CELLULAR REACTIONS |
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WHAT IS THE PRIMARY ECF CATION AND ANION?
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CATION-NA
ANION-CHLORIDE |
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WHAT IS THE PURPOSE OF CHLORIDE?
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PROVIDE ELECTRONEUTRALITY
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WHAT IS THE AVERAGE DAILY INTAKE OF NA?
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5-6 G OR ONLY 500 MG
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WHAT HORMONE REGULATES NA?
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ALDOSTERONE
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WHY ARE OLDER ADULTS AT RISK FOR HYPONATREMIA?
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LESS TBW TO START WITH AN ALTERED THIRST
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WHEN IS NA USUALLY HIGHER?
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WITH CARDIAC,RENAL,OR LIVER DISEASES
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WHAT OCCURS WITH URINARY SYSTEM WHEN THERE IS HYPONATREMIA AND HYPO-OSMOLARITY?
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DIEURESIS
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WHAT OCCURS AS PATHOLOGIC CHANGES DURING HYPONATREMIA?
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-DECREASED MEMBRANE EXCITABILITY, CNS SENSITIVE TO CHANGES IN EXCITABILITY, LESS NA AVAILABLE TO CROSS MEMBRANE
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THESE ARE CLINICAL SIGNS OF WHAT? CNS ALTERATION, HEADACHE,CONFUSION,SEIZURES,BRAIN HERNIATION,COMA, DEATH
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HYPONATREMIA
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WHAT ARE CARDIOVASCULAR CHANGES ASSOCIATED WITH? DECREASED BP,ORTHOSTATIC HYPOTENSION, RAPID,THREADY PULSES?
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HYPONATREMIA
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WHAT ARE CLINICAL SIGNS OF NVD CRAMPING, INCREASED BOWEL SOUNDS,AND SMOOTH MUSCLE DECREASED?
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HYPONATREMIA
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WHAT IS WHEN ADH IS SECRETED IN ABSENCE OF HYPOVOLEMIA OR HYPEROSMOLALITY?
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INAPPROPRIATE ADH SYDROME
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WHAT ARE THE MANIFESTATIONS OF SIADH?
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WEIGHT GAIN, CEREBRAL EDEMA,MUSCLE TWITCHING,HEADACHES,HEART FAILURE
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WHY WOULD HYPOCHLOREMIA RESULT?
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HYPONATREMIA OR ELEVATED BICARB, OR EVEN VOMITING OR LOSS OF HCL
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WHAT IS WHEN NA LOSS GREATER THAN WATER LOSS?
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HYPOVOLEMIC HYPONATREMIA
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HOW IS NA LOST IN HYPOVOLEMIC HYPONATREMIA?
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DIURETIC USE, DIABETIC GLYCOSURIA, ALDOSTERONE DEFICIENCY AND VOMIT, DIAHRREA, SWEAT, BURNS, HI VOL ILEOSTOMIES
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WHAT TYPE OF NATREMIA IS WHEN TBW IS SLIGHTLY INCREASED AND THE NA NORMAL? WHAT SYNDROME IS THIS RELATED TO?
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EUVOLEMIC HYPONATREMIA-SIADH
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WHAT CAUSES EUVOLEMIC HYPONATREMIA?
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INCREASE IN ADH, CANCER,CNS DISORDERS
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WHAT NATREMIA IS WHEN THE TBW INCREASE IS GREATER THAN THE NA?
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HYPERVOLEMIC HYPONATREMIA
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WHAT ARE THE TWO PROBLEMS THAT CAUSE HYPERNATREMIA?
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EXCESSIVE WATER LOSS AND INSUFFICIENT REPLACEMENT
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WHAT ARE THE SYMPTOMS OF HYPERNATREMIA?
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POLYURIA,FEVER,VOMIT,DIARRHEA,DRAINAGE,TUBE FEEDINGS,PROLONGED HYPERVENTILATION
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WHAT DISORDERS CAUSE NA RETENTION?
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CUSHING'S,STEROID THERAPY,HYPERALDOSTERONISM,HEART LIVER AND RENAL DISEASE
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WHAT IS THE WATER MOVEMENT IN HYPERNATREMIA?
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ICF TO ECF AND CAN LEAD TO CELLULAR DEHYDRATION
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WHAT ORGAN IS EXTRA SENSITIVE TO HYPERNATREMIA?
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THE HEART--CALCIUM MUST MOVE THROUGH CA CHANNELS FOR CARDIAC MUSCLE CONTRACTION AND NA COMPETES, DECREASING MYOCARDIAL CONTRACTIBILITY
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HOW DOES THE BODY RESPOND TO HYPERNATREMIA?
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SUPPRESS ADH AND ALDOSTERONE,AND INCREASES RENAL EXCRETION
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IF YOU ARE HYPERNATREMIC AND HAVE INCREASED URINE OUTPUT HOW ARE U VOLEMICLY?
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HYPERVOLEMIC
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IF YOU HAVE OLIGURIA WITH HYPERNATREMIA..HOW R U VOLEMICALLY?
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HYPOVOLEMIC
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WHAT MANIFESTATIONS OCCUR DURING HYPERNATREMIA?
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CELLS SHRINK, DRY MEMBRANES, COMA, AGITATION, FEVER, ELEVATED CHLORIDE
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WHAT KIND OF SOLUTIONS SHOULD YOU USE TO CORRECT HYPERNATREMIA?
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.225 OR .45% NACL OR D5W HYPOTONIC STUFF!
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what kind of ion is k and where does it lie?
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cation and intracellular
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what is k concentration maintained by?
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na-k pump
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what are the 3 things k is essential for?
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transmission and conduction of nerve impulses, normal cardiac rhythms,skeletal and smooth muscle contractions
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changes in what affect k balance?
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ph
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low k causes what kind of manifestations?
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decrease in neuromusc excitability, muscle weak, smooth muscle atony, dysrhythmias,constipation,ventfib or cardiac arrest
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what can most reliably detect hypokalemia within cell?
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ecg
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what are the causes of high hyperkalemia?
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retent of body,decreased renal excretion, trauma, burns, acidosis, tls, insulin deficiency
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what are some disorders where k is released from cells?
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hodgkins,leukemia,diuretics,
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what are some manifestations of hyperkalemia?
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neuro weakness, respiratory paralysis,
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what are other lab studies used to determine hyperkalemia?
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bun,creatnine,co2 levels
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in mild hyperkalemia what occurs?
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hypopolarization so irritability, tingling, restlessness, cramping, diarhhea
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what occurs during severe hyperkalemia
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cannot repolarize so results in weakness, loss of muscle tone, and flaccid paralysis
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what are calcium and phosphate regulated by?
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vitamin d, parathyroid hormone, and calictionin
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what is function of pth?
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increases ca plasma levels
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what is function of vitamind d?
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increases calcium absorption
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what is the function of calcitonin?
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decreases plasma calcium levels
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where is most phosphate located?
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in the bone
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why is phosphate necessary?
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for high energy bonds in creatinine phosphate and atop and as a buffer
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calcium and phosphate have what kind or relationship?
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inverse
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what is when a decrease in block of na into cell, increased neuromuscular excitability, and muscle cramps occcurs?
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hypocalcemia
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what increases the block of na into the cell, decreases neuromusc excitability,muscle weakness,increased bone fractures,kidney stones, and constipation?
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hypercalcemia
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what are manifestation of hypophospatemia?
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osteomalacia,muscle weakness,bleeding disorders,anemia,leukocyte alterations,
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hi phosphate levels are related to what?
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low calcium levels
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Magnesium does what?
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protein and nucleic acid synthesis reactions cofactor
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bmp includes what?
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calcium,glucose,na,potassium,co2,chloride,
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what are kidney tests?
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bun and creatinine
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what is the nitrogenous end product of metabolism that is derived from protein and tissue turnover?
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urea
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what is the product of muscle protein catabolism?
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creatinie
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what is not effected by diet and exercise but will only change if kidneys are not functioning properly?
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creatnine
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what occurs with creatnine when kidneys not functioning steadily?
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amount in urine decreases and blood levels increase
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