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131 Cards in this Set
- Front
- Back
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normal sodium levels |
135-145 |
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normal potassium levels |
3.5-5.0 |
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normal calcium levels |
9-11 |
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normal magnesium levels |
1.3-2.1 |
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normal blood ph |
7.35-7.45 |
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pco2 levels |
35-45 |
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Hco3 levels |
22-26 |
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electrolytes |
substances dissolved in water carry an electrical charge |
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what should your avg water intake be |
2500 ml per day |
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osmosis |
the movement of water through a semipermeable membrane from a low diluted area to a more concentrated area |
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whose the greatest risk for fluid loss |
infant, elder, obese |
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solutes |
substances dissolved in fluid |
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solvent |
liquid in which substances are dissolved |
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electrolytes |
substances when dissolved in water carry a electrical charge |
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is normal saline a isotonic solution |
yes |
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what is the best way to measure accurate I&O |
weight gain and loss |
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how long can avg human go without water |
7-10 days |
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tonicity |
concentration of substances dissolved in water |
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colloids |
large sized substances such as serum proteins |
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osmotic pressure |
power to draw water to an area of greater concentration |
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passive diffusion |
dissolved substances move from high to low concentration |
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facilitated diffusion |
certain dissolved substances move from high to low concentration with help of a carrier module |
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active transport |
requires energy to move ions from high to low concentration |
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hydrostatic pressure |
the force of the b/p |
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translocation |
movement back and forth |
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osmoreceptors |
specialized neurons in the hypothalamus that sense increase or decrease in blood concentration |
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what is fluid volume mainly regulated by |
excretion if h2o (urine) and thirst |
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when do baroreceptors stimulate the production of ADH |
when blood increases concentration (decreases blood volume) |
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what is serum osmolality |
concentration of of substances in blood |
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what does adh do |
increases reabsorption of water in kidneys which causes: increase blood volume improves heart output maintains bp |
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what is adh released by |
posterior lobe pituitary |
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barorecpetors |
stretch receptors located in aortic arch and the carotid sinus that respond to pressure changes |
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do baroreceptors relay messages to osmoreceptors to release or suppress ADH |
yes |
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renin-angiotensin-aldosterone system |
a series of chemicals released to increase bp and blood volume |
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what is the raas system triggered by |
juxtaglomerural apparatus |
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natriuretic peptides |
hormone like substances that decrease renin, ADH, and aldosterone. and increases urine output |
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when is anp secreted |
when atria is overstretched |
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when is bnp secreted |
when ventricle is overstretches |
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when do fluid imbalances occur |
when body’s h2o is not in proper volume or location |
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hypovolemia |
decreased blood volume |
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dehydration |
decreased fluid in both ecf and icf |
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hypervolemia |
increased fluid volume |
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third spacing |
fluid in spaces where normally there is little or no fluid |
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2nd spacing |
fluid in the interstitial area |
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1st spacing |
normal |
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those at risk for hypovolemia |
lethargic dementia fever n/v difficulty swallowing take diuretics or laxatives can’t speak to comm needs eat poorly |
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henoconcentration |
increased blood components related to fluid (increase wbc, rbc, hct, and hgb) |
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is hemodilution the opposite of hemoconcentration |
yes |
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what does 3rd spacing usually result from |
loss of colloids (albumin) |
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examples of 3rd spacing |
ascities, burns, allergic reaction, pancreatitis, cerebral edema, pulmonary edema |
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examples of 2nd spacing |
pedal edema |
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two ions that are electeolytes |
action and anion |
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cation |
positive charged ion |
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anion |
negative charged ion |
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do opposite ions attract |
yes |
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are the charges normally equal on both sides of the cell membrane |
yes |
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how do we measure electrolyte levels |
in the serum |
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extracellular electrolytes |
Na, Ca, Cl |
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Intercellular electrolytes |
K, Mg, Ph |
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is Na a cation or anion |
cation |
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functions of Na |
normal nerve/muscle activity regulates fluid volume maintains acid/base balance |
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what controls sodium levels |
aldosterone |
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what cause sodium retention? what about excretion? |
retention- increase sodium excretion- decreased sodium |
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hyponatremia, what is it and what does it cause |
decreased sodium. mental confusion, weakness, tachycardia, convulsions |
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treatment for hyponatremia |
correct cause increase sodium in diet iv normal saline |
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hypernatremia. what is it and what causes it |
increased sodium. diahrrhea, excessive salt intake w/o water, fever, diabetes, etc. |
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if Na is elevated, K is low |
true |
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hypernatremia treatment |
restrict na intake diuretics monitor vs seizure precautions i&o mouth care |
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potassium functions |
necessary for neuromuscular transmission and excitability in cardiac and skeletal muscles maintains reg heart rhythm acid-base balance — K+ is exchanged for H- |
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where is K excreted |
urine |
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does the body store K |
no |
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hypokalemia |
low potassium |
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what kind of wave does hypokalemia have? what about hyperkalemia? |
hypo- u hyper- v |
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causes of hypokalemia and treatment |
furosemide, HCTZ anorexia large dose of steroids metabolic alkalosis Treatment: K supplements, food rich in K, IV K if deficient (give slowly) |
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when do you not give K |
when patient has decreased renal function |
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hyperkalemia causes and treatment |
causes: renal failure, massive injuries, burns, salt substitutes, etc. treatment: low K intake, kayexalate, dialysis, etc |
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what ion is calcium? what regulates it? |
cation the parathyroid gland |
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does calcium have a sedative effect on the body? |
yes |
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hypocalcemia causes and treatment |
causes: vit D deficiency, hypoparathyroidism, burns, pancreatitis, etc. treatment: Vit D, Ca supplements, seizure precautions. |
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hypercalcemia causes and treatment |
causes: multi fractures, excessive vit d, multiple myeloma, hyperparathyroidism, etc. treatment: decrease ca, increase fluid, furosemide, strain urine, etc. |
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where is mg normally found |
the heart, liver, bone and skeletal muscle. small ant in blood |
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functions of mg |
transmission of nerve impulses and muscle action protects the heart by influencing cardiac enzyme activity and K and Ca levels in cardiac tissue Na & K pump |
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hypomagnesemia causes and treatment |
causes: alcoholism, malnutrition, diuretics, renal disease, burns, etc treatment: oral mag, nuts, pb, whole grains, green leafy veggies, quiet env. |
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hypermagnesemia causes and treatment |
causes: renal failure, addison’s disease, dehydration, hyperparathyroidism treatment: dialysis, correct cause, decrease mg in diet |
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causes and treatment of hypoproteinemia |
causes: anorexia, vegetarians, gi disease, major surgery, burns, inflammation treatment: increase protein intake, albumin |
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what causes kidney stones? |
hypercalcemia |
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what causes facial spasms with circumoral paresthesia |
hypocalcemia |
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what causes pathological fractures |
hypercalcemia |
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what causes cramps in the calves |
hypokalemia |
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what causes thirst with oliguria |
hypernatremia mainly hypovolemia |
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what causes decrease dtrs |
hypermagnesmia |
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what causes edema with decreased muscle mass |
hypoproteinemia |
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what is the main acid |
H2CO3 Carbonic acid |
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what is the main base |
HCO3 bicarbonate |
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what determines if a substance is a acid, base, or neutral |
hydrogen |
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ph |
potential of h and the amt of h in the blood |
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acids |
release/donate H |
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bases |
accept/take H |
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what are the two mechanisms that regulate ph |
chemical regulation organ regulation |
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chemical regulation |
bicarbonate and carbonic acid buffer system |
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organ regulation |
lungs and kidneys |
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anion gap |
the difference between Na and K cations and Cl and HCO3 anions in the extracellular fluid |
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what is the normal anion gap |
12 ( plus of minus 4) |
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assessment findings of hypocalcemia |
tingling of extremities chvosteks sign trousseau sign tetany
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what is the chief electrolyte found in the intercellular fluid |
K |
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what is shock |
A life-threatening condition that occurs when arterial blood flow and oxygen delivery to the tissues and cells are inadequate |
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3 causes of shock |
blood volume decrease the heart fails to pump effectively peripheral blood vessels massively dilate |
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4 types of shock |
hypovolemic distributive obstructive cardiogenic |
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hypovolemic shock causes and treatment |
loss of fluids from circulation (hemorrhage, burn, dehydration, 3rd spacing) treatment: control bleeding, replace fluids, mast trousers |
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distributive shock |
The amount of fluid in the circulatory system is not reduced, yet the fluid circulation does not permit effective tissue perfusion |
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3 types of distributive shock |
neurogenic septic anaphylactic |
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neurogenic shock |
injury to the brain/spinal chord in which there is loss of nervous systems ability to construct blood vessels |
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septic shock |
overwhelming bacterial infections |
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anaphylactic shock |
sever allergic reaction due to abnormal antigen/antibody response |
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obstructive shock |
occurs when hear it great vessels are occluded interference with circulation in and out of the heart |
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cardiogenic shock |
ineffective contraction of the heart and thust have decreased cardiac output |
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what is the most common type of shock |
hypovolemic |
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what is the rarest type of shock |
neurogenic |
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what shock has the highest mortality rate |
septic shock |
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what is the cause of cardiogenic shock |
heart attack |
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what is the death rate of cardiogenic shock |
80-100% |
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what are the 3 phases of shock |
compensation decompensation irreversible stage |
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what is the compensation stage and when does it occur |
occurs when bp is decreasing body compensated by: -release of catecholamines -RAAS system activated -ADH and Corticosteroid hormones |
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what is the decompensation stage and when does it occur |
occurs when out compensatory mechanisms fail causes: cellular hypoxia coagulation defects cardiovascular changes |
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what is the irreversible stage and what happens |
point of no return multi system failure |
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what are the s/s of shock |
decrease bp tachycardia weak/thready increased resp decreased urine output cold/clammy skin mentation changes |
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diagnosis of shock |
oxygen below 90 central venous pressure (CVP) decreased in hypovolemic but increased in cardiogenic Pulmonary artery pressure (PAP) decreased |
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treatment of shock |
iv fluids drugs: vasopressors-dopamine/norepinephrine inotropics-dobutamine/digoxin (slow & strengthen HR) epinephrine vasopressin (raises bp) xigris mast vs dmast |
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nursing interventions with shock |
bed rest VS assess skin i&o LOC IV fluids 02 meds keep warm pain control
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what do beta adgrenic drugs do what’s an example |
increase heart contraction force digoxin/lenoxin |
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what are life threatening complications of shock |
kidney failure neurological deficits bleeding disorders resp distress syndrome stress ulcers sepsis |
