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85 Cards in this Set

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NA
135-145 mEq/L
K
3.5-5.0 MEQ/L
CA 2+ (IONIZED)
4.5-5.5 MG/DL
BICARB (HCO3-)
22-26 (ARTERIAL) MEQ/L (metabolic problem if off)
less- acidosis
more- alkalosis
CL-
95-105 MEQ/L
MG2+
1.5-2.5 MEQ/L
PO4-3 (PHOSPHATE)
2.8-4.5 MG/DL
serum means
in the blood.
FVD (hypovolemia)
water/electrolyte loss:
Fever
Vomiting
Diarrhea
Bleeding
Symptoms-collapsed neck veins, elevated hematocrit, weight loss, tachycardia, poor skin turgor
FVE (hypervolemia)
water/electrolyte retaiened:
Distended neck veins
Edema
Bounding pulse
Crackles in lungs
Engorged peripheral veins
hyperosmolar imbalance
dehydration
hypoosmolar imbalance
water excess
normal PH
7.35-7.45
above- alkalosis
below- acidosis (butt= ac!)
PACO2
35-45 mm hg (respiratory problem if off)
above= acidosis
below= alkalosis
PaO2
80-100 mm hg
ox sat
95-99%
pao2 below 60---> sats drop
compensation for metabolic acidodsis
increase respiration to excrete co2
compensatino for metabolic alkalosis
decrease in respiratory rate and renal loss of bicarbonate
diarrhea causes loss of
potassium
inracellular fluid
inside cells
about 40% of body weight
extracellular fluid
outside (interstitial and blood plasma)
provides a substantial portion of the body's liquids
where is the potassium?
inside the cell
(with phosphate)
where is sodium?
outside the cell
(with chloride) SALT!
osmosis
Movement of a pure solvent such as water from an area of lesser to one of greater concentration
diffusion
Diffusion:
Random movement of a solute through a semipermeable membrane from higher to lower concentration
active transport
Movement of ions against osmotic pressure to an area of higher pressure
filtration
Movement water and diffusible substances move together across a membrane, under pressure, from higher to lower pressure
What is the most abundant cation in ECF?
sodium (90%)
normal saline means
normal with blood
Where is 90% of our calcium?
bone tissue
What is proportional with calcium?
(as one rises the other falls)
Phosphate
Phil and Carol :)
What can low sodium result in?
SEIZURES!!!
What are some signs of hypocalcemia?
Shvostek (tight cheek)
Trousseua (tighten arm, crunched hand)
.9% normal saline is?
isotonic (same as plasma)
1 oz =
30 mls fluid
or 15 mls of ice chips
dextrose 5% in water
isotonic
d5w
dextrose 10% in water
hypertonic
d10w
0.45% sodium chloride
(half normal saline)
hypotonic
1/2 NS or 0.45% NS
0.33% sodium chloride
(1/3 normal saline)
hypotonic
1/3 NS
0.9% sodium chloride
(normal saline)
isotonic
NS
0.9% Ns
0.9% nacl
3-5% sodium chloride
hypertonic
3-5% ns
3-5% nacl
dextrose 5% in 0.9% sodium chloride
hypertonic
d5 0.9% nacl
d5 0.9% Ns
d5ns
dextrose 5% in 0.45% nacl sodium chloride
hypertonic
d5 0.45% nacl
d5 0.45% ns
d5 1/2 ns
lactated ringer's
isotonic
LR
dextrose 5% in lactated ringer's
hypertonic d5LR
what is an electrolyte?
An element or compound that, when dissolved or dissociated in water or solvent, separates into ions
what are the cations?
sodium, potassium, calcium.
positive
what are the anions?
chloride, bicarbonate, sulfate.
negative
Electrolytes are dissolved in ...
plasma.
what does a hypertonic solution do?
pull fluid from the cells
shrink
what does a hypotonic solution do?
push fluid into cells
enlarge
renin angiotensin aldosterone mechanism
renin-angiotensin 1- angiotensin 2- aldosterone
what is aldosterone?
hormone that increases sodium reabsorption and potassium/ hydrogen secretion
where all is fluid lost?
through the kidneys, skin, lungs, and gi tract
where are buffers located?
(for acid-base balance)
lungs and kidneys
what are some electrolyte disturbances?
hypo/hyper natremia
hypo/hyper chloremia
hypo/hyper magnesemia
hypo/hyper calcemia
what are some fluid disturbances?
isotonic
osmolar
what are some acid base disturbances?
metabolic acidosis
metabolic alkalosis
respiratory alkalosis
respiratory acidosis
what does hypernatremia cause?
hypo?
irritability, thirst, CNS probs
CNS probs seizures
hyperkalemia causes
hypokalemia causes
irregular heart rate (vent. fib. & ECG changes), CNS probs
caused by met alkalosis; bradycardia, ECG/CNS probs
hyper?
hypomagnesemia causes
loss of dtrs, CNS depress, dec neuromuscular function
hyperactive dtrs, CNS probs (alcoholism)
what can lead to magnesium imbalance?
alcohol
drip rate calculation
(ml/min) x drops
Respiratory Acidosis
co2 excess, hypo, resp failure
comp: kidneys conserve bicarb and excrete H
Respiratory Alkalosis
co2 deficit, hyper, hypoxemia. acute pulmonary disorders
comp: rare--> treat hypoxemia
metabolic acidosis
bicarb deficit or co2 increase
caused by-ketoacidosis, lactic acid, diarrhea, kidney disease,diabetes, starvation
comp: increase co2 excretion (kussmauls) or kidneys excrete acid
metabolic alkalosis
bicarb excess from vomit or suction.
comp: decrease resp rate to incr co2, renal exretion bicarb
[ HYPOKALEMIA]
What does acidosis cause H ions in the blood to be exchanged for?
K
osmotic pressure
hydrostatic pressure
oncotic pressure
flow of water
force into a compartement
exert by colloids (protein=albumin)
plasma to instersitial space & low albumin =
edema
water deficit
excess
high ECF
low ECF
first spacing
second
third
normal
edema
abnormal, hard to exchange in ECF
decrease thirst mechanism=
decrease fluid intake
When giving a hypertonic solution what do you listen for?
crackles in lungs
name some colloids
albumin, plasma, and packed RBCs
hypercalcemia
hypo
thirst, CNS probs
tetany, Chvostek and Trousseau, CNS probs, ECG, twitching
*walk patient?
Who do we not give water to?
low NA
kidneys can regulate
acid/base
fluid
& electrolyes!
metabolic acidosis
respiratory alkalosis
diabetes & starvation
anxiety, fast breath
hypotonic
hypertonic
pushes (fat bc big O)
pulls (skinny)
colloid osmotic pressure
albumin
pulls fluid in cap
[hydro- pushes fluid out cap]
ADH
water retention w/ too much NA
ECF volume deficit
dec skin turgor, orthostatic hypotension, thirst, low urine.
Weigh pt!
What meds are toxic w hypokalemia?
lasix and digoxin
which one spares K?
spironolactone