Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
31 Cards in this Set
- Front
- Back
|
Fluid balance
|
Fluid mostly shifts between the intravascular and interstial spaces to maintain balance.
|
|
|
Third-spacing or Third-space fluid shift
|
Loss of ECF into a space that does not contribute to equilibrium between ICF and ECF.
|
|
|
Cations (+)
|
Sodium, Potassium, Calcium, Magnesium and Hydrogen ion
|
|
|
Anions (-)
|
Chloride, bicarbonate, Phosphate, Sulfate, Proteinate ions
|
|
|
Osmosis
|
The diffusion of water by a fluid concentration gradient through a membrane
|
|
|
Diffusion
|
The natural tendancy of a substance to move from an area of high concentration to an area of lower concentration.
|
|
|
Filtration
|
Hydrostatic pressure in the capillaries tends to filter fluid out of the vascular compartment into the interstitial fluid
-Ex: filtration of water and electrolytes from the arterial capillary bed to the interstial fluid (hydrostatic pressure is supplied by the pumping heart) |
|
|
Active Transport
|
Implies that energy must be expanded for the movement to occur against the concentration gradient
-Ex: sodium/potassium pump in the cell membrane |
|
|
Routes of gains and losses
|
-Kidney: urine 1ml/kg per hour, abour 1-2L daily for adults
-Skin: Visible loss (sweat) 0-1L, Not visible (evaporation) 600mL per day -Lungs: water vapor 400mL per day -GI tract: 100-200mL per day |
|
|
Urine Specific Gravity
|
Measures the kidneys ability to excrete or conserve water
|
|
|
Blood Urea Nitrogen (BUN)
|
Urea, an end product of protein metabolism
|
|
|
Creatine
|
An end product of muscle metabolism
|
|
|
Hematocrit
|
Measures the volume percentage of RBCs in whole blood
|
|
|
Hypovolemia
|
-D/T: abnormal losses through kidneys, skin, GI tract, decreased intake, bleeding, 3rd spacing shift
-S/S: increased HR, decreased B/P, reduced urine output, dizziness, weakness, dry mucus memebranes, increased specif gravity -Tx: Isotonic fluids (LR, NS) are used if patient is hypotensive, hypotonic fluids are given once normotension is reached (1/2NS) |
|
|
Hypervolemia
|
D/T: body retaining water and electrolytes in ECF, often occurs with CHF, renal failure, cirrhosis, steroid use
S/S: edema, pulmonary edema, low HGB, increased HR, increased B/P Tx: low Na, restrict fluids, normal saline IV |
|
|
Respiratory Acidosis
|
-D/T: pneumonia, pulmonary edema, drowning, asthma, cystic fibrosis, emphysema, CNS depression, inadequate excretion of CO2 (H2CO3 excess)
-S/S: increased pulse and resp. and B/P, SOB, confusion, lethargy Lab: reduced pH (<7.35, PaCO2 > 45) Tx: Improving ventilation, hydrate |
|
|
Respiratory Alkalosis
|
-D/T: H2CO3 deficit, excessive loss of CO2, anxiety, fever, hyperventilation
-S/S: hyperventilation, difficulty concentrating, tingling -Labs: pH > 7.45, PaCO2 < 35 -Tx: Breathing into paper bag, antianxiety drugs, reduce fever |
|
|
Metabolic Acidosis
|
-D/T: HCO3 deficit, products from renal impairment (excessive acid), Diabetes Mellitus, starvation, loss of bicarbonate d/t diarrhea, excessive infusion of NaCl (IV)
-S/S: fruity breath, rapid and deep breathing, lethargy and weakness -Labs: pH < 7.35, HCO3 < 21 -Tx: Na bicarb through IV push, restore F&E, correct underlying problem ie diarrhea... |
|
|
Metabolic Alkalosis
|
-D/T: HCO3 excess, loss of acid through vomiting, GI suction, diuretic, K loss (Lasix), excessive base intake (antacids, IV bicarb, baking soda)
-Labs: HCO3 > 26, pH > 7.45 -S/S: decreased resp. rate and depth, dizziness, tetany-like symptoms, irritability, confusion Tx: IV admin of K, treat vomiting, rid body of excess bicarb and retain CO2 |
|
|
Sodium
|
-Normal: 135-145
-Fx: controls and regulates water balance, conduction of nerves and muscles, stimulates thirst -Most abundant electrolyte in ECF -increase or loss in Na is almost always accompanied by and increase or loss in water |
|
|
Hyponatremia
|
-Na < 135mEq/L
-Causes water to move out of vascular space into intracellular space (cell size increases) -D/T: Losses through GI tract (diarrhea), profuse sweating, diuretics, drinking too much water, head injury, craniotomy, or stroke -S/S: dry mucosa, cerebral edema, edema, hypotension, lethargy, confusion, muscle cramps, N/V, anorexia, poor skin turgor -Tx: Encourage high Na diet, monitor I&Os, fluid restrictions, LR, or NS |
|
|
Hypernatremia
|
-Na > 145
-Pulls water from the cells into the vascular space (dehydrating the cells) -D/T: loss of fluids through diarrhea, hyperventilation, increased Na intake, Diabetes Insipidus, heat stroke, water deprivation -S/S: thrist, dry mucus membranes, fatigue, disorientation, agitation, red tounge -Tx: Restrict Na intake, administer diuretics, D5W or 1/2NS, I&Os monitored |
|
|
Potassium
|
-Normal: 3.5 - 5.0
-Major intracellular electrolyte -Regulated by the kidneys -Effects all body systems, escpecially cardiac and neuromuscular -Plays a role in acid base balance (K losses in metabolic alkalosis) |
|
|
Hypokalemia
|
-K < 3.5 mEq/L
-D/T: losses through vomiting, GI suction, diarrhea, drugs that cause K loss (lasix), low intake (alcoholic, anorexia, debilitaed pts), excessive loss through kidneys -S/S: muscle weakness, leg cramps, anorexia, N/V, decreased bowel motility, cardiac arrhthmias, decreased deep tendon reflexes, increased pH and bicarbonate Tx: admin of KCl (IV or PO), (K can burn the veins and is very upsetting to the stomach), encourage intake of potassium rich foods |
|
|
Hyperkalemia
|
-K > 5.0mEq/L
-D/T: Decreased losses through kindeys due to renal failure, hypoaldosteronism, K sparing diuretics, increased K intake, movement out of cells due to burns, tissue trauma S/S: muscle weakness, cardiac arrhythmias, confusion, numbness in extremities, abscence of reflexes Tx: Sodium bicarbonate (due to high K causing acidosis), Kayexalate, dialysis, avoid high K foods, Ca gluconate, IV glucose (pushes K back into cell) |
|
|
Calcium
|
-Normal: 8.5 - 10.5
-Controlled by the parathyroid -Affects bone reabsorption and is found primarily in bones -Fx: bone formation, transmission of nerve impulses, muscle contraction, and blood coagulation -Calcium is bound primarily to albumin but is binds to phosphate, citrate, and carbonate |
|
|
Hypocalcemia
|
-Ca < 8.5mEq/L
-D/T: parathyroid or thyroid dysfunction, inadequate intake of Vitamin D, Excessive loss of intestinal secretions, alcohol abuse S/S: numbness, tingling, muscle tremors, cardiac arrhythmias, tetany, seizures, hyperactive deep tendon reflexes, + Trousseau's and Chvostek's sign Tx: IV Ca gluconate, Vit D supplement, Phoslo (Vit D and Ca), increase diet in vit D and Ca |
|
|
Hypercalcemia
|
-Ca > 10.5
-D/T: Prolonged immobilization, parathyroid and thyroid conditions, ingestion of antacids, bone malignancy -S/S: Flank pain, urinary calculi, weakness, reduced muscle tone, depressed deep tendon reflexes, cardiac arrest -Tx: Hydrate pt to dilute calcium and promote excretion, lasix, calcitonin |
|
|
Magnesium
|
-Normal: 1.5 - 2.5
-Controlled by the parathyroid, kidneys, and K concentration Fx: neuromuscular activity, metabolism of carbohydrates and proteins, influences vasodilation |
|
|
Hypomagnesemia
|
-Mg < 1.5mEq/L
-D/T: Excessive losses through GI suctioning, diarrhea, fisula draining, diuretics, chemotherapy, alcoholism, renal disease, burns -S/S: 3T's (tremors, twitching, tetany), increased reflexes, seizures, + Trousseau's and Chvostek's sign -Tx: MgSO4 IV (watch for hypotension), monitor for reduced HR, seizure precautions |
|
|
Hypermagnesemia
|
-Mg > 2.5mEq/L
-D/T: Retention d/t renal failure, increased intake (antacids) -S/S: lethargy, coma, muscle weakness, hypotension, impaired respirations, depressed deep tendon reflexes -Tx: Hemodialysis, diuretics, 1/2NS, Ca gluconate |
