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269 Cards in this Set

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Kidneys

Remove wastes from the blood to form urine.

Kidneys II

Filter wastes products of metabolism that collect in the blood, it teaches the kidneys by the renal artery

Cardiac output

Approximately 20% to 25% of the cardiac output circulates each minute through the kidneys.

Nephron

Functional unit of the kidney, forms the urine, composed of glomerulus, bowmans capsule, proximal convoluted tubule, loop of Henley distal tubule and collecting duct.

Glomerular capillaties

Permit filtration of water, glucose, amino acids, urea, creatinine, and major electrolytes into the Bowman's capsule.

Proteinuria

Is a sign of glomerular injury (the presence of large proteins in the urine). The glomerulus filters 125mL of filtrate per minute.

Urine output

Normal adult output is 1200 mL to 1500 mL/day

Erythropoietin

Functions within the bone marrow to stimulate to stimulate RBC production and maturation and prolongs life of mature RBCs

Renon

Renal hormone affects the blood pressure regulation. Functions as an enzyme to convert angiotensin into angiotensin I. ( is converted to angiotensin II in the lungs.)

Aldosterone

Angiotensin II caused vasoconstriction & stimulated the release of aldosterone. Which causes water retention which increases blood volume.

Prostaglandin E2 & Prostacyclin

Produced by kidneys-help maintain renal blood flow through vasodilation. Increase arterial BP & renal blood flow.

Prostaglandin E2 & Prostacyclin

Produced by kidneys-help maintain renal blood flow through vasodilation. Increase arterial BP & renal blood flow.

Act of urination

Cerebral cortex, thalamus, hypothalamus & brainstem all influence bladder function.

Bladder

Capacity ranges from 600-1000mL of urine, voids 2-4 hrs.

Bladder

Capacity ranges from 600-1000mL of urine, voids 2-4 hrs.

Réflex incontinence

Damage to spinal cord above sacral region. Loss of voluntary control of urination. The micturation reflex pathway often remains intact allowing urination to occur w/o sensation.

Overflow incontinence

Occurs when a bladder is overly full & bladder pressure exceeds sphincter pressure resulting in involuntary leakage of urine. Causes: head injury, spinal injury, MS, DM, postanesthesia, tricyclics, analgesia.

Hyperreflexia

A life-threatening problem affecting heart rate & BP is caused by an overly full bladder. Neurogenic in nature, can be caused functionally by blockage.

Factors influencing urination

UTI, sociocultural factors, physiological factors, fluid balance, and surgical, diagnostic procedures. Medications.

Diseases affecting urination

Pre-renal, renal, post-renal. DM, neuromuscular diseases, prostate, cognitive impairment, DJD

Uremic syndrome

An increase in nitrogenous wastes in the. Lois, marines fluid & electrolyte abnormalities, nausea, vomiting, headache, coma, and convulsions.

Peritoneal dialysis

Indirect method of cleaning the blood of waste products using osmosis and diffusion with the peritoneum functioning as the semipermeable membrane. Done by gravity with a catheter inserted in the peritoneum.

Hemodialysis

Requires a machine equipped w/a semipermeable filtering membrane that removes accumulated waste products & excess fluids from the blood.

Indications for dialysis

Renal failure that can no longer be treated by diet or meds.


Worsening uremic syndrome w/ERSD


severe electrolyte and/or fluid abnormalities that cannot be controlled by simpler measures.

Medications inhibit urination

Antipsychotics, antidepressants, alpha-adrenergic agonists, calcium channel blockers can cause urinary retention & over flow incontinence.

Medications indirectly affect urinary dysfunction

Alpha-antagonists, diuretics, sedative hypnotics, opioid analgesics, angiotensin-converting enzyme inhibitors, and antihistamines can cause urinary incontinence.

Medications that change color of urine

Phenazopyridine bright orange, amitriptyline causes green or blue, levadopa brown to black.

Sodium (Na+)

136-145 mEq/L

Potassium (K+)

3.5 -5.0 mEq/L

Chloride (Cl-)

98 to 108 mEq/L

CO2

22 - 30 mEq/L

Calcium (Ca2+)

8.4 to 10.5 mg/dL

Magnesium (Mg2+)

1.5 to 2.5 mEq/L

Fluid

Water that contains dissolved or suspended substances such as glucose, mineral salts and proteins

Extracellular fluid

Outside cells

Sodium (Na+)

136-145 mEq/L

Potassium (K+)

3.5 -5.0 mEq/L

Chloride (Cl-)

98 to 108 mEq/L

CO2

22 - 30 mEq/L

Calcium (Ca2+)

8.4 to 10.5 mg/dL

Magnesium (Mg2+)

1.5 to 2.5 mEq/L

Fluid

Water that contains dissolved or suspended substances such as glucose, mineral salts and proteins

Extracellular fluid

Outside cells

Intercellular fluid

Inside cells

Sodium (Na+)

136-145 mEq/L

Electroytes

Fluid in the body compartments contains mineral salts. Is a compound that separates into ions when it dissolves in water.

Potassium (K+)

3.5 -5.0 mEq/L

Chloride (Cl-)

98 to 108 mEq/L

CO2

22 - 30 mEq/L

Calcium (Ca2+)

8.4 to 10.5 mg/dL

Magnesium (Mg2+)

1.5 to 2.5 mEq/L

Fluid

Water that contains dissolved or suspended substances such as glucose, mineral salts and proteins

Extracellular fluid

Outside cells

Intercellular fluid

Inside cells

Transcellular fluid

Cerebrospinal, pleural, peritoneal, and synovial fluids are secreted by epithelial cells

Sodium (Na+)

136-145 mEq/L

Electroytes

Fluid in the body compartments contains mineral salts. Is a compound that separates into ions when it dissolves in water.

Cations-positively charged ions

Body fluids are sodium, potassium, calcium, magnesium ions.

Anions-negatively charged ions

Body fluids are chloride, bicarbonate ions.

Cations & anions

Combine to make salts.

Normal blood

Isotonic

Hypotonic

More dilute than blood

Hypertonic

More concentrated than blood

Active transprt

Requires energy in the form of ATP to move electrolytes across cell membranes against the concentration gradient.

Sodium potassium pump

Diffusion

Passive movement of electrolyte or other particles down the concentration gradient from areas of higher concentration to areas of lower concentration

Osmosis

A process by which water moves through a membrane that separates fluids with different particle concentrations

Potassium (K+)

3.5 -5.0 mEq/L

Osmotic pressure

Inward pulling force caused by particles in the fluid

Healthy adult I&O

Intake: 1100-1400 mL


Output: 1200-1500 mL

Fluid output normally occurs:

Through four organs: the skin, the lungs, GI, and kidneys

Anti diuretic hormone

Causes renal cells to resorb water taking water from the renal tubular fluid and putting it back in the blood

Renin-angiotensin-aldosterone system

Regulates ECF by influencing how much sodium and water are excreted in urine also contributes to regulation of blood pressure

Osmolality imbalances

Hyponatremia or hypernatremia

Hypernatremia

Also called water deficit, is a hypertonic condition to general causes made body fluids to concentrated loss of relatively more water than salt or gain of relatively more salt than water

Signs and symptoms of hypernatremia

Cerebral dysfunction which arise one Brain cells shrivel

Hyponatremia

Also called water access or water intoxication is a hypotonic condition arises from gain of relatively more water than salt or loss of relatively more salt than water

Clinical dehydration

Is common with Gastroenteritis or other causes of severe vomiting and diarrhea when people are not able to replace their fluid output with enough intake of dilute sodium containing fluids. signs and symptoms of clinical dehydration are those of both ECV deficit and hypernatremia.

Chloride (Cl-)

98 to 108 mEq/L

Extracellular fluid volume deficit

Na+ and water intake less than output, causing isotonic loss


Increased GI output diarrhea, vomiting, laxative overuse drainage from fístulas hemorrhage


Increase Hct, BUN > 25, specific gravity > 1.030

EFV excess

Sodium & water intake > than output; isotonic gain


Excessive intake of salty foods and water


Decreased renal output: CHF, cirrhosis CKD


labs: decreased Hct, BUN < 10,

Hypernatremia

Loss of more water than salt: DM perspiration & respiratory water output


Gain of more salt than water: overuse if amsalt tablets, and if tune feedings, dysfunction of osmoreceptor


Labs: serum Na+ > 145 mEq & serum osmolality > 295 mOmsm/kg, urine specific gravity of 1.030

Hyponatremia

Gain of salt than water: excessive ADH forced excessive water drinking, IV admin D5W, tap water enemas.


Gain of more salt than water: renal salt wasting disease, replacement of large body fluid output


Lab: serum Na+ level < 135 mEq, serum osmolality 280 m0sm/kg or less, urine specific gravity below 1.010

Signs & symptoms of Extracellular fluid volume deficit

Sudden weight loss postural hypotension tachycardia thready pulse neck veins flat or collapsing with inhalation when supreme Slovene feeling oliguria dark yellow urine dry mucous membranes inelastic skin turgor absence of tears and sweat longitudinal furloughs in tongue thirst restlessness confusion cold clammy skin hypotension hypovolemic shock.

Signs & symptoms of extracellular fluid volume excess

Sudden weight gain Adema neck veins food when right or see my upright crackles independent portion of lungs pulmonary edema

S&S of hypernatremia

Extreme thirst dry and flushed skin postural hypotension fever restlessness confusion agitation, coma, seizures if develops rapidly or is very severe

S&S of hyponatremia

Apprehension nausea and vomiting headaches decreased level of consciousness confusion lethargy muscle weakness, coma, seizures if develops rapidly or is severe

Potassium

Free potatoes instant coffee molasses Brazil nuts absorbs easily low in ECF high in ICF insulin epinephrine alkalosis shift potassium into cells maintains resting membrane potential and of skeletal smooth and cardiac muscles allowing for normal muscle function

Calcium

Dairy products can fish with bones broccoli oranges calcium is low in ECF mostly and bones in intracellular some calcium in the blood is bound and in active influences excitability of nerve and muscle cells necessary for muscle contraction

CO2

22 - 30 mEq/L

Magnesium

Dark green leafy vegetables whole-grain's magnesium containing laxatives and aunt acids and digestive that prevents absorption magnesium is low and ECF mostly in bones and intracellular influences function of neuromuscular junction is and is a cofactor for numerous in

Phosphate

Milk processed foods aluminum and acids prevent absorption low in ECF it is higher in ICF and in bones insulin and epinephrine shift phosphate into cells decreases in blood if calcium rises and vice versa necessary for a production of ATP the energy source for cellular metabolism

Hypokalemia

Abnormally low potassium concentration in the blood results from decreased potassium intake and absorption a shift of potassium from ECF into cells and increase potassium output diarrhea repeated vomiting and use of potassium wasting diuretics causes muscle weakness which becomes life-threatening if it includes respiratory muscles & potentially life-threatening cardiac dysrhytmias.

Hyperkalemia

Abnormally high potassium ion concentration in the blood increase potassium intake and absorption shift of potassium from cells into the ECF and decreased potassium output oliguria are at high risk of hyperkalemia causes muscle weakness potentially life-threatening cardiac dysrhythmias and cardiac arrest

Hypocalcemia

Abnormally low calcium concentration in the blood acute pancreatitis frequently develop hypocalcemia increases neuromuscular excitability the basis for its signs and symptoms

Hypercalcemia

Abnormally high calcium concentration in the blood results from an increase calcium intake and absorption patients with cancer often develop hypercalcemia because some cancer cells secrete chemicals into the blood that are related to parathyroid hormone weakens bones and the person sometimes develop pathological fractures decreases neuromuscular excitability most common sign is lethargy

Hypomagnesia

Abnormally low magnesium concentration in the blood decrease magnesium intake and absorption signs and symptoms similar to hypocalcemia because hypo magnesium also increases neuromuscular excitability

Hypermagnesia

Abnormally high magnesium concentration in the blood in stage renal disease causes hyper magnesium unless the person decreases magnesium intake signs and symptoms decrease neuromuscular excitability with lethargy decreased tendon reflexes being most common

Hypokalemia

Bilateral muscle weakness begins in quadraceps, abdominal distrntion, decreased bowel sounds, constipation cardiac dysrythmias. Lab: serum K+ < 3.5 mEq, ECG abnormalities

Hyperkalcemia

Bilateral muscle weakness, transient and cramps, diarrhea


Lab: serum K+ > than 5 mEq, ECG abnormalities

Calcium (Ca2+)

8.4 to 10.5 mg/dL

Hypocalcemia

+ Chvostek's sign (contraction of facial muscles when facial nerve is tapped) + Trousseaus sign numbness of fingers, muscle twitching & cramping larngospasm Lab: serum Ca + < 8.4 mg/dL, serum ionized Ca+ < 4.5 mg/dL

Magnesium (Mg2+)

1.5 to 2.5 mEq/L

Fluid

Water that contains dissolved or suspended substances such as glucose, mineral salts and proteins

Extracellular fluid

Outside cells

Intercellular fluid

Inside cells

Transcellular fluid

Cerebrospinal, pleural, peritoneal, and synovial fluids are secreted by epithelial cells

Sodium (Na+)

136-145 mEq/L

Electroytes

Fluid in the body compartments contains mineral salts. Is a compound that separates into ions when it dissolves in water.

Cations-positively charged ions

Body fluids are sodium, potassium, calcium, magnesium ions.

Anions-negatively charged ions

Body fluids are chloride, bicarbonate ions.

Cations & anions

Combine to make salts.

Normal blood

Isotonic

Hypotonic

More dilute than blood

Hypertonic

More concentrated than blood

Active transprt

Requires energy in the form of ATP to move electrolytes across cell membranes against the concentration gradient.

Sodium potassium pump

Diffusion

Passive movement of electrolyte or other particles down the concentration gradient from areas of higher concentration to areas of lower concentration

Osmosis

A process by which water moves through a membrane that separates fluids with different particle concentrations

Potassium (K+)

3.5 -5.0 mEq/L

Osmotic pressure

Inward pulling force caused by particles in the fluid

Healthy adult I&O

Intake: 1100-1400 mL


Output: 1200-1500 mL

Fluid output normally occurs:

Through four organs: the skin, the lungs, GI, and kidneys

Anti diuretic hormone

Causes renal cells to resorb water taking water from the renal tubular fluid and putting it back in the blood

Renin-angiotensin-aldosterone system

Regulates ECF by influencing how much sodium and water are excreted in urine also contributes to regulation of blood pressure

Osmolality imbalances

Hyponatremia or hypernatremia

Hypernatremia

Also called water deficit, is a hypertonic condition to general causes made body fluids to concentrated loss of relatively more water than salt or gain of relatively more salt than water

Signs and symptoms of hypernatremia

Cerebral dysfunction which arise one Brain cells shrivel

Hyponatremia

Also called water access or water intoxication is a hypotonic condition arises from gain of relatively more water than salt or loss of relatively more salt than water

Clinical dehydration

Is common with Gastroenteritis or other causes of severe vomiting and diarrhea when people are not able to replace their fluid output with enough intake of dilute sodium containing fluids. signs and symptoms of clinical dehydration are those of both ECV deficit and hypernatremia.

Chloride (Cl-)

98 to 108 mEq/L

Extracellular fluid volume deficit

Na+ and water intake less than output, causing isotonic loss


Increased GI output diarrhea, vomiting, laxative overuse drainage from fístulas hemorrhage


Increase Hct, BUN > 25, specific gravity > 1.030

EFV excess

Sodium & water intake > than output; isotonic gain


Excessive intake of salty foods and water


Decreased renal output: CHF, cirrhosis CKD


labs: decreased Hct, BUN < 10,

Hypernatremia

Loss of more water than salt: DM perspiration & respiratory water output


Gain of more salt than water: overuse if amsalt tablets, and if tune feedings, dysfunction of osmoreceptor


Labs: serum Na+ > 145 mEq & serum osmolality > 295 mOmsm/kg, urine specific gravity of 1.030

Hyponatremia

Gain of salt than water: excessive ADH forced excessive water drinking, IV admin D5W, tap water enemas.


Gain of more salt than water: renal salt wasting disease, replacement of large body fluid output


Lab: serum Na+ level < 135 mEq, serum osmolality 280 m0sm/kg or less, urine specific gravity below 1.010

Signs & symptoms of Extracellular fluid volume deficit

Sudden weight loss postural hypotension tachycardia thready pulse neck veins flat or collapsing with inhalation when supreme Slovene feeling oliguria dark yellow urine dry mucous membranes inelastic skin turgor absence of tears and sweat longitudinal furloughs in tongue thirst restlessness confusion cold clammy skin hypotension hypovolemic shock.

Signs & symptoms of extracellular fluid volume excess

Sudden weight gain Adema neck veins food when right or see my upright crackles independent portion of lungs pulmonary edema

S&S of hypernatremia

Extreme thirst dry and flushed skin postural hypotension fever restlessness confusion agitation, coma, seizures if develops rapidly or is very severe

S&S of hyponatremia

Apprehension nausea and vomiting headaches decreased level of consciousness confusion lethargy muscle weakness, coma, seizures if develops rapidly or is severe

Potassium

Free potatoes instant coffee molasses Brazil nuts absorbs easily low in ECF high in ICF insulin epinephrine alkalosis shift potassium into cells maintains resting membrane potential and of skeletal smooth and cardiac muscles allowing for normal muscle function

Calcium

Dairy products can fish with bones broccoli oranges calcium is low in ECF mostly and bones in intracellular some calcium in the blood is bound and in active influences excitability of nerve and muscle cells necessary for muscle contraction

CO2

22 - 30 mEq/L

Magnesium

Dark green leafy vegetables whole-grain's magnesium containing laxatives and aunt acids and digestive that prevents absorption magnesium is low and ECF mostly in bones and intracellular influences function of neuromuscular junction is and is a cofactor for numerous in

Phosphate

Milk processed foods aluminum and acids prevent absorption low in ECF it is higher in ICF and in bones insulin and epinephrine shift phosphate into cells decreases in blood if calcium rises and vice versa necessary for a production of ATP the energy source for cellular metabolism

Hypokalemia

Abnormally low potassium concentration in the blood results from decreased potassium intake and absorption a shift of potassium from ECF into cells and increase potassium output diarrhea repeated vomiting and use of potassium wasting diuretics causes muscle weakness which becomes life-threatening if it includes respiratory muscles & potentially life-threatening cardiac dysrhytmias.

Hyperkalemia

Abnormally high potassium ion concentration in the blood increase potassium intake and absorption shift of potassium from cells into the ECF and decreased potassium output oliguria are at high risk of hyperkalemia causes muscle weakness potentially life-threatening cardiac dysrhythmias and cardiac arrest

Hypocalcemia

Abnormally low calcium concentration in the blood acute pancreatitis frequently develop hypocalcemia increases neuromuscular excitability the basis for its signs and symptoms

Hypercalcemia

Abnormally high calcium concentration in the blood results from an increase calcium intake and absorption patients with cancer often develop hypercalcemia because some cancer cells secrete chemicals into the blood that are related to parathyroid hormone weakens bones and the person sometimes develop pathological fractures decreases neuromuscular excitability most common sign is lethargy

Hypomagnesia

Abnormally low magnesium concentration in the blood decrease magnesium intake and absorption signs and symptoms similar to hypocalcemia because hypo magnesium also increases neuromuscular excitability

Hypermagnesia

Abnormally high magnesium concentration in the blood in stage renal disease causes hyper magnesium unless the person decreases magnesium intake signs and symptoms decrease neuromuscular excitability with lethargy decreased tendon reflexes being most common

Hypokalemia

Bilateral muscle weakness begins in quadraceps, abdominal distrntion, decreased bowel sounds, constipation cardiac dysrythmias. Lab: serum K+ < 3.5 mEq, ECG abnormalities

Hyperkalcemia

Bilateral muscle weakness, transient and cramps, diarrhea


Lab: serum K+ > than 5 mEq, ECG abnormalities

Calcium (Ca2+)

8.4 to 10.5 mg/dL

Hypocalcemia

+ Chvostek's sign (contraction of facial muscles when facial nerve is tapped) + Trousseaus sign numbness of fingers, muscle twitching & cramping larngospasm Lab: serum Ca + < 8.4 mg/dL, serum ionized Ca+ < 4.5 mg/dL

Hypercalcemia

Anorexia, náusea, vomiting, constipation, fatigue, diminished reflexes, lethargy, decreased LOC, confusion, cardiac dysrythmias


Lab: serum Ca+ > 10.5 mg/dL, ionized Ca+ > 5.3 mg/dL

Magnesium (Mg2+)

1.5 to 2.5 mEq/L

Fluid

Water that contains dissolved or suspended substances such as glucose, mineral salts and proteins

Extracellular fluid

Outside cells

Intercellular fluid

Inside cells

Transcellular fluid

Cerebrospinal, pleural, peritoneal, and synovial fluids are secreted by epithelial cells

Sodium (Na+)

136-145 mEq/L

Electroytes

Fluid in the body compartments contains mineral salts. Is a compound that separates into ions when it dissolves in water.

Cations-positively charged ions

Body fluids are sodium, potassium, calcium, magnesium ions.

Anions-negatively charged ions

Body fluids are chloride, bicarbonate ions.

Cations & anions

Combine to make salts.

Normal blood

Isotonic

Hypotonic

More dilute than blood

Hypertonic

More concentrated than blood

Active transprt

Requires energy in the form of ATP to move electrolytes across cell membranes against the concentration gradient.

Sodium potassium pump

Diffusion

Passive movement of electrolyte or other particles down the concentration gradient from areas of higher concentration to areas of lower concentration

Osmosis

A process by which water moves through a membrane that separates fluids with different particle concentrations

Potassium (K+)

3.5 -5.0 mEq/L

Osmotic pressure

Inward pulling force caused by particles in the fluid

Healthy adult I&O

Intake: 1100-1400 mL


Output: 1200-1500 mL

Fluid output normally occurs:

Through four organs: the skin, the lungs, GI, and kidneys

Anti diuretic hormone

Causes renal cells to resorb water taking water from the renal tubular fluid and putting it back in the blood

Renin-angiotensin-aldosterone system

Regulates ECF by influencing how much sodium and water are excreted in urine also contributes to regulation of blood pressure

Osmolality imbalances

Hyponatremia or hypernatremia

Hypernatremia

Also called water deficit, is a hypertonic condition to general causes made body fluids to concentrated loss of relatively more water than salt or gain of relatively more salt than water

Signs and symptoms of hypernatremia

Cerebral dysfunction which arise one Brain cells shrivel

Hyponatremia

Also called water access or water intoxication is a hypotonic condition arises from gain of relatively more water than salt or loss of relatively more salt than water

Clinical dehydration

Is common with Gastroenteritis or other causes of severe vomiting and diarrhea when people are not able to replace their fluid output with enough intake of dilute sodium containing fluids. signs and symptoms of clinical dehydration are those of both ECV deficit and hypernatremia.

Chloride (Cl-)

98 to 108 mEq/L

Extracellular fluid volume deficit

Na+ and water intake less than output, causing isotonic loss


Increased GI output diarrhea, vomiting, laxative overuse drainage from fístulas hemorrhage


Increase Hct, BUN > 25, specific gravity > 1.030

EFV excess

Sodium & water intake > than output; isotonic gain


Excessive intake of salty foods and water


Decreased renal output: CHF, cirrhosis CKD


labs: decreased Hct, BUN < 10,

Hypernatremia

Loss of more water than salt: DM perspiration & respiratory water output


Gain of more salt than water: overuse if amsalt tablets, and if tune feedings, dysfunction of osmoreceptor


Labs: serum Na+ > 145 mEq & serum osmolality > 295 mOmsm/kg, urine specific gravity of 1.030

Hyponatremia

Gain of salt than water: excessive ADH forced excessive water drinking, IV admin D5W, tap water enemas.


Gain of more salt than water: renal salt wasting disease, replacement of large body fluid output


Lab: serum Na+ level < 135 mEq, serum osmolality 280 m0sm/kg or less, urine specific gravity below 1.010

Signs & symptoms of Extracellular fluid volume deficit

Sudden weight loss postural hypotension tachycardia thready pulse neck veins flat or collapsing with inhalation when supreme Slovene feeling oliguria dark yellow urine dry mucous membranes inelastic skin turgor absence of tears and sweat longitudinal furloughs in tongue thirst restlessness confusion cold clammy skin hypotension hypovolemic shock.

Signs & symptoms of extracellular fluid volume excess

Sudden weight gain Adema neck veins food when right or see my upright crackles independent portion of lungs pulmonary edema

S&S of hypernatremia

Extreme thirst dry and flushed skin postural hypotension fever restlessness confusion agitation, coma, seizures if develops rapidly or is very severe

S&S of hyponatremia

Apprehension nausea and vomiting headaches decreased level of consciousness confusion lethargy muscle weakness, coma, seizures if develops rapidly or is severe

Potassium

Free potatoes instant coffee molasses Brazil nuts absorbs easily low in ECF high in ICF insulin epinephrine alkalosis shift potassium into cells maintains resting membrane potential and of skeletal smooth and cardiac muscles allowing for normal muscle function

Calcium

Dairy products can fish with bones broccoli oranges calcium is low in ECF mostly and bones in intracellular some calcium in the blood is bound and in active influences excitability of nerve and muscle cells necessary for muscle contraction

CO2

22 - 30 mEq/L

Magnesium

Dark green leafy vegetables whole-grain's magnesium containing laxatives and aunt acids and digestive that prevents absorption magnesium is low and ECF mostly in bones and intracellular influences function of neuromuscular junction is and is a cofactor for numerous in

Phosphate

Milk processed foods aluminum and acids prevent absorption low in ECF it is higher in ICF and in bones insulin and epinephrine shift phosphate into cells decreases in blood if calcium rises and vice versa necessary for a production of ATP the energy source for cellular metabolism

Hypokalemia

Abnormally low potassium concentration in the blood results from decreased potassium intake and absorption a shift of potassium from ECF into cells and increase potassium output diarrhea repeated vomiting and use of potassium wasting diuretics causes muscle weakness which becomes life-threatening if it includes respiratory muscles & potentially life-threatening cardiac dysrhytmias.

Hyperkalemia

Abnormally high potassium ion concentration in the blood increase potassium intake and absorption shift of potassium from cells into the ECF and decreased potassium output oliguria are at high risk of hyperkalemia causes muscle weakness potentially life-threatening cardiac dysrhythmias and cardiac arrest

Hypocalcemia

Abnormally low calcium concentration in the blood acute pancreatitis frequently develop hypocalcemia increases neuromuscular excitability the basis for its signs and symptoms

Hypercalcemia

Abnormally high calcium concentration in the blood results from an increase calcium intake and absorption patients with cancer often develop hypercalcemia because some cancer cells secrete chemicals into the blood that are related to parathyroid hormone weakens bones and the person sometimes develop pathological fractures decreases neuromuscular excitability most common sign is lethargy

Hypomagnesia

Abnormally low magnesium concentration in the blood decrease magnesium intake and absorption signs and symptoms similar to hypocalcemia because hypo magnesium also increases neuromuscular excitability

Hypermagnesia

Abnormally high magnesium concentration in the blood in stage renal disease causes hyper magnesium unless the person decreases magnesium intake signs and symptoms decrease neuromuscular excitability with lethargy decreased tendon reflexes being most common

Hypokalemia

Bilateral muscle weakness begins in quadraceps, abdominal distrntion, decreased bowel sounds, constipation cardiac dysrythmias. Lab: serum K+ < 3.5 mEq, ECG abnormalities

Hyperkalcemia

Bilateral muscle weakness, transient and cramps, diarrhea


Lab: serum K+ > than 5 mEq, ECG abnormalities

Calcium (Ca2+)

8.4 to 10.5 mg/dL

Hypocalcemia

+ Chvostek's sign (contraction of facial muscles when facial nerve is tapped) + Trousseaus sign numbness of fingers, muscle twitching & cramping larngospasm Lab: serum Ca + < 8.4 mg/dL, serum ionized Ca+ < 4.5 mg/dL

Hypercalcemia

Anorexia, náusea, vomiting, constipation, fatigue, diminished reflexes, lethargy, decreased LOC, confusion, cardiac dysrythmias


Lab: serum Ca+ > 10.5 mg/dL, ionized Ca+ > 5.3 mg/dL

Hypomagnesia

Hyperactive deep tendon reflexes, insomnia, muscle cramps & twitching, grimicing, dysphagia, tachycardia, HTN, tetany


Lab: serum Mg2+ < 1.5 mEq/L

Magnesium (Mg2+)

1.5 to 2.5 mEq/L

Fluid

Water that contains dissolved or suspended substances such as glucose, mineral salts and proteins

Extracellular fluid

Outside cells

Intercellular fluid

Inside cells

Transcellular fluid

Cerebrospinal, pleural, peritoneal, and synovial fluids are secreted by epithelial cells

Sodium (Na+)

136-145 mEq/L

Electroytes

Fluid in the body compartments contains mineral salts. Is a compound that separates into ions when it dissolves in water.

Cations-positively charged ions

Body fluids are sodium, potassium, calcium, magnesium ions.

Anions-negatively charged ions

Body fluids are chloride, bicarbonate ions.

Cations & anions

Combine to make salts.

Normal blood

Isotonic

Hypotonic

More dilute than blood

Hypertonic

More concentrated than blood

Active transprt

Requires energy in the form of ATP to move electrolytes across cell membranes against the concentration gradient.

Sodium potassium pump

Diffusion

Passive movement of electrolyte or other particles down the concentration gradient from areas of higher concentration to areas of lower concentration

Osmosis

A process by which water moves through a membrane that separates fluids with different particle concentrations

Potassium (K+)

3.5 -5.0 mEq/L

Osmotic pressure

Inward pulling force caused by particles in the fluid

Healthy adult I&O

Intake: 1100-1400 mL


Output: 1200-1500 mL

Fluid output normally occurs:

Through four organs: the skin, the lungs, GI, and kidneys

Anti diuretic hormone

Causes renal cells to resorb water taking water from the renal tubular fluid and putting it back in the blood

Renin-angiotensin-aldosterone system

Regulates ECF by influencing how much sodium and water are excreted in urine also contributes to regulation of blood pressure

Osmolality imbalances

Hyponatremia or hypernatremia

Hypernatremia

Also called water deficit, is a hypertonic condition to general causes made body fluids to concentrated loss of relatively more water than salt or gain of relatively more salt than water

Signs and symptoms of hypernatremia

Cerebral dysfunction which arise one Brain cells shrivel

Hyponatremia

Also called water access or water intoxication is a hypotonic condition arises from gain of relatively more water than salt or loss of relatively more salt than water

Clinical dehydration

Is common with Gastroenteritis or other causes of severe vomiting and diarrhea when people are not able to replace their fluid output with enough intake of dilute sodium containing fluids. signs and symptoms of clinical dehydration are those of both ECV deficit and hypernatremia.

Chloride (Cl-)

98 to 108 mEq/L

Extracellular fluid volume deficit

Na+ and water intake less than output, causing isotonic loss


Increased GI output diarrhea, vomiting, laxative overuse drainage from fístulas hemorrhage


Increase Hct, BUN > 25, specific gravity > 1.030

EFV excess

Sodium & water intake > than output; isotonic gain


Excessive intake of salty foods and water


Decreased renal output: CHF, cirrhosis CKD


labs: decreased Hct, BUN < 10,

Hypernatremia

Loss of more water than salt: DM perspiration & respiratory water output


Gain of more salt than water: overuse if amsalt tablets, and if tune feedings, dysfunction of osmoreceptor


Labs: serum Na+ > 145 mEq & serum osmolality > 295 mOmsm/kg, urine specific gravity of 1.030

Hyponatremia

Gain of salt than water: excessive ADH forced excessive water drinking, IV admin D5W, tap water enemas.


Gain of more salt than water: renal salt wasting disease, replacement of large body fluid output


Lab: serum Na+ level < 135 mEq, serum osmolality 280 m0sm/kg or less, urine specific gravity below 1.010

Signs & symptoms of Extracellular fluid volume deficit

Sudden weight loss postural hypotension tachycardia thready pulse neck veins flat or collapsing with inhalation when supreme Slovene feeling oliguria dark yellow urine dry mucous membranes inelastic skin turgor absence of tears and sweat longitudinal furloughs in tongue thirst restlessness confusion cold clammy skin hypotension hypovolemic shock.

Signs & symptoms of extracellular fluid volume excess

Sudden weight gain Adema neck veins food when right or see my upright crackles independent portion of lungs pulmonary edema

S&S of hypernatremia

Extreme thirst dry and flushed skin postural hypotension fever restlessness confusion agitation, coma, seizures if develops rapidly or is very severe

S&S of hyponatremia

Apprehension nausea and vomiting headaches decreased level of consciousness confusion lethargy muscle weakness, coma, seizures if develops rapidly or is severe

Potassium

Free potatoes instant coffee molasses Brazil nuts absorbs easily low in ECF high in ICF insulin epinephrine alkalosis shift potassium into cells maintains resting membrane potential and of skeletal smooth and cardiac muscles allowing for normal muscle function

Calcium

Dairy products can fish with bones broccoli oranges calcium is low in ECF mostly and bones in intracellular some calcium in the blood is bound and in active influences excitability of nerve and muscle cells necessary for muscle contraction

CO2

22 - 30 mEq/L

Magnesium

Dark green leafy vegetables whole-grain's magnesium containing laxatives and aunt acids and digestive that prevents absorption magnesium is low and ECF mostly in bones and intracellular influences function of neuromuscular junction is and is a cofactor for numerous in

Phosphate

Milk processed foods aluminum and acids prevent absorption low in ECF it is higher in ICF and in bones insulin and epinephrine shift phosphate into cells decreases in blood if calcium rises and vice versa necessary for a production of ATP the energy source for cellular metabolism

Hypokalemia

Abnormally low potassium concentration in the blood results from decreased potassium intake and absorption a shift of potassium from ECF into cells and increase potassium output diarrhea repeated vomiting and use of potassium wasting diuretics causes muscle weakness which becomes life-threatening if it includes respiratory muscles & potentially life-threatening cardiac dysrhytmias.

Hyperkalemia

Abnormally high potassium ion concentration in the blood increase potassium intake and absorption shift of potassium from cells into the ECF and decreased potassium output oliguria are at high risk of hyperkalemia causes muscle weakness potentially life-threatening cardiac dysrhythmias and cardiac arrest

Hypocalcemia

Abnormally low calcium concentration in the blood acute pancreatitis frequently develop hypocalcemia increases neuromuscular excitability the basis for its signs and symptoms

Hypercalcemia

Abnormally high calcium concentration in the blood results from an increase calcium intake and absorption patients with cancer often develop hypercalcemia because some cancer cells secrete chemicals into the blood that are related to parathyroid hormone weakens bones and the person sometimes develop pathological fractures decreases neuromuscular excitability most common sign is lethargy

Hypomagnesia

Abnormally low magnesium concentration in the blood decrease magnesium intake and absorption signs and symptoms similar to hypocalcemia because hypo magnesium also increases neuromuscular excitability

Hypermagnesia

Abnormally high magnesium concentration in the blood in stage renal disease causes hyper magnesium unless the person decreases magnesium intake signs and symptoms decrease neuromuscular excitability with lethargy decreased tendon reflexes being most common

Hypokalemia

Bilateral muscle weakness begins in quadraceps, abdominal distrntion, decreased bowel sounds, constipation cardiac dysrythmias. Lab: serum K+ < 3.5 mEq, ECG abnormalities

Hyperkalcemia

Bilateral muscle weakness, transient and cramps, diarrhea


Lab: serum K+ > than 5 mEq, ECG abnormalities

Calcium (Ca2+)

8.4 to 10.5 mg/dL

Hypocalcemia

+ Chvostek's sign (contraction of facial muscles when facial nerve is tapped) + Trousseaus sign numbness of fingers, muscle twitching & cramping larngospasm Lab: serum Ca + < 8.4 mg/dL, serum ionized Ca+ < 4.5 mg/dL

Hypercalcemia

Anorexia, náusea, vomiting, constipation, fatigue, diminished reflexes, lethargy, decreased LOC, confusion, cardiac dysrythmias


Lab: serum Ca+ > 10.5 mg/dL, ionized Ca+ > 5.3 mg/dL

Hypomagnesia

Hyperactive deep tendon reflexes, insomnia, muscle cramps & twitching, grimicing, dysphagia, tachycardia, HTN, tetany


Lab: serum Mg2+ < 1.5 mEq/L

Hypermagnesia

Lethargy, hypoactive deep tendon reflexes, hypotension, acute elevation in mag levels, flushing, flaccid muscle paralysis, decrease rate & depth of respirations, cardiac dysrythmias, arrest


Lab: mg > 2.5 mEq/L

Magnesium (Mg2+)

1.5 to 2.5 mEq/L

Fluid

Water that contains dissolved or suspended substances such as glucose, mineral salts and proteins

Extracellular fluid

Outside cells

Intercellular fluid

Inside cells

Transcellular fluid

Cerebrospinal, pleural, peritoneal, and synovial fluids are secreted by epithelial cells

Isotonic IV solutions

D5W, 0.9% NaCl, LR

Hypotonic IV solutions

0.225% NaCl, 0.45% NaCl,

Hypertonic IV solutions

D10W, 3% or 5% NaCl,


Dextrose 5% in 0.46% NaCl (D5 1/2 NS; D50.45% NaCl)


Dextrose 5% in 0.9% NaCl


Dextose 5% in Lactated Ringers

Good luck

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