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102 Cards in this Set
- Front
- Back
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Intracellular major ion
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Potassium
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2/3 of all body water (body compartment) less for infants
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intracellular
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body compartments
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intracellular
extracellular |
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extracellular major ion
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sodium
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1/3 of all body water
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extracellular
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Locations for extracellular fluid
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intersitial fluid (in between cells)
vascular fluid (in blood vessels - plama) minor compartments (joints, cerbrospinal, GI, lympy, eye, etc) |
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particles crossing the semi-permeable membrane (between blood vessels & interstial compartment)
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filtration
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osmosis
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water crossing a membrane that electrolytes (particles) can't cross (between intersitial & intracellular)
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Movement of water is regulated by the struggle between
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capillary hydrostatic pressure vs. intersitial & capillary osmotic pressure
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The pressure of BP can overpower the attraction between
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water & plasma proteins
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plasma proteins attract water to
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where they are
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Regulation of body fluids
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thirst
hormonal control |
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hypothalamus stimulates osmoreceptors when there is
Thirst |
cellular dehydration
decreased blood volume (more than 2% loss) Dry mouth |
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Hormonal control regulating body fluids
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antidiuretic hormone ADH
aldosterone |
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secreted by the posteriour pituitary gland
stimulated by stretch receptors in atria and carotid sinus |
ADH
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Action of ADH
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reabsorbtion/retention of H2O > less urine output
increased BP increases blood volume |
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less urine output
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ADH
aldosterone |
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Secreted by the adrenal cortex
stimulated by decreased renal blood flow or high K levels |
Aldostrone
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stimulated by stretch receptors in atria & carotid sinus
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posterior pituitary gland (ADH)
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stimulated by decrease in renal blood flow or high K levels
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adrenal cortex (ADH)
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retains Na & H2O
excretes Potasium (K) > less urine output, increased BP & blood volume |
aldosterone
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less urine output
increased BP increased blood volume |
ADH
Aldosterone |
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volume deficit
fluid volume deficit dehydration hypovolemia |
loss of saline (sodium & water) from body
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concentration ratio is OK, volume is low
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dehydration
hypovolemia volume deficit |
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cause of volume deficit
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renal excretion of Na containing fluid
loss of Na containing fluid |
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ascities
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fluid in abdominal cavity
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examples of loss of Na containing fluid
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examples
vomiting diarrhea suction from GI burns fever/excessive sweating hemorrhage third-spacing (ascities) |
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examples of renal excretion of Na containing fluid
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diuretics
renal disorders |
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S/S of decreased vascular & interstitial fluid
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dry skin & MM leading to decreased skin tugor
decreased wt. decreased urine output (concentrated urine) decreased BP increased Pulse as heart tries to pump smaller amount of blood faster |
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To compensate for volume deficit to keep the BP up
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body steals water for blood vessels from the intracellular space leading to sunken cell
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treatment for volume deficit
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IV fluids
oral replacement (also replace Na) |
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cause of volume overload (hypervolemia)
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1. retention of H20 & Na that should be excreted
CHF Kidney disease SIADH 2. increase intake runaway IV |
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wt. gain
edema (pulmonary & generalized) SOB increased HR increased R (fluid in lungs decreases amt of wrkng lung cells increased urine output (if kidneys r wrking) |
S/S of circulatory overload/volume excess
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compensation for volume excess
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extra water is pushed into cells causing swelling
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treatment for volume excess
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treat cause
diuretics limit intake sodium restriction |
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an extracellular electrolyte
controls H2O distribution normal level 135-145 in blood aldostrone regulates while tossing K |
Sodium
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hypoatremia - aka
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sodium deficit
sodium below 135 |
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hypoatremia is caused by
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1. excessive H2O as related to the amount of sodium (H2O dilutes the Na in the blood)
2. Sodium loss |
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possible causes of excessive H2O as related to Na
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SIADH
Lung CA tap water enemas |
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possible causes of sodium loss
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diuretics
sodium/water loss replaced w/ only H2O not usually lack of sodium intake |
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S/S of sodim deficit
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nervous system dysfuntion
malaise anorexia N/V headache confusion > convulsions > coma |
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hyponatremia compensation: as the extracellular sodium gets more dilute, intracellular conentration of Na is
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more concentrated leading to osmosis (pulling H2O into the cells) leading to cellular swelling
sodium can't go into cells because of the Na/K pump |
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treatment for hyponatremia
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salty food
IV solutions w/ extra Na decrease excessive fluid intake |
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hypernatremia (sodium excess)
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sodium level above 145
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causes of hypernatremia
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sodium gain
water loss |
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sodium gain can be caused by
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tube feeding
IV's drinking sea water decreased water intake renal failure |
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water loss caused by
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diabetes inspidus
very water diarhea w/ out replacement |
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non-specific CNS dysfunction
decreased CNS responses as neurons shrivel > lethargy/confusion > coma/death Thirst dry MM decreased urine output (very cncentrated) |
S/S of hypernatremia
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treatment for hypernatremia
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replace water
IV or PO decrease excessive intake (treat the cause) |
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major intracellular ion
important for electrical impulses normal level 3.5 - 5 sources: banana, dried fruit, meat, dairy products, broccoli, etc increased aldosterone causes decrease |
potassium
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hypokalemia
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K level below 3.5
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causes of hypokalemia
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low k intake
k shift into cells k loss/excretion |
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cause of low K intake
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NPO
fasting poor diet alcoholism |
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cause of k shift into cells
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alkalosis
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cause of k loss/excretion
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renal disease
diarrhea sweating emesis gastric suction |
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muscles don't contract smoothly
fatigue > weak muscles (lungs, heart & skeletal) Increased irregular HR > DSYRHYTHMIA > Increased sensitivity to digoxin large urine output w/ inability to concentrate urine |
S/S of hypokalemia
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irregular HR
DYSRHYTHMA sensitivity to digoxin |
hypokalemia
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hypokalemia compensation: K is moved to intacellular space to maintain the
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cell levels and cell action
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Treatment of hypokalemia
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K supplement (IV, PO or diet)
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hyperkalemia
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K level above 5
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cause of hyperkalemia
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high K intake
shift of K from cells to extracellular decreased K excretion |
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cause of high K intake
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massive IV potassium
overdose on supplement |
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cause of K shift from cells to extracellular
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acidosis
cell death low insulin |
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cause of decreased K excretion
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kidney disease
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severe muscle weakness (heart & muscle)
arrythmias/paralysis bradypnea bradycardia cardiac arrest parasthesias of the face hands feet Nausea diarrhea & cramping |
S/S of hperkalemia
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severe muscle weakness almost to the point of paralysis
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hyperkalemia
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hyperkalemia compenstion:
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K moves out of the cell to maintain cell equalibrum
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treatment of hyperkalemia
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treat the cause
K wasting diuretics (lasix) |
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Calcium
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important electrolyte for neuromuscular activity
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causes spasm
twitching hyperactivity of muscles & cardiac dysrhythmias |
hypocalcemia
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causes fatigue
muscle weakness confusion cardiac dysrhythmias like an engine flooded in a car, weak won't start) |
hypercalcemia
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elimination of by-products of metabolism
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acid-base balance
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substance that releases lots of hydrogen molecules
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acid
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something that will accept hydrogen molecules
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base
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Primary acids of body are
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carbonic acid
carbon dioxide |
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H2CO3
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carbonic acid
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QUICK RESPONSE TIME TO ACID-BASE IMBALANCE
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acids of the body
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primary base in body
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bicarbonate (baking soda)
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bases regulated by
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kidneys
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bicarbonate is abbreviated by
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HCO3
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SLOWER RESPONSE TIME TO ACID-BASE IMBALANCE
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base of the body
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another source of base in the body is
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bile in the liver
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arterial blood gases
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pH *7.35 - 7.45
CO2 35 - 45* HCO3 *21 - 28 *direction of acid |
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respiratory acidosis (decreased resp. harder to breath)
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excess acid in the body due to impaired resp.
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"non-repiratory acidosis" ( too much acid caused by something other than respiratory
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metabolic acidosis
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Which of the acid-base imbalances do most people have
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metabolic acidosis
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obstructed airway passages (secretions/foreign bodies)
respiratory depression (pneumonia, morphine overdose) impaired gas exchange in alveoli (COPD, etc) are examples of |
respiratory acidosis
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S/S of
headache tachycardia cardiac arrhythmia neuro signs - tremors, dizzy, disorintated, lethargy |
repiratory acidosis
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compensation
kidney tries to retain more bicarbonate to balance at 20: HCO3 will gradually go up |
repiratory acidosis
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acid ingestion (ASA poisoning)
inadequate renal system alkaline substances losses (diarrhea) overproduction of acid - ketoacidosis w/ diabetes or lactic acid production w/ anaerobic metabolism examples of |
metabolic acidosis
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S/S
Headache abdominal pain CNS depression (lethargy/confusion) Severe S/S kussmaul breathing (blowing off acid as the body tries to compensate) cardiac arrythmias |
metabolic acidosis
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compensation
lungs try to exrete more acid by increasing respiratory rate blow off CO2 CO2 level will gradually go down |
metabolic acidosis
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respiratory alkalosis
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acid deficit or base excess due to respiratory cuase
lungs not retaining acid exhaling to much acid |
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hyperventilation (physical excertion, emotion, respirator set to high)
overstimulation of repiratory center hypoxia (gasping for breath) - Excessive CO2 loss examples of |
respiratory alkalosis
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S/S
diaphoresis neuromuscular irritability paraesthesias in toes fingers lips dizziness confusion |
resp alkalosis
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compensation
kidneys try to lose more alkaline by excreting more HCO3 HCO 3 levels will gradually go down |
resp alkalosis
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metabolic alkalosis
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acid deficit or bicarbonate increase due to any cause other than respiratory
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excessive intak of alkaline substance (NaHCO3)
excessive loss of acid (gastric suction or server vomiting) diuretics are examples of |
metabolic alkalosis
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S/S
signs of hypokalemia increased neuromuscular irritability > tingling, tetany, confusion muscle weakness polyuria |
metabolic alkalosis
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compensation
lungs try to compensate by conserving CO2 - leading to hypoventilation CO2 levels will gradually go up resp rate lowers |
metabolic alkalosis
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The body adapts by stimulating the lungs or renal system (whichever one is opposite of the problem) to bring pH back into a normal range
But the HCO3 and the pCO2 will be far from normal the body will usually just bring the pH "barely" back into normal range U can determine the cause of the imbalance |
copensated acid-base imbalances
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both resp & metabolic causes occuring together
may balance the pH out of extreme pH levels a pt. may have BOTH resp. & met acidosis or alkalosis imbalances a pt may have both met acidosis & resp alkalosis |
mixed acid-base imbalances
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