Patho Ch. 4: Fluid And Electrolytes

Front 1

level of <2.5 of phosphate

Back 1

hypophospatemia

Front 2

level of >4.5 of phosphate

Back 2

hyperphosphatemia

Front 3

Extreme thrist, tachycardia, low-grade fever, dry, sticky tongue and oral mucuosa, disorientation, hallucinations, lethargy progressing to coma, hyperactive deep tendon reflexes, seixures, coma

Back 3

Clinical Manifestations of hypernatremia

Front 4

Level of <1.8 of magnesium

Back 4

Hypomagnesemia

Front 5

Level of >2.4 of magnesium

Back 5

Hypermagnesemia

Front 6

Level of <3.5 of potassium

Back 6

Hypokalemia

Front 7

Level of >5.5 of potassium

Back 7

Hyperkalemia

Front 8

Inadequate dietary P intake,
Severe, prolonged vomiting, Alcoholism and withdrawal, IV glucose or insulin adm (moves P into skeletal muscle), Malabsorption syndromes, Hyperparathyroidism, Severe metabolic acidosis, Respiratory alkalosis, hypokalemia, Hypomagnesemia

Back 8

Causes o phosphatemia

Front 9

Paresthesias, Profound muscle weakness, Muscle pain and tenderness, Anorexia, Malaise ,Rapid, shallow respirations, Altered LOC, seizures
Nystagmus, Heart failure, Platelet dysfunction

Back 9

Clinical mnifestations of hypophosphatremia

Front 10

Acute or chronic renal failure
Excessive dietary P intake
Excessive Vitamin D use
Insufficient dietary intake
Hypoparathyroidism
Cancer chemotherapy
Excessive laxative use

Back 10

Causes of hyperphosphatemia

Front 11

Leve of >147 of sodium

Back 11

Hypernatremia

Front 12

Tetany
Circumoral paresthesias
Muscle spasm
Seizures
Soft tissue calcification

Back 12

Clinical Manifestations of hyperphosphatemia

Front 13

Level of <9.0 of calcium

Back 13

Hypocalcemia

Front 14

Prolonged diuretic therapy, excessive diaphosesis, insufficient Na intake, burns, severe GI loss, adrenal insufficiency, SIADH

Back 14

Causes of Hyponatremia

Front 15

Sum of fluids within all body compartments

Back 15

Total Body Weight (TBW)

Front 16

All fluid within the cells (2/3)

Back 16

Intracellular fluid (ICF)

Front 17

Level of <135 of sodium

Back 17

Hyponatremia

Front 18

All fluid outside the cells (1/3)

Back 18

Extracellular fluid (ECF)

Front 19

Excessive intake of Ca or Vitamin D
Sever GI fluid loss
Prolonged, excessive diuretic therapy
Prolonged malnutrition/starvation
Malabsorption syndromes
Hypoparathyroidism
Hypoaldosteronism
High dose steriod use
Burns
Sepsis
Diabetic ketoacidosis
Chronic alcoholism

Back 19

Causes of Hypomagnesemia

Front 20

Headache, faintness, confusion, muscle cramps, muscle twitching, normal or increased weight, convulsions, coma

Back 20

Clinical Manifestations of Hyponatremia

Front 21

Space between cells and outside the blood vessels

Back 21

Interstitial fluid (ISF)

Front 22

Level of >10.5 of calcium

Back 22

Hypercalcemia

Front 23

Blood plasma

Back 23

Intravascular fluid

Front 24

Tachycardia, hypotension
Tremors
Tetany
Hyperactive DTR
+Trousseau's signs
+Chvostek's signs
Memory loss, emotional lability, confusion
Hallucinations, seizures, coma
Dizziness
Anorexia, nausea
Hypocalcemia; hypokalemia

Back 24

Clinical Manifestations of Hypomagnesemia

Front 25

Deficient water intake, hypertonic parental fluid abdomin, excessive salt ingestion, prolonged high fever, insensible water loss, diarrhea, mojor burns, diabetes inspidus

Back 25

Causes of hypernatremia

Front 26

Drinking, ingestion of water from food, water deprived from metabolism

Back 26

Intake of body water

Front 27

Renal excretion, stool, vaporization from skin and lungs

Back 27

Output of body water

Front 28

Decreased muscle mass, increase fat cells
Decreased ability to regulate sodium and water balance

Back 28

Decreases TBW

Front 29

What causes water movement between ICF and ECF?

Back 29

Potassium

Front 30

What causes water movement between plasma and interstitial fluid?

Back 30

Sodium, water and glucose

Front 31

Plasma proteins (albumin) maintain effective osmolarity (per liter of the solution) by...

Back 31

generating plasma oncotic (result of sweeling) pressure

Front 32

Normal range of 135-147 mEq/L

Back 32

Sodium

Front 33

Normal range of 3.5-5.5 mEq/L

Back 33

Potassium

Front 34

Renal failure
Mg containing antacids
Untreated diabetic ketoacidosis
Hypoadrenalism

Back 34

Causes of Hypermagnesemia

Front 35

Normal range of 9.0-10.5 mg/dL

Back 35

Calcium

Front 36

Normal range of 2.5-4.5 mg/dL

Back 36

Phosphate

Front 37

Normal range of 1.8-2.4 mg/dL

Back 37

Magnesium

Front 38

Muscle weakness; flaccidity
Personal changes; LOC
Coma
n/v; anorexia; extreme thirst
Constipation
Polyuria
Urinary calculi
Pathologic fractures
Metastatic calcifications (cornea and skin) "itching"

Back 38

Clinical Manifestations of Hypercalcemia

Front 39

Excessive excretion
Inadequate intake of K
Increased cellular uptake from insulin excess, alkalosis, renal renal

Back 39

Causes of Hypokalemia

Front 40

Anorexia N/V
Drowsiness, lethargy
Leg cramps
Muscle weakness, esp. legs
Hyporeflexia
Paresthesia
Decreased bowel motility (ileus)
Hypotension
ECG (ST segment depression; U waves; flat T waves)

Back 40

Clinical Manifestations of Hypokalemia

Front 41

Increased dietary with decreased UOP
K supplement therapy
Excessive salt substitutes
K-sparing diuretics
Hyponatremia
Metabolic acidosis
Acute or chronic renal failure

Back 41

Causes of Hyperkalemia

Front 42

Apathy, confusion
Paresthesias
Abdominal cramps, nausea
Flaccid muscle paralysis
Diarrhea
Oliguria
Bradycardia
Cardiac arrest

Back 42

Clinical Manifestations of Hyperkalemia

Front 43

Lethargy and drowsiness, coma
Depressed neuromuscular activity
Depressed respirations
Flushing sensation
Hypoactive DTR
Hypotension, bradycardia
Cardiac arrest

Back 43

Clinical Manifestations of Hypermagnesemia

Front 44

What is responsible for the ECF osmotic balance, and potassium maintains the ICF osmotic balance.

Back 44

Sodium

Front 45

Acute or chronic renal failure
Vitamin D deficiency
Insufficient dietary intake
Hyperphosphatemia
Alkalosis
Hypoalbuminemia
Hypomagnesemia

Back 45

Causes of Hypocalcemia

Front 46

Muscle cramps
Hyperactive DTRs
Paresthesias
Tetany
Trousseau's signs
Chvostek's signs
Laryngeal spasm
Abdominal muscle spasm
Confusion, moody, anxiety
Memory loss, seizures
ECG (prolonged QT & ST)

Back 46

Clinical Manifestations of Hypocalcemia

Front 47

Ca supplement therapy
Excessive use Ca-containing antacids
Prolonged immobility
Excessive vitamin D intake
Primary hyperparathyroidism
Metastatic carcinoma
Hypophoshatemia
Renal tubular necrosis

Back 47

Causes of Hypercalcemia

Front 48

Metabolism of wastes
Fever and increased respiratory rate
Kidneys, GI tract, skin and lungs

Back 48

Loss of water movement

Front 49

Things you can see/measure
Urine and feces

Back 49

Sensible

Front 50

Things you can not see/measure
Lungs and skin

Back 50

Insensible

Front 51

60% of body weight

Back 51

Total Body Water (TBW)

Front 52

40% of body weight

Back 52

Fat and Fat-Free solids, particularly bone

Front 53

Pushes water
Arises from heart contraction
Favors movement to plasma water into ISF

Back 53

Hydrostatic pressure

Front 54

Helps maintain plasma volume

Back 54

Colloid osmotic pressure

Front 55

Pulls water
Movement of water into interstitial space causes accumulation of water into tissue (edema)

Back 55

Osmotic forces

Front 56

Limited to site of trauma

Back 56

Localized

Front 57

Uniform distribution

Back 57

Generalized

Front 58

Loss or trapping of ECF into transcellular space, pericardial sac, peritoneal cavity, pleural cavity

Back 58

Third-space accumulation

Front 59

Excessive fluid into the pleural cavity

Back 59

Hydrothorax

Front 60

Excessive fluid in the peritoneal cavity

Back 60

Ascites

Front 61

Fluid in the serous cavities

Back 61

Effusion

Front 62

Capillary hydrostatic pressure
Interstitial oncotic pressure

Back 62

Filtration

Front 63

Integrity is key in the movement of water and solutes

Back 63

Capillary membrane

Front 64

Movement of particles along a concentration gradient from an area of higher concentration to lower concentration

Back 64

Diffusion

Front 65

Movement of water across a semipermeable membrane

Back 65

Osmosis

Front 66

Pressure needed to move opposite the movement of water across the membrane

Back 66

Osmotic Pressure

Front 67

Osmolar concentration in 1L of solution
Refers to fluids outside of the body

Back 67

Osmolarity

Front 68

Osmolar concentration in 1kg. of water
Refers to fluids inside the body
Controls the distribution and movement of water between body compartments
E.g. kidneys ability to produce a concentrated or dilute urine

Back 68

Osmolality

Front 69

Plasma proteins accumulated into tissue spaces and coagulated
Occurs with local infection or trauma

Back 69

Nonpitting Edema

Front 70

Accumulation of interstitial fluid exceeds the absorptive capacity of tissue
Water is mobile and can be translocated with finger pressure

Back 70

Pitting Edema

Front 71

the abnormal accumulation of fluid in interstitial spaces of tissues, such as in the pericardial sac, intrapleural space, peritoneal cavity, or joint capsules

Back 71

Edema

Front 72

Regulated by Antidiuretic Hormone(ADH) or vasopressin

Back 72

Water Balance

Front 73

Hypothalamus
Angiotensin 2

Back 73

Thirst

Front 74

Absent thirst sensation

Back 74

Adipsia

Front 75

Decrease thirst sensation

Back 75

Hpodipsia

Front 76

Excessive thirst

Back 76

Polydipsia

Front 77

Water deficit
Sodium excess

Back 77

Plasma osmolality increases

Front 78

Plasma osmolality increases
Circulating blood volume decreases and blood pressure drops

Back 78

ADH and vasopressin

Front 79

Tasteless diabetes
Deficiency of ADH

Back 79

Diabetes Insipidus

Front 80

Decrease ADH synthesis
Kidneys inability to respond to ADH

Back 80

Deficiency of ADH

Front 81

Excessive dilute urination(polyuria)

Back 81

Clinical Manifestations of Diabetes Insipidus

Front 82

Kidneys do not respond to ADH

Back 82

Neurogenic Diabetes Insipidus

Front 83

Defect in pituitary gland

Back 83

Primary Diabetes Insipidus

Front 84

Interfere with kidneys response

Back 84

Drug-related Diabetes Insipidus

Front 85

Failure to negative feedback system to regulate ADH
Water retention with dilutional hyponatremia
(Decreased osmolarity)

Back 85

Syndrome of Inappropriate Antidiuretic Hormone(SIADH)

Front 86

Neoplasia
Neurologic disorders
Lung disease
Medicine

Back 86

Causes of SIADH

Front 87

Change in water content resulting in cellular swelling/shrinking

Back 87

Tonicity

Front 88

Same concentration of particles as ICF or ECF

Back 88

Isotonic

Front 89

Lower concentration of particles/dilute

Back 89

Hypertonic

Front 90

Higher concentration of particles

Back 90

Hypotonic

Front 91

Gain or loss of ECF resulting in a concentration equivalent to a 0.9% sodium chloride solution:No shrinking or swelling of cells

Back 91

Isotonic imbalance

Front 92

Imbalances that result in an ECF concentration more than 0.9% salt solution:Cells shrink

Back 92

Hypertonic imbalance

Front 93

Imbalance that results in an ECF less that 0.9% salt solution:Cells swell

Back 93

Hypotonic imbalance

Front 94

Maintained by mechanisms that generate, buffer and eliminate acids and bases
pH 7.35 to 7.45
Acids are continuously generated as byproducts of metabolism

Back 94

Acid-Base Balance

Front 95

H2CO3 determined by lungs and respiratory capacity

Back 95

Volatile

Front 96

Are not eliminated by the lungs, buffered by body proteins such as HCO3 then excreted by the kidneys

Back 96

Nonvolatile

Front 97

Respiratory mechanisms that eliminates CO2
Renal mechanisms that conserve HCO3 and eliminate H+ ions
Electrolyte composition

Back 97

Regulation of pH

Front 98

Maintain membrane integrity
Speed of metabolic enzyme reactions

Back 98

Hydrogen ions

Front 99

Clinical conditions r/t changes in dissolved CO2 and HCO3 concentrations
Sodium bicarbonate is the main alkali in ECF

Back 99

Disorders of Acid-Base

Front 100

Produce alterations in bicarbonate concentration and result from addition or loss of nonvolatile acid or alkali from ECF

Back 100

Metabolic Disorders of Acid-Base

Front 101

Reduction in pH due to decreased HCO3

Back 101

Metabolic Acidosis

Front 102

Elevated pH due to increased HCO3

Back 102

Metabolic Alkalosis

Front 103

Involve alteration in PCO2

Back 103

Respiratory Disorders of Acid-Base

Front 104

Decreased pH, reflecting a decrease in ventilation and an increase in PCO2

Back 104

Respiratory Acidosis

Front 105

Increased pH, reflecting from an increase in alveolar ventilation and a decreased PCO2

Back 105

Respiratory Alkalosis