Special Pts And Special Fluids

Front 1

Physiological changes of neonate?

Back 1

-immature liver= unable to fully conjugate bili

-skeletal sys. immature

-endocrine sys. is maturing; gonadal hormones

Front 2

neonate renal development

Back 2

-glomerular and tubular fund. develop over 1st 2 years
-GFR is decreased in neonates and increase over time
-poor reabsorption of water and electrolytes = hemoconcentration.

-any hyperkalemia must be evaluated for poor capillary puncture technique.

Front 3

neonate hepatic development

Back 3

-increase total bill due tounconj bill = neonatal jaundice

-Tests for albumin, total bill, conju. bill, evaluate synthetic and metabolic functions of liver.

Front 4

Crigler-Najjar

Back 4

genetic diease in which the enzyme UDP-glycuronoyltransferase is not produced. (the enzyme that conjugates bilirubin)

Front 5

neonate Endocrine development include:

Back 5

1.) hypothalmus-pituitary -thyroid:

-congential hypothyroidism: primary disease of thyroid

-secondary hypothyroidism: failure of pituitary to secrete TSH

2.)Hypotalmus-pituitary-adrenal cortex: genetic disorder deficient of the enzyme 21 hydroxylase = decreased synthesis of aldoseterone & cortisol

3.) Sexual maturation: at puberty, Depression of GnRH,FSH, LH.

-as FSH and LH increase, androgens in males & progesterone& estrogens in females.

Front 6

congenital hypothyroidism

Back 6

default in thyroid (primary)

Front 7

secondary hypothyroidism

Back 7

pituitary wont sercrete TSH

Front 8

Until the ages of 2, the immature liver metabolizes drugs more....

Back 8

slowly than adults TDM

Front 9

After the age of 2, the rule of what applies?

Back 9

2, drug metabolized twice as fast. TDM

Front 10

Dosage of child is not based solely on weight but also based on what?

Back 10

maturity of liver & kidney

Front 11

Elderly is defined as?

Back 11

by the gov. by physiology or by population pyramids.

-Elderly in general are at a great risk for cancer, organ disease & malnutrition than younger adults.

Front 12

Physiological changes of aging include?

Back 12

-decrease in :water, muscle mass, bone density

-increase in : lipids (cholesterol & triglycerides)

-gradual decline in organ function

Front 13

Increased in Geriatric patients?

Back 13

-GGT

-LD

-AST

-CK

-ALP (women)

-lipids

-fasting glucose

-BUN

-uric acid

-pc02

-Potassium

-TSH

Front 14

Decreased in geriatric pts?

Back 14

-albumin

-total protein

-creatinine clearance

-bilirubin
-pO2
-T3

-growth hormone

Front 15

Stays the same in geriatric pts?

Back 15

-pH

-Cl-

-Na

-insulin

-Free T4

Front 16

TDM in elderly affects what?

Back 16

-absorption, diestrubtion, metabolism, excretion

-most significant Change = ELMINATION )diminished renal mass & blood flow, GFR decreases, drugs may easily overdose

Front 17

Nutrition in elderly?

Back 17

-decrease muscle,cognitive & impaired mobility,

-Dminished GI tract & endocrine fucn. = decrease absorption of food

-decrease immune functional & loss organ function.

Front 18

CSF?

Back 18

-liquid occupies the spaces of CNS & surrounds all facets of brain & spinal cord.

- total volume - 150 ml in adults
-produced and reabsorbed at 500 ml/day
-formation bu ultrafiltrae of plasma and active secretion by epithelial membranes

Front 19

Function of CSF?

Back 19

-cushion for brain
-maintains constant chemical environment
-removes metabolic products

-may transport biologically active compounds

Front 20

CSF is....

-Glucose level of CSF

-Protein levels of CSF

-Sodium levels of CSF

Back 20

-mostly water
-40-70 mg/dl glc (70-80%)
-0.02 - 0.04 (0.5%)

- same as plasma (~ 280 mOsm/Kg)

Front 21

-Decrease glucose in CSF is what?

-Increased lactate & normal - decreased glucose is what?

Back 21

-significant

- bacterial infection

Front 22

protein in CSF

Back 22

-increase in infection = blood brian barrier damaged
-done by electrophoresis
-incr in prealbumin

-IgG albumin is used to diagnose MS

Front 23

The 3 types of serous fluids?

Back 23

-pleural (lungs)
-peritoneal (intestines)
-pericardial(heart)

Front 24

What are the two membranes that line the serous fluids?

Back 24

1.) parietal membrane - cavity wall

2.) visceral membrane - organs w/in cavity

Front 25

Define serous fluid?

Back 25

-fluid btw the membranes which provides lubrication as the surface moves

-formed as a ultra filtrates of plasma w/no additional material

-only small amts are present, cuz production & reabsorption takes place as a constant rate.

-spaces = hydrostatic & colloidal pressure

Front 26

Disruption of serous fluid formation/reabsorption causes an increase in fluid btw the membrane is termed as?

Back 26

effusion

Front 27

Primary causes of effusion include?

Back 27

-incrase hydrostatic pressure (CHF)

-decrease oncotic pressure (hypoprotenemia)

-increase permeability (inflame/infection)

-lymphatic obstruction = tumor

Front 28

Specimen collection & handling for all the fluids?

Back 28

-needle aspiration = serous fluids

-throacentesis (thoracic cavity) = pleural fluid

-Pericardiocentesis (pericardial cavity) = pericardial fluid

-Paracentesis (abdominal cavity) = peritoneal fluid

Front 29

Another name for peritoneal fluid?

Back 29

ascitic fluid

Front 30

What is transudate?

Back 30

serous effusion due to systemic disorder, disrupts balance in regulation of fluid filtratrion/reabsorb. btw the serous membranes

Front 31

what is exudate?

Back 31

serous effusion directly involve the membranes of particular cavity (infection & malignancies)

Front 32

clear
<1.015 spg
<.5 protein
<.6 LD

< 1000 WbC

clotting= not present

significance: CHF, NS, cirrohosis

Back 32

transudate

Front 33

cloudy
>1.015 spg
>.5 protein
>.6 LD

> 1000 WBC

Clotting = frequent

-Significance: TB, Bacterial

Back 33

exudate

Front 34

> 60 chol
fluid:serum chol >.3
fluid:serum bili >.6

Back 34

pleural exudate

Front 35

TP ratio formula?

Back 35

TP(fluid)/TP(serum)

Front 36

LD ratio formula?

Back 36

LD(fluid)/LD(serum)

Front 37

TP <.5 and LD <.6

Back 37

transudate