Pp Ch 9: Fluid, Electrolyte, Acid-Base Balances

Front 1

Fluid, electrolyte, and acid-base balances, are maintained by these three processes.

Back 1

- ingestion

- distribution

- excretion

Front 2

Fluid, electrolyte, and acid-base balances, are maintained by these three systems.

Back 2

- renal system

- pulmonary system

- buffer system

Front 3

Fluid, electrolyte, and acid-base imbalances are caused by these three factors.

Back 3

- altered intake

- illness

- excessive losses

Front 4

This is an example of excessive fluid or electrolyte loss.

Back 4

exercise induced diaphoresis

Front 5

Imbalances in fluid, electrolyte, and acid-base, affect these levels of the body.

Back 5

- cellular level

- tissue level

- systems level

Front 6

The approximate percentage of an adult's weight that consists of fluid.

Back 6

60%

Front 7

These factors influence percentage of body weight consisting of fluid.

Back 7

- age

- weight

- gender

Front 8

Body fluid is separated into these two distinct compartments.

Back 8

- intracellular fluid (ICF)

- extracellular fluid (ECF)

Front 9

This makes up all fluid within body cells and accounts for approximately 66% of total body water and 40% of total body weight.

Back 9

ICF or intracellular fluid

Front 10

This makes up fluid outside the cells.

Back 10

ECF or extracellular fluid

Front 11

This type of fluid is further divided into three smaller compartments.

Back 11

ECF or extracellular fluid

Front 12

The three smaller compartments that make up the ECF or extracellular fluid are:

Back 12

- interstitial fluid (ISF)

- intravascular fluid

- transcellular fluids

Front 13

This fluid, part of the extracellular fluid, includes lymph and consists of fluid between the cells and outside blood vessels.

Back 13

ISF or interstitial fluid

Front 14

This fluid, part of the extracellular fluid, is blood plasma.

Back 14

intravascular fluid

Front 15

This fluid, part of the extracellular fluid, is separated from other fluid by epithelium.

Back 15

transcellular fluid

Front 16

Transcellular fluid, a compartment of the extracellular fluid, includes these five fluids.

Back 16

- cerebrospinal

- pleural

- peritoneal

- synovial

- gastrointestinal

Front 17

These are important solutes in all body fluids. They are vital to many body functions. They separate into ions when dissolved in aqueous solution, and are able to carry an electrical current.

Back 17

elecrolytes

Front 18

These are positively charged electrolytes.

Back 18

cations

Front 19

These are negatively charged electrolytes.

Back 19

anions

Front 20

Sodium, Potassium, and Calcium are ______ charged electrolytes, making them _____.

Back 20

positively, cations

Front 21

Chloride, Bicarbonate, and Sulphate, are _______ charged electrolytes, making them ______.

Back 21

negatively, anions

Front 22

Na+

Back 22

sodium

Front 23

K+

Back 23

potassium

Front 24

Ca2+

Back 24

calcium

Front 25

HCO3-

Back 25

bicarbonate

Front 26

Cl-

Back 26

chloride

Front 27

CO4-

Back 27

sulphate

Front 28

normal extracellular fluid concentration (mmol/L) for sodium (Na+)

Back 28

136-145 mmol/L

Front 29

normal extracellular fluid concentration (mmol/L) for potassium (K+)

Back 29

3.5-5.0 mmol/L

Front 30

normal extracellular fluid concentration (mmol/L) for calcium (Ca2+)

Back 30

2.25-2.75 mmol/L

Front 31

normal extracellular fluid concentration (mmol/L) for bicarbonate (HCO3-)

Back 31

22-26 mmol/L arterial

34-30 mmol/L venous

Front 32

normal extracellular fluid concentration (mmol/L) for carbon dioxide (CO2)

Back 32

23-30 mmol/L venous

Front 33

normal extracellular fluid concentration (mmol/L) for chloride (Cl-)

Back 33

98-106 mmol/L

Front 34

normal extracellular fluid concentration (mmol/L) for magnesium (Mg2+)

Back 34

0.65-1.05 mmol/L

Front 35

normal extracellular fluid concentration (mmol/L) for phosphate (PO4 3-)

Back 35

0.97-1.45 mmol/L

Front 36

Water can pass through cell membranes between body fluid compartments easily because these membranes are _________.

Back 36

semi-permeable

Front 37

Fluids and solutes move across membranes separating body fluid compartments by these four processes:

Back 37

- osmosis

- diffusion

- filtration

- carrier-mediated transport

Front 38

This process is the movement of water through a semi-permeable membrane from an area of lesser solute concentration to an area of greater solute concentration to equalize concentrations on both sides of the membrane. (solvent moving down its concentration gradient)

Back 38

osmosis

Front 39

The general term for a substance that is dissolved in an aqueous solution.

Back 39

solute

Front 40

The general term for an aqueous solution in which a solute is dissolved.

Back 40

solvent

Front 41

If a substance is moving down the concentration gradient, it is moving from an area where that substance is in _____ concentration to an area of _____ concentration.

Back 41

high, low

Front 42

If a substance is moving against the concentration gradient, it is moving from an are where that substance is in _____ concentration to an area of _____ concentration. This generally requires energy.

Back 42

low, high

Front 43

The rate of osmosis depends on these four factors.

Back 43

- concentration

- temperature

- electrical charges

- osmotic pressure

Front 44

The concentration of a solution is measured in this unit. It reflects the amount of a substance in solution in the form of molecules, ions, or both.

Back 44

osmols

Front 45

These laxative salts are poorly absorbed through the intestinal lining, therefore drawing water into the intestinal lumen, causing accumulation of water and softening the stool.

Back 45

osmotic laxatives

Front 46

Swelling of the intestine from use of osmotic laxatives initiates this natural reaction to aid in intestinal movement.

Back 46

peristalsis

Front 47

The pressure needed to counter the movement of water (solvent) across a semipermeable membrane from low to high concentration of solute.

Back 47

osmotic pressure

Front 48

A solution with _____ solute concentration has _____ osmotic pressure and will draw water into itself.

Back 48

high, high

Front 49

Three main classes of plasma proteins.

Back 49

- albumins

- globulins

- fibrinogen

Front 50

These proteins affect the blood's osmotic pressure.

Back 50

plasma proteins

Front 51

This plasma protein is most abundant, is produced in the liver, and exerts colloid osmotic pressure/oncotic pressure.

Back 51

albumin

Front 52

This type of pressure, produced by albumin, tends to keep fluid in the intravascular compartment by pulling water from the interstitial space back into capillaries.

Back 52

colloid osmotic pressure or oncotic pressure

Front 53

The movement of ions and molecules in a solution across a semipermeable membrane from an area of higher concentration to and area of lower concentration. (down the concentration gradient)

Back 53

diffusion

Front 54

The rate of diffusion is affected by these three factors.

Back 54

- temperature

- molecule size

- concentration

Front 55

The difference between two concentrations.

Back 55

concentration gradient

Front 56

The process by which water and diffusible substances move together in response to fluid pressure, moving from a higher pressure area to a lower pressure area.

Back 56

filtration

Front 57

In this condition, hydrostatic pressure is increased on the venous side of the capillary bed.

Back 57

heart failure

Front 58

Accumulation of excess fluid in the interstitial space.

Back 58

edema

Front 59

_____ is caused by reversal of the normal movement of water from the interstitial space into the intravascular space by filtration.

Back 59

edema

Front 60

In this process, water and solutes are carried across the wall of the glomerular capillaries by hydrostatic or blood pressure.

Back 60

urine formation

Front 61

This process moves molecules across the plasma membrane actively or passively.

Back 61

carrier-mediated transport

Front 62

Facilitated diffusion and active transport are two examples of this.

Back 62

carrier-mediated transport

Front 63

A carrier protein that binds to glucose to carry it across the cell membrane in facilitated diffusion.

Back 63

insulin

Front 64

Energy is required for this process that moves materials across cell membranes against a concentration gradient.

Back 64

active transport

Front 65

The sodium-potassium pump is an example of this type of membrane transport.

Back 65

active transport

Front 66

Body fluids are regulated by these three factors to maintain homeostasis.

Back 66

- intake

- hormonal controls

- output

Front 67

These three primary hormones regulate fluid.

Back 67

- antidiuretic hormone

- aldosterone

- natriuretic peptides

Front 68

Fluid output occurs through these four organs of water loss.

Back 68

- kidneys

- lungs

- skin

- gastrointestinal tract

Front 69

He major regulatory organs of fluid balance.

Back 69

kidneys

Front 70

The kidneys receive approximately _____ L of plasma to filter each day.

Back 70

180 L

Front 71

The kidneys produce _____ to _____ mL of urine each day.

Back 71

1200-1500 mL urine/day

Front 72

This is characterized by continuous, gradual movement of water from the respiratory and skin epitheliums, amounting to about 20-25mL/hour.

Back 72

insensible water loss

Front 73

The lungs expire approximately ____ mL of water daily.

Back 73

400 mL/day

Front 74

Insensible skin perspiration losses are approximately _____ mL per day.

Back 74

600 mL/day

Front 75

This treatment can increase insensible water loss from the lungs.

Back 75

oxygen therapy

Front 76

Sensible or visible water loss depends greatly on these structures.

Back 76

sweat glands

Front 77

This division of the nervous system activates sweat glands and regulates water loss from the skin.

Back 77

sympathetic nervous system

Front 78

Approximately _____ L of fluid is moves into the gastrointestinal tract and then returns to the ECF each day.

Back 78

8 L/day

Front 79

Only about _____ mL of water is lost through feces, because most of the fluid is reabsorbed in the _____.

Back 79

100-200mL, small intestine

Front 80

This condition can cause large amounts of fluid loss from the gastrointestinal tract and can have significant impact on fluid regulation.

Back 80

diarrhea

Front 81

This mechanism regulates fluid intake and is located in the hypothalamus.

Back 81

thirst mechanism

Front 82

Nerve cells in the subfirnical organ (SFO) and the hypothalamus are stimulated for thirst when _____ increases.

Back 82

osmolality or serum osmotic pressure

Front 83

These constantly monitor serum osmotic pressure.

Back 83

osmoreceptors

Front 84

An increase in this substance will cause an increase in osmotic pressure and stimulate the thirst mechanism.

Back 84

sodium (Na+)

Front 85

This can occur in any condition that interferes with the oral ingestion of fluids or with intake of hypertonic fluids.

Back 85

increased plasma osmolality

Front 86

This condition occurs in excessive vomiting or hemorrhage and will trigger the thirst centre.

Back 86

hypovolemia

Front 87

Additional factors that initiate the sensation of thirst.

Back 87

- stimulation of renin-angiotensin aldosterone mechanism

- potassium depletion

- psychological factors

- oropharyngeal dryness

Front 88

Average adult fluid intake.

Back 88

220-2700 mL/day

Front 89

These three means account for fluid intake.

Back 89

- oral intake

- solid food intake

- oxidative metabolism

Front 90

This hormone is stored in the posterior pituitary gland and is released in response to inreased blood osmolality.

Back 90

ADH or antidiuretic hormone

Front 91

This hormone acts directly on the renal tubules and collecting ducts to make them more permeable to water to promote water conservation.

Back 91

ADH or antidiuretic hormone

Front 92

The effects of ADH (antidiuretic hormone) cause water to be returned to the systemic circulation which _____ blood and _____ osmolality.

Back 92

dilutes, reduces

Front 93

The two main functions of antidiuretic hormone (ADH) include:

Back 93

- stimulate thirst center to promote fluid intake

- act on renal tubules and ducts to promote water conservation

Front 94

This hormone is released by the adrenal cortex in response to increased plasma potassium, falling sodium levels, or as pert of the renin-angiotensin-aldosterone system to counteract hypovolemia.

Back 94

aldosterone

Front 95

Renin is released from the kidney in response to sympathetic nervous system stimulation and decreased renal blood flow, initiating a cascade of physiological and endocrine processes including the release of aldosterone, all as a means to resolve this condition.

Back 95

hypovolemia

Front 96

This hormone acts on the distal portion of the renal tubule to increase the reabsorption of sodium and the secretion and excretion of potassium and hydrogen.

Back 96

aldosterone

Front 97

These hormones respond to increases in circulating blood volume and are released by cardiac muscle cells.

Back 97

natriuretic peptides

Front 98

These hormones act on the peripheral vasculature, other hormones, and the kidney to facilitate diuresis.

Back 98

natriuretic peptides

Front 99

These hormones increase sodium excretion and fluid loss while reducing thirst and blocking the release of ADH (antidiuretic hormone) and aldosterone.

Back 99

natriuretic peptides

Front 100

The four major cations within the body fluids are:

Back 100

- sodium

- potassium

- calcium

- magnesium (Mg2+)

Front 101

The most abundant cation in ECF (extracellular fluid) is ____ at 90%.

Back 101

sodium (Na+)

Front 102

Increased sodium intake results in _____ blood volume.

Back 102

increased

Front 103

If the regulation of sodium concentration requires a large change in extracellular fluid volume, these are stimulated to regulate fluid volumes and blood pressure.

Back 103

baroreceptors

Front 104

These ions are major contributors to nerve impulse transmission, regulation of acid-base balance, and cellular chemical reactions.

Back 104

sodium ions

Front 105

Normal extracellular sodium concentration.

Back 105

136-145 mmol/L

Front 106

high sodium, above 145 mmol/L

Back 106

hypernatremia

Front 107

low sodium, below 136 mmol/L

Back 107

hyponatremia

Front 108

The major electrolyte and principal cation in the intracellular compartment.

Back 108

potassium (K+)

Front 109

The majority of this cation is in the intracellular fluid (99%) and cells expend energy to maintain this content.

Back 109

potassium (K+)

Front 110

This electrolyte/cation is regulated by dietary intake and is strongly affected by aldosterone.

Back 110

potassium (K+)

Front 111

Renal excretion is influenced by these four factors.

Back 111

-changes in potassium concentration

-changes in pH of a fluid

-sodium reabsorption

-aldosterone levels

Front 112

The body does not conserve potassium well, so any _____ in urine output, will cause a _____ in serum potassium concentration.

Back 112

increase, decrease

Front 113

This cation/electrolyte is necessary for:

- glycogen deposits in the liver and skeletal muscle

- transmission and conduction of nerve impulses

- normal cardiac conduction

- skeletal and smooth muscle contraction

Back 113

potassium (K+)

Front 114

Normal range for serum potassium concentration.

Back 114

3.5-5 mmol/L

Front 115

This cation/electrolyte is stored in bone, plasma, and body cells. _____% in bone, _____% in ECF (extracellular fluid).

Back 115

calcium, 99% in bone, 1% in ECF

Front 116

Approximately 50% of the calcium in the plasma is bound to _____, primarily _____.

Back 116

protein, albumin

Front 117

Approximately 40% of the calcium in the plasma is _____ calcium.

Back 117

free ionized

Front 118

Approximately 10% of the calcium in the plasma is combined with _____.

Back 118

nonprotein anions

Front 119

Normal serum ionized calcium level.

Back 119

1.0-1.2 mmol/L

Front 120

Normal total calcium level.

Back 120

2.25-2.75 mmol/L

Front 121

This cation is necessary for bone and teeth formation, blood clotting, hormone secretion, cell membrane integrity, cardiac conduction, transmission of nerve impulses, and muscle contraction.

Back 121

calcium

Front 122

The second most abundant intracellular cation.

Back 122

magnesium

Front 123

This cation is essential for many intracellular activities, such as enzyme reactions.

Back 123

magnesium

Front 124

Normal magnesium plasma concentration.

Back 124

0.65-1.05 mmol/L

Front 125

This cation is important for bone structure, neuromuscular function including skeletal and cardiac muscle excitability.

Back 125

magnesium

Front 126

This cation is regulated by dietary intake, renal mechanisms, and actions of parathyroid hormone.

Back 126

magnesium

Front 127

The three major anions of body fluids.

Back 127

- chloride

- bicarbonate

- phosphate

Front 128

The major anion in the extracellular fluid.

Back 128

chloride

Front 129

Normal chloride concentration.

Back 129

97-107 mmol/L

Front 130

Serum chloride is regulated by _____ and _____.

Back 130

- dietary intake

- kidneys

Front 131

The major chemical base buffer within the body.

Back 131

bicarbonate

Front 132

This anion, _____, is an essential component of the carbonic acid-bicarbonate buffering system, which is essential to the _____.

Back 132

bicarbonate, acid-base balance

Front 133

Normal arterial bicarbonate range.

Back 133

22-26 mmol/L

Front 134

Normal venous bicarbonate range. Measured as carbon dioxide content.

Back 134

24-30 mmol/L

Front 135

Major anion in the ICF (intracellular fluid).

Back 135

phosphate

Front 136

This anions major role is in the ICF, assisting in the formation of ATP (adenosine triphosphate) and nucleic acids, and in enzyme activity.

Back 136

phosphate

Front 137

This anion is stored in the skeleton and functions with calcium to develop and maintain teeth.

Back 137

phosphate

Front 138

Calcium and phosphate are _____ proportional. If one rises, the other falls

Back 138

inversely

Front 139

This anion assists in acid-base regulation, promotes normal neuromuscular action, and participates in carbohydrate metabolism.

Back 139

phosphate

Front 140

This anion is absorbed through gastrointestinal tract, regulated by dietary intake, renal and intestinal secretion, and parathyroid hormone.

Back 140

phosphate

Front 141

Normal phosphorus serum level.

Back 141

0.9-1.45 mmol/L

Front 142

When the rate at that the body produces and gains acids or bases equals the rate that thy are excreted, this occurs.

Back 142

acid-base balance

Front 143

The bod produces/gains acids or bases through_____ and _____.

Back 143

gastrointestinal absorption and cellular metabolism

Front 144

Acid-base balance results in a stable concentration of these.

Back 144

hydrogen ions

Front 145

Concentration of hydrogen ions in body fluids is expressed as _____ value.

Back 145

pH

Front 146

Normal pH/hydrogen ion concentration is necessary for these two processes.

Back 146

- maintaining cell membrane integrity

- speed cellular enzymatic reactions

Front 147

Arterial blood pH is _____ proportional to hydrogen ion concentration.

Back 147

inversely

Front 148

The greater the hydrogen ion concentration, the more _____ the solution, and the _____ the pH.

Back 148

acidic, lower

Front 149

The lower the hydrogen ion concentration, the more _____ the solution, and then _____ the pH.

Back 149

basic/alkaline, higher

Front 150

In addition to hydrogen ion concentration, pH is a reflection of the balance between _____ and _____.

Back 150

carbon dioxide, bicarbonate

Front 151

A buffer is a substance of group of substances that can absorb or release _____ to stabilize _____.

Back 151

hydrogen ions, pH

Front 152

Examples of buffers.

Back 152

- bicarbonate

- phosphate

- proteins

Front 153

Chemical buffers act _____.

Back 153

immediately

Front 154

Buffer systems are combinations of a _____ and a _____, and are _____ term regulators of acid-base balance.

Back 154

weak acid, weak base, short term

Front 155

The four main types of buffer systems:

Back 155

- protein

- hemoglobin

- carbonic acid and bicarbonate

- phosphate

Front 156

Two examples of protein buffer systems:

Back 156

- amino acids

- plasma proteins

Front 157

Buffer systems bind _____ until they can be removed through the regulatory systems in the _____ and _____.

Back 157

hydrogen ions, lungs, kidneys

Front 158

The principal buffering system that reacts to changes in pH of extracellular fluid.

Back 158

carbonic acid-bicarbonate buffer system

Front 159

The lungs control the excretion of _____ and the kidneys control the excretion of _____.

Back 159

carbon dioxide, hydrogen and bicarbonate ions

Front 160

This buffer system exists within red blood cells (RBCs)

Back 160

hemoglobin-oxyhemoglobin system

Front 161

Normally, increased levels of these two substances stimulate respiration.

Back 161

carbon dioxide and hydrogen ions

Front 162

When the concentration of hydrogen ions is altered, the lungs react by:

Back 162

changing the rate and depth of respirations

Front 163

The _____ regenerate or reabsorb bicarbonate in cases of acid excess and excrete it in cases of acid deficit.

Back 163

kidneys

Front 164

In this mechanism, used by the kidneys, certain amino acids are chemically changed within the renal tubules into ammonia, which forms ammonium in the presence of hydrogen ions, and is then excreted in urine, releasing hydrogen ions from the body.

Back 164

ammonia mechanism

Front 165

This electrolyte imbalance occurs when there is a lower than normal concentration of sodium in the blood (serum). Occurs with net sodium loss or net water excess.

Back 165

hyponatremia

Front 166

This electrolyte imbalance occurs when there is a higher than normal concentration of sodium in the extracellular fluid. Can be caused by water loss or overall sodium excess.

Back 166

hypernatremia

Front 167

This electrolyte imbalance is characterized by potassium levels less than 3.5 mmol/L. It results in cardiac arrhythmias, fatigue, and altered muscle activity. Commonly cause by use of potassium wasting diuretics (thiazide, loop diuretics).

Back 167

hypokalemia

Front 168

Electrolyte imbalance characterized by higher than normal concentration of potassium in the blood. Levels ove 5.0 mmol/L result in lethal cardiac arrhythmia, skeletal muscle weakness, paralysis. Primary cause is renal failure.

Back 168

hyperkalemia

Front 169

Electrolyte imbalance characterized by drop in serum calcium or ionized calcium. Can result from several illnesses, prolonged bed rest, renal failure. Presents as diminished functioning of neuromuscular, cardiac, and renal systems.

Back 169

hypocalcemia

Front 170

Electrolyte imbalanced characterized by increase in total serum concentration of calcium or ionized calcium. Often a symptom of underlying disease (malignancy, hyperparathyroidism), resulting in excess bone reabsorption and calcium release.

Back 170

hypercalcemia

Front 171

Electrolyte imbalance characterized by drop in serum magnesium below 0.65 mmol/L. Occurs in malnutrition, malabsorption disorders, diarrhea, alcohol withdrawl. Can cause neuromuscular symptoms, arrhythmias, seizures.

Back 171

hypomagnesemia

Front 172

Electrolyte imbalance characterized by increase in serum magnesium levels more than 1.05 mmol/L. Depresses skeletal muscles and nerve function. May inhibit acetylcholine causing sedative effect.

Back 172

hypermagnesemia

Front 173

Electrolyte imbalance characterized by drop in serum chloride levels below normal. Caused by vomiting or prolonged and excessive nasogastric or fistula drainage due to loss of hydrochloric acid, or loop and thiazide diuretics.

Back 173

hypochloremia

Front 174

Electrolyte imbalance characterized by higher than normal serum chloride level.

Back 174

hperchloremia

Front 175

Two basic types of fluid imbalances:

Back 175

- isotonic

- osmolar

Front 176

This type of fluid imbalance occurs when water and electrolytes are lost or gained in equal proportion.

Back 176

isotonic fluid imalance

Front 177

This type of fluid imbalance occurs when there are losses or excess of water, changing the concentration of the serum.

Back 177

osmolar fluid imbalance

Front 178

This analysis is the best way to evaluate acid-base balance and is based on the carbonic acid-bicarbonate buffer system.

Back 178

ABG or arterial blood gas

Front 179

ABG or arterial blood gas involves analysis of these six components:

Back 179

- pH

- PaCO2

- PaO2

- oxygen saturation

- base excess

- bicarbonate

Front 180

Normal pH value:

Back 180

7.35-7.45

Front 181

pH below 7.35 is:

Back 181

acidic

Front 182

pH above 7.45 is:

Back 182

alkalotic

Front 183

The partial pressure of carbon dioxide in arterial blood. A reflection of the depth of pulmonary ventilation.

Back 183

PaCO2

Front 184

Normal range for PaCO2 (partial pressure of carbon dioxide).

Back 184

35-45 mmHg

Front 185

Signs and symptoms of _____ include: apprehension, personality change, postural hypotension, postural dizziness, abdominal cramping, nausea, vomiting, diarrhea, tachycardia, dry mucous membranes, convulsions, coma

Back 185

hyponatremia

Front 186

Signs and symptoms of_____ include: extreme thirst, dry and flushed skin, dry and sticky tongue and mucous membranes, postural hypotension, fever, agitation, convulsions, restlessness, irritability

Back 186

hypernatremia

Front 187

Signs and symptoms of _____ include: weakness, fatigue, nausea, vomiting, intestinal distension, decreased bowel sounds, decreased deep tendon reflexes, ventricular dysrhythmia, paresthesia, weak and irregular pulse

Back 187

hypokalemia

Front 188

Signs and symptoms of ____ include: anxiety, dysrhythmias, paraesthesia, weakness, abdominal cramps, diarrhea

Back 188

hyperkalemia

Front 189

Signs and symptoms of _____ include: numbness and tingling of fingers and circumoral (around mouth) region, hyperactive reflexes, positive Trousseau's sign (carpopedal spasm with hypoxia), positive Chvostek's sign (contraction of facial muscles when facial nerve is tapped), tetany, muscle cramps, pathological fractures

Back 189

hypocalcemia

Front 190

Signs and symptoms of _____ include: anorexia, nausea and vomiting, weakness, hypoactive reflexes, lethargy, flank pain (from kidney stones), decreased level of consciousness, personality changes, cardiac arrest

Back 190

hypercalcemia

Front 191

Signs and symptoms of _____ include: muscular tremors, hyperactive deep tendon reflexes, confusion, disorientation, tachycardia, hypertension, dysrhythmias, positive Chvostek's and Trousseau's signs

Back 191

hypomagnesemia

Front 192

Signs and symptoms of _____ include: acute elevations in magnesium levels, hypoactive deep tendon reflexes, decreased depth and rate of respirations, hypotension, flushing

Back 192

hypermagnesemia

Front 193

Signs and symptoms of _____ include: postural hypotension, tachycardia, dry mucous membranes, poor skin turgor, thirst confusion, rapid weight loss, slow vein filling, flat neck veins, lethargy, oliguria(<30mL/hr), weak pulse

Back 193

isotonic imbalance, fluid volume deficit

Front 194

Signs and symptoms of _____ include: rapid weight gain, edema (esp in dependent areas), hypertension, polyuria, neck vein distention, increased blood venous pressure, crackles in lungs, confusion

Back 194

isotonic imbalance, fluid volume excess

Front 195

Signs and symptoms of _____ include: dry/sticky mucous membranes, flushed and dry skin, thirst, elevated body temperature, irritability, convulsions, coma

Back 195

osmolar imbalance, dehydration

Front 196

Signs and symptoms of _____ include: decreased level of consciousness, convulsions, coma

Back 196

osmolar imbalance, water excess

Front 197

Marked by increased PaCO2, excess carbonic acid, and decreased pH (increased hydrogen ion concentration). Occurs when respirations do not adequately excrete CO2.

Back 197

respiratory acidosis

Front 198

Marked by decreased PaCO2, increased pH (reduced hydrogen ion concentration).

Back 198

respiratory alkalosis

Front 199

Results from decrease in serum bicarbonate or production of organic or fixed acids.

Back 199

metabolic acidosis

Front 200

Reflects unmeasurable anions present in plasma and is calculated by subtracting the sum of chloride and bicarbonate from the amount of plasma sodium concentration.

Back 200

anion gap

Front 201

Normal anion gap.

Back 201

less than 16 mmol/L

Front 202

Characterized by hyperglycemia, high ketones, and metabolic acidosis. A diabetic emergency.

Back 202

diabetic ketoacidosis (DKA)

Front 203

Cause of diabetic ketoacidosis.

Back 203

Total lack of insulin in T1 diabetes causing severely elevated glucose levels.

Front 204

Response to hyperglycemic emergencies involves:

Back 204

- administering insulin

- IV fluids beginning with 0.9% saline

- frequent monitoring of electrolytes, fluid balance, glucose, ABGs

Front 205

Marked by heavy loss of acid from the body of by increased levels of bicarbonate. Most common causes are vomiting and gastric suction, potassium deficiency, hyperaldosteronism, diuretic therapy.

Back 205

metabolic alkalosis

Front 206

Patients at increased risk for imbalances include:

Back 206

- infants

- older adults

- severely ill

- disoriented

- immobile