224 unit 1

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Author:
j.d.harwood16
ID:
126338
Filename:
224 unit 1
Updated:
2012-01-07 01:04:48
Tags:
fluid elecrtrolyte acid base imbalance
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Description:
fluid, electrolyte, acid base imbalance
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  1. Sodium
    ECF; major cation of the ECF, and maintains ECF osmolarity

    • Na imbalances most often occur with fluid volume imbalances
    • "where Na goes, waer follows"
  2. Hyponatreimia
    • Low sodium <136mEq/L
    • Mechanism: decreased excitable depolarization/cellular swelling

    Assessment: confusion, general muscle weakness, increase motility in intestines=nausea, diarrhea abd cramping
  3. Hypernatremia
    High sodium <145mEq/L

    • Mechanism: excitable tissues increase excitability
    • Assessments: agitated, confused seizures, irregular muscle contractions and twisching, decreased contracility of heart
  4. Causes for hyponatremia
    • Fluid volume excess
    • Use/overuse of diuretics
    • Loss of Na
  5. Causes for hypernatremia
    • Fluid volume deficit
    • Excess diaphorsis
    • Renal failure (fluid overload)
    • Increased Na intake
  6. Potassium (K+)
    • ICF
    • Kidney responsible for removing most excess K
    • sSudden changes in K are more devastating and less tolerated then slow changes
  7. Hypokalemia
    • *life threatening
    • low Potassium <35mEq/L
    • Mechanism: decreased exitability of all tissues
    • Assessments: Muscle weakness=shallow breathing; decreased intestine peristalsis; thready weak pulse; altered mental status; coma
  8. Hyperkalemia
    • High Potassium >5.0mEq/L
    • Mechanism: increased cell excitability (esp heart)
    • Assessments: cardiovascular irregularities, muscle twitching progessing to muscle weakness, increased intesting motility
  9. Causes of hypokalmemia
    • Loss of K-->diuretics
    • Water intoxication
    • K loss in urine increases with older adults
  10. Causes for hyperkalemia
    • Renal failure
    • Ksparing diuretics
    • Uncontrolled diabetes mellittus
    • Dehydration
  11. Calcium (Ca2+)
    • ECF
    • Functions closesly related to phosphorus and magnesium
    • Ca absorption requres vit D
    • sotred in bones
    • Stabilizes excitable membranes (ex: decreased Na movement)
    • Sudden changes in Ca are more devastating and less tolerated then slow changes.
  12. Hypocalcemia
    • Low calcium <9.0mg/dL
    • Mechanism: Increaed Na movement across membranes = too much excitement
    • Assessment: painful muscle spasms; trousseau's and chvostek's signs, increased intestine peristalsis, loss in bone density
  13. Hypercalcemia
    • High calcium >10.5mg/dL
    • Mechanism: Decrease sensitivity of excitable membranes; increaced blood clotting
    • Assessments: Increased heart rate and BP later progressing to depressed HR, increased clotting esp legs, muscle weakness, decreased intestine peristalisis, lethargy, coma
  14. Causes of hypocalcemia
    • Decreased in parathyroid gland (does not relase Ca from bones)
    • Ca poor diet
    • Acute pancreatitis
    • Renal failure
  15. Causes for hypercalcemia
    • Excessive intake of Ca/Vit D
    • Renal failure
    • Malgnacies
    • Hyperthyroidism
    • Dehydration

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