Path Test 1

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  1. dyspnea, orthopnea
    sign of what imbalance?
    shortness of breath

    ECV Excess
  2. effervescent medications can cause what fluid imbalance?
    • ECV Excess
    • lots of sodium -> retain fluids
  3. what fluid do you give for ECV deficit?
    normal saline (isotonic)
  4. what solution do you need to treat hypernatremia?
  5. in clinical dehydration, what solutions do you use to treat?
    • first normal saline (address low blood volume first)
    • then address concentration problem with 1/2 normal saline, 1/2 d5w
  6. oliguria
    low urine output
  7. what effect would renal failure have on fluid levels?
    decrease Na+/H20 output
  8. cirrhosis and congestive heart failure both prompt what hormonal change?  What does this do to fluid levels?
    • secretion of excessive aldosterone
    • decrease Na+/H20 output
  9. diuresis
    excessive output of urine
  10. bedrest can cause what to happen to fluid balances?
    diuresis- increased urine output (legs are at same level of heart -> increased renal output)
  11. crackles and rales are a a sign of which fluid imbalance?
    ECV excess
  12. dyspnea/orthopnea are signs of which fluid imblance?
    ECV excess
  13. lightheadedness may be a sign of which fluid imbalance?
    ecv deficit
  14. soft, sunken eyeballs and longitudinal furrows in tongue are a sign of which fluid imbalance?
    ECV deficit
  15. serum sodium concentration reflects osmolality of just blood, or whole body?
    just blood/other body fluids
  16. diabetes insipidus may cause which fluid imbalance?
    • hypernatremia
    • lose more water than salt
  17. with excess sweating and diarrhea (without replacement), do you lose more water, more salt, or equal amounts of both?
    more water than salt -> hypernatremia
  18. if an older adult is on diuretic therapy, are they at risk to lose more water, more salt, or equal amounts of both?
    lose more salt than water
  19. seizures and coma may be a sign of what osmolality imbalance?
    hypernatremia AND hyponatremia
  20. nausea and emesis: which osmolality imbalance?
  21. why do both hyper and hyponatremia cause confusion and lethargy?
    • alter the way neurons function
    • hypo: brain cell swells
    • hyper: cell shrivels
  22. which hormone puts calcium into blood?
    parathyroid hormone
  23. which hormone removes calcium from blood?
  24. is calcium that is bound to albumin in blood physiologically active?
    no, needs to be free
  25. which electrolyte imbalances are floppy?
    • hyperkalemia
    • hypokalemia
    • hypermagnesemia
    • hypercalcemia
  26. which electrolyte imbalances are twitchy?
    • hypocalcemia
    • hypomagnesemia
  27. what do you need for optimal absorption of calcium?
    vitamin D
  28. what can cause a deficit of calcium, potassium or magnesium?  (general)
    take in less than put out, supply shifts from available form to storage pool
  29. what can cause an electrolyte excess?  (general)
    greater intake than output, supply shifts from storage pool into plasma
  30. how does steatorrhea affect calcium levels?
    • undigested fats bind to calcium
    • may decrease intake/absorption
    • may increase output
  31. acute diarrhea may lead to which electrolyte imbalance?
    hypokalemia (increased excretion)
  32. how does pancreatitis affect electrolyte levels?
    • can't digest fat -> undigested fat in colon
    • calcium and magnesium bind to fat and are excreted
  33. what hormone do low magnesium levels affect?  What does this cause?
    hypomagnesium -> low parathyroid -> calcium does not shift from bone to available blood
  34. signs of hypocalcemia
    • positive Chvostek sign
    • positive Trousseau sign
    • muscle twitching, cramping
    • grimacing
    • carpopedal spasm
    • tetany
    • laryngospasm
    • seizures
    • cardiac dysrhythmias
  35. signs and symptoms of hypercalcemia
    • anorexia
    • constipation
    • nausea/emesis
    • muscle weakness, fatigue
    • polyuria
  36. if hypercalcemia, what should you do to your fluid intake?
    drink a lot of fluid to keep urine dilute (prevents renal damage)
  37. calcium rich foods
    • almonds
    • cream of wheat
    • chocolate
    • fish with bones (salmon, sardines)
    • oranges/oj
    • oysters
    • tofu
    • corn tortillas
    • DGLV's
  38. what 3 things cause potassium to move out of plasma and into cells?
    insulin, alkalosis, epinephrine
  39. high levels of potassium in the blood stimulate the release of what hormone?
  40. factors that decrease K+ intake
    • NPO status
    • anorexia
    • unusual weight-loss diet w/o K+
    • IV therapy w/o K+
  41. factors that increase K+ intake
    • too much/too fast IV with KCl
    • insufficient mixing of IV bag
    • administration of stored blood
  42. cushing's syndrome (glucocorticoid excess) make cause what electrolye imbalance?
    increased output of potassium
  43. hypomagnesemia may cause increased output of which electrolyte?
    • potassium
    • (also causes shift of calcium into bone)
  44. potassium imbalances affect what?
    smooth, skeletal and cardiac muscles
  45. bilateral and ascending flaccid paralysis may indicate what?
    • hypokalemia
    • hyperkalemia (doesn't ascend as far)
  46. dysrhythmias caused by _______ are among the potentially most dangerous ones
  47. abdominal distension, decreased bowel sounds, constipation, polyuria, flaccid skeletal muscle weakness and cardian dysrhythmias
  48. flaccid skeletal muscle weakness, transient intestinal cramping and diarrhea, cardiac dysrhythmias
  49. salt substitutes put you at risk for which imbalance?
    hyperkalemia (contain KCl)
  50. potassium rich foods
    • apricots
    • canteloupe
    • dates
    • figs
    • grapefruit
    • kiwi
    • oranges/oj
    • peaches
    • prunes
    • raisins
    • strawberrys
    • aspragus
    • beets/green beans
    • broccoli
    • carrots, cauliflower, celery, potatoes
    • pumpkin, squash
    • almonds, brazil nuts, cashews, sunflower seeds
    • instant coffee
  51. chronic alcoholism and magnesium
    causes increased output (undigested fats from liver failure?)
  52. steatorrhea
    unbound fats may bind to magnesium or calcium -> decreased intake/absorption, increased output
  53. aspiration of sea water may increase levels of which electrolyte?
  54. positive chvostek and trousseau sign are signs of what imbalances?
    hypomagnesemia, hypocalcemia
  55. magnesium imbalances affect what?
    neuromuscular excitability, deep tendon reflexes
  56. an exaggerated patellar reflex may be a sign of
  57. decreased reflex response
  58. magnesium rich foods
    • cocoa
    • coffee
    • egg yolk
    • DGLV's -> have chlorophyll
    • legumes
    • milk
    • meat
    • nuts
    • whole grain cereals
Card Set:
Path Test 1
2013-10-29 04:26:42

Path midterm 1- fall 13
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