Fluid/Electrolytes

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Author:
kathleenagrace
ID:
53963
Filename:
Fluid/Electrolytes
Updated:
2010-12-07 00:50:20
Tags:
nursing fluid electrolytes
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Description:
test 4
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  1. What does ROME mean?
    • RO: Respiratory Opposite
    • Resp Acidosis: ↓ pH ↑ paCO2
    • Resp Alkalosis: ↑ pH ↓ paCO2

    • ME: Metabolic Equal
    • Met Acidosis: ↓ pH ↓ HCO3-
    • Met Alkalosis: ↑ pH ↑ HCO3-
  2. What can cause Respiratory Acidosis?
    • Hypoventilation
    • Drug Overdose
    • Airway Obstruction
    • Pulmonary Edema
    • Chest Trauma
    • COPD
  3. What can cause Metabolic Acidosis?
    • DKA
    • Shock
    • Sepsis
    • Diarrhea
    • Renal Failure
    • Salicyate Overdose
  4. What can cause Respiratory Alkalosis?
    • Hyperventilation
    • Anxiety
    • High Altitudes
    • Pregnancy
    • Fever
    • Hypoxia
    • Initial Pulmonary Embolism
  5. What can cause Metabolic Alkalosis?
    • Lost Gastric Juices (vomiting)
    • Potassium-Wasting Diuretics
    • Overuse of Antacids
  6. What are some manifestations of Respiratory Acidosis?
    • ↓ pH (↓ 7.35)
    • ↑ paCO2 (↑ 45 mmHg)
    • Hypoventilation = Hypoxia
    • Rapid, Shallow Breaths
    • Dyspnea
    • ↓ BP w/vasodilation
    • Hyperkalemia w/ Dysrhythmias
    • Drowzy, Dizzy, Disoriented, HA
    • Muscle Weakness or Hyperreflexia
    • Retention of CO2 in lungs
  7. What are some manifestions of Respiratory Alkalosis?
    • ↑ pH (↑ 7.45)
    • ↓ paCO2 (↓ 35 mmHg)
    • Hyperventilation
    • Deep, Rapid Breathing
    • Tachycardia
    • ↓ BP
    • Seizures
    • Lethargy, Confusion, Light-Headedness
    • Nausea/Vomiting
    • Hypokalemia
    • Numbness/Tingling
  8. What are some manifestations of Metabolic Acidosis?
    • ↓ pH (↓ 7.35)
    • ↓ HCO3 (↓ 22 mEq/L)
    • Compensatory Hyperventilation
    • ↓ BP
    • Change in LOC, Confusion, HA, Drowzy
    • Hyperkalemia, Muscle Twitching
    • Warm, Flushed Skin
    • N/V, Diarrhea
  9. What are some manifestations of Metabolic Alkalosis?
    • ↑ pH (↑ 7.45)
    • ↑ HCO3 (↑ 26 mEq/L)
    • Compensatory Hypoventilation
    • Dysrhythmias, Tachycardia
    • Dizzy, Confusion, ↓ LOC, Irritability
    • N/V, Diarrhea
    • Tingling, Tremors, Cramps
    • Hypokalemia
  10. Does potassium increase or decrease during acidosis?
    Increase
  11. Under what conditions should you watch potassium levels?
    • Renal Failure
    • Hydration Imbalances
    • Acid-Base Imbalances
    • Cellular Damage (burns, accidents, srgry)
    • Diabetes
    • Digitalis
    • Diuretics
    • IV Fluids
  12. What are some signs of Hyperkalemia?
    • Muscle: Twitches, Cramps, Paresthesia
    • CNS: Irritability, Anxiety
    • Heart: ↓ BP, EKG Δ, Dysrhythmia
    • GI: Diarrhea, Abd Cramps
  13. What are some s/sx Hypokalemia?
    "ASIC WALT"
    • A: Alkalosis
    • S: Shallow Breathing
    • I: Irritability
    • C: Confusion, Drowsiness

    • W: Weakness, Fatigue
    • A: Arrhythmias
    • L: Lethargy
    • T: Thready Pulse
  14. What are the functions of Sodium?
    • nerve impulses
    • Na/K Pump
    • Control/Regulate Body Fluid Volume
    • Maintain Water Balance
    • Primary Regulator of ECF Volume
  15. Regulation of Sodium?
    • maintained in narrow range
    • deviations quickly become serious to health
    • affected by both salt and water intake
    • conserved by reabsorption in kidneys by aldosterone
  16. Primary solvent, medium for transport, facilitates, metabolism and chemical process, maintain temperature, facilitate digestion and elimination, tissue lubricant
    Water
  17. Total Body Water Fluid:
    • total amount of water in body
    • 50-60% body weight
  18. What is Intracellular Fluid?
    • ICF: inside the cell
    • 35-40% body weight
  19. What is Extracellular Fluid?
    • ECF: outside the cell
    • 15-20% body weight
    • provides nourishment and receives wastes to/from each cell
  20. What is Intravascular Fluid?
    • IntraVascular: 5% TBW
    • Plasma; liquid component of blood
  21. What is Interstitial Fluid?
    • Interstitial: 10-15% TBW
    • between cells and tissues
    • includes lymph
  22. Explain Osmosis:
    • Semipermeable membrane: some solutes pass, some don’t
    • MAJOR METHOD of transporting body fluid
    • Water shifts from low solute concentration to high solute concentration to reach equilibrium
    • An increased difference in solute concentrations mean an increased OSMOTIC PRESSURE
  23. What is Diffusion?
    • Tendency of solutes to move freely throughout a solution
    • Solutes move from area of high concentration to low concentration
    • Ex. O2 and CO2 in lungs
  24. What is Active Transport?
    • Active Transport “Pump Action”
    • Requires ATP energy to pump solutes across membrane from high concentration to low concentration
    • Ex. amino acid, some glucose, sodium, chloride, potassium, hydrogen, calcium, magnesium, phosphate
  25. Explain Filtration:
    Factilitates passage of fluid through a permeable membrane from area of high concentration to low concentration
  26. Explain the Thirst Mechanism in Homeostasis:
    • Regulatory center in hypothalamus
    • Triggered in response to low blood volume, intracellular dehydration
    • (ADH hormone)
  27. Explain role of Kidneys in Homeostatis:
    • Kidneys: “master chemist”
    • Normally filters 180L plasma/day
    • Only produces 1.5L urine/day
    • Selectively retains or excretes electrolytes and water based on body’s needs
    • Regulates pH by excreting H+ ions
    • Excretes wastes and toxic substances
  28. Explain the role of the Lungs to maintain Homeostasis:
    • Lungs: fast-acting
    • ACID-BASE BALANCE
    • Regulates 02 and CO2 levels
    • Metabolic Alkalosis: lungs hypoventilate to increase CO2 and decrease O2
    • Metabolic Acidosis: lungs hyperventilate to decrease CO2 and increase O2
  29. Role of Heart/Blood Vessels in Homeostasis:
    • Circulates blood through kidneys to produce urine
    • Stimulated fluid retention in Hypovolemia
  30. Role of Parathyroid Gland in Homeostasis:
    • PTH regulates calcium and phosphate levels
    • REABSORPTION of calcium from [bones, kidneys, sm. int.] and into blood
    • Phosphorous from blood enters kidney and excretes in urine
  31. Role of Adrenal Glad in Homeostasis:
    • Regulates Blood Volume and Sodium-Potassium balance
    • Secretes Aldosterone to retain sodium and excrete potassium
  32. Role of Pituitary Gland in Homeostasis:
    • ADH hormone for increased water retention
    • Maintain osmotic pressure
    • Controls Blood Volume
  33. What are Buffer Systems? Name 3.
    • Buffer Systems: prevent body fluids from becoming too acidic or alkalotic
    • --Carbonic Acid-Sodium System
    • --Phosphate System
    • --Protein System
  34. Respiratory Mechanism:
    Buffer
    • (short term)
    • Primary controller of carbonic acid
    • Acidic: increase in CO2 stimulates the medulla to increase rate/depth respiration to decrease carbonic acid and become more alkaline
    • Alkolitic: decrease in CO2 stimulates the medulla to decrease rate/depth of respirations to increase carbonic acid and become more acidic
  35. Renal Mechanism:
    Buffer
    • (takes longer, about 3 days)
    • Primary controller of bicarbonate concentration
    • Excretes or retains H+ ions and forms or excretes bicarbonate ions in response to pH of blood
    • Acidosis: excrete H+, form and conserve bicarbonate
    • Alkalosis: retain H+, excrete bicarbonate
    • NORMAL pH of URINE: 4.2-8.5
  36. What is a Hypertonic solution?
    • [3% saline solution]
    • more solutes than own blood
    • (solution pulls fluid from body)
  37. What is an Isotonic solution?
    • [0.9% saline, most like blood]
    • “even”=most like your serum/blood
    • (there should not be any substantial difference in the way the blood works)
    • for replacement of fluid in your vascular space
  38. What is a Hypotonic Solution?
    • [0.3% normal saline or 0.45% 1/2normal saline]
    • less solutes than own blood
    • (body pulls fluid from solution)
  39. What are s/sx Fluid Deficit?
    • Eyes sunken
    • Halosis
    • Dry mouth: mucous membrane, chapped/ dry lips
    • Dry skin
    • Decreased skin turgor
    • Central cyanosis of tongue, maybe deep furrows
    • Weight loss
    • Fatigued
    • Pale
  40. What is an Acid?
    Acid: substance contains hydrogen ions that can be contained or released
  41. What is a Base?
    Base: has an affinity for hydrogen ions, traps them

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