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Ch. 41 Fluids and Electrolytes Study Guide Questions – Flashcards

Chloe Barnes

7 July 2022

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Extracellular body fluids

answer

Is the fluid outside the cell (interstitial, intravascular, and transcellular fluid)

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Intracellular body fluids

answer

Comprises all fluid within the cells of the body (42% of body weight)

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Cations

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Positively charged electrolytes (sodium, potassium, and calcium)

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Anions

answer

Negatively charged electrolytes (chloride, bicarbonate, and sulfate)

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meg/L

answer

Represents the number of grams of the specific electrolyte dissolved in a liter of plasma

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Solute

answer

Is an electrolyte; oxygen, carbon dioxide, glucose, and proteins

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Osmosis

answer

Involves the movement of a pure solvent across a semipermeable membrane from an area of lesser solute concentration to an area of greater solute concentration

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Osmols

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The concentration of a solution is measured in osmols, which reflects the amount of a substance in the form of molecules, ions, or both

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Osmotic pressure

answer

Is the drawing power of water and depends on the number of molecules in solution

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Osmolality

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The osmotic pressure of a solution

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Osmolarity

answer

Another term that describes the concentration of solution

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Isotonic solution

answer

The solutions on both sides of the semipermeable membrane are equal in concentration (expand the body's fluid volume without causing a fluid shift from one compartment to another).

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Hypertonic solution

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A solution of higher osmotic pressure (pulls fluid from cells, causing them to shrink)

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Hypotonic solution

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A solution of lower osmotic pressure (moves fluids into the cells, causing them to enlarge)

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Diffusion

answer

Random movement of a solute in a solution across a semipermeable membrane from an area of higher concentration to an area of lower concentration

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Concentration gradient

answer

The difference between two concentrations

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Filtration

answer

Is the process by which water and diffusible substances move together across a membrane, in response to fluid pressure, moving from an area of higher pressure to one of lower pressure

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Active transport

answer

Requires metabolic activity and expenditure of energy to move substances across the cell membrane

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Three ways that body fluids are regulated

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a. Fluid intake b. Hormonal controls c. Fluid output

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Osmoreceptors

answer

Continually monitor the serum osmotic pressure

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Hypovolemia

answer

Excess fluid is lost

question

Dehydration

answer

Risk for clients who are unable to perceive or respond to the thirst mechanism

question

Antidiuretic hormone

answer

Is stored in the pituitary gland and is released in response to changes in the blood osmolarity

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Angiotension I

answer

Causes vasoconstriction

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Angiotension II

answer

Causes massive selective vasoconstriction of blood vessels and relocates blood flow to kidneys and stimulates the release of aldosterone (when the sodium is low)

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Aldosterone

answer

Adrenal cortex releases in response to increased plasma potassium levels

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atrial natriuetic peptide

answer

Plays a critical role in the balance of fluid and electrolytes and the maintenance of vascular tone

question

Four organs of water loss

answer

a. Kidneys b. Skin c. Lungs d. Gastrointestinal tract

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Insensible water loss

answer

Is continuous and occurs through the skin and lungs, not perceived by the person

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Sensible water loss

answer

Occurs through excess perspiration and can be perceived by the client

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Values of Sodium

answer

135-145 mEq/L

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Values of Potassium

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3.5-5.0 mEq/L

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Values of Calcium

answer

4.5-5.5 mg/dL

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Values of Magnesium

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1.5-2.5 mEq/L

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Values of Chloride

answer

95-105 mEq/L

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Values of Bicarbonate

answer

22-26 (arterial) mEq/L 24-30 (venous) mEq/L

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Values of Phosphate

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2.8-4.5 mg/dL

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Function of Sodium

answer

Major contributor to maintain water balance

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Function of Potassium

answer

Is necessary for glycogen deposits in the liver and skeletal muscle, transmission and conduction of nerve impulses, normal cardiac conduction, and skeletal and smooth muscle contraction

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Function of Calcium

answer

Bone and teeth formation, blood clotting, hormone secretion, cell membrane integrity, cardiac conduction, transmission of nerve impulses, and muscle contraction

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Function of Magnesium

answer

Essential for enzyme activities, neurochemical activities, and cardiac and skeletal muscle excitability

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Function of Chloride

answer

Chloride is the major anion in extracellular fluid (ECF). The transport of _______ follows sodium.

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Function of Bicarbonate

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The ________ ion is an essential component of the carbonic acid-bicarbonate buffering system essential to acid-base balance.

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Function of Phosphate

answer

It assists in acid-base regulation. ______ and calcium help to develop and maintain bones and teeth. ________ also promotes normal neuromuscular action and participates in carbohydrate metabolism.

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Regulatory Mechanism of Sodium

answer

Dietary intake and aldosterone secretion

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Regulatory Mechanism of Potassium

answer

Dietary intake and renal excretion regulate this

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Regulatory Mechanism of Calcium

answer

Absorbed from intestine, excreted by the kidneys and reabsorbed or deposited in bone Regulated by parathyroid hormone, vitamin D, and calcitonin

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Regulatory Mechanism of Magnesium

answer

regulated by dietary intake, renal mechanisms, and actions of the parathyroid hormone (PTH).

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Regulatory Mechanism of Chloride

answer

regulated by dietary intake and the kidneys

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Regulatory Mechanism of Bicarbonate

answer

The kidneys regulate this

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Regulatory Mechanism of Phosphate

answer

normally absorbed through the gastrointestinal (GI) tract. It is regulated by dietary intake, renal excretion, intestinal absorption, and PTH

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Three types of acid-base regulators in the body

answer

a. Chemical b. Biological c. Physiological buffering

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Hyponatremia Lab Finding

answer

Serum sodium level below 135 mEq/L, serum osmolality 280 mOsm/kg, and urine specific gravity below 1.010 (if not caused by syndrome of inappropriate antidiuretic hormone [SIADH])

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Hyponatremia Signs and Symptoms

answer

Apprehension, personality change, postural hypotension, postural dizziness, abdominal cramping, nausea and vomiting, diarrhea, tachycardia, dry mucous membranes, convulsions, and coma

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Hypernatremia Lab Finding

answer

Serum sodium levels above 145 mEq/L, serum osmolality 300 mOsm/kg, and urine specific gravity 1.030 (if not caused by diabetes insipidus

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Hypernatremia Signs and Symptoms

answer

Extreme thirst, dry and flushed skin, dry and sticky tongue and mucous membranes, postural hypotension, fever, agitation, convulsions, restlessness, and irritability

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Hypokalemia Lab Finding

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Serum potassium level below 3.5 mEq/L and electrocardiogram (ECG) abnormalities: flattened T wave; ST segment depression; U wave; potentiated digoxin effects (e.g., ventricular dysrhythmias)

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Hypokalemia Signs and Symptoms

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Weakness and fatigue, muscle weakness, nausea and vomiting, intestinal distention, decreased bowel sounds, decreased deep tendon reflexes, ventricular dysrhythmias, paresthesias, and weak, irregular pulse

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Hyperkalemia Lab Finding

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Serum potassium level above 5.0 mEq/L and ECG abnormalities: peaked T wave and widened QRS complex (bradycardia, heart block, dysrhythmias); eventually QRS pattern widens and cardiac arrest occurs

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Hyperkalemia Signs and Symptoms

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Anxiety, dysrhythmias, paresthesia, weakness, abdominal cramps, and diarrhea

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Hypocalcemia Lab Finding

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Serum ionized calcium level below 4.5 mEq/L or total serum calcium below 8.5 mg/dL and ECG abnormalities: ventricular tachycardia

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Hypocalcemia Signs and Symptoms

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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, and pathological fractures (chronic hypocalcemia)

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Hypercalcemia Lab Finding

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Serum ionized calcium level above 5.5 mEq/L or total serum calcium level above 10.5 mg/dL; x-ray examination showing generalized osteoporosis, widespread bone cavitation, radiopaque urinary stones; and elevated blood urea nitrogen (BUN) level 25 mg/100 mL and elevated creatinine level 1.5 mg/100 mL caused by fluid volume deficit (FVD) or renal damage caused by urolithiasis; ECG abnormalities: heart block

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Hypercalcemia Signs and Symptoms

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Anorexia, nausea and vomiting, weakness, hypoactive reflexes, lethargy, flank pain (from kidney stones), decreased level of consciousness, personality changes, and cardiac arrest

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Hypomagnesemia Lab Finding

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Serum magnesium level below 1.5 mEq/L

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Hypomagnesemia Signs and Symptoms

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Muscular tremors, hyperactive deep tendon reflexes, confusion and disorientation, tachycardia, hypertension, dysrhythmias, and positive Chvostek's sign and Trousseau's sign

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Hypermagnesemia Lab Finding

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Serum magnesium level above 2.5 mEq/L; ECG abnormalities: prolonged QT interval, AV block

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Hypermagnesemia Signs and Symptoms

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Acute elevations in magnesium levels: hypoactive deep tendon reflexes, decreased depth and rate of respirations, hypotension, and flushing

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answer

Measures the hydrogen ion concentration in the body fluids (7.35 to 7.45)

question

PaCO2

answer

Is the partial pressure of carbon dioxide in arterial blood (35 to 45 mm Hg)

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PaO2

answer

Is the partial pressure of oxygen in the blood (80 to 100 mm Hg)

question

Oxygen saturation

answer

Is the point at which hemoglobin is saturated by oxygen (95% to 99%)

question

Base excess

answer

Is the amount of blood buffer (hemoglobin and bicarbonate) that exists (+/- 2 mEq/L)

question

Bicarbonate

answer

Is the major renal component of acid-base balance (22 to 26 mEq/L)

question

Respiratory acidosis Lab Findings

answer

Arterial blood gas alterations: pH 45 mm Hg, PaO2 26 mEq/L (if compensated)

question

Respiratory acidosis Signs and Symptoms

answer

Confusion, dizziness, lethargy, headache, ventricular dysrhythmias, warm and flushed skin, muscular twitching, convulsions, and coma

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Metabolic acidosis Lab Findings

answer

Arterial blood gas alterations: pH < 7.35, PaCO2 normal (if uncompensated) or < 35 mm Hg (if compensated), PaO2 normal or increased (with rapid, deep respirations), bicarbonate level < 22 mEq/L, and oxygen saturation normal

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Metabolic acidosis Signs and Symptoms

answer

Headache, lethargy, confusion, dysrhythmias, tachypnea with deep respirations, abdominal cramps, and flushed skin

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Respiratory alkalosis Lab Findings

answer

Arterial blood gas alterations: pH > 7.45, PaCO2 < 35 mm Hg, PaO2 normal, and bicarbonate level normal (if short lived or uncompensated) or < 22 mEq/L (if compensated)

question

Respiratory alkalosis Signs and Symptoms

answer

Dizziness, confusion, dysrhythmias, tachypnea, numbness and tingling of extremities, convulsions, and coma

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Metabolic alkalosis Lab Findings

answer

Arterial blood gas alterations: pH > 7.45, PaCO2 normal (if uncompensated) or > 45 mm Hg (if compensated), PaO2 normal, and bicarbonate level > 26 mEq/L

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Metabolic alkalosis Signs and Symptoms

answer

Dizziness; dysrhythmias; numbness and tingling of fingers, toes, and circumoral region; muscle cramps; tetany

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Risk factors for fluid, electrolyte and acid-base imbalances

answer

a. Age—Very young; very old b. Gender—Women c. Environment—Diet, exercise, and hot weather and sweating d. Chronic diseases—Cancer; cardiovascular disease, such as congestive heart failure; endocrine disease, such as Cushing's disease and diabetes mellitus; malnutrition; chronic obstructive pulmonary disease; and renal disease e. Trauma—Crush injuries, head injuries, burns f. Therapies—Diuretics, steroids, intravenous (IV) therapy, and total parenteral nutrition (TPN) g. Gastrointestinal losses - Gastroenteritis; nasogastric suctioning; fistulas

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How can age affect fluid, electrolyte, and acid-base balances?

answer

Infants and children have greater water needs and are more vulnerable to fluid volume alterations; fever in children creates an increase in the rate of insensible water loss; adolescents have increased metabolic processes; older adults have decreased thirst sensation, which often causes electrolyte imbalances

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How can acute illness affect fluid, electrolyte, and acid-base balances?

answer

Surgery, head and chest trauma, shock, and second- and third-degree burns place the clients at risk.

question

How can surgery affect fluid, electrolyte, and acid-base balances?

answer

The more extensive the surgery and fluid loss, the greater the body's response

question

How can burns affect fluid, electrolyte, and acid-base balances?

answer

The greater the body surface burned, the greater the fluid loss

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How can respiratory disorders affect fluid, electrolyte, and acid-base balances?

answer

Predispose to respiratory acidosis and/or respiratory alkalosis

question

How can head injury affect fluid, electrolyte, and acid-base balances?

answer

Can result in cerebral edema and diabetes insipidus

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How can chronic illness affect fluid, electrolyte, and acid-base balances?

answer

Cancer, congestive heart failure (CHF), or renal disease

question

How can cancer affect fluid, electrolyte, and acid-base balances?

answer

Depends on the type and progression of the cancer and its treatment (diarrhea and anorexia)

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How can cardiovascular disease affect fluid, electrolyte, and acid-base balances?

answer

Diminished cardiac output, which reduces kidney perfusion and decreases urine output

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How can renal disorders affect fluid, electrolyte, and acid-base balances?

answer

Causes an abnormal retention of sodium, chloride, potassium, and water (metabolic acidosis)

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How can gastrointestinal disturbances affect fluid, electrolyte, and acid-base balances?

answer

Gastroenteritis and nasogastric suctioning result in the loss of fluid, potassium, and chloride ions.

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How can environmental factors affect fluid, electrolyte, and acid-base balances?

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Vigorous exercise or exposure to extreme temperatures

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How can diet affect fluid, electrolyte, and acid-base balances?

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Recent changes in appetite or the ability to chew and swallow (breakdown of glycogen and fat stores, metabolic acidosis, hypoalbuminemia, edema)

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How can lifestyle affect fluid, electrolyte, and acid-base balances?

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History of smoking or alcohol consumption (respiratory acidosis)

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How can medication affect fluid, electrolyte, and acid-base balances?

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Diuretics—Metabolic alkalosis, hyperkalemia, and hypokalemia Steroids—Metabolic alkalosis Potassium supplements—GI disturbances, including intestinal and gastric ulcers and diarrhea Respiratory center depressants (e.g., opioid analgesics)—Decreased rate and depth of respirations, resulting in respiratory acidosis Antibiotics—Nephrotoxicity (e.g., vancomycin, methicillin, or aminoglycosides); hyperkalemia and/or hypernatremia (e.g., azlocillin, carbenicillin, piperacillin, ticarcillin, or Unasyn) Calcium carbonate (Tums)—Mild metabolic alkalosis with nausea and vomiting Magnesium hydroxide (Milk of Magnesia)—Hypokalemia Nonsteroidal antiinflammatory drugs—Nephrotoxicity

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Imbalances associated with Weight loss of 5% to 8%:

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Mild to moderate fluid volume deficit (FVD)

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Imbalances associated with Irritability

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Metabolic or respiratory alkalosis, hyperosmolar imbalance, hypernatremia, hypokalemia

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Imbalances associated with Lethargy

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FVD, metabolic acidosis or alkalosis, respiratory acidosis, hypercalcemia

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Imbalances associated with Periorbital edema

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Fluid volume excess (FVE)

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Imbalances associated with Sticky, dry mucous membranes

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FVD, hypernatremia

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Imbalances associated with Chvostek's sign

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Hypocalcemia

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Imbalances associated with Distended neck veins

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FVE

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Imbalances associated with Dysrhythmias

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Metabolic acidosis, respiratory alkalosis and acidosis, potassium imbalance, hypomagnesemia

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Imbalances associated with Weak pulse

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FVD, hypokalemia

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Imbalances associated with Low blood pressure

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FVD, hyponatremia, hyperkalemia, hypermagnesemia

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Imbalances associated with Third heart sound

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FVE

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Imbalances associated with Increased respiratory rate

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FVE, respiratory alkalosis, metabolic acidosis

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Imbalances associated with Crackles

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FVE

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Imbalances associated with Anorexia

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Metabolic acidosis

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Imbalances associated with Abdominal cramps

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Metabolic acidosis

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Imbalances associated with Poor skin turgor

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FVD

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Imbalances associated with Oliguria or anuria

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FVD, FVE

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Imbalances associated with Increased specific gravity

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FVD

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Imbalances associated with Muscle cramps, tetany

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: Hypocalcemia, metabolic or respiratory alkalosis

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Imbalances associated with Hypertonicity of muscles on palpation

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Hypocalcemia, hypomagnesemia, metabolic alkalosis

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Imbalances associated with Decreased or absent deep tendon reflexes

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Hypokalemia, hypercalcemia

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Imbalances associated with Increased temperature

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Hypernatremia, hyperosmolar imbalance, metabolic acidosis

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Imbalances associated with Distended abdomen

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Third-space syndrome

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Imbalances associated with Cold, clammy skin

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FVD

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Imbalances associated with 2+ edema

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FVE

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question

Extracellular body fluids

answer

Is the fluid outside the cell (interstitial, intravascular, and transcellular fluid)

question

Intracellular body fluids

answer

Comprises all fluid within the cells of the body (42% of body weight)

question

Cations

answer

Positively charged electrolytes (sodium, potassium, and calcium)

question

Anions

answer

Negatively charged electrolytes (chloride, bicarbonate, and sulfate)

question

meg/L

answer

Represents the number of grams of the specific electrolyte dissolved in a liter of plasma

question

Solute

answer

Is an electrolyte; oxygen, carbon dioxide, glucose, and proteins

question

Osmosis

answer

Involves the movement of a pure solvent across a semipermeable membrane from an area of lesser solute concentration to an area of greater solute concentration

question

Osmols

answer

The concentration of a solution is measured in osmols, which reflects the amount of a substance in the form of molecules, ions, or both

question

Osmotic pressure

answer

Is the drawing power of water and depends on the number of molecules in solution

question

Osmolality

answer

The osmotic pressure of a solution

question

Osmolarity

answer

Another term that describes the concentration of solution

question

Isotonic solution

answer

The solutions on both sides of the semipermeable membrane are equal in concentration (expand the body's fluid volume without causing a fluid shift from one compartment to another).

question

Hypertonic solution

answer

A solution of higher osmotic pressure (pulls fluid from cells, causing them to shrink)

question

Hypotonic solution

answer

A solution of lower osmotic pressure (moves fluids into the cells, causing them to enlarge)

question

Diffusion

answer

Random movement of a solute in a solution across a semipermeable membrane from an area of higher concentration to an area of lower concentration

question

Concentration gradient

answer

The difference between two concentrations

question

Filtration

answer

Is the process by which water and diffusible substances move together across a membrane, in response to fluid pressure, moving from an area of higher pressure to one of lower pressure

question

Active transport

answer

Requires metabolic activity and expenditure of energy to move substances across the cell membrane

question

Three ways that body fluids are regulated

answer

a. Fluid intake b. Hormonal controls c. Fluid output

question

Osmoreceptors

answer

Continually monitor the serum osmotic pressure

question

Hypovolemia

answer

Excess fluid is lost

question

Dehydration

answer

Risk for clients who are unable to perceive or respond to the thirst mechanism

question

Antidiuretic hormone

answer

Is stored in the pituitary gland and is released in response to changes in the blood osmolarity

question

Angiotension I

answer

Causes vasoconstriction

question

Angiotension II

answer

Causes massive selective vasoconstriction of blood vessels and relocates blood flow to kidneys and stimulates the release of aldosterone (when the sodium is low)

question

Aldosterone

answer

Adrenal cortex releases in response to increased plasma potassium levels

question

atrial natriuetic peptide

answer

Plays a critical role in the balance of fluid and electrolytes and the maintenance of vascular tone

question

Four organs of water loss

answer

a. Kidneys b. Skin c. Lungs d. Gastrointestinal tract

question

Insensible water loss

answer

Is continuous and occurs through the skin and lungs, not perceived by the person

question

Sensible water loss

answer

Occurs through excess perspiration and can be perceived by the client

question

Values of Sodium

answer

135-145 mEq/L

question

Values of Potassium

answer

3.5-5.0 mEq/L

question

Values of Calcium

answer

4.5-5.5 mg/dL

question

Values of Magnesium

answer

1.5-2.5 mEq/L

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Values of Chloride

answer

95-105 mEq/L

question

Values of Bicarbonate

answer

22-26 (arterial) mEq/L 24-30 (venous) mEq/L

question

Values of Phosphate

answer

2.8-4.5 mg/dL

question

Function of Sodium

answer

Major contributor to maintain water balance

question

Function of Potassium

answer

Is necessary for glycogen deposits in the liver and skeletal muscle, transmission and conduction of nerve impulses, normal cardiac conduction, and skeletal and smooth muscle contraction

question

Function of Calcium

answer

Bone and teeth formation, blood clotting, hormone secretion, cell membrane integrity, cardiac conduction, transmission of nerve impulses, and muscle contraction

question

Function of Magnesium

answer

Essential for enzyme activities, neurochemical activities, and cardiac and skeletal muscle excitability

question

Function of Chloride

answer

Chloride is the major anion in extracellular fluid (ECF). The transport of _______ follows sodium.

question

Function of Bicarbonate

answer

The ________ ion is an essential component of the carbonic acid-bicarbonate buffering system essential to acid-base balance.

question

Function of Phosphate

answer

It assists in acid-base regulation. ______ and calcium help to develop and maintain bones and teeth. ________ also promotes normal neuromuscular action and participates in carbohydrate metabolism.

question

Regulatory Mechanism of Sodium

answer

Dietary intake and aldosterone secretion

question

Regulatory Mechanism of Potassium

answer

Dietary intake and renal excretion regulate this

question

Regulatory Mechanism of Calcium

answer

Absorbed from intestine, excreted by the kidneys and reabsorbed or deposited in bone Regulated by parathyroid hormone, vitamin D, and calcitonin

question

Regulatory Mechanism of Magnesium

answer

regulated by dietary intake, renal mechanisms, and actions of the parathyroid hormone (PTH).

question

Regulatory Mechanism of Chloride

answer

regulated by dietary intake and the kidneys

question

Regulatory Mechanism of Bicarbonate

answer

The kidneys regulate this

question

Regulatory Mechanism of Phosphate

answer

normally absorbed through the gastrointestinal (GI) tract. It is regulated by dietary intake, renal excretion, intestinal absorption, and PTH

question

Three types of acid-base regulators in the body

answer

a. Chemical b. Biological c. Physiological buffering

question

Hyponatremia Lab Finding

answer

Serum sodium level below 135 mEq/L, serum osmolality 280 mOsm/kg, and urine specific gravity below 1.010 (if not caused by syndrome of inappropriate antidiuretic hormone [SIADH])

question

Hyponatremia Signs and Symptoms

answer

Apprehension, personality change, postural hypotension, postural dizziness, abdominal cramping, nausea and vomiting, diarrhea, tachycardia, dry mucous membranes, convulsions, and coma

question

Hypernatremia Lab Finding

answer

Serum sodium levels above 145 mEq/L, serum osmolality 300 mOsm/kg, and urine specific gravity 1.030 (if not caused by diabetes insipidus

question

Hypernatremia Signs and Symptoms

answer

Extreme thirst, dry and flushed skin, dry and sticky tongue and mucous membranes, postural hypotension, fever, agitation, convulsions, restlessness, and irritability

question

Hypokalemia Lab Finding

answer

Serum potassium level below 3.5 mEq/L and electrocardiogram (ECG) abnormalities: flattened T wave; ST segment depression; U wave; potentiated digoxin effects (e.g., ventricular dysrhythmias)

question

Hypokalemia Signs and Symptoms

answer

question

Hyperkalemia Lab Finding

answer

Serum potassium level above 5.0 mEq/L and ECG abnormalities: peaked T wave and widened QRS complex (bradycardia, heart block, dysrhythmias); eventually QRS pattern widens and cardiac arrest occurs

question

Hyperkalemia Signs and Symptoms

answer

Anxiety, dysrhythmias, paresthesia, weakness, abdominal cramps, and diarrhea

question

Hypocalcemia Lab Finding

answer

Serum ionized calcium level below 4.5 mEq/L or total serum calcium below 8.5 mg/dL and ECG abnormalities: ventricular tachycardia

question

Hypocalcemia Signs and Symptoms

answer

question

Hypercalcemia Lab Finding

answer

question

Hypercalcemia Signs and Symptoms

answer

Anorexia, nausea and vomiting, weakness, hypoactive reflexes, lethargy, flank pain (from kidney stones), decreased level of consciousness, personality changes, and cardiac arrest

question

Hypomagnesemia Lab Finding

answer

Serum magnesium level below 1.5 mEq/L

question

Hypomagnesemia Signs and Symptoms

answer

Muscular tremors, hyperactive deep tendon reflexes, confusion and disorientation, tachycardia, hypertension, dysrhythmias, and positive Chvostek's sign and Trousseau's sign

question

Hypermagnesemia Lab Finding

answer

Serum magnesium level above 2.5 mEq/L; ECG abnormalities: prolonged QT interval, AV block

question

Hypermagnesemia Signs and Symptoms

answer

Acute elevations in magnesium levels: hypoactive deep tendon reflexes, decreased depth and rate of respirations, hypotension, and flushing

question

answer

Measures the hydrogen ion concentration in the body fluids (7.35 to 7.45)

question

PaCO2

answer

Is the partial pressure of carbon dioxide in arterial blood (35 to 45 mm Hg)

question

PaO2

answer

Is the partial pressure of oxygen in the blood (80 to 100 mm Hg)

question

Oxygen saturation

answer

Is the point at which hemoglobin is saturated by oxygen (95% to 99%)

question

Base excess

answer

Is the amount of blood buffer (hemoglobin and bicarbonate) that exists (+/- 2 mEq/L)

question

Bicarbonate

answer

Is the major renal component of acid-base balance (22 to 26 mEq/L)

question

Respiratory acidosis Lab Findings

answer

Arterial blood gas alterations: pH 45 mm Hg, PaO2 26 mEq/L (if compensated)

question

Respiratory acidosis Signs and Symptoms

answer

Confusion, dizziness, lethargy, headache, ventricular dysrhythmias, warm and flushed skin, muscular twitching, convulsions, and coma

question

Metabolic acidosis Lab Findings

answer

question

Metabolic acidosis Signs and Symptoms

answer

Headache, lethargy, confusion, dysrhythmias, tachypnea with deep respirations, abdominal cramps, and flushed skin

question

Respiratory alkalosis Lab Findings

answer

Arterial blood gas alterations: pH > 7.45, PaCO2 < 35 mm Hg, PaO2 normal, and bicarbonate level normal (if short lived or uncompensated) or < 22 mEq/L (if compensated)

question

Respiratory alkalosis Signs and Symptoms

answer

Dizziness, confusion, dysrhythmias, tachypnea, numbness and tingling of extremities, convulsions, and coma

question

Metabolic alkalosis Lab Findings

answer

Arterial blood gas alterations: pH > 7.45, PaCO2 normal (if uncompensated) or > 45 mm Hg (if compensated), PaO2 normal, and bicarbonate level > 26 mEq/L

question

Metabolic alkalosis Signs and Symptoms

answer

Dizziness; dysrhythmias; numbness and tingling of fingers, toes, and circumoral region; muscle cramps; tetany

question

Risk factors for fluid, electrolyte and acid-base imbalances

answer

question

How can age affect fluid, electrolyte, and acid-base balances?

answer

question

How can acute illness affect fluid, electrolyte, and acid-base balances?

answer

Surgery, head and chest trauma, shock, and second- and third-degree burns place the clients at risk.

question

How can surgery affect fluid, electrolyte, and acid-base balances?

answer

The more extensive the surgery and fluid loss, the greater the body's response

question

How can burns affect fluid, electrolyte, and acid-base balances?

answer

The greater the body surface burned, the greater the fluid loss

question

How can respiratory disorders affect fluid, electrolyte, and acid-base balances?

answer

Predispose to respiratory acidosis and/or respiratory alkalosis

question

How can head injury affect fluid, electrolyte, and acid-base balances?

answer

Can result in cerebral edema and diabetes insipidus

question

How can chronic illness affect fluid, electrolyte, and acid-base balances?

answer

Cancer, congestive heart failure (CHF), or renal disease

question

How can cancer affect fluid, electrolyte, and acid-base balances?

answer

Depends on the type and progression of the cancer and its treatment (diarrhea and anorexia)

question

How can cardiovascular disease affect fluid, electrolyte, and acid-base balances?

answer

Diminished cardiac output, which reduces kidney perfusion and decreases urine output

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How can renal disorders affect fluid, electrolyte, and acid-base balances?

answer

Causes an abnormal retention of sodium, chloride, potassium, and water (metabolic acidosis)

question

How can gastrointestinal disturbances affect fluid, electrolyte, and acid-base balances?

answer

Gastroenteritis and nasogastric suctioning result in the loss of fluid, potassium, and chloride ions.

question

How can environmental factors affect fluid, electrolyte, and acid-base balances?

answer

Vigorous exercise or exposure to extreme temperatures

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How can diet affect fluid, electrolyte, and acid-base balances?

answer

Recent changes in appetite or the ability to chew and swallow (breakdown of glycogen and fat stores, metabolic acidosis, hypoalbuminemia, edema)

question

How can lifestyle affect fluid, electrolyte, and acid-base balances?

answer

History of smoking or alcohol consumption (respiratory acidosis)

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How can medication affect fluid, electrolyte, and acid-base balances?

answer

question

Imbalances associated with Weight loss of 5% to 8%:

answer

Mild to moderate fluid volume deficit (FVD)

question

Imbalances associated with Irritability

answer

Metabolic or respiratory alkalosis, hyperosmolar imbalance, hypernatremia, hypokalemia

question

Imbalances associated with Lethargy

answer

FVD, metabolic acidosis or alkalosis, respiratory acidosis, hypercalcemia

question

Imbalances associated with Periorbital edema

answer

Fluid volume excess (FVE)

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Imbalances associated with Sticky, dry mucous membranes

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FVD, hypernatremia

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Imbalances associated with Chvostek's sign

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Hypocalcemia

question

Imbalances associated with Distended neck veins

answer

FVE

question

Imbalances associated with Dysrhythmias

answer

Metabolic acidosis, respiratory alkalosis and acidosis, potassium imbalance, hypomagnesemia

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Imbalances associated with Weak pulse

answer

FVD, hypokalemia

question

Imbalances associated with Low blood pressure

answer

FVD, hyponatremia, hyperkalemia, hypermagnesemia

question

Imbalances associated with Third heart sound

answer

FVE

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Imbalances associated with Increased respiratory rate

answer

FVE, respiratory alkalosis, metabolic acidosis

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Imbalances associated with Crackles

answer

FVE

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Imbalances associated with Anorexia

answer

Metabolic acidosis

question

Imbalances associated with Abdominal cramps

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Metabolic acidosis

question

Imbalances associated with Poor skin turgor

answer

FVD

question

Imbalances associated with Oliguria or anuria

answer

FVD, FVE

question

Imbalances associated with Increased specific gravity

answer

FVD

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Imbalances associated with Muscle cramps, tetany

answer

: Hypocalcemia, metabolic or respiratory alkalosis

question

Imbalances associated with Hypertonicity of muscles on palpation

answer

Hypocalcemia, hypomagnesemia, metabolic alkalosis

question

Imbalances associated with Decreased or absent deep tendon reflexes

answer

Hypokalemia, hypercalcemia

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Imbalances associated with Increased temperature

answer

Hypernatremia, hyperosmolar imbalance, metabolic acidosis

question

Imbalances associated with Distended abdomen

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Third-space syndrome

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Imbalances associated with Cold, clammy skin

answer

FVD

question

Imbalances associated with 2+ edema

answer

FVE

Ch. 41 Fluids and Electrolytes Study Guide Questions – Flashcards

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