question

Homeostasis

answer

-Ability to maintain internal equilibrium by adjusting physiologic processes -Reestablishment and maintenance a goal in managing fluid, electrolyte, and acid-base imbalance

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Water

answer

-transport of nutrients -medium for metabolic reactions -regulation of body temperature

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Electrolytes

answer

-water balance regulation -acid-base balance -enzyme reaction -neuromuscular activity

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Intracellular fluid (ICF)

answer

-found within cells -essential for normal cell division --40% of total body weight

question

Extracellular fluid (ECF)

answer

-located outside of cells -interstitial fluid -intravascular fluid -transcellular fluid -20% of total body weight

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(ICF) contains solutes

answer

-Potassium -Magnesium -Phosphate -glucose -oxygen

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(ECF) contains solutes

answer

-sodium -chloride -bicarbonate

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Osmosis

answer

-concentration of a solution -osmotic pressure and tonicity

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Diffusion

answer

-simple -facilitated(carrier-mediated)

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filtration

answer

-balance of hydrostatic osmotic pressure

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active transport

answer

-sodium-potassium pump

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Thirst

answer

-primary regulator of water intake

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Kidneys

answer

regulates volume, osmolality of body fluids

question

Renin-angiotensin-aldosterone system

answer

helps maintain intravascular fluid balance and blood pressure

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Antidiuretic hormone

answer

regulates water excretion from kidneys

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Atrial natriuretic peptide

answer

released by atrial muscle cells in response to distention from fluid overload

question

The Patient with a Fluid Volume Deficit: Causes

answer

-vomiting and diarrhea -gastrointestinal suctioning, intestinal fistulas, and intestinal drainage -diuretics, renal disorders, and endocrine disorders -hot environment -hemorrhage

question

The Patient with a fluid volume deficit: Patho

answer

-hypovolemia from loss of ECF -Third Spacing shift of fluid out of vascular space into unusable space triggered by stress hormones difficult assessment shock, multiorgan failure

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The Patient with a Fluid volume deficit: Manifestations

answer

-rapid weight loss and pale skin -decrease in skin turgor and urine output -Tachycardia -decreased systolic blood pressure and venous pressure

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The Patient with fluid volume deficit: Fluid management

answer

-oral rehydration(safest) -IV therapy

question

the patient with fluid volume deficit: Interprofessional care

answer

-Diagnosis serum electrolytes serum osmolality hemoglobin and hematocrit urine specific gravity and osmolality hemodynamic pressures

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fluid volume deficit: health promotion

answer

-teaching to prevent fluid volume deficits -carefully monitor intake and output

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fluid volume deficit: Assessment

answer

-health history -physical assessment

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fluid volume deficit: Priorities of care

answer

-restoration of adequate fluid volume

question

fluid volume deficit: diagnoses, outcomes and interventions, continuity of care

answer

-Deficient fluid volume -Ineffective Tissue Perfusion -Risk for Injury -assess patients understanding of the cause of the deficit

question

fluid volume excess: manifestations and complications

answer

-Extracellular hypovolemia circulatory overload -Interstitial peripheral edema generalized edema -Complications CHF,pulmonary edema

question

fluid volume excess: patho

answer

-heart or renal failure -cirrhosis of the liver -adrenal gland disorders -corticosteroid administration -stress conditions causing release of ADH and aldosterone -excessive sodium intake -medication side effects

question

fluid volume excess: interprofessional care

answer

-Diagnosis serum eletrolytes, osmolality serum hematocrit, hemoglobin often decreased renal, liver function

question

fluid volume excess: medications

answer

-Diuretics loop (furosemide) Thiazide-type (hydrochlorothiazide) Potassium-sparing (amiloride, spironolactone)

question

fluid volume excess: treatments

answer

-fluid management -dietary management

question

fluid volume excess: health promotion

answer

-relationship between sodium intake and water retention

question

fluid volume excess: assessment

answer

-health history -physical assessment weight, vital signs, circulatory signs, lung sounds, dyspnea, cough urine output, mental status

question

fluid volume excess: Priorities of care

answer

-supporting cardiovascular, respiratory function

question

fluid volume excess: diagnosis, outcomes, interventions

answer

-fluid volume excess -risk for impaired skin integrity -impaired gas exchange

question

fluid volume excess: continuity of care

answer

-manage cause of fluid volume excess -prevent future episodes of excess volume

question

Sodium Balance: Normal levels,affects,organ is primary regulator and 3hormones

answer

-135-145mEq/L -affects distribution of fluids -kidney is primary regulator renin-angiotensin-aldosterone system antidiuretic hormone (ADH) atrial natriuretic peptide (ANP)

question

Patient with hyponatremia: patho

answer

-excessive loss via kidneys, gi tract, skin, cerebral wasting, third spacing -water gains from systemic diseases -decrease in serum osmolality

question

Patient with hyponatremia: manifestations

answer

-depend on rapidity, severity, and cause of imbalance

question

Patient with hyponatremia: Diagnosis

answer

-serum sodium decreased -serum osmolality decreased -24hour urine specimen 40-220 mEq/L

question

Patient with hyponatremia: medications

answer

-sodium containing fluids

question

Patient with hyponatremia: Fluid and dietary mangement

answer

-high in sodium -fluid restriction

question

Patient with hyponatremia: health promotion

answer

-teach manifestations -important to drink liquids with sodium, electrolytes when perspiring, in high temperature

question

Patient with hyponatremia: Assessment

answer

-health history -physical assessment

question

Patient with hyponatremia: Priorities of care

answer

-restoring sodium, water balance -preventing cerebral edema

question

Patient with hyponatremia: Diagnoses, outcomes, and interventions

answer

-risk for imbalanced fluid volume -risk for ineffective cerebral tissue perfusion

question

Patient with hyponatremia: continuity of care

answer

-figure out what is the underlying cause of sodium deficit -prevention -manifestations

question

patient with hypernatremia: patho

answer

-excessive water loss -excessive sodium intake -increased osmolality

question

patient with hypernatremia: manifestations

answer

-thirst, altered neurologic function -seizures,coma, and death

question

patient with hypernatremia: Diagnosis

answer

-serum sodium elevated -serum osmolaltiy elevated

question

patient with hypernatremia: medications

answer

-oral,enteral,iv fluid replacement

question

patient with hypernatremia: health promotion

answer

-prevention -adequate water for patients receiving tube feedings

question

patient with hypernatremia: Priorities of care

answer

-Mental status and brain function

question

patient with hypernatremia: diagnoses, outcomes, and interventions

answer

-Risk for injury

question

patient with hypernatremia: Continuity of care

answer

-respond to thirst and consume adequate fluids -low sodium diet -schedule for monitoring of serum electrolyte levels

question

Hyponatremia: manifestations

answer

-plasma sodium <135 -decrease in serum osmolality -muscle cramps -headache -anxiety -nausea, anorexia,vomiting,hypotentions,shock

question

Hypernatremia: manifestations

answer

-plasma sodium >145 -increase in serum osmolality -increase in thirst, oliguria, urine specific gravity -dry skin and mucous membranes and decreased skin turgor, dry mouth, headache, restlessness, seizures, coma, tachy, hypotention, vascular collapse

question

Potassium balance

answer

3.5-5.3 mEq/L

question

Potassium: functions

answer

-nerve impulses -cardiac rhythm -muscle contractions

question

Potassium: regulator structures

answer

-sodium-potassium pump -kidneys and aldosterone

question

patient w/hypokalemia: patho

answer

-inadequate potassium intake -excessive skin,renal or intestinal losses -redistribution between the ICF and ECF

question

patient w/hypokalemia: manifestations

answer

-nausea and vomiting -muscle weakness and cramps -polyuria -decreased cardiac output

question

patient w/hypokalemia: Diagnosis (what to tests to use)

answer

-serum potassium and electrolytes -arterial blood gases -renal function tests -ecf reading

question

patient w/hypokalemia: meds

answer

oral and/or parenteral supplements

question

patient w/hypokalemia: nutrition

answer

diet high in potassium rich foods

question

patient w/hypokalemia: health promo

answer

balanced electrolyte solutions

question

patient w/hypokalemia: assessment

answer

health history physical assesment

question

patient w/hypokalemia: priorities of care

answer

cardiac impulse transmission cardiac and skeletal muscle function

question

patient w/hypokalemia: Diagnosis, outcomes

answer

decreased cardia output activity intolerance risk for imbalance fluid volume

question

patient w/hypokalemia: continuity of care

answer

recommended diet meds, supplements use of salt supplements

question

patient w/hyperkalemia: pathophysiology

answer

inadequate renal excretion of potassium rapid iv administration acidosis, tissue trauma, chemotherapy, starvation

question

patient w/hypokalemia: manifestations

answer

neuromuscular -muscle weakness -tremors gi discomfort cardia -ecg changes -dysrhythmias -cardiac arrest

question

patient w/hypokalemia: diagnosis

answer

serum electrolytes, abgs, and ecg

question

patient w/hypokalemia:

answer

calcium gluconate calcium chloride insulin and glucose hypertonic dextrose sodium bicarbonate sodium polystyrene sulfonate

question

patient w/hypokalemia: Dialysis

answer

peritoneal or hemodialysis

question

patient w/hypokalemia: health promo

answer

reading food and dietary supplement labels

question

patient w/hypokalemia: priorities of care

answer

electrical conduction and contractility of the heart

question

patient w/hypokalemia: outcomes

answer

risk for decreased cardiac output risk for activity intolerance

question

patient w/hypokalemia: continuity of care

answer

diet restrictions manifestations otc medications to avoid

question

Calcium balance: serum level

answer

9-11 mg/dl

question

Calcium balance: functions

answer

stabilizing cell membranes muscle contraction and relaxation cardiac function and blood clotting

question

Calcium balance: regulation

answer

parathyroid hormone, calicitriol, calcitonin, acid-base balance, plasma protein levels

question

Hypocalcemia: risk factors

answer

Parathyroidectomy older women lactose intolerance alcoholism

question

Hypocalcemia: patho

answer

pancreatitis hypoparathyroidism electrolyte imbalances alkalosis malabsorption disorders inadequate vitamin D medication

question

Hypocalcemia: manifestations

answer

tetany convulsions

question

Hypocalcemia: Diagnosis tests

answer

serum calcium total albumin magnesium phosphate parathyroid hormone ecg

question

Hypocalcemia: health promotion

answer

deficit associated with aging female gender

question

Hypocalcemia: nursing diagnosis

answer

risk for injury

question

Hypocalcemia: continuity of care

answer

educate on risk factors, meds, dietary recommendations, manifestations

question

hypercalcemia: patho

answer

hyperparathyroidism and malignancies prolonged immobility excessive intake of vitamin d

question

hypercalcemia: manifestations

answer

subtle and mild at first decrease in neuromuscular excitability cns symtoms cardia effects

question

hypercalcemia: Diagnosis

answer

serum pth levels ecg test bone density test

question

hypercalcemia: meds

answer

loop diuretics bisphosphonates sodium phosphate gulcocorticoids

question

hypercalcemia: Fluid management

answer

isotonic saline

question

hypercalcemia: helath promotion

answer

promote mobility fluid intake

question

hypercalcemia: priorities of care

answer

safety

question

hypercalcemia: outcomes

answer

risk for injury risk for fluid volume excess

question

hypercalcemia: continuity of care

answer

limiting intake meds increase fluid intake weight bearing exercise

question

Hyocalcemia: manifestations

answer

serum <9 numbness and tingling muscle cramping hyperactive reflexes tetany carpopedal adn larygeal spasms positive chvostek and trousseau hypotention ventricular dysrhythmias bone pain and fractures

question

hypercalcemia: manifestations

answer

serum >11 increased thrist anorexia nausea and vomiting constipation muscle weakness increased bp av block lethargy coma

question

Magnesium balance: normal serum

answer

1.8-3.0

question

Magnesium: functions

answer

intracellular processes neuromuscular transmission cardiovascular function

question

hypomagnesmia: risk factors

answer

alcoholism protein malnutrition diabetic ketoacidosis kidney disease meds

question

hypomagnesmia patho

answer

relates to hypokalemia, hypocalcemia

question

hypomagnesmia: manifestations

answer

tremors hyperrecative reflexes positive chvostek, trousseau signs tetany paresthesias seizures

question

hypomagnesmia: assessment

answer

manifestations of hypokalemia,hypocalcemia gI function

question

hypomagnesmia: Diangonis

answer

monitor serum mag, potassium, calcium cardiac status dioxin toxicity deep tendon reflexes

question

hypomagnesmia: continuity of care

answer

discuss alcoholism treatment options educate on mag sources

question

hypermagnesemia: patho

answer

renal failure nausea and vomiting interfered neuromuscular transmission depressed CNS

question

hypomagnesmia: patho and manifestations

answer

hypotention flushing, sweating bradydysrhythmias respiratory depression

question

hypo mag nes emia: interprofessional care

answer

hemodialysis or peritoneal dialysis calcium gluconate mechanical ventilation

question

hypomagnesemia: manifestations

answer

canges in personality nystagmus positve babinski and chvostek hypertension tachy cardiac dysrhythmias

question

hypermagnesemia: manifestations

answer

confusion and lethargy hypotension cardic dysrthythmias coma cardiac arrest

question

Phosphate balanced level

answer

2.5-4.5

question

phosphate functions:

answer

production of atp red blood cell, nervous system, muscle function metabolism acid-base balance`

question

hypophosphatemia: manifestations

answer

decrease gi absorption increased renal excretion refeeding syndrome meds

question

hypophosphatemia: patho

answer

alcoholism hyperventilation respiratory alkalosis diabetic ketoacidosis

question

hyperphospatemia: manisfestations

answer

paresthesias muscle weakness nausea and vomiting dysphagia tetany decreased bp cardiac dysrhythmias

question

hypophosphatemai

answer

intention tremor confusion bone pain joint stiffness bleeding impaired wbc seizures

question

nonvolatile acids:

answer

lactic acid hcl acid sulfuric acid

question

First line of defense:

answer

buffer systems bicarbonate phosphate protein

question

Second line of defense: respiratory

answer

hyperventilation hypoventilation (hours) to days

question

Renal system: third line of defense

answer

days to weeks kidneys

question

ph

answer

7.35-7.45

question

paco2

answer

35-45

question

pao2

answer

80-100

question

serum bicarbonate

answer

22-26

question

base excess

answer

-3.0to3.0

question

HCo2

answer

22-26

question

metabolic acidosis: patho

answer

accumulation of metabolic acids excess loss of bicarbonate increase in chloride levels anion gap

question

metabolic acidosi: diagnosis

answer

abgs serum electrolytes, ecg, blood glucose, renal function

question

metabolic acidosis: meds

answer

sodium bicarbonate iv insulin and fluid for dka saline solutions and glucose etoh

question

Metabolic alkalosis: meds

answer

potassium chloride sodium chloride acidifying solution for severe cases

question

acidosis: meds

answer

bronchodilators antibiotics

Medsurg Exam 3: Chapter 10 Altered Fluid, electrolyte, and Acid-Base Balance – Flashcards

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