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Acid-Base/Fluid-Elec

Fluid & Electrolyte & Acid-Base Balance

QuestionAnswer
How does the body compensate for Respiratory Acidosis? Kidneys retain bicarb & release H+ to increase pH
How does the body compensate for Respiratory Alkalosis? The kidneys retain H+ and excretee bicarb to decrease pH
How does the body compensate for Metabolic Acidosis? Respiration increase to decrease the CO2 which lowers carbonic acid, which increases bicarb and pH
How does the body compensate for Metabolic Alkalosis? Respirations decrease which increases CO2, causing carbonic acid to increase and pH to decrease
What actions in the body causes Respiratory Acidosis? decreased respiration causes increase in CO2 and carbonic acid, which decreases bicarb and pH...
What actions in the body causes Respiratory Alkalosis? Increased respiration causes a decrease in CO2 and carbonic acid, which increases bicarb and pH...
What actions in the body causes Metabolic Acidosis? Decreased bicarb (from diarrhea, DKA or renal failure) causes increased carbonic acid and decreased pH...
What actions in the body causes Metabolic Alkalosis? Increased bicarb (from prolonged vomiting, diuretics, antacids) causes a decrease in carbonic acid and increased pH...
What is the normal range for pH? 7.35 to 7.45
What is the normal range for CO2? 35 to 45
What is the normal range for HCO3 (bicarb)? 22 to 26
What is the problem if the CO2 drops below 35? Respiratory Alkalosis
What is the problem if the CO2 rises above 45? Respiratory Acidosis
What is the problem if the bicarb drops below 22? Metabolic Acidosis
What is the problem if the bicarb rises above 26? Metabolic Alkalosis
What is the problem if the pH drops below 7.35? Acidosis
What is the problem if the pH rises above 7.45? Alkalosis
Does osmosis push or pull? Pulls water ONLY
Does filtration push or pull? Pushes water & solutes
Where is Na+ more concentrated...ECF or ICF? (ECF) extra cellular fluid
Where is K+ more concentrated...ECF or ICF? (ICF) intracellular fluid
What is potassium (K+) responsible for? nerve impulses
What is calcium (Ca+) responsible for? muscle contractions
What is sodium (Na+) responsible for? maintaining fluid balance
What is Chloride (Cl-) responsible for? maintaining fluid balance
What is magnesium (Mg2+) responsible for? cellular metabolism (ATP)
What is phosphorus (PO4) responsible for? muscle, nerves & RBCs
What is bicarbonate (HCO3) responsible for? It a buffer to regulate acid-base balance
Which area (blood volume or cellular level) does Isotonic refer to? Blood volume
Which area (blood volume or cellular level) does Osmolar refer to? Cellular level
what does decreased blood volume, weak/rapid pulse, decreased urine output (<30ml/h) indicate? fluid volume defecit (FVD)
What does increased Na+ & BP, rapid weight changes, and decreased urine output (more than intake) indicate? fluid volume excess (FVE)
What can trauma, bleeding and burns lead to? FVD (think cell destruction)
What can heart/renal failure, cirrhosis, altered hormone levels (corticosteroids, aldosterone), too much sodium bicarbonate (Alka Seltzer) lead to? FVE
What does hyperventilation, DKA, and fever lead to? dehydration
What do tumors, head injury, certain meds, and extreme athletes that drink only water after exercise lead to? overhydration
Describe dehydration water leaves the cells & moves to the bloodstream
Describe overhydration water leaves the bloodstream & enters the cells
What happens to the water during hyperventilation, DKA & fever? leaves the cells & moves to bloodstream
What happens to the water in response to tumors & head injuries? water leaves the bloodstream & enters the cells
What is the relationships between pH, bicarb, and CO2? pH & bicarb change in same direction and CO2 is always in the opposite direction
What happens to the pH when the CO2 rises? pH goes down (bicarb too)
What happens to the pH when the CO2 drops? pH goes up (bicarb too)
What happens to bicarb when the CO2 rises? bicarb goes down (pH too)
What happens to bicarb when the CO2 drops? bicarb goes up (pH too)
What are the clinical manifestations of Hyponatremia? Lethargy, confusion, apprehension, muscle twitching, abdominal cramps, anorexia, N/V, headaches, seizures, coma
What are the lab findings of hyponatremia? Serum sodium below 135 mEq/L, and Serum osmolality below 280 mOsm/kg
What electrolyte imbalance is associated with a loss of water? Hypernatremia
What electrolyte imbalance is associated with a loss of sodium? Hyponatremia
What electrolyte imbalance is associated with a loss of potassium? Hypokalemia
What electrolyte imbalance is associated with a decrease in potassium excretion? Hyperkalemia
What electrolyte imbalance is associated with surgical removal of the parathyroid glands? Hypocalcemia
What electrolyte imbalance is associated with acute pancreatitis? Hypocalcemia
What electrolyte imbalance is associate with an inadequate vitamin D intake? Hypocalcemia
What electrolyte imbalance is associated with Paget's disease? Hypercalcemia
What electrolyte imbalance is associated with renal failure? Hyperkalemia
What electrolyte imbalance is associated with hypoaldosteronism? Hyperkalemia
What electrolyte imbalance is associated with hyperaldosteronism? Hypokalemia
What electrolyte imbalance is associated with diabetes insipidus? Hypernatremia
What electrolyte imbalance is associated with parenteral administration of saline solutions? Hypernatremia
What electrolyte imbalance is associated with SIADH? Hyponatremia
What are the clinical manifestations of Hypernatremia? Thirst, dry/sticky mucous membranes, tongue red/dry/swollen, weakness
What are the clinical manifestations of severe hypernatremia? Fatigue, restlessness, decreased LOC, disorientation, convulsions
What are the clinical manifestations of hypokalemia? Muscle weakness, leg cramps, fatigue, lethargy, anorexia, N/V, decreased bowel sounds & motility, cardia dysrhythmias, depressed DTRs, weak/irregular pulses
What are the clinical manifestations of hyperkalemia? Gastrointestinal hyperactivity, diarrhea, irritability, apathy, confusion, cardiac dysrhythmias or arrest, muscle weakness, areflexia, decreased HR, irregular pulse, and paresthesias & numbness in extremities
What are the clinical manifestations of hypocalcemia? Numbness/tingling of extremities or around mouth, muscle tremors, cramps; if severe can progress to tetany & convulsions, cardiac dysrhythmias; decreased cardiac output, confusion, anxiety, possible psychoses, hyperactive DTRs
What are the clinical manifestations of hypercalcemia? Lethargy, weakness, depressed DTRs, bone pain, anorexia, N/V, constipation, polyuria, hypercalciuria, flank pain secondary to urinary calculi, dysrhythmias, possible heart block
What are the clinical manifestations of hypomagnesemia? Neuromuscular irritability w/tremors, increased reflexes, tremors, convulsions, tachycardia, elevated BP, dysrhythmias, disorientation & confusion, vertigo, anorexia, dysphagia, respiratory difficulties
What are the clinical manifestations of hypermagnesemia? Peripheral vasodilation, flushing, N/V, muscle weakness, paralysis, hypotension, bradycardia, depressed DTRs, lethargy, drowsiness, respiratory depression, coma, respiratory & cardiac arrest if severe
Created by: janetjp on 2009-03-15



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