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Adult Health I

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is responsible for the reduction of urine production   antidiuretic hormone  
is released in response to decreased blood flow or decreased renal pressure and is sensed by receptors in the nephrons   renin  
is produced by the adrenal cortex in response to stimulation by angiotensin II causing the tubules to excrete K+ while retaining Na2+, adding to the reabsorption of water back into the vascular system   aldosterone  
body loses both water and electrolytes from the EFC   hypovolemia  
water is lost from the body, but there is no loss of electrolytes   dehydration  
what are 3 risk factors for dehydration?   hyperventilation, diabetic ketoacidosis, and enteral feeding without sufficient water intake  
what are 6 risk factors for hypovolemia?   GI losses, skin losses, renal losses. third spacing (burns, ascites, obstruction), hemorrhage, and altered intake  
hgb and hct are ____ during hypovolemia   LOW  
hgb and hct are ____ during dehydration   HIGH  
serum osmolarity, sp. gravity, serum sodium are all ___ during dehydration   HIGH  
common vital signs for hypovolemia and dehydration are:   hyperthermia, tachycardia, thready pulse, hypotension, orthostatic hypotension, < central venous pressure  
occurs when both water and sodium are retained in abnormally high proportions   hypervolemia  
occurs when more water is gained than electrolytes   overhydration  
risk factor for overhydration   water replacement without electrolyte replacement such as strenuous exercise with profuse diaphoresis  
risk factors for hypervolemia   chronic stimulus to the kidney (heart failure, cirrhosis, glucocorticosteriods), abn renal function, fluid shifts (burns, hypertonic fluids), age-related changes, excessive sodium intake  
hgb and hct are ___ with overhydration   LOW  
serum osmolarity and serum sodium are ___ with overhydration   LOW  
electrolytes, BUN, and creatinine are ___ with hypervolemia   HIGH  
what are vital signs for overhydration and hypervolemia?   tachycardia, bounding pulse, HTN, tachypnea, > central venous pressure  
what position is best for pt with overhydration or hypervolemia?   semi-fowler's  
pt with pulmonary edema should be in what position?   fowler's  
a pt with hypovolemic shock should be placed in what position?   on back with legs elevated  
major electrolyte found in EFC   sodium  
essential for the maintance of acid-base balance, active and passive transport mechanisms, and maintaining irritability and conduction of nerve and muscle tissue   sodium  
normal sodium values   135-145  
is the major cation in ICF   potassium  
plays vital role in cell metabolism, transmission of nerve impulses, functioning cardiac, lung, and muscle tissues, and acid-base balance   potassium  
___ has reciprocal action with sodium   potassium  
normal potassium values   3.5-5  
normal calcium values   8.5-10.5  
normal magnesium values   1.3-2.1  
is a gain of water or the loss of sodium-rich fluids   hyponatremia  
delays and slows the depolarization of membranes   hyponatremia  
water moves from ECF into the ICF   hyponatremia  
risk factors for hyponatremia   abn GI losses, renal losses, skin losses, > or normal ECF volume, edematous state (heart failure, cirrhosis), excessive hypotonic IV, age-related factors  
vital signs of hyponatremia   hypothermia, tachycardia, thready pulse, hypotension, orthostatic hypotension  
is a serious electrolyte inbalance and can cause significant neurological, endocrine, and cardiac disturbances   hypernatremia  
cells are dehydrated with ___   hypernatremia  
risk factors for hypernatremia   water deprivation, excessive Na intake, excessive Na retention, fluid losses, age-related changes  
vital signs of hypernatremia   hyperthermia, tachycardia, orthostatic hypotension  
is the result of increased loss of K from the body ot movement of K into the cells   hypokalemia  
risk factors for hypokalemia   < K thru GI losses, renal losses, skin losses, <intake, ICF shift, age-related factors  
with hypokalemia the body is in a ____ state   alkalosis state  
vital signs for hypokalemia   hyperthermia, weak irregular pulse, hypotension, resp distress  
NEVER PUSH ____ IV   potassium  
phlebitis   tissue irritant  
is the result of > intake of K, movement of K out of the cells, or inadequate renal excretion   hyperkalemia  
risk factors for hyperkalemia   ECF shift (< insulin, acidosis, fever, surgery, sepsis), < excretion (renal failure, dehydration, NSAIDS), age-related factors  
with hyperkalemia the body is in a ____ state   acidosis  
vital signs for hyperkalemia   slow, irregular pulse, hypotension  
foods with potassium   avocado, broccoli, dairy, dried fruit, cantaloupe, bananas  
risk factors for hypocalcemia   malaborption (chrons disease), end-stage renal disease, post thyroidectomy  
+ chvostek's sign and + trousseau's sign   hypocalcemia and hypomagnesmia  
vital signs for hypocalcemia   < heart rate, hypotension, dysrhythemia  
what food has high calcium and magnesium?   dairy and dark green veggies  
risk factors for hypomagnesmia   malnutrition, alcohol ingestion  
greater concentration of H+ ions the more ____ the body fluids are with a ___ pH   acidic, LOW  
lesser concentration of H+ ions the more ____ the body fluids are with a ___ pH   alkaline, HIGHER  
occurs when the body attempts to correct changes and imbalances in pH levels   compensation  
occurs when pH returns to normal   full compensation  
pH is not able to normalize   partial compensation  
risk factors for respiratory acidosis   resp. depression, inadequate chest expansion, airway obstruction, alveolar-capillary blockage, inadequate mechanical ventilation  
risk factors for respiratory alkalosis   hyperventilation and hypoxemia  
risk factors for metabolic acidosis   excess production of H+ (DKA, stravation, heavy exercise, seizures, fever, hypoxia), inadequate elimination of H+ions (renal failure), inadequate production of bicarb (renal failure, pancreatitis, liver failure, dehyration), and excess elim of bicarb  
risk factors for metabolic alkalosis   base excess, acid def (loss of GI secretions from vomiting or suction and K+ depletion due to diuetics, laxatives, cushings syndrome)  
vital signs and cardiovascular for resp acidosis   tachycardia and tachypnea, dysrthmias  
vital signs and cardiovascular for resp alkalosis   tachypnea, palpitations, chest pain, dysrhytmias  
vital signs and cardiovascular for metabolic acidosis   bradycardia, tachypnea, hypotension, dysrhymias  
vital signs and cardiovascular for metabolic alkalosis   tachycardia, hypotension,dysrhytmias  
what are common neurological s/s for resp alkalosis   tetany and convulsions  
what are common neurological s/s for metabolic alkalosis   tetany and muscle weakness  
impaired gas exchange or ineffective breathing pattern   respiratory acidosis/alkalosis  
decreased cardiac OP related to dysrhythmias   metabolic acidosis/alkalosis  
what is a med that puts older adults at risk for hyperkalemia?   lisinopril (prinivil)  
normal ionized Ca values   4.5-5.5  
normal bicarb (HCO3-) values   22-26  
normal CO2 values   35-45  
normal base (blood buffer) that exists   + or - 2  
normal range for PaO2   80-100  
normal O2 sats   95-100%  
normal Chloride values   95-105  
normal Magnesium values   1.5-2.5  
normal Phosphate (PO43-)   2.8-4.5  
normal serum osmolality values   275-295  
movement of solvent across semipermeable membrane from an area of LOWER concentration to an area of HIGHER concentration   osmosis  
membrane allows solvent in, but not the solute so there is a fluid shift   osmosis  
movement of solute in a solution across semipermeable membrane from an area of HIGHER concentration to an area of LOWER concentration   diffusion  
during diffusion, what effects the movement?   size, concentration, and temp of solution  
process by which water and diffusible substances move together across a membrane in repsonse to fluid pressure, and area of HIGHER pressure to an area of LOWER pressure   filtration  
example of filtration?   edema  
requires metabolic activity and expenditure of energy to move substances across cell membranes   active transport  
average adult fluid intake   2200-2700 mL daily  
where is the antidiuretic hormone stored?   posterior pituitary gland  
when is the antidiuretic hormone released?   response to changes in blood osmolarity  
makes renal tubules and collecting ducts more permeable to H2O   antidiuretic hormone  
what initiates the renin-sngiotensin-aldosterone mechanism?   renal perfusion  
proteoltic enzyme that responds to decrease renal perfusion secondary to decrease ECF volume   renin  
what produces angiotension I?   renin  
what happens when angiotension I turns into angiotension II?   massive vasoconstriction of vessels and relocates and increases blood flow to kidneys to improve perfusion  
what releases aldosterone and why?   adrenal cortex in response to increase plasma K+ levels ot when helping counteract hypovolema  
helps maintain vascular tone?   atrial natriuretic peptide  
where and why is atrial natriuretic peptide secreted?   from atrial cells of heart in response to atrial stretching and an increase in circulating blood vloume  
average adult fluid loss daily   2200-2700  
where are most fluids lost?   kidneys (then lungs, skin, GI)  
essential for enzyme activities, neurochemical activites, and cardiac and skeletal muscles   magnesium  
where is 50-60% of Mg found?   bone  
nescessary for glycogen deposits in liver and muscles, transmission and conduction of nerve impulses   potassium  
substance or group of substances that can absorb or release H+ to correct acid-base balance   buffer  
regulated by lungs   CO2  
regulated by kidneys   HCO3  
normal pH range   7.35-7.45  
what are the 3 acid-base regulators?   chemical, biological, and physiological regulations  
largest chemical buffer in ECF   carbonic acid and bicarb buffer system  
when CO2 increases ___ increases   H+ ions  
when H+ ions increase ____ increasees   CO2  
what are 2 physiological regulators?   lungs and kidneys  
pH is ____ during hyperventalation   < 35  
pH is ____ during hypoventalation   > 45  
when bicarb is < 22 _____   metabolic acidosis  
when bicard is > 26 _____   metabolic alkalosis  
metabolic ALKALOSIS takes place when pH _____, PaCO2 ______, PaO2 ______, O2 sats _______, HCO3- ____,ionized Ca _____, and K+ _____   pH- >7.45-----------PaCO2- norm or >45---------PaO2-norm----------O2 sats-norm------------HCO3---->26-------ionized Ca+----<4.5------------K+- <3.5  
metabolic ACIDOSIS takes place when pH _____, PaCO2 _____, PaO2 _____, O2 sats _____, HCO3 _____, K+ ______   pH- <7.35--------PaCO2- norm or <35------PaO2- norm--------O2 sats- norm-----HCO3- <22------K+- >5  
respiratory ALKALOSIS takes place when pH _____, PaCo2 ____, PaO2 ____, O2 sats ____, HCO3- _____, ionized Ca+ ______, K+ _____   pH- >7.45------PaCO2- <35-----PaO2-norm-----O2 sats- norm------HCO3- <22----ion Ca+- <4.5-----K+- <3.5  
respiratory ACIDOSIS takes place when pH _____, PaCO2 _____, PaO2 ____, O2 sats ____, HCO3- ____, K+ _____   pH- <7.35------PaCO2- >45--------O2 PaO2- norm or <80----sats- norm or <95%-------HCO3- norm or >26-----K+- >5.0  
aldoserone holds in ___   Na (sodium)  
polydipsia   excessive thrist (ex:DM)  
hormone that prevents from going to BR   antidiuretic hormone  
diabetes insipidis   go, go, go prob with antidiuretic hormone  
disorder that holds in too much fluid b/c if inappropriate amount of antidiruetic hormone   SIADH (syndrome of inappropriate ADH)  


   


 

 

 
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