Fluid & Electrolyte & Acid-Base Balance
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| How does the body compensate for Respiratory Acidosis? | Kidneys retain bicarb & release H+ to increase ph
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| How does the body compensate for Respiratory Alkalosis? | The kidneys retain H+ and excretee bicarb to decrease pH
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| How does the body compensate for Metabolic Acidosis? | Respiration increase to decrease the CO2 which lowers carbonic acid, which increases bicarb and pH
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| How does the body compensate for Metabolic Alkalosis? | Respirations decrease which increases CO2, causing carbonic acid to increase and pH to decrease
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| What actions in the body causes Respiratory Acidosis? | decreased respiration causes increase in CO2 and carbonic acid, which decreases bicarb and pH...
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| What actions in the body causes Respiratory Alkalosis? | Increased respiration causes a decrease in CO2 and carbonic acid, which increases bicarb and pH...
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| What actions in the body causes Metabolic Acidosis? | Decreased bicarb (from diarrhea, DKA or renal failure) causes increased carbonic acid and decreased pH...
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| What actions in the body causes Metabolic Alkalosis? | Increased bicarb (from prolonged vomiting, diuretics, antacids) causes a decrease in carbonic acid and increased pH...
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| What is the normal range for pH? | 7.35 to 7.45
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| What is the normal range for CO2? | 35 to 45
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| What is the normal range for HCO3 (bicarb)? | 22 to 26
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| What is the problem if the CO2 drops below 35? | Respiratory Alkalosis
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| What is the problem if the CO2 rises above 45? | Respiratory Acidosis
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| What is the problem if the bicarb drops below 22? | Metabolic Acidosis
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| What is the problem if the bicarb rises above 26? | Metabolic Alkalosis
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| What is the problem if the pH drops below 7.35? | Acidosis
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| What is the problem if the pH rises above 7.45? | Alkalosis
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| Does osmosis push or pull? | Pulls water ONLY
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| Does filtration push or pull? | Pushes water & solutes
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| Where is Na+ more concentrated...ECF or ICF? | (ECF) extra cellular fluid
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| Where is K+ more concentrated...ECF or ICF? | (ICF) intracellular fluid
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| What is potassium (K+) responsible for? | nerve impulses
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| What is calcium (Ca+) responsible for? | muscle contractions
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| What is sodium (Na+) responsible for? | maintaining fluid balance
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| What is Chloride (Cl-) responsible for? | maintaining fluid balance
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| What is magnesium (Mg2+) responsible for? | cellular metabolism (ATP)
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| What is phosphorus (PO4) responsible for? | muscle, nerves & RBCs
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| What is bicarbonate (HCO3) responsible for? | It a buffer to regulate acid-base balance
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| Which area (blood volume or cellular level) does Isotonic refer to? | Blood volume
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| Which area (blood volume or cellular level) does Osmolar refer to? | Cellular level
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| what does decreased blood volume, weak/rapid pulse, decreased urine output (<30ml/h) indicate? | fluid volume defecit (FVD)
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| What does increased Na+ & BP, rapid weight changes, and decreased urine output (more than intake) indicate? | fluid volume excess (FVE)
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| What can trauma, bleeding and burns lead to? | FVD (think cell destruction)
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| What can heart/renal failure, cirrhosis, altered hormone levels (corticosteroids, aldosterone), too much sodium bicarbonate (Alka Seltzer) lead to? | FVE
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| What does hyperventilation, DKA, and fever lead to? | dehydration
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| What do tumors, head injury, certain meds, and extreme athletes that drink only water after exercise lead to? | overhydration
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| Describe dehydration | water leaves the cells & moves to the bloodstream
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| Describe overhydration | water leaves the bloodstream & enters the cells
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| What happens to the water during hyperventilation, DKA & fever? | leaves the cells & moves to bloodstream
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| What happens to the water in response to tumors & head injuries? | water leaves the bloodstream & enters the cells
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| What is the relationships between pH, bicarb, and CO2? | pH & bicarb change in same direction and CO2 is always in the opposite direction
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| What happens to the pH when the CO2 rises? | pH goes down (bicarb too)
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| What happens to the pH when the CO2 drops? | pH goes up (bicarb too)
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| What happens to bicarb when the CO2 rises? | bicarb goes down (pH too)
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| What happens to bicarb when the CO2 drops? | bicarb goes up (pH too)
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| What are the clinical manifestations of Hyponatremia? | Lethargy, confusion, apprehension, muscle twitching, abdominal cramps, anorexia, N/V, headaches, seizures, coma
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| What are the lab findings of hyponatremia? | Serum sodium below 135 mEq/L, and Serum osmolality below 280 mOsm/kg
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| What electrolyte imbalance is associated with a loss of water? | Hypernatremia
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| What electrolyte imbalance is associated with a loss of sodium? | Hyponatremia
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| What electrolyte imbalance is associated with a loss of potassium? | Hypokalemia
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| What electrolyte imbalance is associated with a decrease in potassium excretion? | Hyperkalemia
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| What electrolyte imbalance is associated with surgical removal of the parathyroid glands? | Hypocalcemia
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| What electrolyte imbalance is associated with acute pancreatitis? | Hypocalcemia
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| What electrolyte imbalance is associate with an inadequate vitamin D intake? | Hypocalcemia
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| What electrolyte imbalance is associated with Paget's disease? | Hypercalcemia
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| What electrolyte imbalance is associated with renal failure? | Hyperkalemia
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| What electrolyte imbalance is associated with hypoaldosteronism? | Hyperkalemia
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| What electrolyte imbalance is associated with hyperaldosteronism? | Hypokalemia
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| What electrolyte imbalance is associated with diabetes insipidus? | Hypernatremia
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| What electrolyte imbalance is associated with parenteral administration of saline solutions? | Hypernatremia
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| What electrolyte imbalance is associated with SIADH? | Hyponatremia
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| What are the clinical manifestations of Hypernatremia? | Thirst, dry/sticky mucous membranes, tongue red/dry/swollen, weakness
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| What are the clinical manifestations of severe hypernatremia? | Fatigue, restlessness, decreased LOC, disorientation, convulsions
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| 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
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| 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
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| 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
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| 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
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| 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
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| 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
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