n316 exam 2Fluids and Electrolytes
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| *Dehydration | "the excessive loss of water from the body."
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| *hypercalemia | An abnormally high concentration of calcium in the blood.
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| *fluid volume deficit | When fluid loss exceeds intake, a fluid volume deficit exists
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| *older adult considerations | increase risk for FVD
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| *Acidosis/alkalosis-application | (blank)
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| Acidosis- | An abnormal increase in the acidity of the body's fluids, caused either by accumulation of acids or by depletion of bicarbonates.
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| alkalosis | Abnormally high alkalinity of the blood and body fluids.
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| *Metabolic/resp. | (blank)
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| homeostasis | The body's tendency to maintain a state of physiologic balance in the presence of constantly changing conditions.
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| Body fluid distribution H20 = [] % of body weight ICF = ? % and ECF = []?% | Body fluid distribution H20 = 60 % of body weight ICF = 40 % and ECF = 20%
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| Body fluid distribution H20 = | 60 % of body weight
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| ICF = ?? | E-lytes and 40% of body weight
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| ECF = ?? | e lytes and 20% of body weight
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| what E-lytes are found in ICF? | Potassium K+ magnesium Mg+
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| what E-lytes are found in ECF? | e-lytes Sodium Na+ Chloride Cl- calcium Ca+
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| ECF is classified by ? | Location
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| Name the types of Ecf | interstital, intravascular, trancvellular
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| define the following EFC fluid interstital, | fluid between cells
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| define the following EFC fluid , intravascular, | fluid w/in blood vessels plasma
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| define the following EFC fluid trancellular | urine, GI fluid, cerebral spinal fluid, pleural, synovial, intraocular etc.
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| Normal fluid I & O Normal adult Intake = | 2500 mL/24 hrs.
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| output = | 2500ml/ 24/ hrs.
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| oral fluid intake = | 1200 cc/ 24 hrs.
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| urine output = | 1500/24 hrs.
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| water in food intake = | 1000/24 hrs.
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| output respiration = | 500/24hrs.
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| intake oxidation of food = | 300cc/24hyrs.
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| output perspiration | 300/24hrs.
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| cations= | + carged
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| anions | - carge
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| catinas, consist of | sodium,potassium,calcium,and magesium
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| anions, consist of negetavely charged | psosphorous bicarbonate chloride
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| mechanisms of body fluid movement | osometic preassure, hydrostatic preassure, diffusion, filtration, active transport
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| osometic preassure, | power of a solution to draw h20 across a membrane high pressure gradient to low preassure gradient
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| hydrostatic preassure, |
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| diffusion, | The transport of matter from one point to another by random molecular motions. It occurs in gases, liquids, and solids.
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| filtration, | The separation of solid particles from a fluidsolids suspension of which they are a part by passage of most of the fluid through a septum or membrane that retains most of the solids on or within itself.
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| active transport | The passage of ions or molecules across a cell membrane against an electrochemical or concentration gradient, or against the normal direction of diffusion.
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| body maintains homeostasis ? | thrist, kidneys, renin angiotensin/ aldosterone system, adh, ANF
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| thrist, | felt when serum osmolarity > 295
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| kidneys, | volume and electrolyte balance osmalarity
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| renin angiotensin/ aldosterone system, | intravascular fluid balance and blood preassure
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| adh, | antidiuretic hormone regulates h20 excreation from the kidney
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| ANF | atrial natriuretic factor releases when fluid is ovweloaded /to high
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| roy behavior assessment | (oxygenation,nutrition, elimination, activity rest, protection, neurological alterations, labs
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| roy stimuli assessment | chronic Illness, Medical intervention, cognator effectness, developmental-older adults*, enviromental
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| why r older adults have an increased risk for FVD? | decrease perception thrist, - in body fluid amount, changes in body structure and function ie renal , temp regulation, incontinence, physical conditions/dissabalities, cognitive impaorments
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| dehydration | loss of h20 alone
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| hypovolemia | decrease in circulating blood volume
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| Third spacing | a shift of fluid from vascular space into an unuseable space.
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| causes of FVD | inadaquate fluid intake, failure of regulatory mechanism fluid loss,
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| signs and symptoms of fvd | weight loss, thrist, postural hypotension, tachycardia, increase body temp, decrease pulse volume
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| tachycardia | A rapid heart rate, especially one above 100 beats per minute in an adult.
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| FVD diagnostic tests | concentrated urin SG> 1.030, decreased urine output, E-lytes, osmolarity, CVP sub normal, increased hemocrit elevated bun(possible
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| nursing diagnosis in hypovolemia | Fluid volume deficit [r/t} inabality to maintain oral intake of fluids AEB vomiting [2] r/t lack of cognative abality to understand neeed to drink fluids AEB: confusion disorentation [3] r/t lack of info 2 replace fluids-Ineffective tissue perfusion, risk
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| treatment hypovolemia | prevention, treat cause of deficits evaluate effectness of treatment
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| treatment hypovolemia prevention at risk | elderly, children, persons with fluid loss (V/D) atheletes
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| treatment hypovolemia treat cause of deficits | replace oral, iv, enteral, isotonic may need to add e-lytes
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| fFE terminology hypervolemia, edema, causes | system failure,excessive intake of sodium, IV solution w/ NaCI
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| fFE terminology hypervolemia, edema, system failure causes | heart, kidney cirrhosis of Liver, adrenal gland dissorders, corticossteroides, stress conditions causing a release of ADH/aldosterone
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| ADH/aldosterone | antidiuateric hormone A steroid hormone secreted by the adrenal cortex that regulates the salt and water balance in the body.
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| adrenal gland dissorders | water and electrolyte loss associated with this condition results from deficiency of the adrenal hormone, aldosterone
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| corticosteroid | Any of the steroid hormones produced by the adrenal cortex or their synthetic equivalents, such as cortisol and aldosterone. Some corticosteroids regulate fluid balance in the body
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| S/S of fluid excess | weight gain, circulatory overload peripheral edema, diagnostics
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| S/S of fluid excess weight gain, | >5% over short period
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| Diagnostics S/S of fluid excess chest x-ray | pulmonary edema
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| Diagnostics S/S of fluid excess Serum Na and Osmolarity: | WNL Within Normal Limits
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| Diagnostics S/S of fluid excess Hgb. and Hct | slightly below normal limits
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| Diagnostics S/S of fluid excess may develop metabolic acidosis | if fails to adapt
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| Diagnostics S/S of fluid excess low BUN | (blank)
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| pulmonary edema | An effusion of fluid into the alveoli and interstitial spaces of the lungs. Edema of the lungs usually due to mitral stenosis or left ventricular failure
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| Serum Na and Osmolarity | Serum = Watery fluid from animal tissue, such as that found in edema. Na = The symbol for the element sodium.Osmolarity = The osmotic concentration of a solution expressed as osmoles of solute per liter of solution.
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| WNL | Within Normal Limits
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| Hgb. and Hct | HGB (Hemoglobin) HCT (Hematocrit)
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| BUN | blood urea nitrogen
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| treatment of FVE | prevention, manage fluid intake, diuretics
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| treatment of FVE diuretics | loop lasix,thiazides, osmotic diuretic, potassium sparing
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| treatment of FVE loop lasix | inhibit Na reabsorption in ascending loop of henle
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| treatment of FVE thiazides | diuril same as loop lasix but @ distal tubule less potent than loop same SE
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| treatment of FVE osmotic diuretic | Mannitol (IV)
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| treatment of FVE potassium sparing | spironolactone
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| spironolactone | spi·ro·no·lac·tone (spī'rə-nō-lăk'tōn, spī-rō'-, spī-rŏn'ə-)
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| adaptation to hypervolemia | left sided heart failure,right sided heart failure
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| adaptation to hypervolemia left sided heart failure will present as | pulmonary edema crackles
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| adaptation to hypervolemia right sided heart failure will present as | pweipheral edema pedal edema
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| nursing diagnosis hypervolemia | (blank)
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| electrolyte imbalances characteristics | mainly in ECF, normal values 135-145 mEq/L,
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| ECF | extracellular fluid
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| electrolyte normal lab values | 135-145 mEq/L
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| electrolytes actions | regulates fluid volume, osmolality, maintains neuromuscular activity
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| sources of electrolytes | (blank)
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| electrolyte adaptation to imbalances | kidney saves or excretes stimulates renin and aldosterone system , ADH, glomercular filtration rate, natriuretic peptide release
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| electrolyte adaptation kidney saves or excretes stimulates renin and aldosterone system why? | (blank)
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| electrolyte adaptation kidney saves or excretes ADH, why? | (blank)
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| electrolyte adaptation kidney saves or excretes glomercular filtration rate, natriuretic peptide release Why? | (blank)
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| @next hyponatrumia | (blank)
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| hyponatrumia | A serum sodium level of less than 136 mEq/L. A deficiency of sodium in the blood
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| hypernatremia | >145mEq/L An abnormally high plasma concentration of sodium ions.
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| *hyperkalemia | >5 mEq/L An abnormally high concentration of potassium ions in the blood.
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| *hyperkalemia cause less common more dangerous | cardiac arrest, renal failure, medications, extensive tissue trtauma-burns, crush injuries, severe infections, rapid IV infusion
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| pseudo hyperkalemia | (blank)
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| S/S hyperkalemia | abnormal heart rate/rythem/ecg changes skeletal muscle weaqkness tremors, irritability GI diarrhea colic, Nero paresthesias flacid paralysis Collaborative care
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| paresthesias | A skin sensation, such as burning, prickling, itching, or tingling, with no apparent physical cause.
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| Calcium | 8.5 to 10mEq/L 99% bound to phosphorus to form minerals in bones and teeth only 1% extracellular and ionized (free) active
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| actions of ionized Calcium | regulates muscle contraction and relaxation Maintains cardiac function, acts in blood clotting process
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| Potassium | <3.5 mEq/L intracellular cation (K+) vital to cellular metabolism especially skeletal and cardiac muscle activity Daily intake needed, kidneys primary regulator aldosterone shifts in and out of cells in response to ph of the blood
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| hypocalemia | <8.5mEq/L low calcium
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| hypercalemia | serum calcium >10mEq/L
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| hypercalemia causes | hyperparathyroidism malignancies lack of weight bearing w/ prolonged immobility self limited in a successful kidney transplant and excessive intake of ViD or Ca thiazide diuretics and renal failure
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| thiazide diuretics | Any of a group of drugs that block reabsorption of sodium in the distal tubules of the kidneys, used as diuretics primarily in the treatment of hypertension.
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| S/S hypercalemia | muscle weakness slow GI Abn heart rythm
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| hypercalemia may lead to | peptic ulcer, kidneystones, cardiac arrest
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| magnesium | 1.6-2.6mEq/L
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| magnesium characteristics | mainly intracellular in bone, green veggies, excreated kidneys, vital 2 cellular function, affected by K and Ca levels
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| K and Ca | K Abbrev. for potassium.Abbrev. Ca for calcium.
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| hypomagnesia | <1.6mEq/L
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| Acidosis | The condition where the hydrogen ion concentration increases above normal (reflected in a pH below 7.35).
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| Alkalosis | The condition where the hydrogen ion concentration decreases below normal (reflected in a pH above 7.45).
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| Alkalosis Acidosis application | (blank)
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| acid base balancenormal p.h. | 7.35-7.45
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| body constantly produces acids | carbonic acid
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| eliminated through lungs | as co2
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| lactic hydrochloric sulfuric | kidney
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| most acids and bases are | weak
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| the major base = | bicarbonate
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| body constantly responds to regulate ph by | buffer systems, respiratory systems, renal (metaBOLIC) SYSTEMS
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| buffer systems, | IMMEDIATE RESPONSE
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| RESPIRATORY SYSTEMS | RESPONDS W/IN MINUTES
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| RENAL (METABOLIC) SYSTEMS | RESPONDS HRS TO DAYS
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| ARTERIAL BLOOD GAS MEASUREMENT PH NORMAL= () ACIDIC =() ALKALINE =() | PH NORMAL= =7.35-7.45 ACIDIC <7.35 ALKALINE = >7.45
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| Pco2 NORMAL = ACIDIC = ALKALINE = | NORMAL = 34-45 MMHg ACIDIC =>45 MM hG ALKALINE =< 35 mm Hg
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| Pco2 | Partial Pressure of Carbon Dioxide
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| HCo3 NORMAL = ACIDIC = ALKALINE = | NORMAL =22-26 mEq/L ACIDIC = <22mEq/L ALKALINE =>26 mEq/L
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| HCo3 | Bicarbonate
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| pO2 normal hypoxia | normal = 80-100mm Hg hypoxia<80 mm Hg
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| pO2 | Partial Pressure of Oxygen
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| hypoxia | Insufficient levels of oxygen in blood or tissue
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| Acidosis | A state characterized by actual or relative decrease of alkali in body fluids in relation to the acid content; depending on the degree of compensation for the acidosis, the pH of body fluids may be normal or decreased; an accumulation of acid metabolites
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| Acidosis | H ions concentration increases and pH <7.35
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| Acidosis respiratory | unable to get rid of CO2
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| Acidosis metabolic | excess acid or lack of bicarb
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| alkalosis | A pathophysiological disorder characterized by H-ion loss or base excess in body fluids (metabolic alkalosis), or caused by CO2 loss due to hyperventilation (respiratory alkalosis).
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| alkalosis | H ion concentration decreases below normal and ph > 7.45
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| alkalosis respiratory | exce4ssive co2 loss
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| alkalosis | bicarb excess or loss of H ions
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| symptoms of acidosis respiratory | ph <7.35, pCO2 > 45mm Hg resp hypoventilation is cause (likely Resp. can't respond) Neuro: HA, blurred vision, irritable, confused
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| symptoms of Acidosis Metabolic : pH | Metabolic : pH < 7.35, HCO3 < 22mEq/L resp. hyperventaltion to blow off CO2, NEURO, HA, weak, fatigue, confusion, stupor, coma GI: N/V Skin:warm/ flushed CV Dysrhythmias d/t hyperkalema
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| symptoms of alkalosis | respiratory ph>7.45, pCO2 <35mm Hg resp rapid shallow breathing cause NEURO panic light headed paresthesias of extremities lead to seizure LOC CV palpitions, chest tightness
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| symptoms of alkalosis metabolic | ph>7.45, HCO3 >26mEq/L RESP response dec rate and depth of respirations NEURO; altered mental status numbness tingling at mouth & extremities muscle spasms may lead to seizure LOC CV: Arrhythmias d/t hypokalemia
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