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Albumin 3.5-5.0 most abundant plasma protein of the intravascular space. Produced by the liver.
Sodium 135-145 Exciter. When you excrete Na, you save K. Major extracellular cation. Helps nerve and muscle cell activity. Found in table salt, pork products, butter, condiments, canned and processed foods
Potassium 3.5-5.0 Exciter.Major intracellular cation. Excreted by kidneys only. Responsible for cell excitability, nerve impulse conduction, muscle contraction,intracellular osmolarity. Found in meats, fish,oranges dried fruit Low in eggs, bread and cereal grains.
Magnesium 1.3-2.1 Stabilizer Intracellular. Absorbed in GI, excreted by kidneys. Stabilizes neuromuscular contractions, normal functions of nervesous and cardiovascular system, protein synthesis, blood coag, formation of healthy bones. Found in green leafy veg,nuts
Calcium 9.0-10.5 Stabilizer. Extracellular. Stored in bones and teeth. Stabilizes cell membranes, reduced permeability, transmits nerve impulses, contracts muscles, coag blood, forms bones and teeth. Need vit D to absorb. Found in dairy. broccoli, kale, eeg yolks
Phosphorus 3.0-4.5 Most abundant intracellular anion. Stored as ATP. Responsible for energy metabolism. Perfectly inverse relationship w/Ca. Fix Ca then phos usually follows. Found in dairy, peas, soft drinks, meat, eggs, some grains.
Hypertonic solution >300 More solute than solvent. Greater osmotic pressure.
Hypotonic Solution <270 More solvent than solute. Lower osmotic pressure
Isotonic Solution 270-300 Osmotic pressures are equal on both sides
Hypertonic Dehydration Water loss is greater than electrolyte loss. Cells shrink.
Hypertonic Dehydration Etiology inadequate water intake, nausea, dysphagia, long term NPO, watery diarrhea, DI, ^solute intake, TPN, osmotic diuretic use (mannitol)
Hypertonic Dehydration Interventions Replace the WATER. Encourage oral intake, or hypotonic IV solutions: 1/2 NS (0.45% NaCl in H2O)
Hypotonic Dehydration Greater loss of electrolytes than water. Cells swell. *Rare
Hypotonic Dehydration Etiology renal failure, hyponatremia, not eating but still drinking water, water intoxication
Hypotonic Dehydration Interventions Aimed at pulling water out of the cells. Hypertonic IV solutions: D5NS (5% dextrose in 9.0% NaCl in water) D5LR (5% dextrose in lactated ringers)
Isotonic Dehydration Most common, also called hypovolemia. Equal amounts of water and electrolytes lost
Isotonic Dehydration Etiology hemorrhage, NG suction, diarrhea, vomiting, wound drainage, profuse diaphoresis, burns, diuretics
Isotonic Dehydration Interventions Replace the VOLUME. Encourage PO electrolyte replacement solutions (pedialyte) IV solutions: NS (0.9% Na in water), LR (contains Na, K, Ca, Cl, and lactate), D5W (dextrose in water) Sometimes blood transfusion
Hypovolemic Shock 1/3 of body fluid is lost. b/p decreased. HR increased initially, then decreased. Urine output decreased, with DI increased
Hypertonic Fluid Overload Too much sodium intake or rapid infusion of a hypertonic solution, cirrhosis. Cells shrink. Urine output is high.
Hypertonic Fluid Overload Treatment sodium restriction, loop diuretics w/slow infusion of hypotonic IV solution.
Hypotonic Fluid Overload Water intoxication, SIADH, overuse of hyptonic IV solutions. Cells swell.
Hypotonic Fluid Overload Treatment Osmotic diuretics (mannitol), water restriction
Isotonic Fluid Overload Hypervolemia (want water and Na off) Poorly controlled IV therapy, renal failure, steroid use.
Isotonic Fluid Overload Treatment Decrease the volume-Fluid restriction Administration of loop diuretic like lasix
Dehydration Increased Hgb and HCT (hemoconcentration) Increased glucose, BUN, protein and var. electrolytes Decreased output with increased specific gravity
Fluid Overload Decreased Hgb, HCT and protein (hemoconcentration) Serum electrolytes normal or decreased Increased unrine output (unless d/t renal failure) Decreased urine specific gravity
Osmotic Diuretics Mannitol. Large molecule that is freely filtered, but not reabsorbed. Attracts water into the renal tubule. Used to decrease ICP due to fluid overload
Loop Diuretics Lasix (furosimide), bumetinide, bumex. Blocks active transport of Na and Cl in the ascending loop and DCT. Hyponatermia, hypochloremia, hypokalemia, hypomagnesemia, hypocalcemia. Used for fluid overload and renal failure.
Thiazides Hydrochlorothiazide (HCTZ or HydroDIURIL) Blocks Na and Cl reabsorption in DCT. Hyponatermia, hypochloremia, hypokalemia, hypomagnesemia, hypocalcemia. Used for fluid overload and renal failure.
Potassium Sparing Diuretics Spironolactone (Aldactone) Inhibits aldosterone. Results in water and Na loss, but also K and Mg retention. Used for heart failure, edema, ascites, hypertension, hypokalemia
Glucose 70-100
Chloride 98-106 Extracellular. Maintains osmotic pressure and helps gastric cells produce HCL
Aldosterone *volume. Secreted from adrenal cortex. Acts on the kidneys. Increases blood osmolarity and blood volume, decreases plasma K. Reabsorbs Na and H2O and secretes K. Too much Cushings syndrome, Adenoma, Conn's disease. Too little Addison's disease
ADH-Anitdiuretic Hormone(vasopressin) *Osmolarity. Secreted from posterior pituitary. Acts on kidney tubules and collecting ducts. Reabsorbs water. Reduces blood osmolarity (more dilute) and increases blood volume. Too much SIADH, too little DI
Natriuretic Peptides Secreted from specialized cells in the atria and ventricles of the heart. Acts on Kidney nephrons. Increases excretion of sodium and water. Decreases blood volume, blood pressure, and increases urine output.
Created by: J777