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Adult Health I

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)
Created by: TayBay15