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FINALS F&E
Adult Health I
| Question | Answer |
|---|---|
| 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
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