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F/E MCC Block 1
Chpt 52 Kozier and Kee
| Question | Answer |
|---|---|
| Role of Sodium (Na+) | (extracellular) osmolarity, affects water distribution between ECF and ICF. Regulates body fluids. |
| Na sources | bacon, beef cubes, catsup, corned beef, ham, tomatoe juice, soda crackers, pickles |
| Hyponatremia lab values | Na < 135 mEq/L |
| Symptoms of Hyponatremia | muscle weakness, headaches, lethargy, confusion, siezures,abdominal cramps, tachycardia |
| Hyponatremia etiology | vomiting, diarrhea, surgery, diuretics( water loss), kidney disease, excessive perspiration |
| Hyponatremia management | fluid restictions, Na rich foods, monitor I/O, monitor labs |
| Hypernatremia lab values | Na >145 mEq/L |
| Symptoms of Hypernatremia | Flushed dry skin, agitation, elevated body temperature, increased BP, nausea, vomiting, hypertension, muscle twitching |
| Hypernatremia etiology | excess Na intake leads to elevated serum sodium which leads to dehydration and increase in myocardial depolarization |
| Hypernatremia management | strict I/O, encourage fluids, Na restriction, monitor labs |
| Normal lab values of Sodium (Na+) | 135 - 145 mEq/L |
| Role of Calcium (Ca2+) | Promote normal nerve and muscle activity. Promotes normal neve and muscl activity. Increases contraction of heart muscle. Maintain cell permeability, protes blood clotting,aides formation of bone and teeth |
| Sources of Ca | dairy products, spinach, OJ, seeds, nuts |
| Hypocalemia etiology | Vit. D deficient, pancreatisits, Alkalosis (high pH), chronic renal failure, chronic alcoholism |
| Hypocalcemia symptoms | Chvostek's sign(facial nerves) , Trousseau's(carpal spasm from BP cuff)sign, numbness, tingling, hyperative reflex, tetany, muscle cramps, ECG abnormalities |
| Hypocalcemia management | Calcium rich foods, supplements, |
| Hypercalcemia Etiology | Osteometastasis, Paget's disease (brittle bones), osteoporosis, prolonged immobolization, acidosis (low pH) |
| Hypercalcemia symptoms | anorexia, weekness, hypoactive reflex, flank pain, decreased LOC, personality change, cardiac arrest, THINK CARDIAC |
| Normal lab values of Calcium (Ca2+) | serum ionized 4.5 (hypo) - 5.6 mg/dL (hyper) total serum 9.0 (hypo) - 10.5 mg/dL (hyper) |
| Role of Potassium (K+) | Transmission and conduction of nerve impules and for contractioin of smooth cardiac and skeletal muscles, Changes carbs to energy and amino acids to protiein. |
| Sources of potassium | fruits, fruit juice, veggies, bananas and dried fruits |
| Hypokalemia etiology | When cells are damaged K+ leaks from the cell into the intravascular fluid and is excreted by the kidneys. With cellular lossof K+, K+ shifts from blood plasma into the cellto restore the cellular K+ balance. Vomit and diarrhea 80-90% excreted in Urine |
| Hypokalemia symptoms | Nausea, vomiting, dysrhythmia, ab distention, soft flabby muscles. |
| Hypokalemia lab values | K < 3.5 mEq/L |
| Hypokalemia management | monitor heart rate/rhythm, oral/IV potassium, rich diet, education on K+ loss in diuretics |
| Hyperkalemia etiology | Renal failure, hypoaldosteronism, potassium conserving diuretics, renal insufficiency |
| Hyperkalemia lab values | K > 5.0 mEq/L |
| Hyperkalemia symptoms | nausea, ab cramps, oliguria, tachycardia, weakness, nubness/tingling in extremities |
| Hyperkalemia management | Monitor cardiac status and ECG, diuretics and glucose/insulin as ordered, Hold potassium supplements and K+ conserving diuretic |
| Function of Phospate (PO4-) | primary ICf anion, essential to function of muscle, red blood cells & nervous system. Deposited wth Ca for bone and tooth structure, inversly related to Ca. Energy transfer in cells, celolular osmotic pressure, component of nucleic acids (DNA/RNA) |
| Function of Magnesium (MG2+) | ICF intracellular metabolism, especially in the production and use of ATP. Necessary for protien and DNA synthesis within cells. transmits neuro muscular activity. myocardial contraction |
| Function of Chloride (Cl-) | ECF. functions with Na+ to regulate sodium osmolity and blood volume. major gastric juice component as hydrochloric acid (HCI), regulates acid base balance |
| Function of Bicarbonate (HCO3-) | ICF & ECF. regulates acid base balance as a component of the arbonic acid-bicarbonate buffering system |
| Phosphate lab values (PO4)_ | 1.8 - 2.6 mEq/L or 2.5 - 4.5 mEq/L |
| Magnesium lab value (MG2+) | 1.5 - 2.5 mEq/L or 1.6 - 2.5 mEq/L |
| Chloride lab value (Cl-) | 95 - 108 mEq/L |
| oliguria | low urine output <30cc/hr |
| ICF intracellular fluids | fluids with in cell membreanes, 40 % body weight, provides cells with internal aqeous medium used for chemical functions |
| ECF extracellular fluid | fluid found outside of cell membrane, 15 - 20% of body weight, transport system |
| Components of ECF | plasma (intravascular fluid) 20% of ECF and intersistal fluid (in tissues) 75% of ECF |
| List four ways body fluids move | filtration, diffusion, osmosis & active transport |
| Filtration | movement of fluid through a membrane as a result of hydrostatic pressure |
| Diffusion | process by which solid, particulate matter moves from an area of higher concentration to an area of lower concentration |
| Osmosis | water moves through semipermeable membrane from a solution of lower concentration to a high concentration |
| active transport | metabolic energy (Na/K pump) is expended to move cells from less consentrated solution to more concentrated one |
| thirst center of brain | regulated by hypothalamus. stimulated by increased serum osmolarity and decreased blood volume to kidneys |
| four routes of fluid output | urine, feces, insensible loss (lungs, perspiration) |
| sensible loss | perceived by individual |
| insensible loss | thorugh skin and lungs. not noticeable to individual |
| ADH Antidiuretic hormone | released from hypothalamus stimulation, increases the reabsorption of water into blood decreasing serum osmolality. |
| Aldosterone | mineralcorticoid produced by adrenal cortex, causes kidneys to reabsorb Na and excrete K (increased Na = Increased water retention) |
| Fluid Volume Deficit FVD | loss of water and electrolytes fom ECF AKA: hypovolemia |
| FVD causes | abormal loss through skin, GI or kidney, decreased fluid intake, movement of fluid to third space |
| Fluid Volume Excess FVE | retention of water and electrolytes in equal portions to normal ECF. AKA: hypervolemia |
| Symptoms of FVD | dry skin and mucous membrane, poor skin tugor, coated tongue, low BP, collapsed vein, weak pulses, oliguria |
| Symptoms of FVE | increased Hgb and Hct, Increased BUN, increased specific gravity, increased serum osmolarity |
| BUN | Blood Urea Nitrogen - renal/liver function 10 - 20 mg/dL or 3.6 - 7.1 mmol/L (SI units) |
| RBC | Red Blood Count - hemoglobin and hematocrite Male: 4.7 - 6.1 million Female: 4.2 - 5.4 million |
| WBC | Leukocytes - evaluates for infection 1. Tota number of WBC: 5000 - 10000mm3 2.Differential (% of each type of WBC) |
| Creatinine | Impaired renal function Male: 0.5 - 1.1 mg/dl Femle: 0.6 - 1.2 mg/dl |
| HgB | Amount of HgB in blood as part of CBC rapid measurement of RBC Male: 14 - 18 g/dl Female: 12 - 16 g/dl |
| Hct | Hematocrit % of RBC found in 100 ml Male: 0.42 - 0.52 volume fraction (%) Female: 0.37 - 0.47 volume fraction (%) |
| K | Potassium electrolyte/cardiac essential Blood: 3.5 - 5.0 mEq/L |
| Na | Sodium electrolyte Blood: 135 - 145 mEq/L |
| Ca | Calcium parathyroid function and Ca metabolism Adult Total: 9.0 - 10.5 Adult Ionized: 4.5 - 5.6 |
| ABG | Arterial Blood Gas pH: 7.35 - 7.45 PaCO2: 35 - 45 mmHg HCO3: 22 - 26 mEq/L PaO2: 80 - 100 mmHg |
| list four types of acid/base imbalances | Respitory Acidosis, Respitory Alkalosis, Metabolic Acidosis, Metbolic Alkalosis |
| Respitory Acidosis ABG | pH<7.35, PaCo2>45, HCO3 about normal 22 - 26 |
| Respitory Alkalosis ABG | pH>7.45, PaCo2<35 |
| Metabolic Acidosis ABG | pH<7.35, HCO3<22 |
| Metabolic Alkalosis ABG | pH>7.45, HCO3>26 |
| S/S Respiratory Acidotic state | Increased HR & RR, headache, diziness, confusion, decreased LOC, convulsions, warm flushed skin |
| S/S Metabolic Acidotic state | Kussmal respirations (deep/rapid), lethargy, confusion, headache, weakness, nausea, vomiting |
| S/S Resiratory Alkalotic state | SOB, tight chest, light head, parathesis (burning/prickling), difficulty concentrating, tremulous, blurred vision |
| S/S Metabolic Alkalotic state | decreased RR/depth, diziness, parathesis (burning/prickling), Tetany |
| What happens to the serum osmoality in a dehydrated patient? | Increase. Decrease in fluid, leads to an increase proportion of solutes to fluid volume in the blood. |
| What happens to the serum hematocrit level in a patient with a FVE? | Decreases. Increased fluid leads to a decrease in the proportion of a solutes to fluid volume in the blood. |
| Cations (+) | Potassium K+ ; Sodium Na+ ; Calcium Ca2+ ; Magnesium Mg2+ |
| Anions (-) | Chloride Cl- ; Bicarbonate HCO3- ; Phosphate PO4- ; Sulfate SO4- |
| Adult Body Fluid Volume | ICF 40%, ECF 20% - Intracellular 15% & Intravascular 5%, Total body fluid 60% |
| platelets | thrombocytes: 150K - 400Kmm3 |
| R.O.M.E. Acid Base Balance interpret | RESPIRATORY = OPPOSITE (Ph/PaCO2 values opposed means respiratory problem) METABOLIC = EQUALS (pH/PaCO2 values both high or low means a metabolic problem) |
| pH acid or base | A=Acid <7.35 B=Base >7.45 Alkaline |
| Metabolic Acidosis | Excessive blood acidity caused by and overabundance of acid or loss of bicarbonate from the blood |
| Respiratory Acidosis | a buildup of carbon dioxide in the blood that results from poor lung function |
| Metabolic Alkalosis | overabundance of bicarbonate in the blood or a loss of acid in the blood |
| Resiratory Alkalosis | carbon dioxide in the blood that results from rapid or deep breathing |
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lucky duck
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