N245 Final
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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| show | 60% of body weight; 40% ICF' 20% ECF;' 4% Plasma; 16% Interstitium
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| Serum Osmolality | show 🗑
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| Osmolarity | show 🗑
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| show | (Na+ X 2)+(glucose/18)+(BUN/2.8)
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| show | 230-300 mOSm/kg/liter
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| show | Tension that effective osmotic pressure exerts on cell size through movement of water across the cell membrane. Determined through electrolytes which cannot permeate membrane and therefore pull water out of cell via osmosis.
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| Isotonic solution | show 🗑
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| Hypotonic solution | show 🗑
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| show | Concentration outside cell of electrolytes is larger than inside. Water is being pulled out of cell and cell shrinks.
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| show | Water and Sodium
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| show | changes in vascular and interstitial fluid volume
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| show | Hyponatremia or Hypernatremia (low or high sodium levels)
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| show | Result of saline deficit or excess (respectively) and therefore isotonic fluid volume deficit or excess
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| Hypotonic dilution of extracellular sodium | show 🗑
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| show | Hypernatremia
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| show | 1-2% change in serium osmolality activates thirst; this is emergency response and it normally doesn't come to this. Increased osmolality stimulates osmoreceptors via tonicity; vascular stretch receptors monitor volume; angiotension II responds to low vol.
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| show | ADH opens aquaporin channels at collecting duct of kidneys to allow reabsorption of water into blood. Vasopressin receptors are activated to cause vasoconstriction even in low blood volume
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| R-A-A System for regulating water and sodium | show 🗑
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| Effects of Isotonic Fluid (saline) Deficit | show 🗑
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| show | Baroreceptors sense volume deficit; sympathetic nervous system increases Na and H2O reabsorption; ADH released from pituitary to increase thirst.
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| show | Normal Na associated with volume loss; acute weight loss; increase in ADH (as compensation)=decreased urine output but increased urine specific gravity and osmolality; increased serum osmolality; increased thirst, hematocrit, BUN
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| show | Hypotension; Tachycardia, weak pulse; Shock; Decreased ECF volume; Impaired temperature regulation (increased body temp)
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| Saline (isotonic fluid) Excess | show 🗑
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| Saline Excess compensatory mechanisms | show 🗑
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| Saline Excess manifestations | show 🗑
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| Serium Electrolyte Imbalance causes | show 🗑
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| Hypernatremia Causes | show 🗑
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| show | Elevated serium Na, osmolaliity, BUN, hematocrit; Increased ADH and thirst; Intracellular Dehydration; Headache, agitation, decreased reflexes, seizures, coma, tachycardia, decreased BP
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| show | Sodium loss or water gain; inadequate sodium intake
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| Hypovolemic Hyponatremia | show 🗑
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| show | ECF volume is abnormally increased
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| Isovolemic Hyponatremia | show 🗑
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| Hypertonic Hyponatremia | show 🗑
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| Hypotonic Hyponatremia | show 🗑
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| Hyponatremia Manifestations | show 🗑
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| show | Predominantly intracellular; largely in muscle; largely excreted and regulated by kidney; controlled by aldosterone(Na retain, K excrete)
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| show | When H ions increase inside the cell, K gets pushed out. This helps buffer but can cause hyperkalemia. Kidneys then get rid of K to prevent hyper.
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| show | When you give insulin, acidosis corrected and H is no longer pushing K out of cell. But important to regulate K levels because may have already been pushed out and excreted, so with type 1 hypokalemia can occur.
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| Functions of Serium Potassium | show 🗑
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| show | As K increases=more positive potential (cells more excitable and rate of repolarization incrases) K decrease=more negative potenital, takes greater stimulus to excite cell and open Na channels, rate of repolarization delayed
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| Hypokalemia Causes | show 🗑
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| show | Impaired ability to concentrate urine; anorexia, nausea, vomit, constipation, ab distenstion; muscle flabbiness, weakness, fatigue, cramps, tenderness,paralysis; hypotension, increased sensitivity to DIG, dysrhythmias; confusion; metabolic alkalosis
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| Hypokalemia EKG changes | show 🗑
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| show | Decreased renal elimination, excessive rapid administration, shifts from ICF to ECF (as with H ions)
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| show | nausea, vomit, diarrhea, cramps; weakness, dizziness, cramps at muscles; EKG changes, cardiac arrest
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| Hyperkalemia EKG Changes | show 🗑
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| Calcium and Phosphorus Facts and Distribution | show 🗑
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| Regulation of Calcium and Phosphorus | show 🗑
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| show | Protein bound: cannot diffuse into ICF from plasma; Complexed: chelated with citrate, phosphate, not ionized; Ionized: Free to influence cellular functions
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| show | Enzyme rxns, membrane potentials and neuronal excitability, muscle contraction, hormone and NT release, cardiac contractility/automaticity, blood coagulation
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| Hypocalcemia Causes | show 🗑
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| show | increased neuromuscular excitability, cramps, seizure
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| show | Increased intestinal absorption, excessive vitamin D, increased bone resorption (increased PTH, malignant neoplasms, promlonged immobility), decreased elimination (thiazide diuretics, lithium therapy)
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| show | Decreased neuromuscular excitability; weakness, lethargy, CNS depression; inability to concentrate urine, kidney stones; hypertension, AV block
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