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Fluid and Electrolytes

Quiz yourself by thinking what should be in each of the black spaces below before clicking on it to display the answer.
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Question
Answer
show 135-145 mEq/L  
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show 3.5-5 mEq/L  
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show 7-20 mg/dl  
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normal hematocrit   show
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normal urine specific gravity   show
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normal glucose   show
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normal osmolality   show
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show dry mucous membranes, comes later  
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FVD late sign   show
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show decreased temp, blood shunted to central area  
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show increased respiratory rate bc acidotic, blowing of CO2; thick and sticky secretions  
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show severe, generalized third spacing  
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most common site, 3rd spacing   show
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primary mediator of fluids   show
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show stage where fluid moves from one space to another  
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show fluid in interstitial compartments  
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show normal to high (hemoconcentration)  
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FVD potassium   show
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show high (hemoconcentration); in children may be low but not pathologic  
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FVD glucose   show
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show high >1.030  
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show >300, more particles ↑ number of particles, concentration  
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FVE hemodynamic signs   show
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show seen with FVE, Confusion, dizziness, convulsions, coma  
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pulmonary edema   show
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FVE general signs   show
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FVE first sign seen   show
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neck vein distension   show
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goal of Rx for FVE   show
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show renal failure, heart failure, excess fluid intake (without electrolytes), high corticosteroids, high aldosterone, plain water enema, NG irrigations, excess hypotonic IV fluids, SIADH, inappropriately prepared formula (dilute formula)  
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show excessive hypertonic fluids, binge drinking contest, psych disorders, drowning in fresh water, inappropriate dialysis  
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FVE, potassium   show
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show very low, <125  
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FVE, BUN   show
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show low, <1.005  
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show normal to high (stress response, >120)  
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show lethargy, weakness  
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increased sodium and potassium signs   show
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acid   show
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base   show
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buffers   show
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carbonic acid   show
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acid-base homeostasis   show
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carbonic acid-bicarb system   show
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alkaline environment   show
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show carbonic acid compensates and dissociates into CO2 and H20, CO2 exhaled by lungs, system activates rapidly but exhausted quickly  
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respiratory buffer system, breathing changes   show
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renal buffer system: time and effectiveness   show
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renal buffering system, bicarbonate   show
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show regulatory mechanism to return pH to normal level by transforming acids and bases within the body  
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primary metabolic disturbance   show
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acute primary respiratory disturbance   show
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show pH is fully corrected (normal)  
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show buffers are in the process of working; pH is low but the bicarb is elevating to compensate (or pH is high but CO2 is elevating to compensate)  
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pH   show
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HCO3- (bicarb)   show
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BE "base excess"   show
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show *Concentration of anions (HCO3- , Cl-, protein, phosphate, & sulfates) and cations (Na+, K+, MG++, & Ca++) *10-12 mEq/L normal *increased in metabolic acidosis (but can be normal) *calculated by Na - Cl + bicarb  
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show the percent of Hb saturated with O2, a calculated value (indirect measurement), calculated with pH and PaO2 (combination of O2 sat, PaO2, and Hb), indicates tissue oxygenation  
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PaO2   show
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the lower teh PaO2 pressure, the ....   show
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show correlate with dramatic drops in oxygen saturation  
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PaO2 normal values   show
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PaCO2   show
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show correct cause, rebreathe CO2 as needed, alter ventilation rate, sedatives (for anxiety)  
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respiratory alkalosis assessment (7)   show
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show tachycardia, palpitations, increased myocardial irritability  
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show rapid shallow breathing (trying to retain CO2, oxygenate), chest tightness  
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show paresthesia, dizzyness, confusion, tetany, convulsion, numb/tingling, light headed, anxiety/panic, Loss of consciousness, hyperactive reflexes  
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show hyperventilation, sepsis/infection, over ventilation, hepatic cirrhosis  
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respiratory alkalosis: labs   show
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show correct cause, CPT, TCDB if able, suction as needed, semi-Fowlers, fluids to thin secretions, low-flow O2 as needed  
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show VS, ABGs, RR/depth, apical pulse, LOC, EKG, skin color/nail beds/mucous membranes, I&O  
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respiratory acidosis cardiac signs   show
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respiratory acidosis respiratory signs   show
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respiratory acidosis CNS signs (6)   show
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respiratory acidosis causes (4)   show
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show pH low <7.35, PaCO2 high >42, HCO3- normal (or elevated with compensation), hyperkalemia  
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show correct cause, restore normal fluid balance, adequate chloride (enhance renal absorption of sodium and excretion of bicarb)  
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show VS, ABGs, RR/depth, LOC, I&O, ECG  
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metabolic alkalosis GI signs (3)   show
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metabolic alkalosis CNS signs (10)   show
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met alkalosis respiratory signs (2)   show
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show tachycardia, HTN, PVC, atrial tachycardia, dysthrythmias (from FVE)  
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show vomiting, NG suctioning, eating bicarb-based antacids, diuretics  
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met alkalosis: labs   show
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met acidosis mgmnt (6)   show
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show used to treat metabolic acidosis (ketoacidosis), forces potassium back into cells  
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alkaline fluids for met acidosis   show
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show VS, ABGs, RR/depth, apical and peripheral pulses, ECG (bc of dramatic K changes), LOC, I&O  
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metabolic acidosis CV signs (4)   show
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metabolic acidosis resp signs   show
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metabolic acidosis CNS signs (6)   show
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show n/v, diarrhea, abdominal pain  
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show chronic diarrhea, malnutrition, starvation, renal failure, DKA, trauma, shock, sepsis, fever, salicylate toxicity  
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show low bicarb, decreased BE, increased anion gap, hyperkalemia (from breakdown of cells from acidosis), high metabolic acids (lactic acids, ketoacids)  
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