Fluid and Electrolytes
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each of the black spaces below before clicking
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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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Created by:
hanalin2
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