Fluid & Electrolytes
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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| normal sodium | show 🗑
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| normal potassium | show 🗑
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| normal BUN | show 🗑
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| show | 40-50%
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| show | 1.002-1.030
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| normal glucose | show 🗑
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| show | 275-295
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| show | dry mucous membranes, comes later
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| show | hypotension
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| show | decreased temp, blood shunted to central area
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| FVD, respiratory | show 🗑
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| show | severe, generalized third spacing
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| show | abdomen (ascites, in peritoneal cavity?)
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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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| show | normal to high (stress response, >120)
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| FVD urine specific gravity | show 🗑
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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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| show | sign of FVE but not seen in kids, make sure know baseline for adults
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| show | prevent cerebral edema
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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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| show | low (hemodilution)
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| FVE, urine spec gravity | show 🗑
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| show | normal to high (stress response, >120)
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| show | lethargy, weakness
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| show | increased excitability
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| acid | show 🗑
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| show | binds to H+ ions in water
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| buffers | show 🗑
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| carbonic acid | show 🗑
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| show | bicarb: carbonic acid = 20:1
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| show | primary system, 50% of activity, to maintain balance l/t have to also use protein and phosphate buffer systems, 1-2 hours to kick in, bicarb is the major ECF buffer
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| show | hard for cells to grow
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| >>> Respiratory buffer system, carbonic acid | show 🗑
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| show | changes in depth/rate of resp alters it: hypoventilation retains CO2/carbonic acid and causes acidosis, hyperventilation loses CO2 and causes alkalosis
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| show | works w/in hours/days, more efficient than respiratory can go for longer periods of time
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| show | primary renal component, can be absobed as needed, combines HCl with ammonia to make ammonium, which is easily excreted by kidneys into urine
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| compensation | show 🗑
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| primary metabolic disturbance | show 🗑
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| show | causes an acute metabolic response
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| complete compensation | show 🗑
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| partial compensation | show 🗑
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| show | *negative logarithm of H+ ion concentration in mEq/L (as H+ ion concentration increases, pH decreases)*normal values 7.35 -7.45 (less is acidotic, more is alkalotic)
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| show | *normal 22-26 mEq/L (decreased in acidosis, increased in alkalosis)
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| show | indicates the amount of bicarb available in the ECF normal value: +/- 2 mEq/L
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| serum anion gap | show 🗑
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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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| show | amount of oxygen available to bind with hemoglobin, amount of pressure exerted on O2 by plasma
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| the lower the PaO2 pressure, the .... | show 🗑
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| show | correlate with dramatic drops in oxygen saturation
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| show | 75-100 mmHg (for every year above 60 drop 1mmHg)
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| show | *partial pressure of CO2 | *reflects adequacy of alveolar ventilation, regulated by lungs, alterations indicate resp disturbance | *normal values 35-45 mmHg (less is alkalotic, more is acidotic)
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| show | correct cause, rebreathe CO2 as needed, alter ventilation rate, sedatives (for anxiety)
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| show | VS, ABGs, RR/depth, LOC/anxiety, neuro checks, injury potential, I&O
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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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| respiratory acidosis management (7) | show 🗑
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| respiratory acidosis assessment (8) | show 🗑
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| respiratory acidosis cardiac signs | show 🗑
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| respiratory acidosis respiratory signs | show 🗑
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| show | HA, seizures, altered LOC, papilledema, twitching/tremors, drowsy --> coma
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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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| metabolic alkalosis mgmnt (3) | show 🗑
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| metabolic alkalosis assessment (6) | show 🗑
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| metabolic alkalosis GI signs (3) | show 🗑
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| metabolic alkalosis CNS signs (10) | show 🗑
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| show | hypoventilation, respiratory failure
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| met alkalosis CV signs (5) | show 🗑
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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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| show | if severe, sodium bicarb if pH<7.20, salts of organic acid (lactate, citrate), tromethamine THAM
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| met acidosis assessment (7) | show 🗑
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| metabolic acidosis CV signs (4) | show 🗑
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| show | Kussmaul/deep/rapid respirations, trying to blow off CO2
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| metabolic acidosis CNS signs (6) | show 🗑
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| show | n/v, diarrhea, abdominal pain
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| causes of metabolic acidosis | show 🗑
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| metabolic acidosis: labs | show 🗑
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| causes of metabolic acidosis | show 🗑
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| metabolic acidosis: labs | show 🗑
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| show | if severe, sodium bicarb if pH<7.20, salts of organic acid (lactate, citrate), tromethamine THAM
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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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| show | Kussmaul/deep/rapid respirations, trying to blow off CO2
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| show | think of septic patient: drowsy, HA (from cerebral edema), lethargy, coma, confusion/restless, weakness
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| show | n/v, diarrhea, abdominal pain
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| causes of metabolic acidosis | show 🗑
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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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