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Level 115

Electrolytes & Acid Base Balance


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metabolic acidosis
Abnormal condition of high hydrogen ion concentration in the extracellular fluid caused by either a primary increase in hydrogen ions or a decrease in bicarbonate.
metabolic alkalosis
Abnormal condition characterized by the significant loss of acid from the body or by increased levels of bicarbonate.
respiratory acidosis
Abnormal condition characterized by increased arterial carbon dioxide concentration, excess carbonic acid, and increased hydrogen ion concentration.
respiratory alkalosis
Abnormal condition characterized by decreased arterial carbon dioxide concentration and decreased hydrogen ion concentration.
causes of Hyponatremia
GI loss - NG suction, vomit, diarrhea, Renal loss
causes of Hypernatremia
Excess aldosterone secretion, water deprivation or increased water loss.
causes of Hyperkalemia
Fluid Volume Deficit, Renal Failure, Acidosis
causes of Hypokalemia
Diuretics (Lasix), Diarrhea, GI loss, polyuria
causes of Hypercalcemia
Osteoperosis, hyperparathyroidism, immobilization
causes of Hypocalcemia
chronic alcoholism, chronic renal failure, Vitamin D deficiency
Potassium (K)
[Ar] 4s¹
Signs and symptoms of Fluid volume excess
1)weight gain 2)High BP 3)shallow, rapid respirations 4)crackles 5)Fluid intake > outake 6)weakness, fatigue, dyspnea 7)edema, taut shiny skin 8)JVD 9)bounding pulse
Foods high in potassium
potatoes, raisins, bananas, spinach, avacados, carrots
causes of Hypermagnesemia
Renal failure, excess intake
causes of Hypomagnesemia
Malnutrition, alcoholism, diarrhea, vomiting, polyuria
Hypotonic solution
Is a solution having a LOWER osmolarity than the cytoplasm of the cells
S&S of Hypokalemia
muscle weakness & cramps, irregular pulse
S&S of Hypocalcemia
pathological fractures, Trousseau's sign, Chvostek's sign
S&S of Hypomagnesemia
hyperactive deep tendon reflexes, muscle tremors
Renal system (kidneys)
3rd line of defense for acid base balance.
S&S of Hypercalcemia
hypoactive reflexes, cardiac arrest
causes Hypervolemia - crackles, SOB
Too much fluid to patient with kidney failure or CHF.
Osmolality
concentration of solutes in a solution.
Lasix (diuretic)
causes loss of potassium. (hypokalemia)
examples of Isotonic solutions
1)Lactaid Ringers 2) NS (0.9% NaCl) 3) 5% Dextrose
pH
= -log10 [H?(aq)]
causes of Fluid Volume Deficit
1)decreased intake 2)increased excretion 3)fluid shift 4)strenuous exercise 5)extreme heat/dryness 6)fever (increased metabolic rate)
Blood gas values - pH, PO2, HCO3, PCO2
1)7.35-7.45 2) 80-100 mm Hg 3) 22-27 mEq/L 4)35-45 mm Hg
Metabolic Imbalance
Bicarbonate (PCO2) concentration corresponds with pH.
Absorbs nutrients H2O.
Fluid Regulation of GI tract
Blood, Lungs, Kidneys
Acid Base regulatory mechanisms
Istotonic solution
Expands ECF volume. (same concentrate as plasma.)
Respiratory system (lungs)
2nd line of defense for acid base balance.
Aldosterone
Increases reabsorption of Na and water and excretion of K in kidneys. Causes vasoconstriction, increases BP. (main Na-retaining hormone)
Fluid Volume Excess
Excessive retention of water and Na in extracellular fluid.
Hyponatremia
Net gain of water or loss of Na-rich fluids.
S&S of Fluid Volume Excess
1)weight gain 2)weakness, fatigue 3)dyspnea with exertion 4)pitting edema 4)JVD 5)taut, shiny skin 6)bounding pulse 7)shallow, rapid respiration 8)crackles 9)high BP 10)fluid intake > outake
Fluid Output
Occurs through kidneys, skin, lungs and GI tract.
Respiratory Imbalance
Bicarbonate (PCO2) has opposite response of pH.
Fluid Regulation of Nervous System
Hypothalamus controls thirst - thirst center.
Fluid Regulation of Kidneys
1)Filters blood 2)Excretes urine 3)Secretes aldosterone - reabsorbs Na, H2O and Cl and exceretes K.
Fluid Regulation of Lungs
1)Regulates O2 and CO2 2)Eliminates H 3)Acid/Base Balance
Vegetables, nuts, fish
Foods high in Magnesium
serum Magnesium level
1.3 - 2.1 mEq/L
serum Potassium level
3.5 - 5 mEq/ L
serum Calcium level
4.5 - 5.5 mEq/L
S&S of Hypernatremia
Extreme thirst, sticky tongue and mucous membranes, postural hypotension.
Hypernatremia value
serum sodium greater than 145 mEq/L
Hypertonic solution
Is a solution having a GREATER osmolarity than the cytoplasm of the cells
Blood - Bicarbonate
1st line of defense of acid base balance. (immediate response, only small fluctuations)
Fluid Excretion
Vomiting, diarrhea, abnormal drainage, excessive use of laxatives, enema, diuretics, blood loss, diaphoresis, burns
S&S of Fluid Volume Deficit
1)Increased pulse and respirations 2)decreased BP 3)output > intake 4)dry oral mucosa 5)increased thirst 6)weight loss (5lbs.) 7)scanty or concentrated urine 8)collapsed neck veins
Fluid Regulation of Thyroid Gland
Increases blood flow in the body and increases output.
serum Sodium level
135 - 145 mEq/L
Oxygen Saturation
Point at which hemoglobin is saturated by O2.
Sensible Loss
loss that is perceived or is measurable. (wound drainage, GI tract, urine)
S&S of Hyperkalemia
life threatening dysrhythmias
Sodium (Na)
[Ne] 3s¹
dehydration
Excessive loss of water from the body tissues, accompanied by a disturbance of body electrolytes.
Insensible Loss
Continuous loss occurring through skin and lungs.
Effects of Aldosterone
Excretes K and retains Na.
Hypovolemia
Body loses both water and electrolytes from the ECF.
Fluid Regulation of Cardiovascular system
Distributes nutrients and water throughout the body.
Postassium (K)
Major cation in the intracellular fluid.
reciprocal
potassium has action with sodium.
Renin
Released in response to decreased blood flow or decreased pressure in nephrons.
S&S of Hyponatremia
personality change, postural hypotension
S&S of Hypermagnesemia
hypoactive deep tendon reflexes