Free Online NCLEX LVN LPN: Electrolytes and Acid Base Balance #1 flashcards |

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Metabolic Acidosis

pH < 7.35 , PaCO3 normal or < 35, HCO3 < 22

Metabolic Alkalosis

pH > 7.45, PaCO2 normal or > 45, HCO3 > 26

Respiratory Acidosis

pH < 7.35, PaCO2 > 45, HCO3 >26

Respiratory Alkalosis

pH > 7.45, PaCO2 < 35, HCO3 < 22

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)

electrolyte imbalance in which cardiovascular is always a concern.

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

reverses dehydration.

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

measures hydrogen ion concentration in the body fluids.

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.

Fluid Regulation of GI tract

Absorbs nutrients H2O.

Acid Base regulatory mechanisms

Blood, Lungs, Kidneys

Renin-Angiotensin mechanism initiates

1) low blood volume 2)low serum Na 3) low BP 4)high serum K
5) low cardiac output

Respiratory Alkalosis

Result of hyperventilation.

Metabolic Acidosis

Results from severe diarrhea or renal disease.

Hypotonic solution

Water moves into cell and causes cell to swell. Fluid shift out of blood vessels into interstitial spaces.

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.

Renal System (kidneys)

Primary system in regulating fluid and electrolyte balance.

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

Foods high in Magnesium

Vegetables, nuts, fish

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

Respiratory Acidosis

Result of hypoventilation.

Metabolic Alkalosis

Results from vomiting, gastric suction, K deficiency, increased renal excretion of acid.

S&S of Hypernatremia

Extreme thirst, sticky tongue and mucous membranes, postural hypotension.

Hypernatremia value

serum sodium greater than 145 mEq/L

Hypertonic solution

solution with greater concentration than plasma.

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

Hypertonic solution

Water moves out of cell and causes cell to shrink.

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

Hyponatremia

serum Sodium level less than 135 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)

major electrolyte found in extracellular fluid

Dehydration

Water lost from body - no loss of electrolytes.

Insensible Loss

Continuous loss occurring through skin and lungs.

Fluid Regulation of Lungs

Regulates O2 and CO2, Acid/Base Balance and eliminates H+.

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

cause of decreased excretion

renal disease,cancer

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