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85 Cards in this Set
- Front
- Back
Intracellular Fluid (ICF)
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- Comprises all fluid within the cells of the body
- About 42% total body weight - Approximately 28 L of body water in the average male and 20 L in the average female - Fluid Deficit - Body loses water in intracellular fluids - Fluids within cells - ⅔ of total body water |
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Extracellular fluid (ECF)
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All fluid outside a cell
- Broken into 3 compartments - Interstitial Fluid - Intravascular Fluid - Transcellular Fluid - About 17% of body weight |
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Interstitial Fluid
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Contains lymph, is the fluid between the cells and outside the blood vessels
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Intravascular Fluid
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Blood plasma found in the vascular system
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Transcellular Fluid
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Fluid separated from other fluids by a cellular barrier and consists of cerebrospinal, pleural, gastrointestinal (GI), intraocular, peritoneal, and synovial fluid
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Electrolytes
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- Substances in water that are also called minerals or salts
- Is an element or compound that when dissolved or dissociated in water or another solvent, separates into ions that are electrically charged |
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Cation
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- Positively charged electrolytes
- Sodium (Na+) - Potassium (K+) - Calcium (Ca2+) |
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Anion
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- Negatively charged electrolytes
- Chloride (Cl-) - Bicarbonate (HCO3-) - Sulfate (So4-) |
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Osmosis
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- Involves the movement of a pure solvent, such as water, across a semipermeable membrane from an area of lesser solute concentration to an area of greater solute concentration
*Movement of water across semipermeable membrane from lesser to greater concentration |
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Osmotic Pressure
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Is drawing power of water and depends on the number of molecules in solution
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Osmolality
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- The osmotic pressure of a solution is its osmolarity
- Expressed in osmols, or milliosmols per kilogram (mOsm/kg) of the solution - Normal serum osmolality is 275-295 mOsm/kg |
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Osmolarity
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- Another term that describes the concentration of solutions
- Reflects the number of molecules in a liter of solution - Is measured in milliosmoles per liter (mOsm/L) - Split into 3 groups - Hypertonic - Isotonic - Hypotonic |
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Hypertonic
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- Solution of higher osmotic pressure
- Ex: 3% sodium chloride - Pulls fluid from cells causing them to shrink |
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Hypotonic
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- Lower osmotic pressure
- Ex: 0.45% sodium chloride - Moves fluid into the cells, causing them to enlarge |
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Colloid Osmotic or Oncotic Pressure
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- Tends to keep fluid in the intravascular compartment by pulling water form the interstitial space back into the capillaries
- Albumin exerts this pressure (albumin attracts fluid) - Low albumin levels could cause low blood pressure but mainly edema |
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If someone has decreased intravenous fluids then you want to give: hypertonic, hypotonic, isotonic solution
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Hypertonic Solution
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If someone has edema than fluid is interstitally, then give patient: hypertonic, hypotonic, isotonic solution
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Hypertonic.
Hypotonic will make it worse |
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If someone has low serum sodium give patient: hypertonic, hypotonic, isotonic solution
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Hypertonic solution - preferably with high sodium concentrate
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Diffusion
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- Is the random movement of a solute (gas or solid) in a solution across a semipermeable membrane from an area of higher concentration to an area of lower concentration
*Movement of solute in solution from high to lower concentration |
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Filtration
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- Process by which water and diffusible substances move together across a membrane in response to fluid pressure, moving from an area of higher pressure to one of lower pressure
*Water and substances move from high to low pressure in response to fluid pressure |
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Hydrostatic pressure
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- Differences determine the movement of water
- Active in capillary beds |
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Edema
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Accumulation of excess fluid in interstitial space
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Active Transport
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- Requires metabolic activity and expenditure of energy to move substances across cell membrane
*Must pay toll (energy) to cross the bridge - Ex: sodium-potassium-ATPase pump - Sodium pumped out - Potassium pumped in - Against concentration gradient (uphill) - Is mechanism by which cells absorb glucose and other substances to carry out metabolism |
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Osmoreceptors
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Continually monitor the serum osmotic pressure, when osmolality increases the hypothalamus is stimulated
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Hypovolemia
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- Hypothalamus is also stimulated when excess fluid is lost and hypovolemia occurs, as in excessive vomiting and hemorrhage
- Average adult’s intake is about 2200 to 2700 mL per day - Oral intake accounts for 1100 to 1400 mL - Solid foods about 800 to 1000 mL and oxidative metabolism 300 mL daily |
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Antidiuretic Hormone (ADH)
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- Stored in the posterior pituitary gland
- Released to changes in blood osmolarity - Pain, stress, circulating blood volume and some drugs affect ADH production - ADH prevents diuresis, thus causing the body to save water - Increase in osmolarity and releases ADH - Works directly on the renal tubules and collecting ducts to make them more permeable to water - Body attempts to compensate, there will be a temporary decrease in urinary output - Changes in renal perfusion initiate the renin-angiotensin-aldosterone mechanism |
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Renin
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- Proteolytic enzyme secreted by the kidneys
- Responds to decreased renal perfusion secondary to decrease in extracellular volume - Acts to produce angiotension I, which causes some vasoconstriction |
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Aldosterone
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- Adrenal cortex releases aldosterone in response to increased plasma potassium levels or as part of renin-angiotensin-aldosterone mechanism to counteract hypovolemia
- Increases absorption of sodium and secretion and excretion of potassium and hydrogen - Overall effect of renin-angiotensin-aldosterone mechanism is sodium and water retention, leading to restoration of blood volume |
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Angiotensin 1
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- Vasoconstriction
- With ACE(enzyme) makes - Angiotensin 2 - Adrenal cortex - Aldosterone - Increase reabsorption of sodium - Attracts H2O - Conserves H2O` |
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If someone is bleeding what would you see with angiotensin initially
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Initially you will have increased angiotensin 2
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Atrial natriuretic peptide (ANP)
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- Is a hormone secreted from atrial cells of the heart in response to atrial stretching and an increase in circulating blood volume
- Acts as a diuretic that causes sodium loss and inhibits the thirst mechanism |
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Fluid Output Regulation
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- Fluid output occurs through four organs of water loss: the kidneys, skin, lungs, and the GI tract
- The kidneys are the major regulatory organs of fluid balance - An average of 500-600 mL of sensible and insensible fluid is lost via the skin each day - Approximately 3-6 L of isotonic fluid moves into the gastrointestinal tract and then returns again to the extracellular fluid - Average adult loses only 200 mL of the 3-6 mL each day through feces - Want to drink about 30 mL/kg |
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Insensible water loss
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- Is continuous and occurs through the skin and lungs
- Increase with fever or burns - Lungs expire about 500 mL of water daily - Loss increases in response to changes in respiratory rate and depth - Devices for administering oxygen increase insensible water loss from the lungs |
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Sensible water loss
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Occurs through excess perspiration and can be perceived by the client or through inspection
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If patient has inappropriate antidiuretic hormone what do you do?
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- Give administration of ordered loop diuretics
- Promote diuresis - Excess production of antidiuretic hormone results in hypervolemia and hyponatremia |
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Cations
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- Major cations within the body fluids include
- Sodium (Na+) - Potassium (K+) - Calcium (Ca2+) - Magnesium (Mg2+) |
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Sodium Regulation
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- Is most abundant cation (90%) in ECF
- Major contributors to maintaining water balance through their effect on: -Serum osmolality -Nerve impulse transmission -Regulation of acid-base balance -Participation in cellular chemical reactions - Regulated by dietary intake and aldosterone secretion - Normal extracellular sodium concentration is 135-145 mEq/L - Most important electrolyte for water balance - If sodium is low, than there is low water and causes low blood pressure |
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Potassium Regulation
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- Is the major electrolyte and principal cation in the intracellular compartment
- Regulates many metabolic activities and is necessary for - Glycogen deposits in the liver and skeletal muscle - role in glucose metabolism - no potassium, will see imbalance in glucose levels - hyperglycemia - not surprised if orders insulin and potassium - Transmission and conduction of nerve impulse - including smooth muscle and skeletal muscle - Normal cardiac conduction - Skeletal and smooth muscle contraction - 2% is located within ECF - Normal range for serum potassium concentrations is 3.5-5 mEq/L - Dietary intake and renal excretion regulate potassium - Body conserves potassium poorly, so any condition that increases urine output decreases the serum potassium concentration - 80-90% removed from body in urine |
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Renal failure would need to watch potassium levels because they would...?
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Rise - Hyperkalemia
You might see increased heart rate or patient might have cardiac arrhythmias |
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Calcium Regulation
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- Calcium is stored in bone, plasma, and body cells
- 99% is located in bone, 1% in ECF - Approx 50% of calcium in plasma binds to protein, primarily albumin - 40% is free ionized calcium - Remaining small percentage combines with nonprotein anions like phosphate, citrate, and carbonate - Normal serum ionized calcium is 4.5 - 5.5 mg/dl - Normal total calcium is 8l5-10.5 mg/dl - Calcium is necessary for: - Bone and teeth formation - Blood clotting - Hormone secretion - Cell membrane integrity - Cardiac conduction - Transmission of nerve impulses - Muscle contraction |
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Magnesium Regulation
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Essential for:
- Enzyme activities - Neurochemical activities - Cardiac and skeletal muscle excitability - Plasma concentrations range from 1.5-2.5 mEq/L - Serum magnesium is regulated by: - Dietary intake - Renal mechanisms - Actions of the parathyroid hormone (PTH) - About 50-60% of body magnesium is contained within the bone |
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Anions
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3 major anions of body fluids are:
- Chloride (Cl-) - Bicarbonate (HCO3-) - Phosphate (PO43-) |
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Chloride Regulation
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- Major anion in ECF
- Transport of chloride follows sodium - Normal concentrations of chloride range from 95-105 mEq/L - Serum chloride is regulated by dietary intake and kidneys |
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Bicarbonate Regulation
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- Is major chemical base buffer within body
- Found in both ECF & ICF - Essential component of carbonic acid-bicarbonate buffering system essential to acid-base balance - Kidneys regulate bicarbonate - Normal arterial bicarbonate levels range between 22-26 mEq/L - Normal venous bicarbonate (carbon dioxide content) is 24-30 mEq/L |
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Phosphorus-Phosphate Regulation
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- Nearly all phosphorus in body exists in form of phosphate (PO43-)
- Phosphate is buffer anion found primarily in ICF - Assists in acid-base regulation - Calcium and phosphate are inversely proportional - If one rises, the other falls - Promotes normal neuromuscular action and participates in carbohydrate metabolism - Is normally absorbed through the GI tract - Is regulated by: - Dietary intake - Renal excretion - Intestinal absorption - PTH - Normal serum level is 2.8-4.5 mg/dL |
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If phosphorus is very high, who have kidney failure and not eliminating phosphorus, calcium levels will...?
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Drop
Calcium is important for clotting, cardiac conduction, nerve impulse transmission |
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Patient has potassium level of 6.8 mEq/L what is priority nursing action?
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- Hyperkalemia leads to cardiac conduction problems and possible fatal dysrhythmias, ECG is indicated
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Buffer
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- Is a substance or a group of substances that can absorb or release H+ to correct an acid-base imbalance
- Arterial pH is an indirect measurement of the hydrogen ion (H+) concentration - Greater the concentration of H+ more acidic the solution lower the pH - Ph is also reflection of balance between carbon dioxide (CO2) which is regulated by lungs, and bicarbonate (HCO3) base regulated by kidneys - Normal values in arterial blood range from 7.35-7.45 - 3 general types of acid-base regulators in body are: - Chemical (carbonic acid-base buffer system) - Biological (absorption and release of hydrogen ions by cells) - Physiological buffering system (lungs and kidneys) |
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Chemical Regulation
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- Largest chemical buffer in ECF is carbonic acid and bicarbonate buffer system
- Co2 + H2O <-> H2CO3 <-> H+ +Carbonic Acid <-> Hydrogen ion + Bicarbonate - Carbonic acid-bicarbonate buffer system is the first buffering system to react to - Carbon dioxide increases there is increase in hydrogen ions produces which equals in more carbon dioxide produced - Lungs primarily control the excretion of carbon dioxide - Respiratory acidosis = heavy breathing to correct it - Kidneys control excretion of hydrogen and bicarbonate ions - slower takes 2-3 days to correct any acid imbalance |
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Biological Regulation
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- Occurs when hydrogen ions are absorbed or released by cells
- Occurs after chemical buffering - Hydrogen ions act as positive and must be exchanged with another positively charged ion - Second biological buffer is hemoglobin-oxyhemoglobin system - Carbon dioxide diffuses into RBC and forms carbonic acid - Carbonic acid dissociates into hydrogen and bicarbonate ions - Another buffer is chloride shift within RBCs - Blood is oxygenated in lungs, bicarbonate diffuses into cells and chloride travels from hemoglobin to plasma to maintain electrical neutrality - Process is referred to as chloride shift and is reciprocal exchange between these anions |
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Physiological Regulation
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- 2 physiological buffers in body are lungs and kidneys
- Ordinarily, increased levels of hydrogen ions and carbon dioxide stimulate respiration - When the hydrogen concentration changes lungs react by altering rate and depth of respiration - Ex: with metabolic acidosis respirations increase = in greater amount of exhaled CO2 = decreased acidic level - Ex: With Metabolic alkalosis lungs retain CO2 by decreasing respirations = increasing acidic level - In response to acid-base imbalance kidneys increase or decrease bicarbonate production - Kidneys use ammonia mechanism to regulate acid-base balance Certain amino acids within renal tubules chemically change into ammonia (NH3-) = forms with hydrogen to make ammonium (NH4) = excreted in urine = releasing hydrogen ions from the body |
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Hyponatremia
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- Lower than normal concentration of sodium in the blood (Serum)
- As sodium loss continues, body continues to preserve blood and interstitial (tissue) volume - As result sodium in ECF becomes diluted |
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Hypernatremia
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- Greater than normal concentration of sodium in ECF that can be caused by excess water loss or an overall sodium excess
- Body conserves as much water as possible through renal absorption |
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Hypokalemia
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- One of most common electrolyte imbalances
- An inadequate amount of potassium circulates in ECF - Most common cause is vomiting and use of potassium-wasting diuretics |
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Hyperkalemia
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- Greater than normal amount of potassium in the blood
- Primary cause is renal failure, because any decrease in renal function diminishes the amount of potassium the kidney can excrete |
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Hypocalcemia
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- Represents a drop in total serum and/or ionized calcium
- Results from illness which directly affects the thyroid and parathyroid glands - Another cause is renal insufficiency Signs and symptoms - Often related to diminished function of the neuromuscular and cardiac systems |
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Hypercalcemia
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- Increase in total serum concentration of calcium and/or ionized calcium
- Frequently symptom of underlying disease such as hyperparathyroidism or neoplasm, resulting in excess bone reabsorption with release of calcium - Seen in patients with bone cancer |
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Hypomagnesemia
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- Drop in serum magnesium
- Occurs with malnutrition and with malabsorption disorders - Signs and symptoms - Directly related to neuromuscular excitability and appear very similar to hypocalcemia - Muscular tremors - hyperactive reflexes - Tachycardia, confusion, disorientation, hypertension, dysrhythmias |
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Hypermagnesemia
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- Increase in serum magnesium levels
- Depresses skeletal muscles and nerve function - Result of excess magnesium intake in a client with renal insufficiency - Depression of acetylcholine leads to a sedative effect, which can lead to: - Bradycardia - Electrocardiogram (ECG) changes - Cardiac arrhythmias - Decreased respiratory rate and depth |
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Hypochloremia
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- Occurs when the serum chloride level falls below normal
- Chloride imbalance is usually associated with sodium imbalance - Vomiting or excessive nasogastric or fistula drainage results in hypochloremia because of the loss of hydrochloric acid - Use of loop and thiazide diuretics also results in increased chloride loss as sodium is excreted |
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Hyperchloremia
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- Occurs when the serum chloride level rises above normal
- Usually occurs when serum bicarbonate value falls or sodium level rises - Hyper and hypo rarely occur as single disease process but are commonly associated with acid-base imbalance |
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Arterial blood gas (ABG)
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- ABG analysis is the most effective way to evaluate acid-base balance and oxygenation
- Measurement of ABGs involves analysis of six components: - Determination of ABG levels requires the removal of a sample of blood from an artery for laboratory testing to assess the client’s acid-base status and the adequacy of ventilation and oxygenation - Draws arterial blood from a peripheral artery (usually the radial) or from an existing arterial line - Before the arterial blood draw, ensure that the client has an ulnar pulse, to prevent loss of blood flow to the hand if the radial artery is damaged - Take care to prevent air from entering the syringe because this will affect the blood gas analysis - To reduce oxygen metabolism of cells, submerge the syringe in crushed ice and transport it immediately to the laboratory - Apply pressure to the puncture site for at least 5 minutes to reduce the risk of hematoma formation - Reassess the radial pulse after removing the pressure Ph 7.35-7.45 PaCO2 35-46 mm Hg PaO2 80-100 mm Hg Oxygen Saturation 95-99% Base excess Bicarbonate -HCO3- 22-26 mEq/L |
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PaCO2
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- Is the partial pressure of carbon dioxide in arterial blood and is a reflection of the depth of pulmonary ventilation
- Normal range is 35-45 mm Hg Hyperventilation occurs when - PaCO2 is less than 35 mm Hg - Rate and depth increase = more CO2 exhaled = CO2 concentration decreases - Hypoventilation occurs when PaCO2 is more than 45 mm Hg - Rate and depth decrease = less CO2 exhaled = more CO2 retained = concentration of CO2 increased |
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PaO2
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- Is partial pressure of oxygen in arterial blood
- Normal range is 80-100 mm Hg - PaO2 less than 60 mm Hg leads to anaerobic metabolism resulting in lactic acid production and metabolic acidosis - Normal decline in PaO2 in older adults - Hyperventilation also causes a decrease in PaO2 resulting in respiratory alkalosis |
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Base Excess
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- Is the amount of blood buffer (hemoglobin and bicarbonate) that exists
- Normal range is +- 2 mEq/L - High value indicates alkalosis can result from: - The ingestion of large amounts of sodium bicarbonate solutions (some antacids) - Citrate excess from rapid blood transfusions - Intravenous infusion of sodium bicarbonate to correct ketoacidosis - Low value indicates acidosis usually result of the elimination of too many bicarbonate ions - Example is diarrhea |
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Bicarbonate
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- Serum bicarbonate HCO3- is the major renal component of acid-base balance
- Kidneys excrete and retain HCO3- - Principal buffer of the extracellular fluids of the body - Normal range is 22-26 mEq/L - Less than 22 mEq/L usually indicates metabolic acidosis, greater than 26 mEq/L indicates metabolic alkalosis |
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Respiratory Acidosis
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- Is a combination of:
- Increased arterial carbon dioxide concentration (PaCO2) - Excess carbonic acid (H2CO3) - Increased hydrogen ion concentration (pH less than 7.35) - Result of hypoventilation - Causes neurological changes - Hypoxemia occurs because of respiratory depression - To compensate for acidosis, kidneys conserve bicarbonate and release hydrogen ions in the urine - Kidneys are slow to compensate, this process may take 24 hours Ph<7.35 PaCO2 > 45 mm Hg - PaO2 normal or < 80 mm Hg, depending on cause of acidosis - SaO2 normal or < 95%, depending on cause of acidosis - HCO3- normal if early respiratory acidosis or > 26 mEq/L if kidneys are compensating K+ > 5.0 mEq/L |
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Respiratory Alkalosis
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Marked by a decreased PaCO2 and increased pH (greater than 7.45)
Body does not usually compensate for respiratory alkalosis because the pH returns to normal before the kidneys can respond Ph >7.45 PaCO2 <35 mm Hg PaO2 normal O2 saturation (SaO2) normal HCO3- < 22 mEq/L Ionized Calcium < 4.5 mg/dL K+ < 3.5 mEq/L |
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Metabolic Acidosis
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- Results because of the high acid content of the blood, which also causes a loss of sodium bicarbonate, the alkaline half of carbonate buffer system, resulting in bicarbonate deficit
- In an attempt to identify the cause of metabolic acidosis, an analysis of serum electrolytes to detect an anion gap may be helpful - Anion Gap - Reflects unmeasurable anions present in plasma - Calculate an anion gap by subtracting the sum of chloride and bicarbonate from the amount of plasma sodium concentration - Compensation for metabolic acidosis is an increased CO2 excretion by the lungs with an increase in rate and depth of respiration Ph<7.35 PaCO2 normal or <35 mm Hg if lungs are compensating PaO2 normal O2 saturation (SaO2) normal HCO3- < 22 mEq/L K+ > 5.0 mEq/L |
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Metabolic Alkalosis
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- Result of the heavy loss of acid from the body or an increase in levels of bicarbonate
- Most common causes are vomiting and gastric suction - Other causes include: - Overreaction of metabolic acidosis - Potassium deficiency - Hyperaldosteronism - Use of thiazide therapy that causes an increase in renal excretion of acid - Compensation occurs with decrease in respiratory rate and if there is no underlying kidney disease, renal loss of bicarbonate Ph >7.45 PaCO2 normal or >45 mm Hg if lungs are compensating PaO2 normal O2 saturation (SO2) normal HCO3- >26 mEq/L Ionized calcium <4.5 mg/dL K+ <3.5 mEq/L |
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Medications that cause fluid, Electrolyte, and Acid-Base Disturbances
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Diuretics
- Metabolic alkalosis, hyperkalemia, hypokalemia Steroids - Metabolic alkalosis Potassium supplements - Gastrointestinal disturbances, including intestinal and gastric ulcers and diarrhea Respiratory Center Depressants (Opioid Analgesics) - Decreased rate and depth of respirations, resulting in respiratory acidosis Antibiotics - Nephrotoxicity (vancomycin, methicillin, amino glycosides), hyperkalemia and/or hypernatremia Could cause diarrhea, nausea, vomiting Calcium carbonate (Tums) - Mild metabolic alkalosis with nausea and vomiting Magnesium hydroxide (Milk of Magnesia) - Hypokalemia Nonsteroidal antiinflammatory drugs - Nephrotoxicity |
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CBC - Complete blood count
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- Part of that would be hematocrit
- Is the percent of RBC to serum - Could be reflection of patient’s hydration status - If there is less water component in blood - hematocrit values would be higher - Dehydrated patient - hematocrit is higher |
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Creatinine
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Measure of protein
Patient who is not urinating blood creatinine levels will increase If check urine creatinine levels patients kidney is not voiding - urine levels would go low |
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Urine Specific Gravity
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- Patient has dehydration
- Reflects number of particles compared to water component of urine - Higher concentration if dehydrated - Urine has inappropriate antidiuretic hormone - patient has diaphoresis - specific gravity is lower |
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Serum electrolyte levels determines the
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- Hydration status
- Electrolyte concentration of the blood plasma - Acid-base balance - Routinely performed on any client entering a hospital - If client is stable, daily weights, intake and output, and direct physical care can be delegated to NAP |
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Intravenous Solutions
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Dextrose in water solutions
Saline Solutions Dextrose in Saline Solutions Multiple Electrolyte Solutions |
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Saline Solutions
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- 0.45% sodium chloride (half normal saline) (½ NS)
Hypotonic - 0.33% sodium chloride (one-third normal saline) (⅓ NS) Hypotonic - 0.9% Sodium Chloride (normal saline) (NS Isotonic |
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Dextrose in Saline Solutions
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- Dextrose 5% in 0.9% sodium chloride (D50.9% NaCl)
Hypertonic - Dextrose 5% in 0.45% NaCl sodium chloride (D50.45% NaCl) Hypertonic |
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Multiple Electrolyte Solutions
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- Lactated Ringers (LR)
Isotonic - Dextrose 5% in lactated Ringers (D5LR) Hypertonic |
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Regulating the Infusion Flow Rate
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- After initiating the IV infusion and checking the line for patency, regulate the rate of infusion according to the health care provider’s orders
- Too slow a rate can lead to: - Further cardiovascular and circulatory collapse in a client who is dehydrated, in shock, or critically ill - Risk of becoming clotted - Too fast a rate can lead to: - Fluid overload, resulting in cardiovascular, kidney, and neurological complications in vulnerable clients (older adults or clients with preexisting heart and renal disease - Adjust fluids that run by gravity through the use of a flow control/regulator clamp - Fluids infused by an electronic infusion device (EID) or IV volume controller are regulated by a mechanical mechanism set at the prescribed rate - These devices maintain flow rates, cannula patency, and prevent an unexpected bolus of IV infusion |
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Complications of IV Therapy
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Infiltration
Phlebitis Fluid Volume Excess |
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Infiltration
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- Occurs when IV fluids enter the subcutaneous tissue around the venipuncture site
- Causes swelling (from increased tissue fluid) and pallor and coolness (caused by decreased circulation) around the venipuncture site - Pain may be present and usually results from tissue edema - If infiltration occurs, discontinue the infusion and if IV is still needed, insert a new cannula into a vein in another extremity - To reduce discomfort, raise the extremity to promote venous drainage and decrease edema - Wrapping the extremity in a warm, moist towel for 20 minutes promotes venous return, increases circulation, and reduces pain and edema - Heat therapy can be repeated 3-4 times during the day |
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Phlebitis
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- Is an inflammation of the vein
- Selected risk factors include: - Type of cannula material - Chemical irritation of additives and drugs given intravenously (antibiotics) - The anatomical position of the cannula - Signs and symptoms may include: - Pain - Edema - Erythema - Increased skin temperature over the vein - In some instances, redness traveling along the path of the vein |
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Fluid Volume Excess
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- Occurs when the client has received a too-rapid administration of IV solutions
- Assessment findings include shortness of breath, crackles in lungs, tachycardia - Weight gain - biggest thing to look for * - Edema - anuria (less than 100 mL per day) - Decreased urine output is less than 30 mL per hour - If signs are present then: - Slow the rate of IV infusion - Notify health care provider - Raise the head of the bed - Monitor vital signs |
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Autologous Transfusion
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- Is the collection and reinfusion of a client’s own blood
- Can be obtained by preoperative donation up to 5 weeks before the planned surgery - Client can donate 1-5 units of blood depending on the type of surgery and the ability of the client to maintain to an acceptable hematocrit - Blood can be salvaged postoperatively from mediastinal and chest-tube drainage and after joint and spinal surgery - Transfusions are safer for the client because they decrease the risk of complications such as mismatched blood and exposure to blood-borne infectious agents |