Populations at risk for dehydration due to the inability to percieve or respond to the thrist mechanism include:
Infants
Clients with neurological or psychological problems
Some older adults (elderly)
ADH prevents ___, thus causing the body to save water.
Diuresis
True or False.
The Atrial Natriuretic Peptide (ANP) acts as a diuretic that causes sodium loss and inhibits the thirst mechanism.
True
_____ loss is continuous and occurs through the skin and lungs. A person does not perceive the loss, but it can significantly increase with fever or burns
Insensible water
___ loss occurs through excess perspiration and can be perceived by the client or through inspection.
Sensible water
Fluid output occurs through four organs of water loss:
Kidneys
Skin
Lungs
GI tract
The normal range for serum potassium concentrations is ____.
3.5 - 5 mEq/L
Calcium is necessary for:
Bone and teeth formation
Blood clotting
Hormone secretion
Cell membrane integrity
Cardiac conduction
Transmission of nerve impulses
Muscle contraction
Normal range for chloride range from _____.
95 - 105 mEq/L
____ regulates many metabolic activities and is necessary for glycogen deposits in the liver and skeletal muscle, transmission and conduction of nerve impulses, normal cardiac conduction, and skeletal and smooth muscle contraction.
Potassium
The normal pH arterial blood ranges from ___.
7.35 to 7.45
Acid-base balance exists when _____.
The rate at which the body produces acids or bases equals the rate at which acids or bases are excreted
Factors that contribute to alterations in fluid are:
Trauma
Disease
Medication
Burns
Vomitting
Diarrhea
Inability to communicate fluid needs
What is hyponatremia?
It is a lower than normal concentration of sodium in the blood (serum).
What is hypernatremia?
It is a greater than normal concentration of sodium in the extracellular fluid.
How can hypernatremia be caused?
It can be caused by excess water loss or an overall sodium excess.
True or False.
When hypernatremia occurs, the body conserves as much water as possible through renal reabsorption.
True
____ is one of the most common electrolyte imbalances, in which an inadequate amount of potassium circulates in ECF.
Hypokalemia
Name 2 common causes for hypokalemia.
Vomitting
Use of potassium-wasting diuretics
What is the primary cause of hyperkalemia?
Renal failure
____ represents a drop in total serum and/or ionized calcium. It results from illness, which directly affects the thyroid and parathyroid glands.
Hypocalcemia
Signs & symptoms of hyponatremia include:
Apprehension
Personality change
Postural hypotension
Postural dizziness
Abdominal cramping
Nausea and vomiting
Diarrhea
Tachycardia
Dry mucous membranes
Convulsions and coma
Related causes of hyponatremia include:
Vomitting
Diarrhea
NG suction
Kidney disease
Adrenal insufficiency
Excessive perspiration
Burns
Psychogenic polydipsia
Syndrome of inappropriate ADH (SIADH)
Related causes of hypernatremia include:
Water deprivation
Diabetes insipidus
Excess aldosterone secretion
Increases sensible & insensible water loss
Excess salt intake
Related causes of hypokalemia include:
Polyuria
Extreme sweating
Diarrhea & vomitting
Alkalosis
Use of potassium-wasting diuretics
Excess aldosterone secretion
Treatment of diabetic ketoacidosis with insulin
Excessive use of potassium free IV solutions
Signs & symptoms of hypokalemia include:
Weakness and fatigue
Muscle weakness
Nausea and vomiting
Intestinal distention
Decreased bowel sounds
Decreased deep tendon reflexes Ventricular dysrhythmias
Paresthesias and weak
Irregular pulse
Related causes of hyperkalemia include:
Renal failue
Fluid volume deficit
Massive cellular damage such as from burns and trauma
Iatrogenic administration of large amounts of potassium intravenously
Adrenal insufficiency
Acidosis, especially diabetic ketoacidosis
Rapid infusion of stored blood
Use of potassium-sparing diuretics
Ingestion of K+ salt substitutes
Signs & symptoms of hyperkalemia include:
Anxiety
Dysrhythmias
Paresthesia
Weakness
Abdominal cramps
Diarrhea
Signs & symptoms of hypocalcemia include:
Numbness and tingling of fingers and circumoral (around mouth) region
Hyperactive reflexes
Positive Trousseau's sign (carpopedal spasm with hypoxia)
Positive Chvostek's sign (contraction of facial muscles when facial nerve is tapped)
Tetany
Muscle cramps
Pathological fractures (chronic hypocalcemia)
Related causes of hypocalcemia include:
Pancreatitis
Vitamin D deficiecy
Alkalosis
Chronic renal failure
Chronic alcoholism
Hypoparathyroidism
Hypoalbuminemia
Rapid administration of blood transfusions causing citrate
Related causes of hypercalcemia include:
Hyperparathyroidism
Osteoporosis
Osteometastasis
Paget's disease
Prolonged immobilization Acidosis
Signs & symptoms of hypercalcemia include:
Anorexia
Nausea and vomiting
Weakness
Hypoactive reflexes
Lethargy
Flank pain (from kidney stones)
Decreased level of consciousness
Personality changes
Cardiac arrest
True or False.
Chloride imbalance is usually associated with sodium imbalance.
True
_____ exist when water and electrolytes are gained or lost in equal proportions but osmolality remains unchanged.
Isotonic deficit and excess
The 4 main types of acid-base imbalances are:
Respiratory acidosis
Respiratory alkalosis
Metabolic acidosis
Metabolic alkalosis
Respiratory acidosis is the result of ___.
Hypoventiliation
Electrolyte changes such as ___ & ___ may accompany respiratory acidosis.
Hyperkalemia & hypercalcemia
Compesation for metabolic acidosis is an ____.
Increased CO2 excretion by the lungs with an increase in rate and depth of respiration.
Name 2 causes for metabolic acidosis.
Severe diarrhea
Renal disease
____ is the result of the heavy loss of acid from the body or an increase in levels of bicarbonate.
Metabolic alkalosis
Name 2 common causes for metabolic alkalosis.
Vomitting
Gastric suctioning
Risk factors for fluid & electrolyte, and acid-base imbalances include:
Age (very young & old)
Gender (women)
Environment (diet; exercise; hot weather and sweating)
Oral replacement of fluids is contraindicated when the client is ____.
Vomiting
Has a mechanical obstruction of the GI tract
Is at risk for aspiration
Has impaired swallowing
The normal range for sodium is ____.
135 to 145 mEq/L
True or False.
The body conserves potassium poorly, so any
condition that increases urine output decreases the serum potassium
concentration.
True
Severe _____ produces marked cardiac conduction abnormalities.
Hyperkalemia
The normal serum ionized calcium is ______.
4 to 5 mEq/L
The normal total calcium is _____.
8.5 - 10.5 mg/100mL
How is magnesium regulated?
Dietary intake
Renal mechanisms
Actions of the parathyroid hormone
Plasma concentrations of magnesium range from ______.
1.5 - 2.5 mEq/L
When serum _____ levels fall, the reabsorption
of the bicarbonate ion occurs to maintain electrical neutrality
Chloride
True or False.
Calcium and phosphate are inversely
proportional; if one rises, the other falls.
True
The normal serum level of Phosphate is ___.
2.5 - 4.5 mg/100mL
(1) is regulated by the lungs; ___(2) is a base regulated by the kidneys.
1. Carbon dioxide (CO2)
2. Bicarbonate
Whenever carbon dioxide
increases, there is an ____ in hydrogen ions produced.
Increase
True or False.
Whenever hydrogen ions are
produced, there is more carbon dioxide produced.
True
The two physiological buffers in the body are the ____ & ___.
Lungs & the kidneys
When the concentration of hydrogen ions is altered, the lungs ____.
React to correct the imbalance by altering the rate and depth of respiration.
When a client is ____ and uses up readily
available oxygen, the reserve oxygen (oxygen attached to hemoglobin) is drawn
upon to provide oxygen to the tissues.
Hypoxic
_____ is marked by a decreased PaCO2, and increased pH.
Respiratory alkalosis
_____ is marked by a decreased HCO3 and a decreased pH.
Metabolic acidosis
____ is marked by an increased HCO3 and an
increased pH.
