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| refers to the homeostasis of the hydrogen (H) ion concentrations in body fluids. |
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| LUNGS – KIDNEYS - BUFFER SYSTEMS |
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| Arterial Blood Gas (ABG) Analysis |
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| -the best way to evaluate acid-base balance: |
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| Normal ranges: pH, PaCO2, HCO3 |
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Definition
| 7.35 - 7.45, 35 – 45 mm/Hg,22 – 26 mEq/L |
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| PaCO2 reflects depth of pulmonary ventilation |
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Definition
| < 35 = hyperventilation, > 45 = hypoventilation |
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| HCO3 (bicarbonate) Major renal component |
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Definition
| <22 = metabolic acidosis; >26 = metabolic alkalosis |
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| Hypoventilation,Chronic COPD patients LIVE in this status, pH ↓, PaCO2 ↑ |
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Definition
| Hyperventilation – anxiety is most common cause – ‘blowing off CO2’, pH ↑, PaCo2 ↓ |
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Definition
| AID’s patient’s severe diarrhea, pH ↓, HCO3 ↓ |
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Definition
| Most common causes: vomiting and gastric suction, pH ↑, HCO3 ↑ |
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| Hyponatremia (low sodium in blood), |
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Definition
| s/s: hypotension, tachycardia, coma, death |
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| Hypernatremia (high sodium in blood) |
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Definition
| s/s: thirst, dry sticky mucous membranes, confusion |
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| Hypokalemia (low potassium in blood) |
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Definition
| s/s: muscle weakness, cardiac arrhythmias, paresthesias |
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| Hyperkalemia (high potassium in blood) |
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Definition
| s/s: muscular weakness, cardiac irregularities; nausea & vomiting |
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| Hypocalcemia (low calcium in blood) |
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Definition
| s/s: muscle tetany, muscle cramps, cardiac arrhythmias |
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| Hypercalcemia (high calcium in blood) |
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Definition
| s/s: bone and joint pain, muscle weakness |
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| Hypomagnesemia (low magnesium in blood) |
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Definition
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| normal level Serum Potassium (K+) |
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Definition
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| normal level Serum Sodium (Na+) |
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Definition
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| normal level Serum Chloride (Cl-) |
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Definition
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| normal level Serum Bicarbonate (HCO3) |
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| →Daily total fluid intake: |
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Definition
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| →Daily total fluid output: |
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| Vulnerable to dehydration: |
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Definition
| very young / very old, -massive burn victims (susceptible to shock / dehydration), people on diuretics |
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Definition
| – number of osmols per Kg of solution. |
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| 3 Types of Fluid Given Intravenously: |
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Definition
| 1. Isotonic: expands intracellular and extracellular space equally – stays in the vascular space, 2. Hypotonic: swells the cells, 3. Hypertonic: shrinks the cells |
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| used most often, stays in the intravascular space, the doctor orders the rate of fluid flow,monitor patient for: appropriate rate/flow and s/s of fluid overload |
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| Lactated Ringers (LR) – volume expander, the fluid of choice in massive burn victims, 0.9% Normal Saline (NS), D5W **D5W isotonic ONLY IN BAG – acts like a hypotonic solution in body as it metabolizes, leaving only water** |
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Definition
| swells the cells, mostly used when people need hydration, DO NOT GIVE in patient with increased intracranial pressure – CVA, head trauma, →Most Used: 0.45% saline (1/2 Normal Saline) |
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Definition
| higher osmolality than plasma, > 375 mEq/L, shrinks the cells – pulls fluid from the cells to the vascular space, closely monitor for circulatory overload due to intravascular expansion, NOT GIVEN in congestive heart failure, DO NOT GIVE in cellular dehydration |
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| →Most Used: D5 1/2 NS, D5 LR, D5 NS |
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| AID’s patient with excessive diarrhea |
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| Fluid Deficit/ dehydration, what will be higher? |
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