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| How much of adult body is water? |
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| The movement of water from less concentration of solutes to more concentration of solutes |
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| What are the classic signs and symptoms of progressively abnormal sodium levels? |
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| Confusion, Seisures, Coma, Death |
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| The number of solutes in a solution. |
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| How do you calculate a rough estimate of a patient's tonicity? |
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| Multiply the sodium level by TWO. isotonic = Na= 140 multiply by 2 = 280 which is isotonic for this patient. |
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| If a person's sodium level is 140 what is their isotonic value? How do you calculate it? |
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| A solution having less solutes than the patient's osmolarity. |
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| A solution having more solutes than the patient's osmolarity. na = 160 then isotinic is 320 then iv solution should be hypertonic like 3% NaCl. |
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| If a patient isotonic value is 160 then would a solution with a tonicity of 278 be hypotonic or hypertonic for the patient? Why? |
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| Hypertonic because the solution has a tonicity higher than the patient's tonicity. |
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| How would D5W in 0.45 Sodium Chloride affect a patient's tonicity? |
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Definition
| Considering a patient's natural osmolarity is roughly 280 and D5W/0.45NS osmolarity is 154 then it will lower the patient's serum osmolarity thus drawing fluid from the serum into the cells. |
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| What affect does the destrose have in a "D5W" solution? |
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| Dextrose is taken up so quickly be the cells that a dextrose solution's net result is effectively adding fluid volume to the serum. Usually given to very hypertonic patients. |
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| What are the different dextrose concentrations? |
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| 5%, 10% (highest in peripheral line), 20%, 50% |
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| peripheral perenteral nutrition (GI problems) |
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| Total perental nutrition (central line) |
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| no lactated ringers to bring K up. Is used to replace for blood loss. ER and OR. Isotinoc fluid with electrolytes and plasma when person is bleeding out. |
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| What is a normal isotonic range? |
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| D5W: Osmolarity? Hypotonic or Hypertonic? |
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| 0.9% NaCl: Osmolarity? Tonicity? |
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| 0.45% NaCl: Osmolarity? Tonicity? |
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| d5 .25 NaCl: Osmolarity? Tonicity? |
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| Ringers: Osmolarity? Tonicity? |
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| Lactated Ringers: Osmolarity? Tonicity? |
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| D10W: Osmolarity? Tonicity? |
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| 3% NaCl: Osmolarity? Tonicity? |
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| D5 0.5 NaCl: Osmolarity? Tonicity? |
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| D5 0.9% NaCl: Osmolarity? Tonicity? |
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| What types of diagnoses would require daily weights? |
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| How many liters of fluid would equal two pounds? |
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| How many pounds is one liter of fluid? |
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| Percentage of serum volume made up of red blood cells. |
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| What values are tested in a CHEM7? |
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| NaCl, Co2, K,Bun, Cl, Cr, Glucose |
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| What is urine specific gravity and its normal range? |
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| Its the measure of non-water material in the urine. Normal range is 1.015 - 1.030 |
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| Give examples of a low specific gravity and a high specific gravity. |
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Low: any value above 1.000 and below 1.015
High: any value above 1.030 |
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| What general affect does Antidiuretic Hormone (ADH) have on the body? |
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| Reduces urine by increasing water absorption. |
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| Where does renin come from and what does it do? |
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| It comes from the kidneys and it retains Na and water. Avoid this for cardiac patients. |
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| What is Angiotensin and what does it do? |
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| Peptide that causes vasoconstriction. |
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| Where does Aldosterone come from and what does it do? |
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Definition
| It comes from the adrenal glands and it causes a reabsorption of NaCl and excretes Potassium. |
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| Describe the Renin Angiotensin Aldosterone System. |
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Definition
| If low blood pressure is detected the liver releases angiotinsenigen which causes the kidnies to release renin which also react with the angiotensenigen to create angiotensen 1. When angiotensen 1 reaches the lungs they relase ACE (angiotenson converting enzyme). ACE and angiotensen 1 react to create angiotensen 2 which travels to the adrenal gland which then releases aldosterone. aldosterone increases the reabsorpson of sodium into serum thus causing a transfer of water from teh cells to the serum and increasing blood pressure. A side affect, however is the release of potassium through the urine. |
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| What is Atrial Naturetic Factor? |
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| It's an powerful internal diuretic (CHF) |
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| used for osmotic pressure and asic base balance |
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| Describe potassium as it relates to pH |
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| 98% of all K is in the cells. It increasis in acidosis and decreases in alkalosis. |
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| Only 2% of calcium is in in the serium while most is in bone. |
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| What is calcium good for? |
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| Calcium is heavily involved in neuromuscular reaction and blood clotting. |
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| How is calcium regulated? |
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Definition
| PTH (parathyroid hormone), vitamin D (calcitrol), and calcitonin which is released by the thyroid which causes calcium to be transfered to bone. |
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| What are two tests used to determine abnormal calcium levels? |
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| Describe the trousseau's test and what its used for. |
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| The squeeze of a blood pressure cuff will cause a hypocalcemic patient's fingers to uincontrollably contract. |
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| Describe the chvostek test and what its used for. |
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| The tapping of the cheek bone of a hypocalcemic patient will cause the facial muscles on the same side to momentarily contract as well. |
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| Give some clinical examples of fluid loss. |
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| Hemmorrhage, GI Suctioning, Intestinal Fistulas, Vomiting, Diarrhea |
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| Give some clinical examples of insufficient intake. |
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| Lack of access to fluids, Oral Trauma, Swallowing difficulty, Altered Thirst Mechanism |
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| Give some clinical examples of failure of regulatory mechanisms. |
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