Term
| What percent greater does a male have in comparison to a female in regards to total body weight? |
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Definition
| 5% more solids and 5% more fluids |
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Term
| What percent of the body fluid is in the intracellular and what percent is extracellular? |
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Definition
•ICF =2/3 (65%) – the fluid within the cells
ECF-1/3 (35%)- all the fluid outside the cells |
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Term
| What is the extracellular breakdown of fluid? |
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Definition
•25% interstitial fluid-the space between cells and outside the body
•5-8% in plasma (IVF fluid)-intravascular fluid-
•1-2% in transcellular fluids |
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Term
| What pressures leave the capillary and go into the interstitial space? |
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Definition
•Capilary hydrostatic pressure
•Interstitial oncotic pressure |
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Term
| What pressures go from the interstitial space into the capillaries |
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Definition
•Capillary oncotic pressure
•Interstitial hydrostatic pressure |
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Term
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Definition
| Movement of fluid from an area of high to low concentration |
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Term
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Definition
| Pressure exerted by a liquid with in a closed system (ex bp) |
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Term
| What are fluid compartments separated by? |
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Definition
| Membranes that are freely permeable to water |
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Term
|
Definition
| Fluid and electrolyte homeostasis is maintained in the body |
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Term
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Definition
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Term
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Definition
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Term
|
Definition
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Term
| How much water is taken in daily in the following areas; food, beverages, and metabolism |
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Definition
•Food- 30%
•Beverages-60%
•Metabolism-10% |
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Term
| How much water is lost in daily function in the following areas; Sweat, feces, skin and lungs, and urine? |
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Definition
•Sweat- 6%
•Feces- 6%
•Skin and lungs: 28%
•Urine: 60% |
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Term
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Definition
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Term
| Give 4 examples of cations: |
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Definition
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Term
|
Definition
|
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Term
| What are 3 examples on anions? |
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Definition
|
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Term
| What are non electrolytes? |
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Definition
|
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Term
| What are 2 examples of electrolytes? |
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Definition
| Proteins, urea, glucose, O2 and CO2 |
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Term
| Are body fluids Electrically charged? |
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Definition
|
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Term
| How are body fluids maintained? |
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Definition
•Osmosis
•There are always a specific number of particles per volume of fluid |
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Term
| What three things help to maintain homeostasis? |
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Definition
•Ion transport
•Water movement
•Kidney function |
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Term
| What is molecular weight (MW)? |
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Definition
| The sum of the weights of atoms in a molecule |
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Term
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Definition
|
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Term
|
Definition
| number of particles in a solution |
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Term
|
Definition
| Normal concentration- )0.9% salt solution in ECF |
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Term
|
Definition
•Too salty
•>0.9 salt in ECF
•cell shrinkage |
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Term
|
Definition
•<0.9 salt in ECF
•cell swells |
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Term
|
Definition
•Isotonic
•Hypotonic
•Hypertonic |
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Term
| What is the saying of movement of body fluids |
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Definition
| “where sodium goes, water follow” |
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Term
|
Definition
| Movement of particles down a concentration gradient |
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Term
|
Definition
| Diffusion of water across a selectively permeable membrane |
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Term
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Definition
•Movement of particles up a concentration gradient
•Uses energy |
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Term
|
Definition
•Anti-diuretic hormone
•INCREASES THIRST
•increases amount of water in body
•Increased amount of Na+ in body
•Increase blood asmolality (# of particles)
•Increased circulating blood volume
•Stimulates osmoreceptors in hypothalamus ADH released from posterior pituitary- Increased thirst |
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Term
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Definition
| The accumulation of fluid within the interstitial spaces |
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Term
| What are some causes of edema? |
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Definition
•Increased hydrostatic pressure
•Lowered plasma osmotic pressure
•Increased capillary membrane permeability
•Lymphatic channel obstruction |
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Term
| Hydrostatic pressure can increase due to what two things? |
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Definition
•Venous obstruction:
•Salt or water retention: |
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Term
| What things can cause a venous obstruction therefore increasing Hydrostatic pressure: |
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Definition
•Thrombophelebitis (inflammation of the veins)
•Hepatic obstruction
•Tight clothing on extremities
•Prolonged standing |
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Term
| What can cause salt or water retention? |
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Definition
•Congestive heart failure
•Renal failure |
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Term
| Decrease in what major protein causes a decrease in plasma osmotic pressure |
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Definition
|
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Term
| What can cause a decrease in plasma albumin output? |
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Definition
•Liver disease
•Protein malnutrition |
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Term
| How are plasma proteins lost? |
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Definition
•Glomerular disease of the kidney (filter not working correctly = increase secretion of proteins)
•Hemorrhage (blood loss=protein loss)
•Burns
•Open wounds
•Cirrhosis of the liver (liver makes proteins!!!) |
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Term
| What causes increased capillary permeability? |
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Definition
| Inflammation (normal immune response) |
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Term
| Lymphatic channels can be blocked by what? What does the lymphatic system do? |
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Definition
•Can be blocked via surgical removal, obstruction, or infection involving lymphatic’s or lymphodemia ( blockage of a part of lymphatic pathway)
•Lymphatic system’s purpose is to remove and regulate fluid in the body |
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Term
| Does fluid increase or decrease the distance of diffusion? |
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Definition
| Increases it (has to spread across a larger area |
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Term
| How does fluid accumulation slow healing? |
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Definition
•It can impair blood flow
•Increases risk for infection
•Increases amount of pressure sores over bony prominences |
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Term
| Edema can be life threatening if it occurs where? |
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Definition
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Term
| Loss of water in body due to Edema can be harmful. Why? |
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Definition
•Water is trapped and is unavailable for metabolic processes
•This can cause dehydration
•Can cause shock!! |
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Term
| Na+ makes up what % of ECF cations? |
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Definition
|
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Term
| Loss of water in body due to Edema can be harmful. Why? |
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Definition
•Water is trapped and is unavailable for metabolic processes
•This can cause dehydration
•Can cause shock!! |
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Term
| What two anions does the cation sodium pair with to neutralize its charge? |
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Definition
|
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Term
| Is sodium low or high in ICF? |
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Definition
| Low- 90% is in the ECF NOT the ICF |
|
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Term
| •Why is sodium important? |
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Definition
•It regulates water balance
•It is vip to nerve and muscle function |
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Term
| What hormones affects if the kidneys (renal tube) can reabsorb sodium? |
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Definition
• Aldosterone
• Renin/angiotensin
• Arial natriuretic Peptide (ANP)
•These all regulate heart contration stuff…I think..except for aldosterone |
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Term
| What is the recommended intake of Na+ a day? |
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Definition
|
|
Term
| What is a normal blood sodium level? |
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Definition
|
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Term
| Is Potassium a cation or anion? |
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Definition
|
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Term
| What is the ICF of Potassium? |
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Definition
|
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Term
| Potassium is important for what? |
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Definition
| Resting membrane potential |
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Term
| What two things do the kidneys release that help to regulate potassium? |
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Definition
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Term
| Isotonic alterations in water balance is due to what flux in ECF or ICF? |
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Definition
| It is due to a decrease in ECF volume |
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Term
| A lack of Isotonic fluid can cause what? |
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Definition
• Decrease ECF volume
•weight loss
•dry skin and mucous membranes
•decrease urine output
•increase heart rate
•flattened neck veins
•decrease blood pressure=shock |
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Term
| What can cause and excess of isotonic fluids? |
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Definition
•Excess IV fluids
•Hypersecretion of aldosterone
•Effect of drugs-cortisone |
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Term
| Hypervolemia results in…? |
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Definition
•Weight gain, decrease hematocrit (since more fluid dilutes the levels), diluted plasma proteins
•Distended neck veins
•Increase in BP
•Edema (increased capillary pressure- pulmonary edema and heart failure) |
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Term
|
Definition
| High sodium levels due to increase of sodium or water loss |
|
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Term
| •What can cause Hypernatremia? |
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Definition
•Hypertonic saline solution
•Over stimulation of aldosterone=increase fluid volume=Hypernatremia
•Long term sweating (loose water but maintain sodium)
•diabetic –polyuria
•respiratory infection→ water vapor loss |
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Term
| Is sodium imbalance dangerous? |
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Definition
| Yes! It is the most dangerous! |
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Term
| What must blood sodium levels be at to be considered Hypernatremia? |
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Definition
|
|
Term
| where would water move in a hypoernatrmic cellular situation? |
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Definition
| From ICF→ECF= cell dehydrates |
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Term
| What are the clinical manifestations of Hypernatremia? |
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Definition
•Thirst
•Lethargy
•Neurological dysfunction due to dehydration
•Decreased vascular volume |
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Term
| What are some treatment of Hypernatremia? |
|
Definition
•Isotonic salt free IV fluid
•Oral solution |
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Term
|
Definition
| Overall decrease in sodium in ECF |
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|
Term
| What are the two types of hyponatremia? |
|
Definition
•1-depletional
•2-dilutional |
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Term
| What causes depletional hyponatremia? |
|
Definition
•Diuretics
•Chronic vomiting
•Decreased aldosterone (sodium saver)
•Decreased sodium intake |
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Term
| What causes dilutional hyponatremia ? |
|
Definition
•Renal dysfunction with ↑ intake of hypotonic fluids
•Excessive sweating→ increased thirst → intake of excessive amounts of pure water
•Syndrome of Inappropriate ADH-makes you thirsty-saves water= we save sodium ☺ (SIADH) or oliguric renal failure, severe congestive heart failure, cirrhosis |
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Term
|
Definition
•Normal glucose level is 70-110
•This attracts water |
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Term
| •What are the CLINICAL MANIFESTATIONS OF HYPONATREMIA? |
|
Definition
•Neurological symptoms
•Lethargy, headache, confusion, apprehension, depressed reflexes, seizures and coma
•Muscle symptoms
•Cramps, weakness, fatigue
•Gastrointestinal symptoms
•Nausea, vomiting, abdominal cramps, and diarrhea
•Tx – limit water intake or discontinue meds |
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Term
| HYPOKALEMIA is dominant in ECF or ICF? |
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Definition
|
|
Term
| •Serum potassium level is what |
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Definition
|
|
Term
|
Definition
•Decreased intake of K+ (Ivs)
•Increased K+ loss
•Chronic diuretics- becasue we get rid of potassium in our urine
•Acid/base imbalance
•Trauma and stress
•Increased aldosterone
•Redistribution between ICF and ECF
•Laxatives |
|
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Term
| What are the CLINICAL MANIFESTATIONS OF HYPOKALEMIA? |
|
Definition
•Neuromuscular disorders
•Weakness, flaccid paralysis, respiratory arrest, constipation
•Dysrhythmias, appearance of U wave
•Postural hypotension
•Cardiac arrest |
|
|
Term
| What is the treatment of hypokalemia? |
|
Definition
•Increase K+ intake, but slowly, preferably by foods!!!
•Can give it PO (packets that can be poured into juice)
•10 mEq per 100 mil equivalents per hour
•ALWAYS ASSESS IV site for redness
•NEVER GIVE POTASSIUM IM |
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Term
|
Definition
|
|
Term
| What causes hyperkalemia? |
|
Definition
•Serum K+ > 5.5 mEq / L
•Check for renal disease
•Massive cellular trauma
•Insulin deficiency
•Addison’s disease
•Potassium sparing diuretics
•Decreased blood pH
•Exercise causes K+ to move out of cells
•98% of potassium is in the intracellular- so if patients are in a major vehicle accident there cells are crushed and potassium are leaked out
•Aldoctone: potassium sparing diuretic
•Exercise can cause a loss of potassium |
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|
Term
| CLINICAL MANIFESTATIONS OF HYPERKALEMIA: |
|
Definition
•Early – hyperactive muscles , paresthesia
•Late - Muscle weakness, flaccid paralysis
•Change in ECG pattern
•Dysrhythmias
•Bradycardia , heart block, cardiac arrest
•Patients will have a really hard time talking because their muscles that are used to speak are affected |
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Term
| Treatment of hyperkalemia: |
|
Definition
•If time, decrease intake and increase renal excretion
•Insulin + glucose
•Bicarbonate
•Ca++ counters effect on heart
•Patient needs to receive 6mEq or more
•Give them dextrose and regular insulin (this helps potassium move into the cell)
•k-ecolyte binds with k and is excrete through the gut
•Moderate hyoerkalemia 5.5-5.9 |
|
|
Term
| Where do calcium imbalances occur? |
|
Definition
|
|
Term
| Calcium is regulated by what? |
|
Definition
•Parathyroid hormone (PTH)
•↑Blood Ca++ by stimulating osteoclasts
•↑GI absorption and renal retention
•Calcitonin from the thyroid gland
•Promotes bone formation
•↑ renal excretion |
|
|
Term
| Calcium is regulated by what? |
|
Definition
•Parathyroid hormone (PTH)
•↑Blood Ca++ by stimulating osteoclasts
•↑GI absorption and renal retention
•Calcitonin from the thyroid gland
•Promotes bone formation
•↑ renal excretion |
|
|
Term
| What are normal serum potassium levels? |
|
Definition
| serum potassium level 8.8-10.5mg/dl |
|
|
Term
| What are normal serum potassium levels? |
|
Definition
| serum potassium level 8.8-10.5mg/dl |
|
|
Term
| What are normal Ionized potassium levels |
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Definition
|
|
Term
| how is the amount of calcium in our body distributed? |
|
Definition
| •99 % of calcium is in our bones and teeth the other 1% is in our ECF-we measure our calcium levels from here |
|
|
Term
| why can lack of calcium cause neurological damage? |
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Definition
| Neurons require calcium to work effectively |
|
|
Term
| When calcium is present what happens physically? |
|
Definition
•When calcium is present it gives us a sedative activity level
•So lack of calcium = muscle twitching |
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|
Term
|
Definition
|
|
Term
| Hypercalcemia results from what? |
|
Definition
•Hyperparathyroidism
•Hypothyroid states
•Renal disease – high levels of PTH
•Excessive intake of vitamin D- you would need to drink a lot of milk!
•Milk-alkali syndrome
•Certain drugs
•Malignant tumors – hypercalcemia of malignancy- common in ppl who have cancer that is metastasized
•Patients with cancer of the blood stream
•Tumor products promote bone breakdown
•Tumor growth in bone causing Ca++ release |
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|
Term
| When a patient has hypercalcemia what do their phosphate levels look like? |
|
Definition
| Low phosphate levels hypophosphatemia |
|
|
Term
| Hypercalcemia can cause what effects? |
|
Definition
| Many nonspecific – fatigue, weakness, lethargy |
|
|
Term
| •Hypercalcemia can cause what effects? |
|
Definition
•Many nonspecific – fatigue, weakness, lethargy
•Increases formation of kidney stones and pancreatic stones
•Muscle cramps
•Bradycardia, cardiac arrest
•Pain
•GI activity also common
•Nausea, abdominal cramps
•Diarrhea / constipation
•Metastatic calcification
•20% of calcium ingested is absorbed
•Calcium is safer to give PO
•Phosphate brings down calcium level |
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|
Term
| •Hypocalcemia differs from hypercalcemia: |
|
Definition
| •Hyperactive neuromuscular reflexes and TETNAY differentiate it from hypercalcemia |
|
|
Term
| Hypocalcemia is caused by: |
|
Definition
• Renal failure
•Lack of vitamin D
•Suppression of parathyroid function so no PTH- helps to increase calcium levels when working properly- it pulls calcium from our bones (osteoclast or osteoblasts)
•Hypersecretion of calcitonin
•Malabsorption states
•Abnormal intestinal acidity and acid/ base bal.
•Widespread infection or peritoneal inflammation
•Hyperphosphatemia- so as phosphate levels are high- then there are low calcium levels (inverse relationship) |
|
|
Term
| How can you diagnose hypocalcemia? |
|
Definition
•Chvostek’s sign
•Trousseau’s sign (Bp cuff- inflate the cuff – look for muscle spasms
•Diagnosed through tetany
•Hyperactive tendon reflexes
•Abnormal tingling of fingers
•Spasms of bronchial muscles |
|
|
Term
| What is the treatment for hypocalcemia? |
|
Definition
•IV calcium for acute
•Oral calcium and vitamin D for chronic
•Ex) calcitrilol
•May need to receive vit D if they have renal disease
•Oral calcium works too |
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|
Term
| Good luck on your test!!! |
|
Definition
| Remember you made it this far so don't stress! Do your best and don't stress! |
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|
Term
|
Definition
| Do not be anxious about anything but in everything, by prayer and petition with thanksgiving, present your request to God. And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus |
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