Term
| body fluids are made up of |
|
Definition
|
|
Term
| ______ % of the body weight of men is composed of water, while in women it is ________% and in the very young & elderly it is ___________ % |
|
Definition
| 60 % of the body weight of men is composed of water, while in women it is 55 % and in the very young & elderly it is <55 % |
|
|
Term
| why do the extremely young and old have a lower body percentage of water? |
|
Definition
| because muscle attracts water and these age groups have less muscle cells |
|
|
Term
| what are the purposes of water in the body? |
|
Definition
1. transportation of nutrients, electrolytes, and O2
2. excrete waste
3. regulate body temp
4. lubricate joints/membranes
5. serve as a medium for food digestion |
|
|
Term
|
Definition
|
|
Term
| the function of intracellular fluid |
|
Definition
| aids in chemical reactions necessary for metabolism |
|
|
Term
| intracellular fluid makes up what percent of your body weight? |
|
Definition
|
|
Term
|
Definition
| fluid outside of the cells |
|
|
Term
| what is extracellular fluid distributed between? |
|
Definition
1. interstitial-around the cells
2. intravascular- within the vessels
3. third space- 1% of the interstitial fluid |
|
|
Term
| extracellular fluid makes up ____ % of your body weight |
|
Definition
|
|
Term
|
Definition
| 11 L of fluid around the cell that provides transportation between the cells and the intravascular system |
|
|
Term
|
Definition
| fluid within the vessels that aids in the transportation of cells to the body |
|
|
Term
|
Definition
| 1% of the interstitial fluid that in specialized cavities that is not available for body use. Normally includes the urine and intestinal fluids |
|
|
Term
| about how many liters is maintained in the vessels? |
|
Definition
|
|
Term
| why are the very young/old sensitive to shifts in fluid volume? |
|
Definition
| they have a reduced proportion of water to solids in the body |
|
|
Term
| what are the several factors that affect water gain and loss? |
|
Definition
1. fluid intake
2. fluid output
3. ADH
4. Renin-angiotensin-aldosterone |
|
|
Term
| fluid intake is mostly controlled by the |
|
Definition
| thirst center in the hypothalamus |
|
|
Term
|
Definition
1. dry mouth
2. low BP
3. hypertonic body fluid
4. decreased cardiac output (CO)
5. angiotensin |
|
|
Term
| a decreased amount of water would do what to urine? an increase? |
|
Definition
| concentrate it, and an increased amount of water would dilute urine |
|
|
Term
| a healthy kidney can filter how much in one hour? What happens if fluid intake exceeds this amount? |
|
Definition
| 1 L/hr. If it exceeds this amount it causes the kidneys to overwork due to fluid overload |
|
|
Term
|
Definition
| antidiuretic horome (ADH) |
|
|
Term
| explain the process of the ADH hormone |
|
Definition
1. A decreased BP and fluid volume along with increased plasma osmolarity causes the posterior pituitary gland to release ADH
2. this causes water retention, concentrated urine, increase in BP and fluid volume and a decrease in plasma osmolarity |
|
|
Term
| explain the renin-angiotensin cascade |
|
Definition
1. a decreased BP causes the juxtoglomerular cells to secrete renin
2. Renin converts protein in the liver to angiotensin I
3. angiotensin I is convereted to II in the lungs by ACE: Angiotensin Converting Enzyme
4. This causes the release of aldosterone which causes sodium and water retention
5. this causes decreased urine volume and increase fluid volume and BP |
|
|
Term
| what is the normal range for BP? what is the ideal? |
|
Definition
Normal range: 90/60 to 140/90
Ideal: 120/70 |
|
|
Term
| what would a BP that needs to be reported to the MD? what are the specific interventions? Hint: there are 2 BPs. |
|
Definition
Too Low: under 90/60: CALL MD STAT! because this could be hypovolemic shock. Trandelenburg and IV fluids if ordered.
Too High: if over 140/90: Call MD stat, could be hypervolemia, stroke, or HTN |
|
|
Term
| what are the methods by which fluids and solutes move throughout the body? |
|
Definition
1. diffusion
2. osmosis
3. active transport
4. osmotic pressure
5. hydrostatic pressure |
|
|
Term
|
Definition
| is the movement or particles or solutes from an area of higher concentration to an area of lower concentration |
|
|
Term
|
Definition
| is the movement of fluid from an area of low particle concentration to an area of high particle concentration |
|
|
Term
| in simple terms "using from low to high" or "from high to low" with respect to fluid or particle, explain osmosis and diffusion. |
|
Definition
osmosis: fluids from low to high
diffusion: particles from high to low |
|
|
Term
| when particles or solutes are not able to move throughout the body, what happens? |
|
Definition
|
|
Term
|
Definition
| movement of particles against the movement of osmotic pressure gradient |
|
|
Term
|
Definition
| pressure that builds up when there are fluids of different strengths on opposite sides of a semipermeable membrane |
|
|
Term
| what causes water to be "pulled out" of a membrane? |
|
Definition
| the water moves from an area of lower solute concentration to an area of high solut concentration to reach equilibrium due to osmotic pressure |
|
|
Term
| a major driver of osmotic force |
|
Definition
|
|
Term
|
Definition
| pressure created by fluid in an area such as extracellular or intracellular space; it pushes; is the pressure of the fluid against the walls of the vessels |
|
|
Term
| in terms of fluid pressures, which one pushes, and which one pulls? |
|
Definition
| hydrostatic pressure PUSHES and osmotic/oncotic pressure pulls |
|
|
Term
| what affects the movement of fluids in the capillay membrane? |
|
Definition
| hydrostatic (push) and osmotic (oncotic) (pulls) |
|
|
Term
| how long does it take for fluid to move back into the intravascular space? |
|
Definition
|
|
Term
|
Definition
| deficit in ECF and loss of intravascular volume |
|
|
Term
| what are the causes of hypovolemia? |
|
Definition
low fluid intake
high fluid loss
a shift of fluid from the intravascular to the extravascular |
|
|
Term
| what types of patients (circumstances) are at risk for hypovolemia? |
|
Definition
NPO
N/V and diarrhea
diuretics
hemorrhaging
wound drainage
fever |
|
|
Term
| what fluid shifts can cause hypovolemia? |
|
Definition
ascites
intestinal obstruction
burns |
|
|
Term
|
Definition
| an abnormal protein deficiency in the blood due to oncotic pressure loss |
|
|
Term
| what are the s/s of hypovolemia? |
|
Definition
CNS: restlessness to lethargy to coma
Skin: dry, clammy and cool
Mouth: dry mucous membranes and high thirst
CV: tachycardia, orthostatic hypotension, decreased BP, and rapid respiration rate
blood: HIGH Hct and BUN
urine: scant and concentrated |
|
|
Term
| what is the Tx for hypovolemia |
|
Definition
| infusion with NaCl and water wither oral or IV |
|
|
Term
| if left untreated, hypovolemia will progress into |
|
Definition
|
|
Term
|
Definition
| the heart is unable to supply blood to the body because of a loss of blood that is 20% or more than the normal amount of blood |
|
|
Term
| what are some causes that can cause blood loss leading to hypovolemic shock? |
|
Definition
| bleeding and excessive body fluid loss |
|
|
Term
| who is at risk for hypovolemic shock in order to provide nursing care? |
|
Definition
elderly
ill
handicapped
decreased LOC
and those with decreased access to food and water |
|
|
Term
| what are some nursing interventions to treat hypovolemia? |
|
Definition
increase fluid intake
increase Na intake (it attracts water)
monitor their weight, BP and Is and Os
stop diuretics
monitor electrolytes to avoid concentration |
|
|
Term
| what are the s/s of heat exhaustion? what are the treatments? |
|
Definition
s/s: profuse sweating, increased body temp, decreased B/P, and increased HR, hyperventilation
Tx: give Na and water replacement and rest |
|
|
Term
|
Definition
|
|
Term
| what are some causes of hypervolemia? |
|
Definition
too much fluid intake
too much Na intake
sodium/water retention
hormone abnormalities: too much ADH or aldosterone
regulatory failure in kidneys |
|
|
Term
| what are the s/s of hypervolemia? |
|
Definition
| increased BP and low and thready pulse, sudden weight gain, peripheral edema, lungs with crackles/rales, hyperventilation,confusion and seizures, warm and moist skin, increased ICP and distended neck veins |
|
|
Term
| what are the nursing interventions for the treatment of hypervolemia? |
|
Definition
administer diuretics to help in the removal of excess fluid
retrict Na and fluid intake
monitor weight, BP, pulse, and electrolytes
care for edematous skin
auscultate to check for progression of rales and crackles
if there is renal insufficiency: hemodialysis and renal replacement therapy |
|
|
Term
|
Definition
| fluid with the same concentration as blood plasma |
|
|
Term
|
Definition
| fluid with a lower concentration than blood plasma |
|
|
Term
|
Definition
| fluid with a concentration that is greater than blood plasma |
|
|
Term
|
Definition
| concentration of solutes (particles) in a solvent (fluid); measured by the # of dissolved particles/kg of water |
|
|
Term
|
Definition
| is the same as blood plasma concentration, isotonic, is between 275-295 mOsm/kg |
|
|
Term
| when you are below serum fluid osmolarity |
|
Definition
| intravascular fluid overload |
|
|
Term
| when you are above serum fluid osmolarity |
|
Definition
| hemoconcentration, dehydration |
|
|
Term
| what is the appearance of a cell that is in isotonic fluid? hypotonic? hypertonic? why? |
|
Definition
isotonic fluid: normal
because water loss = Na loss
hypotonic= cell is puffy and swollen because there is more concentration inside the cell than out so water rushes in
hypertonic- the cell is shrunken and shriveled because there is more concentration outside of the cell so water rushes out of the cell |
|
|
Term
| hypotonic fluids will go where first? after? |
|
Definition
| first hypotonic fluids fill the intravascular space then fill the extravascular tissues |
|
|
Term
| what are the bad side effects of too much hypotonic fluid? what are the good uses? |
|
Definition
bad: too much fluid shift into a cell cause changed mental stats, BP, and heart function
good: for dehyrdated patients because it will rehydrate intravscular spaces then extracellular spaces |
|
|
Term
| what are the good uses for hypertonic solutions? what is an example? |
|
Definition
| is good for patients with too much fluid. will cause fluid to exit the cell. albumin is VERY hypertonic |
|
|
Term
| albumin is an example of a |
|
Definition
|
|
Term
| list some isotonic solutions: |
|
Definition
lactated ringers
D5W
0.9% NaCl |
|
|
Term
| What are isotonic solutions used for? |
|
Definition
| to fill up the vessels and elevate BP without affecting the intercellular or intersitial spaces |
|
|
Term
| what is a potential problem in overusing isotonic solutions? |
|
Definition
| circulatory volume overload due to too much volume entering the intravascular space |
|
|
Term
| what do isotonic solutions do to the shifts in fluids and solutes? |
|
Definition
| none, it only increases fluid in the intravascular space |
|
|
Term
| what is the rule for determining whether a solution is either hypo or hypertonic? |
|
Definition
For saline:
Isotonic: 0.9% NaCl
Hypotonic: < 0.9% NaCl
Hypertonic: > 0.9% NaCl
Dextrose in water:
Isotonic: D5W
Hypotonic: < D5W
Hypertonic: > D5W |
|
|
Term
| Hypotonic fluid causes? Ideal for? Dowsnide? Too much can cause? Monitor for? |
|
Definition
Causes fluid to shift from the intravascular space and into the cell (puff them up)
Ideal for cellularly dehydrated patients who are hypovolemic and hypotensive.
Downside: can cause circulatory volume depletion because it is pulling fluid from the vessels and taking it to the cells
Too much can cause: tissue edema
Monitor for: edema and crackles/rales in the lungs |
|
|
Term
| Hypertonic fluid causes? Ideal for? Dowsnide? Too much can cause? Monitor for? Contraindicated for? |
|
Definition
Causes: fluid to move out of the cells and into intravascular spaces
Ideal for: patients with heart failure, fluid overload, hypervolemia, hypertension, post surgery who had too much fluid intake, need to decrease edema, maintain urinary output, have been on IV fluids too long and have 3rd spacing
Too much: can cause hypovolemia
Monitor: S/S hypovolemia
Contraindicated for: patients with heart/kidney impairments or cellular dehydration disorders |
|
|
Term
| what type of fluid should be given to a hypovolemic patient who is hypotensive? what can occur if this fluid is overinfused? |
|
Definition
give them a hypotonic solution to help plump
too much: hypervolemia |
|
|
Term
| what type of fluid should be given to a patient who is hypervolemic and hypertensive? be careful for? |
|
Definition
a hypertonic solution
be careful to not cause hypovolemia |
|
|
Term
| when wanting to correct an inbalanced fluid problem, what is preferred? |
|
Definition
| preferred is to make oral changes first (increases/decreases in oral intake, etc), IV therapy is a last resort to make fluid balance normal |
|
|
Term
what type of fluid is:
5% dextrose is normal saline? |
|
Definition
|
|
Term
what type of fluid is:
5% dextrose in lactated Ringers |
|
Definition
|
|
Term
what type of fluid is:
D10W |
|
Definition
|
|
Term
|
Definition
| when fluid shifts out of the intravascular space |
|
|
Term
| for a patient with severe blood loss or has refused blood products what fluid type would be ideal? |
|
Definition
| isotonic because you don't want to shift any solutes/fluids, just fill the vessels with fluid to increase BP |
|
|
Term
| what must be done in IV administration? |
|
Definition
1. verify the 5 rights
2. assess the IV site
3. gather equipment
4. set up IV |
|
|
Term
| what are the 5 rights of administration? |
|
Definition
1. patient
2. medication
3. route
4. time
5. dose |
|
|
Term
| when assessing the IV site what are you looking for? |
|
Definition
1. phelebtis and infiltration: should be none
2. patency: can aspirate for blood return or infuse with 1-2 ml normal saline there should be no bubble. if there is a bubble could be infiltration |
|
|
Term
| what equipment do you need to set up an IV? |
|
Definition
IV pump
IV pole
IV tubing
label with date and time
med/fluid bag
red cap to place on previously existing tubing if present
2 x 2
5 ml prefilled syringe of NS for troubleshooting |
|
|
Term
| while assessing the IV site you see it is covered by tape and gauze but see no bleeding, is this acceptable? |
|
Definition
| no you must be able to see the IV cannula in order to properly assess |
|
|
Term
| explain the process to set up an IV |
|
Definition
1. remove the tubing and close the clamp
2. invert the bag
3. spike the bag
4. hang it the bag
5. squeeze the draw chamber until it hald full
6. prime the tubing |
|
|
Term
| IV medications given gravity drip are for? examples? |
|
Definition
are given for medications that need to be administered rapidly
Examples:
-isotonic fluid bolus
-antibiotics
-codes or critical situations |
|
|
Term
| medication ALWAYS given via IV pump |
|
Definition
| potassium, magnesium, and heparin |
|
|
Term
|
Definition
|
|
Term
| how long would it take an IV pump to infuse a patient with 1 L of normal saline? |
|
Definition
|
|
Term
|
Definition
| an IVPB is a smaller container than the primary, is hung higher to allow gravity to infuse it first, and has shorter tubing that is "piggybacked" into the primary tubing |
|
|
Term
| what are the steps for setting up an IVPB? |
|
Definition
1. prepare tubing and close clamp
2. invert the bag
3. spike the bag
4. hang it higher than the primary to allow gravity to infuse it first |
|
|
Term
| for which delivery of IV medication do you need to know the drop factor? |
|
Definition
|
|
Term
| where can you find the drop factor? |
|
Definition
| on all IV tubing packages |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| are solutes that generate an electrical charge when in solution |
|
|
Term
|
Definition
|
|
Term
| potassium and sodium are ______ charged ions while chloride and phosphate are ______ charged ions. |
|
Definition
| potassium and sodium are + charged ions while chloride and phosphate are - charged ions. |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| what are the 4 reasons that can cause too much (HYPER) of an electrolyte? |
|
Definition
1. increased consumption
2. increased holding onto/decreased excretion
3. high concentration
4. increased amount coming into vessels from bone, tissue, and cells |
|
|
Term
| to measure serum electrolytes and protein, where are you measuring? |
|
Definition
| you are measuring how much of something is inside of the VESSELS, not the tissue, bone, or cells. |
|
|
Term
| what are the 4 reasons that you would too little of something in your blood (HYPO)? |
|
Definition
1. decreased consumption/absorption
2. increased excretion/decreased holding on to
3. increased circulating blood volume (dilutes it)
4. increased giving off of substance outside of vessel and into the tissue, cells, and bone |
|
|
Term
| what are the principle ways of repairing a HYPER condition of a substance? |
|
Definition
1. decrease PO and IV consumption/administration
2. increase excretion
3. dilute the blood or increase circulating volume
4. increase the "pushing out" of the substance out of vessels and into cells, tissues, and bones |
|
|
Term
| what are the principle ways of repairing a HYPO condition of a substance? |
|
Definition
1. increase IV PO administration/consumption
2. decrease excretion/increase holding onto
3. concentrate the blood
4. increase "pulling in" of the substance into the vessels from the cells, tissue and bones |
|
|
Term
|
Definition
1. extracellular cation
2. necessary for protein synthesis and impulse nerve transmission
3. regulated by water retention and reabsorption
4. eliminated through the kidneys
5. influenced by glomerular filtration rate (GFR) and aldosterone which regulates Na reabsorption |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
condition: too much sodium in the blood
explanation:
normal range of that electrolyte/substance
causes:
s/s:
treatment:
important reminders: |
|
Definition
condition: too much sodium in the blood
explanation: hypernatremia is an increased level of sodium in the blood that causes cellular shrinking since there is a higher concentration of Na outside of the cell, osmosis pulls water out of the cell
normal range of that electrolyte/substance: Na: 135-145 mEq/L
causes:
1. decreased fluid intake
2. increased Na/saline intake
3. increased protein feedings
s/s:
1. weight gain
2. tachycardia
3. thirst/dry mucous membranes
4. agitation
5. seizure/coma
treatment:
1. increase fluid intake
2. decrease Na intake
3. give diuretics
4. dilute blood concentration
5. give HYPOtonic fluids to rehydrate cells
important reminders: n/a |
|
|
Term
condition: too little sodium
explanation:
causes:
s/s:
treatment:
important reminders: |
|
Definition
condition: too little sodium
explanation: hyponatremia is too little sodium in the blood which causes cellular swelling
causes:
1. increased fluid intake
2. decreased renal function
3. adrenal insufficiency
s/s:
1. weight loss
2. confusion
3. hypotension
4. seizure/coma
treatment:
1. increase Na intake
2. restrict fluids
3. give hypertonic fluids like 3% NaCl
4. monitor weight and vitals
5. perform oral and skin care
important reminders:
n/a |
|
|
Term
condition: too much potassium
explanation:
causes:
s/s:
treatment:
important reminders: |
|
Definition
condition: too much potassium
explanation: hyperkalemia is when there is too much potassium in the blood.
causes:
1. kidney disease/renal failure: causes there to be a decrease in excretion, therefore an increase left in the body
2. rapid K infusion via IV
3. too much K entering blood from tissues like broken crushed bones or an MI
4. excessive ecchymosis
s/s:
1. weakness
2. fatigue
3. lethargy
4. numbness
5. muscle cramps
6. arrhythmias
treatment:
1. decrease K intake
2. give Kayexelate to increase K excretion but it will cause diarrhea and also check for hypokalemia
3. give insulin with D50 glucose to cause K to temporarily shift intracellularly and the glucose will prevent hypoglycemia. This is temporary and the K will come back out. This is used in life-threatening situations like life threatening arrythmias.
4. give diuretics that are NOT potassium sparing like Lasix (Furosemide), Bumex, and Demodex
5. give isotonic fluids, PO and IV
6. if severe then they will need dialysis
important reminders: NEVER ever give K IV push or gravity hang. Always administer it slowly through an IV pump in diluted form. But in this case, where we are dealing with HYPERkalemia, or too much K, we don't need to worry about administering K unless our patient becomes hypokalemic from the Kayexalate. |
|
|
Term
condition: too little potassium
explanation:
causes:
s/s:
treatment:
important reminders: |
|
Definition
condition: too little potassium
explanation: hypokalemia is when there is too little potassium in the blood.
causes:
1. nausea/vomiting/diarrhea
2. diuretics
3. NG tubes: nasogastric tubes
4. shift of K into the cells (like with insulin)
s/s:
1. N/V
2. fatigue
3. malaise
4. weakness
5. muscle cramps
6. arrythmias
7. shallow respirations
8. confusion
treatment:
1. treat the cause
2. provide K supplements
3. monitor K levels every 2-4 hours post Tx
4. educate pt on S/S
important reminders:
1. giving K is contraindicated for renal failure patients
2. K should NEVER be given IV push or gravity hang. It should always be given SLOWLY on an IV pump in diluted form
3. At a K level of less than 2.0 cardiac arrest can occur |
|
|
Term
| when cardiac arrest occur? |
|
Definition
| when K levels go below 2.0 mEq/L |
|
|
Term
| According to FH's K protocol, what is the MAXIMUM dose of K that can be given on an IV pump? |
|
Definition
10 mEq/100 mL/ hr
If patient's K is below 2.5, then it can be increased to 20 mEq/ 100 ml/ hr |
|
|
Term
|
Definition
1. baked potatoes
2. broccoli
3. bananas |
|
|
Term
|
Definition
| by filtration and reabsorption of the kidneys |
|
|
Term
| what is the most important Ca regulator in the body? |
|
Definition
|
|
Term
| what does the parathyroid gland release to regulate Ca in the body. What does this do? |
|
Definition
the parathyroid releases: parathyroid hormone (PTH)
PTH is secreted when there are low levels of calcium (hypocalcemia) in the blood. PTH prevents the excretion of calcium, increases calcium reabsorption by the kidneys and Ca and P release from the bones since Ca is bound in the bones by P |
|
|
Term
| what substance increases the absorption of Ca particularly in the GI tract? |
|
Definition
|
|
Term
| what type of relationship does Ca have with P? |
|
Definition
an inverse relationship,
an increase in Ca leads to a decrease in P vice versa |
|
|
Term
condition: too much calcium in the blood
explanation:
normal range of that electrolyte/substance
causes:
s/s:
treatment:
important reminders: |
|
Definition
condition: too much calcium in the blood
explanation: hypercalcemia
normal range of that electrolyte/substance: 9-11 mg/dl
causes:
1. metastatic bone disease- excessive release of Ca from the bones
2. hyperparathyroidism- since PTH prevents the excretion of Ca and increases its release from bones and absorption, too much leads to hypercalcemia
3. immobility- causes too much release of Ca from the bones due to no weight bearing excercises
4. excessive vitamin D- increases the absorption of Ca
5. thiazide diuretics- has the body hold on the Ca
s/s:
1. lethargy
2. slurred speech
3. kidney stones
4. decreased reflexes
5. potential death is Ca is above 15
treatment:
1. assess cardio/neuro
2. address the cause
3. give isotonic fluids, loop diuretics, and P
4. limit Ca intake
5. meds:
a. biphosphanates: increase Ca holding in the bones which decreases Ca in the blood
1. alendronate (fosamax)
2. ibandronate (boniva)
3. risendronate (actonel)
b. calcitonin- opposes PTH
1. myacalcin
important reminders: |
|
|
Term
| what drugs are used to treat hypercalcemia? |
|
Definition
a. biphosphanates: increase Ca holding in the bones which decreases Ca in the blood
1. alendronate (fosamax)
2. ibandronate (boniva)
3. risendronate (actonel)
b. calcitonin- opposes PTH
1. myacalcin |
|
|
Term
condition: too little calcium in the blood
explanation:
normal range of that electrolyte/substance
causes:
s/s:
treatment:
important reminders: |
|
Definition
condition: too little calcium in the blood
explanation: hypocalcemia
normal range of that electrolyte/substance: 9-11 mg/dl
causes:
1. deficient vitamin D intake
2. removal of the parathyroid
3. acute pancreaitis
4. renal failure
s/s:
1. increased deep tendon reflex:
a. Chvostek's sign: facial twitching when you tap on face
b. Trosseau's sign: carpal spasms after 3 min of BP cuff inflation to a level above systolic pressure
2. tingling in fingers and toes
treatment:
1. limit fluid intake
2. give more Ca and prevent Ca excretion
3. Increase Ca in diet and decrease P
4. give P binding antacids
5. give IV gluconate not IM to avoid Ca precipitation in the muscles
important reminders:
1. always monitor patient who have recently had neck surgery closely for this |
|
|
Term
|
Definition
|
|
Term
| why does kidney damage have an impact on P? |
|
Definition
| because P is excreted by the kidneys |
|
|
Term
| what are the clinical manifestations of hyperphosphatemia? |
|
Definition
| the same as hypocalcemia due to their inverse relationship |
|
|
Term
condition: too much phosphorus in the blood
explanation:
normal range of that electrolyte/substance
causes:
s/s:
treatment:
important reminders: |
|
Definition
condition: too much phosphorus in the blood
explanation: hyperphosphatemia
normal range of that electrolyte/substance: 2.8-4.5 mg/dl
causes:
1. renal failure
2. chemotherapy
3. increased PO intake
s/s: same as hypocalcemia
1. fatigue
2. anxiety
3. confusion
4. hyperrelexia
5. tetany
6. seizure
treatment:
1. treat cause
2. increase Ca intake to decrease P
3. give PO4 binding agents to decrease serum level
a. renvela (sevalamen carbonate)
b. renegel (sevalamen HCl)
4. control P level
important reminders:
1. frequently assess CKD patients
2. |
|
|
Term
| in hypermagnesia, what is the goal? |
|
Definition
| to reduce P while slowly replacing Ca |
|
|
Term
condition: too little phosphorus in the blood
explanation:
normal range of that electrolyte/substance
causes:
s/s:
treatment:
important reminders: |
|
Definition
condition: too little phosphorus in the blood
explanation: hypophosphatemia
normal range of that electrolyte/substance: 2.8-4.5 mg/dL
causes:
1. malnourishment
2. malabsorption syndromes
3. alcoholism
s/s:
1. impaired cellular energy production
2. muscle weakness
3. cardiac arrhythmia
4. decreased O2 delivery causes patient confusion and come
treatment:
1. oral P in diet
important reminders:
1. remember, an increase in P will cause a decrease in Ca |
|
|
Term
| what does magnesium aid in? |
|
Definition
| Mg aids in: neuromuscular transmission and cardiac contractility |
|
|
Term
| Mg is regulated by the same factors that regulate |
|
Definition
|
|
Term
| what electrolyte is known as the "me too" electrolyte? what electrolyte does the "me too" electrolyte act like? |
|
Definition
what electrolyte is known as the "me too" electrolyte? Mg
what electrolyte does the "me too" electrolyte act like? K |
|
|
Term
| when K is high then _____ is high as well: |
|
Definition
| when K is high then Mg is high as well: |
|
|
Term
condition: too much magnesium in the blood
explanation:
normal range of that electrolyte/substance
s/s:
treatment:
important reminders: |
|
Definition
condition: too much magnesium in the blood
explanation: hypermagnesia
normal range of that electrolyte/substance 1.5-2.5
s/s:
1. depression of CNS and neuromuscular function
2. N/V
3. lethargy
4. somnolence
5. coma/death
treatment:
1. prevention
2. administer IV Ca to counteract cardiac muscle inhibition
3. diuretics to excrete Mg
important reminders:
1. NO Mg or K for patients in renal failure |
|
|
Term
condition: too little magnesium in the blood
explanation:
normal range of that electrolyte/substance
s/s:
treatment:
important reminders: |
|
Definition
condition: too little magnesium in the blood
explanation: hypomagnesium
normal range of that electrolyte/substance: 1.5-2.5
s/s:
1. confusion
2. hyperactive reflexes
3. seizures
4. cardiac arrythmias
5. hypocalcemia/hypokalemia
treatment:
1. oral Mg in diet
2. IV Mg SLOWLY NO IV PUSH OR GRAVITY, drip slowly!!!!!!!!!!!!
important reminders:
1. if Mg < 1.5 then patient maybe unresponsive, Mg must be replaced before K replacement is given |
|
|
Term
hyperproteinemia:
is it common or rare?
causes:
management: |
|
Definition
hyperproteinemia:
is it common or rare? more rare
causes:
1. dehydration
2. hemoconcentration
management:
1. rehydration with hypotonic IV fluids |
|
|
Term
hypoproteinemia:
is it common or rare?
causes:
leads to:
management: |
|
Definition
hypoproteinemia:
is it common or rare: this is more common
causes:
1. malnutrition
2. liver/renal disease
3. burns
4. malignancy/sepsis
leads to:
1. ascites (pot belly)
2. edema
3. muscle wasting
4. pulmonary edema
management:
1. increase protein, carb in diet along with protein supplements
2. some may need TPN and IV albumin to correct protein levels |
|
|
