Term
| What are the 4 major cations? |
|
Definition
Sodium Na+
Potassium K+
Calcium Ca++
Magnesium Mg++ |
|
|
Term
| What is the function of sodium and what are the routine lab values? |
|
Definition
| Major extracellular cation, fluid balance,crystalloid osmotic pressure,135-145 mEq/L |
|
|
Term
| What is the function of potassium and what are the routine lab values? |
|
Definition
| Major intracellular cation, neuromuscular excitability; acid-base balance,3.5-5.0 mEq/L |
|
|
Term
| What is the function of Calcium and what are the routine lab values? |
|
Definition
| neuromuscular irritability, blood clotting, bone structure 8.5-10.5mg/dl |
|
|
Term
| What is the function of magnesium and what are the routine lab values? |
|
Definition
|
|
Term
| What are the 6 major cations? |
|
Definition
Chloride Cl-
Bicarbonate HCO3
Proteinase
Organic acids
Phospahtes HPO04--
Sulfates HSO4-- |
|
|
Term
| What's the function of chloride and what is the routine value? |
|
Definition
| Major extracellular anion, fluid balance, crystalloid osmotic pressure |
|
|
Term
| What is the major function of bicarbonate and what are the normal lab values? |
|
Definition
| acid-base balance (acidosis)24-26 mEq/L |
|
|
Term
| What is the major function of proteinates and what are the normal lab values? |
|
Definition
| Colloid osmatic pressure;Acid-base balance 6-8 gr/dl |
|
|
Term
| What are is the major function of organic acids and what are the normal values? |
|
Definition
| Intermediary cellular metabolism |
|
|
Term
| What is the major function of phosphates? |
|
Definition
| major intracellular anion |
|
|
Term
| What is the major function of sulfate? |
|
Definition
|
|
Term
| What is the normal lab value for CO2? |
|
Definition
|
|
Term
| What is the normal lab value for BUN? |
|
Definition
|
|
Term
| What is the normal lab value for creat? |
|
Definition
|
|
Term
| What is the normal lab value for glucose? |
|
Definition
|
|
Term
| What is the normal lab value for HbA1c? |
|
Definition
|
|
Term
| What's included in the white count differential? |
|
Definition
Bands/stabs
Neutrophils
Eosinophils
Lymphocytes
Monocytes
Total |
|
|
Term
| What is the normal lab value for nads/stabs? |
|
Definition
|
|
Term
| What is teh normal lab value for neutrophils? |
|
Definition
|
|
Term
| What is the normal lab value for eosinophils? |
|
Definition
|
|
Term
| What is the normal lab value for basophils? |
|
Definition
|
|
Term
| What is the normal lab value for lymphocytes? |
|
Definition
|
|
Term
| What is the normal lab value for monocytes? |
|
Definition
|
|
Term
| What is included in the CBC/Platelets lab values? |
|
Definition
|
|
Term
| What's the normal Hbg lab value? |
|
Definition
|
|
Term
| What's the normal Hct lab value? |
|
Definition
|
|
Term
| What's the normal WBC lab values? |
|
Definition
|
|
Term
| What's the normal platelet lab value? |
|
Definition
|
|
Term
| What's included in the arterial blood gas lab values? |
|
Definition
|
|
Term
| What's the normal lab value for pH? |
|
Definition
|
|
Term
| What's the normal lab value for PaO2? |
|
Definition
|
|
Term
| What's the normal lab value for PaCO2? |
|
Definition
|
|
Term
| What's the normal lab value for HCO3? |
|
Definition
|
|
Term
| What are the red blood cell lab values? |
|
Definition
Retriclocytes
Means corp vol
Means corp Hbg
Means corp Hbg Conc
ESR |
|
|
Term
| What is the normal value for MCV? |
|
Definition
|
|
Term
| What is the normal value for retriculocytes? |
|
Definition
|
|
Term
| What is the normal value for MCH? |
|
Definition
|
|
Term
| What is the normal value for MCHC? |
|
Definition
|
|
Term
| What is the normal value for ESR? |
|
Definition
| male:1-13, Female:1-20mm/hr |
|
|
Term
| What are the normal lab values for blood saturation levels? |
|
Definition
SpO2 pulse ox> 97%
SaO2 oxygen sat> 95%
SvO2 mixed venous=75% |
|
|
Term
| What are the normal hemodynamic parameters? |
|
Definition
CO 4-6 L/min
CVP 6-12 cm H20
SVR 900-1600
PVR 155-255
PCWP 6-10 mmHg |
|
|
Term
| What is the normal pH level of urine? |
|
Definition
|
|
Term
| What is the normal value for PTT? |
|
Definition
|
|
Term
| What is the normal value for PT? |
|
Definition
|
|
Term
| What is the normal value for INR? |
|
Definition
|
|
Term
| What is the normal value for Alk phos? |
|
Definition
|
|
Term
| What are the isotonic/crystalloid IV solutions? |
|
Definition
|
|
Term
| What are the hypotonic IV solutions? |
|
Definition
| 1/2NS, D% 1/2NS, D5 1/4NS |
|
|
Term
| What are the hypertonic IV solutions? |
|
Definition
| D5NS,D5RL, D10W,D20W, D50W, 3%NS |
|
|
Term
| What are the colloids IV solutions? |
|
Definition
| dextran, hetastarch,plasmanate, albumin |
|
|
Term
| What are the blood products IV solutions? |
|
Definition
| Whole blood, packed RBCs, Platelets, fresh frozen plasma, cryoprecipate |
|
|
Term
| What are the TPN IV solutions? |
|
Definition
| lipid solutions, 3 in 1 solutions |
|
|
Term
| What two systems regulate homeostasis? |
|
Definition
|
|
Term
| What are the normal intake values for water balance? |
|
Definition
Fluid ingestion 60%
Foods 30%
Metabolism 10% |
|
|
Term
| What are the normal uptake values for water balance? |
|
Definition
Urine 60%
Sweat 8%
Feces 4%
"Insensible" loss 28% |
|
|
Term
|
Definition
| The force that the ECF solutes (mainly Na) have to pull water into the ECF. |
|
|
Term
| What happens to a RBC in hypotonic solution? |
|
Definition
|
|
Term
| What happens to a RBC in hypertonic solution? |
|
Definition
|
|
Term
| What are the ECF electrolytes |
|
Definition
Sodium - Na 135-145mEq/L
Potassium - K 3.5-5.0 mEq.L
Calcium - Ca 4.5-5.5 mEq/L
Magnesium - Mg 1.5 - 2.5 mEq/L
Chloride - Cl 90-110 mEq/L
Bicarbonate – HCO3
Arterial 22-26 mEq/L
Venous 24-30 mEq/L |
|
|
Term
| What's the difference between ICF & ECF? |
|
Definition
| ECF high Na and Ch, ICF high K & phos |
|
|
Term
| What regulates sodium levels? |
|
Definition
| dietery intake & aldosterone |
|
|
Term
| What's the major determinant of the size of the ECF Volume |
|
Definition
| The total amount of Sodium in ECF |
|
|
Term
| What system retains Na in the kidneys? |
|
Definition
|
|
Term
| Explain the 3 steps of Na regulation |
|
Definition
1. Kidney receptors sense changes in renal perfusion causing renin-angiotensin system to retain sodium in kidney.
2. Volume receptors in great veins sense filling and release atrial natriuretic factor that promotes Na excretion.
3. Pressure receptors in aorta and carotid sinus activate sympathetic NS to retain Na. |
|
|
Term
| Discribe the steps of water regulation. |
|
Definition
1. Osmolality increase in ECF -> Thirst
2. Renal responsiveness to tonicity
3. Adequate delivery of water and solutes to glomerulus of kidney (Problem: Early reabsorption of water due to volume depletion or edematous states)
4. Water conservation mechanisms in kidney (Can be overridden by diuretics either in loop or in distal tubule.
5. ADH in response to tonicity changes, i.e., Na, or in response to volume changes |
|
|
Term
| How do Thiazides and Loop diuretics effect water balance? |
|
Definition
| block Na reabsorption and cause decrease in ECF |
|
|
Term
| How do Thiazides and Loop diuretics differ? |
|
Definition
| Loop cause greater loss of Na but equal water, but thiazides lose less water than Na and can cause hyponatremia. |
|
|
Term
| What is the only solution used in administering blood? |
|
Definition
|
|
Term
| What are hypertonic IV solutions such as 3%-5%NS used for? |
|
Definition
| to reverse severe Na deficit |
|
|
Term
| What are hypotonic solutions such as Saline 0.2% or 0.45% used for? |
|
Definition
| Assists with renal fx; provides free water Na and Cl; replaces nml hypotonic daily fluids losses – assists with daily body fluid needs but not with electrolyte replacement or provision of calories |
|
|
Term
| What are the major ECF electrolytes? |
|
Definition
|
|
Term
| What are the major ICF electrolytes? |
|
Definition
|
|
Term
| What are some causes of hyponatrema? |
|
Definition
| losses of GI, burns, diuretics, wound drainage |
|
|
Term
| What are some causes of hypernatrema? |
|
Definition
| High fever, heat stroke due to insensible water loss, diabetes insipidus |
|
|
Term
| What's the major function of K? |
|
Definition
Major ICF cation; cellular and metabolic fx including cardiac rhythms
Regulates metabolic activities, necessary for glycogen deposits in liver and skeletal muscles, transmission and conduction of nerve impulses and normal cardiac cond.and skeletal and smooth musc.contraction |
|
|
Term
| What are some causes of hypokalemia? |
|
Definition
| GI losses – diarrhea, vomiting, diuretics, diaphoresis |
|
|
Term
| What are some major causes of hyperkalemia? |
|
Definition
| acidosis, renal disease, potassium containing drugs, potassium supplements |
|
|
Term
| What are major causes of hypocalcemia? |
|
Definition
| chronic renal failure,vitamin D deficiency, pancreatitis, loop diuretics, diarrhea, hypoparathyroidism |
|
|
Term
| What are major causes of hypercalcemia? |
|
Definition
| multiple myeloma, thiazide diuretics, malignancies |
|
|
Term
|
Definition
|
|
Term
| What's the normal levels for bicarbonate? |
|
Definition
arterial 22-26 mEq/L
venous 24-30 mEq/L |
|
|
Term
| What is the edematous state? |
|
Definition
| ECFV increases till overload |
|
|
Term
| How do obesity effect body fluid? |
|
Definition
| obesed people has less body fluids b/c fat cells contain less water |
|
|
Term
| What % of body fluids are located in the ICF & ECF? |
|
Definition
ICF-2/3 (primarily in skeletal muscle mass)
ECF-1/3 |
|
|
Term
| What are the divisions of the ECF? |
|
Definition
| intravascular, interstitial, transcellular fluid |
|
|
Term
| What is third space fluid shift? |
|
Definition
| Loss of ECF into a space that does not contribute to equilibrium between the ICF and ECF |
|
|
Term
| Whaat's are early evidence of third space fluid shift? |
|
Definition
| decrease in urine output despite adequate fluid intake |
|
|
Term
| What are the major ECF cations? |
|
Definition
|
|
Term
| What are the major ECF anions? |
|
Definition
| Cl, HCO3, HPO4, SO4, organica acids and proteinase |
|
|
Term
| What are the major ICF cations? |
|
Definition
|
|
Term
| how does renal functon effect serum creatinine levels? |
|
Definition
| creat level inc. when renal function dec. |
|
|
Term
| what conditions inc hct levels? |
|
Definition
| dehydration and polycythemia |
|
|
Term
| What conditions dec hct levels? |
|
Definition
|
|
Term
| What conditions dec hct levels? |
|
Definition
|
|
Term
| How does the pituitary gland function to maintain fluid balance? |
|
Definition
| releases ADH as needed to conserve water. ADH mainains osmatic pressure of cells by controlling retention and execretion of kidneys and regulating blood vol. |
|
|
Term
| How does the adrenal gland regulate body fluids? |
|
Definition
|
|
Term
| How does the parathyroid help to maintain fluid balance? |
|
Definition
| PTH- regulate Ca & HPO4 balance, bone reapsorption, Ca absorbtion from intestines, Ca reabsorbtion from renal tubules |
|
|
Term
| How does the kidneys function to maintain fluid balance? |
|
Definition
-Regulate ECF vol & osmalality by selective retention and excretion of body fluids
-Mainatain normal electrolyte levels in ECF by selective electolytes retention and excretion
-Regulate pH of ECF by retention of H ions
Excretion of metabolic wastes and toxic substances |
|
|
Term
| What are the clinical menifestations of FVD? |
|
Definition
| acute weight loss, decrease skin turgor, oliguria,concentrated urine,orthostatic htn due to vol depletion, weak & rapid HR, ,flattened neck veins, inc temp,thirst, delayed capulary refill, decreased CVP, cool clamy pale skin related to vasoconstriction, anorexia, nausea, lassitude, muscle weakness, cramps, increases pulse |
|
|
Term
| Describe the lab findings of FVD |
|
Definition
| inc hemo, inc urine osmolality & specific gravity, dec urine Na, inc BUN and creat |
|
|
Term
| Describe .9 NaCl and it's uses |
|
Definition
| isotonic solution, increases ECF, used to treat hypovolemia, resescitative efforts, shock, diabetic ketoacidosis, metabolic alkalosis, hypercalcemia, mild Na+ deficit. Supply excess of Na & Cl |
|
|
Term
| Describe Lactated ringers solutions and the uses |
|
Definition
| isotonic solution, contains multiple electrolytes in roughly same concentration as found in plasma. Used to trat hypovolemia, burns, fluid lost as bile or diarrhea, acute blood loss replacement |
|
|
Term
| What are some precautions to consider when administering lactated ringer's solution? |
|
Definition
-do not use in lactic acidosis b/c the ability to convert lactate into HCO3 is impaired in this disorder
-do not give w/ pH >7.5 b/c bicarbonate is formed as lactate breaks down causing alkadosis
- Do not use in renal failure b/c it contains K and can cause hyperkalemia |
|
|
Term
| Describe D5W solution and its uses |
|
Definition
| isotonic,aid in renal execretion of solutes,used to treat hypernatremia, fluid loss, and dehydration |
|
|
Term
| What are some precations to consider when administering D5W solution? |
|
Definition
-Do not use in excess vol. early in post op period due to antiduretic hormone increase due to stress reaction
-Do not use soley in treatment of FVD b/c it dilutes plasma electroltye concentrations
-Condraindicated in head injury b/c it may cause increased ICP,
Do not use for fluid resesitation b/c it may cause hyperglycemia
-Caution w/ renal & cardiac disease due to risk of fluid overload
-may cause peripheral ciculatory collapse, anuria in pt w/ Na deficiency,inc body fluid
-Cause water toxication over time b/c it converts to hypotonic solution
-May result in hypokalemia |
|
|
Term
| Describe .45% Nacl solution and its functions |
|
Definition
hypotonic, provides Na, Cl, and free water.free water aid kidney in elimination of solutes,
-Used to treat hypertonic dehydration,Na+ and Cl depletion, and gastric fluid loss |
|
|
Term
| What are some precautions to consider when administering .45 NaCl? |
|
Definition
Not indicated for 3rd space fluid shifts, or increased ICP
-May cause fluid shifts from vascular systems to cells resulting in cardio collapse and increased ICP |
|
|
Term
| Describe 3% Nacl and its uses |
|
Definition
| hypertonic, increase ECF, decrease cellular swelling,, used only in critical situations to treat hyponatremia, assist in removing ICF excess |
|
|
Term
| What are some precautions to take when administering 3% NaCl? |
|
Definition
| administer slowly and cautiosly b/c it can cause intravascular vol overload and pulmonary edema |
|
|
Term
| Describe the uses and function f 5% NaCl |
|
Definition
| used to treat symptomatic hyponatremia |
|
|
Term
| Describe the use of dextran solution |
|
Definition
-coloid solution, available in NS or 5% D5W,
-vol/plasma expander for intravascular part of ECF
-Affects clotting by coating platelets and decreasing ability to clot.
- remains in ciculatory system for 24h
-Used to treat hypovolemia in early shock to increase pulse pressure, CO, and arterial bp,
-Improves microcirculation by decreasing rbc aggregation,
-Contraindicated in hemorrhage, thrombocytopenia, renal disease, and severe dehydration. |
|
|
Term
|
Definition
| isotonic solution used to treat hypotensive pt, as soon as pt becomes normotensive then hypotonic solution given to provide both electrolytes and water for renal execretion of metabolic wastes |
|
|
Term
| What are some nursing signs of FVD? |
|
Definition
| urine output of less than 30 ml/hr, weight loss of 1lb in 1 day,decrease in body temp,urine specific gravity of > 1.020 indicating healthy reanal conservation. |
|
|
Term
| What are the contributing factors of FVE? |
|
Definition
| renal failure, heart failure, cirrhosis,excess salt, fluid shifts,too much Na containing fluids,prolonged carticosteriod therapy, severe stress, hyperaldesteronism |
|
|
Term
| What are the contributing factors of FVE? |
|
Definition
| renal failure, heart failure, cirrhosis, excess Na containing fluids, fluid shifts, prolonged corticosteriod therapy, severe stress, hyperaldesteronism |
|
|
Term
| what are some ecpected lab findings in a pt with FVE? |
|
Definition
| acute weight gain, periperal edema, ascites, distended jugular weins, crackles, elevated CVP,SOB, increased bp, bounding pulse and cough, increase RR, decreased hct & hbg, decreased serum and urine osmolality, decreased urine Na and specific gravity |
|
|
Term
| How is FVE medically managed? |
|
Definition
Diuretics: Thiazide-mild to moderate, loop-severe.
Dialysis:used to removed nitrogenous waste and control K and acid base balance, and to remove Na and fluid |
|
|
Term
| What are some contributing factors of hyponatremia? |
|
Definition
| loss of Na, use of diuretics,loss of GI fluids,water gain, too much D5W and water supplements to pts receiving hypotonic tube feedings, hyperglycemia, heart failure |
|
|
Term
| What are signs of hyponutremia? |
|
Definition
| anorexia, nausua, vomitting, headache, lethergy,dizziness, confusion,muscle cramps & weakness,muscular twitchung, seizures,pallilipedemia,dry skin,high pulse, low bp, weight gain,edema |
|
|
Term
| What type of lab values would indicate hyponatremia? |
|
Definition
| low serum and urine Na, low specific gravity and osmolality |
|
|
Term
| What are the contributing factors of hypernatremia? |
|
Definition
| Water deprivation,hypertonic tube feedings w/o adequate water supplements, diabetes insipidus, heatstroke,hyperventilation, diarrhea, burn, diaphoresis, excess coticosterois, HSO3,NaCl, salt water drowning victims |
|
|
Term
| What are the signs and symptoms of hypernatremia? |
|
Definition
| Thirst,elevated body temp, swollen dry tongue, and sticky mucous membrances, hallucinations, lethargy, restlessness, irritability, focal or grand mal seizures, pulmonary edema, hyperreflexia, twitching, nausea, vomitting, anorexia high pulse and high bp |
|
|
Term
| What are the lab values of hypernatremia? |
|
Definition
| increase serum sodium, decreased urine sodium, increased specific gravity and oslmolality, decreased CVP |
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|
Term
|
Definition
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