Term
|
Definition
•Is the major ECF cation.
•An elevated serum sodium may occur with water loss or sodium gain.
levels between 135-145 meq/L |
|
|
Term
|
Definition
-Common causes include water excess from inappropriate use of sodium-free or hypotonic IV fluids.
-Symptoms of hyponatremia are related to cellular swelling and are first manifested in the central nervous system (CNS). |
|
|
Term
|
Definition
•Is the major ICF cation.
•Factors that cause potassium to move from the ICF to the ECF include acidosis, trauma to cells (as in massive soft tissue damage or in tumor lysis), and exercise.
levels between 3.5-5 |
|
|
Term
|
Definition
o The most common cause is renal failure. Hyperkalemia is also common with massive cell destruction (e.g., burn or crush injury, tumor lysis); rapid transfusion of stored, hemolyzed blood; and catabolic states (e.g., severe infections).
o Manifestations of hyperkalemia include cramping leg pain, followed by weakness or paralysis of skeletal muscles.
o All patients with clinically significant hyperkalemia should be monitored electrocardiographically to detect dysrhythmias and to monitor the effects of therapy. Cardiac depolarization is decreased, leading to flattening of the P wave and widening of the QRS wave. Repolarization occurs more rapidly, resulting in shortening of the QT interval and causing the T wave to be narrower and more peaked. Ventricular fibrillation or cardiac standstill may occur.
o The patient experiencing dangerous cardiac dysrhythmias should receive IV calcium gluconate immediately while the potassium is being eliminated and forced into cells. |
|
|
Term
|
Definition
o The most common causes are from abnormal losses via either the kidneys or the gastrointestinal tract. Abnormal losses occur when the patient is diuresing, particularly in the patient with an elevated aldosterone level.
o In the patient with hypokalemia, cardiac changes include impaired repolarization, resulting in a flattening of the T wave and eventually in emergence of a U wave. The incidence of potentially lethal ventricular dysrhythmias is increased in hypokalemia.
o Patients taking digoxin experience increased digoxin toxicity if their serum potassium level is low. Skeletal muscle weakness and paralysis may occur with hypokalemia. Severe hypokalemia can cause weakness or paralysis of respiratory muscles, leading to shallow respirations and respiratory arrest.
o Hypokalemia is treated by giving potassium chloride supplements and increasing dietary intake of potassium. |
|
|
Term
|
Definition
o About two thirds of cases are caused by hyperparathyroidism and one third are caused by malignancy, especially from breast cancer, lung cancer, and multiple myeloma.
o Manifestations of hypercalcemia include decreased memory, confusion, disorientation, fatigue, muscle weakness, constipation, cardiac dysrhythmias, and renal calculi.
o Treatment of hypercalcemia is promotion of excretion of calcium in urine by administration of a loop diuretic and hydration of the patient with isotonic saline infusions. |
|
|
Term
|
Definition
o Is caused by a decrease in the production of parathyroid hormone.
o Hypocalcemia is characterized by increased muscle excitability resulting in tetany.
o A patient who has had neck surgery including thyroidectomy is observed carefully for signs of hypocalcemia. |
|
|
Term
|
Definition
• The major condition that can lead to hyperphosphatemia is acute or chronic renal failure.
• Hypophosphatemia (low serum phosphate) is seen in the patient who is malnourished or has a malabsorption syndrome. |
|
|
Term
|
Definition
• Hypomagnesemia (low serum magnesium level) produces neuromuscular and CNS hyperirritability.
• Hypermagnesemia usually occurs only with an increase in magnesium intake accompanied by renal insufficiency or failure. |
|
|
Term
|
Definition
| fastest acting system and the primary regulator of acid-base |
|
|
Term
|
Definition
| (carbonic acid excess) occurs whenever there is hypoventilation. |
|
|
Term
|
Definition
| (carbonic acid deficit) occurs whenever there is hyperventilation. |
|
|
Term
|
Definition
| (base bicarbonate deficit) occurs when an acid other than carbonic acid accumulates in the body or when bicarbonate is lost from body fluids. |
|
|
Term
|
Definition
| (base bicarbonate excess) occurs when a loss of acid (prolonged vomiting or gastric suction) or a gain in bicarbonate occurs. |
|
|
Term
|
Definition
provides more water than electrolytes, diluting the ECF.
0.45% Saline, D2.5W
o Plasma expanders stay in the vascular space and increase the osmotic pressure |
|
|
Term
|
Definition
initially raises the osmolality by the ECF and expands it.
D5PSS, D5ringers, D50 |
|
|
Term
|
Definition
pH- 7.35-7.45
paCO2- 35-45mmHg
PaO2- 80-100mmHg
oxygen sat- 95-100%
base excess/deficiet- + or - 2
HCO3- 22-26 mEq/L |
|
|
