Term
| 4 things involved in electrolyte balance |
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Definition
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Term
| four processes of electrolytes that maintain |
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Definition
| electrolytes we take in, absorbed, distrbuted and how they're excreted |
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Term
| routes that electrolytes are brought into body |
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Definition
| food, drinks, medications-antacids, iv fluids-Na, K, donated blood |
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Term
| some of the factors that effect absorption of electrolytes |
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Definition
| binding proteins, food in your gut, medications, partial intestinal removal |
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Term
| K is dependent on what in order to be absorbed? |
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Definition
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Term
| how are electrolytes excreted? |
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Definition
| urine, feces, sweat- feces type can effect electrolyte loss, diarrhea- K loss, undigested fat can prevent absorption and gets lost in feces, sweating results in loss of Na. |
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Term
| what are some abnormal routes of loss from the body |
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Definition
| blood loss, vomiting, wound drainage, patients on hemodialysis |
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Term
| Sodium acounts for how much of extracellular electrolytes? |
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Definition
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Term
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Definition
| regulates osmotic forces and water balance, works with K and Ca for normal conduction of nerve impulses, as well as acid based balance. 130-145 milli equivalents |
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Term
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Definition
| intracellular electrolyte, normal level- 3.5-5.0 meql |
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Term
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Definition
| maintenance of cardiac rhythms, skeletal smooth muscle contraction |
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Term
| what is "tilting" your patient? |
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Definition
| take bp while laying down, and sitting up.. see if there's a major difference- postural hypotension |
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Term
| ****Chloride normal levels? |
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Definition
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Term
| phopshorous normal level???*** |
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Definition
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Term
| What are the two major fluid compartments of the body? |
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Definition
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Term
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Definition
| fluid trapped in one of several possible intracellular spaces. ex: pleural effusion, it is considered fluid loss |
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Term
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Definition
| a result of liver damage, and increased pressure. sodium and water is retained therefore an increase in fluids of vascular system. also results in albumin dysfunction. |
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Term
| fluid loss is regulated by... |
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Definition
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Term
| the osmoreceptors in the hypothalamus detect... |
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Definition
| a decrease in the osmolarity of the fluids in the body, ADH |
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Term
| the kidneys do two things... |
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Definition
| help control osmolarity and they also control volume. |
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Term
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Definition
| water reabsoption in the kidneys, the more ADH released, the more that is absorbed or retained by the kidneys |
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Term
| there is constant exchange between... |
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Definition
| EXF and ICF, results in normal fluid balance. |
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Term
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Definition
| forces fluid and solutes out of the capillaries through capillary filtration pressure |
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Term
| capillary osmoidal pressure.. |
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Definition
| fluids are drawn back into the capillaries |
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Term
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Definition
| the movement of water from lower concentration to a greated concentration of solutes, electrolytes |
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Term
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Definition
| osmotic pressure of a fluid is determined by its osmolarity |
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Term
| what plays a key role in osmolarity? |
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Definition
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Term
| obligatory urine output... |
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Definition
| 300-500 ml/24 hour. hourly output may need to be assessed |
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Term
| also lose fluid through.. |
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Definition
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Term
| what are some signs of fluid deficits? |
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Definition
| BP decrease with heart rate increase, a depressed fontanel in babies, decreased urine output, dry skin and mucous membranes, turgor |
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Term
| two tests to assess fluid balance |
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Definition
| hematocrit and urine specific gravity |
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Term
| specific gravity of urine is... |
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Definition
| measures density of urine, compared to the density of water, a low SG is seen in dilute urine, a concrentrated form has high SG |
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Term
| what are the ranges of a normal urine SG |
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Definition
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Term
| what defines fluid volume excess? |
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Definition
| increased blood pressure, strong bounding pusle, possible shortness of breath, jugular venous distention, and acute weight gain |
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Term
| two other factors in fluid balance... |
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Definition
| aldosterone, and renin-aldosterone system |
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Term
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Definition
| causes kidneys to reabsorb sodium |
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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
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Definition
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Term
| nausea, vomiting, intestinal cramps... |
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Definition
| fast bowels, hyperactive bowels= hyperkalemia. |
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Term
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Definition
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Term
| peaked t waves can be seen in... |
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Definition
| what you see in hyperkalemia **** |
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Term
| calcium has a huge effect on the... (initially) |
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Definition
| smooth muscle in the bowels. too much slows everything down. |
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Term
| if anything stops the constant good flow... |
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Definition
| the kidney gets mad, and the bladder will get infected. "wash out phenomenon" |
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Term
| E. coli is really good at.. |
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Definition
| gripping cells of bladder wall |
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Term
| three bacteria involved in UTI |
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Definition
| E. Coli, staph, enterobacter |
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Term
| what is a urethrovesical reflux? |
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Definition
| urine from the uretha is drawn back in the bladder due to increase in intradabominal pressure from coughing/sneezing |
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Term
| vesicoureteral reflux is.. |
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Definition
| urine from the bladder moves into the ureters due to defects of the URETER, |
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Term
| number one nosocomial infection.. |
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Definition
| UTi's caused by urinary catheters |
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Term
| acute pyelonephritis is... |
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Definition
| infection of the kidney, can be caused by toxemia, block in ureters, etc. responds well to 10-14 days of organizm specific antibiotic therapy. much less severe than cystitis. |
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Term
| chronic pyelonephritis... |
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Definition
| persistent or recurrent infection of the kidney associated with inflammation..could be symptomless, can lead to renal failure |
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Term
| what is glomerulonephritis? |
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Definition
| inflammation of glomerlar structures, globs of antibodies reacting with fixed glomerular antigens, or injury resulting from ciruclating antigen-antibody complexes |
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Term
| a classical case of glomerulonephritis can follow a.. |
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Definition
| strep infection after 7-12 dys. |
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Term
| symptoms of glomerulonephritis.. |
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Definition
| no bacteria, oliguria, proteinuria, and cola colored due to loss of RBCs, edema of face and hands, and HTN; treat with antibiotics |
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Term
| Acute renal failure can be reversed.. |
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Definition
| if you quickly reverse the cause, no permanent damage may be done. |
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Term
| what is pre-renal, interrenal, postrenal |
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Definition
| pre- something that happened before the kidney (sig blood loss), inter- the problem is in the actual kidney- caused by a block that prevents blood flow, post renal is any kind of blockage from flow of kidney to urethra (swollen prostrate) |
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Term
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Definition
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Term
| risk factors of renal stones |
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Definition
| dehydration, sedentary lifestyles, off on calcium, mg, amon, uric acid, and cystine ions |
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Term
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Definition
| spinach, swiss chard, cocoa, chocolate, pecans, and peanuts |
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Term
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Definition
| glomerular filtration rate.. 15 is BAD, need a new kidney or be on dialysis.. 15 ml of blood per minute. |
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Term
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Definition
| 15 ml per minute, normally >120 |
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Term
| impaired phosphate excretion can result in.. |
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Definition
| Chronic renal failure and less calcium |
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Term
| main function of kindey.. |
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Definition
| maintain how much water and sodium is in the body. |
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Term
| too much water in the body results in.. |
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Definition
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Term
| started with asthma slide |
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Definition
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Term
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Definition
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Term
| asthma can be triggered by.. |
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Definition
| allergens pollutants, etc. |
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Term
| what is extrinsic asthma.. |
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Definition
| Atopic, child onset, hay fever, acute phase response- 10-20 minutes release of chemical mediators, bronchospasm and edema, late phase response- 4-8 hrs inflammation |
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Term
| what is intrisic asthma.. |
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Definition
| respiratory infections, exercise induced asthma, medication, chemical exposure, and GE reflux. occurs within the 3 minutes, resolves within hour. |
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Term
| asthma is caused by two things.. |
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Definition
| inappropriate immune response, and neural response |
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Term
| what are the two main goals for cotnrolling asthma? |
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Definition
| prevention and control of triggers, medications |
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Term
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Definition
| can be caused by airway obsturction of major and small airways, 90% of cases due to ciggy smoking |
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Term
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Definition
| blue bloater, hypersecretion of bronchial mucus, chronic/recurrent productive cough, decreased Pa02, increased PCO2, polycthemia |
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Term
| people with chronic bronchitis may be.. |
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Definition
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Term
| Emphysema is a chronic disease at the.. |
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Definition
| alveolar level, the walls of the alveoli are destroyed |
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Term
| patients with emphysema have difficulty.. |
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Definition
| breathing out. so air becomes trapped in the alveoli |
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Term
| ppl with emphysema exhibit, |
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Definition
| pink puffers, dyspnea on exertion, sputum is mucoid, fatigue and insomnia, pursed lip breathing, decreased breath sounds, barrel chest, thin body fluid |
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Term
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Definition
| an incomplete expansion of the lung or portion of a lung. |
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Term
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Definition
| tachynpea, tachycardia, dyspnea, cyanosis, hypoxemia, decreased chest expansion, absent breaht sounds, intercostal retraction. |
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Term
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Definition
| double layer membrane that covers the lungs |
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Term
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Definition
| definition- presence of air within the pleural space resulting in partial or complete collapse of the lung |
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Term
| start with cardiac output slide |
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Definition
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Term
| how much blood the heart pumps with each beat. a function of preload, afterload, and cardiac contractility |
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Definition
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Term
| the amount of volume coming back to the heart from the body |
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Definition
| preload, goes the right atrium |
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Term
| end of cycle, the resistance in the aortic valve in order to pump out blood, the resistance. |
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Definition
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Term
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Definition
Physiologic effects of the impaired pumping ability of the heart
Decreased renal blood flow
Activation of the sympathetic compensatory mechanisms |
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Term
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Definition
Coronary Artery Disease
Cardiomyopathy
Myocardial infarction
Valvular heart disease |
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Term
| symptoms of heart failure.. |
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Definition
Respiratory Manifestations
Fatigue, Weakness, & Mental Confusion
Fluid Retention and Edema
Cachexia and Malnutrition, Cyanosis, Arrhythmias and Sudden Cardiac Death |
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Term
| right heart failure means.. |
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Definition
| blood is not being pumped effectively, so it backs up to the right atrium, and out to the body. |
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Term
| right heart failure effects.. |
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Definition
| congestions of peripheral tissues, liver congestion/ascites, Gi tract congestion, anorexia, gi distress, weight loss |
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Term
| left heart failure means.. |
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Definition
| blood backs up into lungs, pulmonary congestion, they are essentially drowning |
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Term
| left hear failure effects |
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Definition
| decreased tissue perfusion, impaired gas exchange, pulmonary edema, orthopnea, cyanosis, frothy sputum |
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Term
| respiratory manifestations in CHF |
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Definition
| dyspnea (speaking) (exertional), orthopnea, paroxysmal nocturnal dyspnea |
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Term
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Definition
| phy exam, EKG, ECHO, plasma BNP levels |
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Term
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Definition
| brain natriuretic peptide, elevated in heart failure |
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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
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Definition
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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
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Definition
| men- 40-50%, women- 37-47% |
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Term
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Definition
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Term
| two other important electrolytes used in clinical setting |
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Definition
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Term
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Definition
| decreased USG, abdominal distention, constipation, low bowel sounds, hypotension, muscle weakness, paralysis, heart dysrhthmias |
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Term
| hypokalemia is caused by... |
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Definition
| anorexia, NPO, unbalanced diet, K wasting diuretics, diarreha, emesis, GI suction |
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Term
| hyponatremia is caused by.. |
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Definition
| excessive ADH, GI losses, hypotonic solution, tap water enemas, excessive water |
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Term
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Definition
| muscle cramping and weakness, abdominal cramps, headache confusion, lethargy seizures h |
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Term
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Definition
| tube feeding, watery diarrhea, hypertonic IV, salt tablets, food intake>fluid intake, |
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Term
| symptoms of hypernatremia |
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Definition
| thrist, oliguria, decreased turgor, headache, agitation, decreased reflexes, seizures |
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Term
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Definition
| decreased renal function, K fluid, too much, crushing injury, K sparing diuretics, excessive oral ingestion |
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Term
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Definition
| nausea, vomiting, intestinal cramps, diarrhea, heart dysrhthmias, cardiac conduction affected. muscle weakness, decreased neuromuscular excitability. |
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Term
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Definition
| low Vit D, pancreatitis, steatorrhea, chronic diarrhea, hypoparaythyroidism |
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Term
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Definition
| neuromuscular irritability, paresthesias, muscle cramping, hyperactive reflexes, tetany, hypotension, cardiac dysrythmias |
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Term
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Definition
| vitamin D overconsumption, hyperparathyroidism, bone tumors |
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Term
| symptoms of hypercalcemia |
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Definition
| anorexia, nausea, emesis, constipation, fatigue, muscle weakness, decreased neuro , headache, stupor, dysrhtmias/venricular |
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Term
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Definition
| malabsorption, chronic alcoholism, diuretic therapy, hyperparathyroidism, diabetic ketoacidosis, pancreatitis |
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Term
| symptoms of hypomagnesemia.. |
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Definition
| tetany, personality changes, nystagmus, choreiform movements, trousseau signs, + babinski |
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Term
| causes of hypermagnesemia.. |
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Definition
| excessive IV magnesium fluids, excessive antacids, kidney disease |
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Term
| symptoms of hypermagnesemia |
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Definition
| lethargy, hyporeflexia, confusion, drowsiness, coma, hypotension, respiratory depression, cardiac arrhthmias, cardiac arrest |
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Term
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Definition
| pumping a liquid into an organ or tissue (especially by way of blood vessels). |
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Term
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Definition
| the physical condition of having the presence of an abnormally high level of carbon dioxide in the circulating blood. |
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Term
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Definition
| low PH with excessive amount of lactate, distinct form of metabolic acidosis |
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Term
| polycythemia/erythrocytosis |
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Definition
| Polycythemia is a disease state in which the proportion of blood volume that is occupied by red blood cells increases... |
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Term
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Definition
| heart rate and BP elevates, changes in mental status, hyperventilation, possible cyanosis |
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Term
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Definition
| hypoventilation, increased metabolic rate |
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Term
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Definition
| decreased PH, respiratory acidosis, effects kidneys and heart |
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Term
| normal diffusion requires what? |
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Definition
| normal alveoli function, adequate amounts of blood present in the pulmonary circulation to perfuse the alveolar capillaries |
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Term
| ventilation perfusion mismatch |
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Definition
| problems that affect either delivery, oxygen to the alveoli or blood to the alvelolar capillaries |
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Term
| what are some pulmonary diseases? |
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Definition
| obstructive diseases- disorders that limit expiratory airflow.. ex: asthma, COPD, chronic bronchitis, emphysema |
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Term
| disorders of lung inflation |
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Definition
| atelectasis, pneumothorax |
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Term
| spontaneous pneumothorax... |
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Definition
| due to a rupture of a bleb on the surface of the lung, associated with tall young males and heavy smoking |
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Term
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Definition
| due to injuries, penetrating or not |
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Term
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Definition
| intrapleural pressure exceeds atmospheric pressure, life threatening |
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Term
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Definition
| increased resp rate, dyspnea, decreased/absent breath sounds on affected sides, increased heart rate, hypoxemia, assymetrical breathing |
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Term
| mediastinal shift can be seen in.. |
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Definition
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Term
|
Definition
| alveolar air spaces to fill with exudate, hypoxemia results due to poor oxygenation, exudate becomes consolidated, difficult to cough up |
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Term
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Definition
| individual has not been in a long term facility within 14 days prior to admission |
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Term
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Definition
| s.pneuomonia, s. aureus, mycoplasma pnemomonia, and chlamydia , viral -influenza |
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Term
|
Definition
| occurs 48 hrs or longer after admission, lower RTI, difficult to treat due to resistance to antibiotics |
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Term
| 4 stages of Pneumococcal pneuomonia |
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Definition
| edema, red hepatization, gray hepatization, resolution |
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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
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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
|
Definition
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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
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Definition
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Term
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Definition
| cholesterol away from blood vessels, remove excess cholesterol and plaque found in blood vessels |
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Term
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Definition
| obstructs blood flow to heart muscle, |
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Term
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Definition
| can rupture which results in platelet adhesion and thrombus within the coronary artery, can lead to MI |
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Term
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Definition
| disease of the vessels that carry oxygen to the heart |
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Term
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Definition
| fixed coronary obstruction |
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Term
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Definition
| inability to supply adequate amounts of blood to the cardiac tissue, most commonly due to atherosclerosis and vasospasm |
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Term
| frank starling mechanism.. |
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Definition
| stroke volume increases in response to an increase in amount of blood filling the heart |
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Term
| signs of acute arterial occlusion.. |
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Definition
| 7 p"s, a sharp line of demarcation between oxygenated tissue above the line of obstruction and below the obstruction |
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Term
| third leading cause of death.. |
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Definition
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Term
|
Definition
| thrombotic strokes, result from inadequate blood flow to the brain from partial or complete occlusion of an artery |
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Term
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Definition
| commonly occurs where arthrosclerotic plaques have already narrowed the blood vessel |
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Term
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Definition
| transient ischemic attack, all stroke symptoms but just temporary, less than 24 hours |
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Term
|
Definition
| usually due to a rupture of a vessel, bleeding in brain tissue |
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Term
| symptoms of hemorrhagic strokes.. |
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Definition
| neuro deficits, headache, n/v, decreased consciousness (LOC) |
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Term
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Definition
| motor, communication, intellectual functions, emotions, spatial-perceptual alterations |
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Term
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Definition
| thrombus, fat or air embolus, amniotic fluid |
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Term
| lethal PE's usually originate from.. |
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Definition
| femoral or iliac veins, most arise from thrombi in the deep veins of legs |
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Term
| other places where PE's arise.. |
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Definition
| right side of heart (a-fib), pelvic veins (after chidlbirth or surgery) |
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Term
|
Definition
| venitlation/perfusion mismatch, pulmonary infarction |
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Term
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Definition
| depends on size of embolus, anxiety dyspnea, tachnypea, tachycardia, cough, crackles, sudden change in mental status-- hypoexemia |
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Term
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Definition
| IV injection of a radioisoptope, a scanning device, detects the adequacy of pulmonary circulation |
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Term
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Definition
| allows for visualization of entire lung tissue |
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Term
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Definition
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Term
|
Definition
| partial thromboplastin time |
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Term
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Definition
| international normalized ratio, scale |
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Term
|
Definition
| syndrome results in hypoperfusion of blood and oxygen, resulting in cellular hypoxia and cell death |
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Term
| what system assists with CV balance? |
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Definition
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Term
| types of low blood flow shock |
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Definition
| hypovolemic and cardiogenic |
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Term
|
Definition
| severe trauma with massive blood loss, loss of plasma (burns), severe dehyrdation |
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Term
|
Definition
| acute MI, cardiac surgery, arrhythmias |
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Term
| anaphylactic shock caused by.. |
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Definition
| maldistribution of blood flow |
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Term
|
Definition
| fluid loss through hemorrhage, GI loss, diabetes insipidus, or diuresis |
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Term
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Definition
| fluid moves out of vascular spaces into the extravascular space- 3rd spacing |
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Term
| symptoms of hypovolemic shock.. |
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Definition
| 10-25% blood loss- SNS response- increased heart rate, vasoconstriction. 35-45&- diminished cardiac output and arterial pressure |
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Term
| SNS compensatory mechanisms of hypovolemic shock |
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Definition
| SNS- increased heart rate, cardiac contractility, vasoconstriction, and increased venous return |
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Term
| Renin angiotensin aldosterone compensatory mechanism for hypovolemic shock.. |
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Definition
| increased sodium absorption by the kidneys |
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Term
| antidiuretic hormone compensatory mechanism for hypovolemic shock.. |
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Definition
| constricts peripheral arteries, veins, and increases water retention |
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Term
| late stages of hypovolemic shock.. |
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Definition
| vasoconstriction of the skin, muscles, kidneys, abdominal organs |
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Term
| treatment of hypovolemic shock.. |
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Definition
| correct the cause (surgery), volume replacement, increase oxygenation, monitor hemodynamics |
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Term
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Definition
| occurs when the heart fails to pump sufficiently to meet needs of the body's demands |
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Term
| cardiogenic shock is commonly caused by.. |
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Definition
| myocardial infarction (left ventricle) |
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Term
|
Definition
| decreased CO, hypotension, peripheral hypoperfusion- cyanosis, pallor, cool/clammy skin, decreased urine output, decreased mentation |
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Term
| treatment for cardiogenic shock. |
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Definition
| decrease O2 demand, increase 02 delivery by providing supplemental, careful fluid managemnt, use of vasodialotrs, diuresis to optimize fluid status |
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Term
| anaphylactic shock results in |
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Definition
| massive vasodilation, release of vasoactive mediators, increased capillary permeability |
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Term
| symptoms of anaphylactic shock.. |
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Definition
| abdominal cramps, sudden hypotension, sudden chest pain tightness, swelling of lips and tongue, airway obstruction, wheezing, stridor, skin changes, panic anxiety confusion |
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