patho

Tachypnea, distended neck veins, and edema

Clinical manifestations of hypervolemia

Tachycardia and hypotension

Clinical manifestations of hypovolemia

Hemorrhage

Severe blood loss

Phosphorus is an essential component of ______________

bone

What are the manifestations of fluid volume deficit:

-thirst -Weight loss -Reduced urine output (0.5mL/kg/hr) -Increased concentration of urine, specific gravity -Increased serum osmolality, -Increased hematocrit -Low BP, increased HR -Weak thread pulses -Delayed capillary refill time -Mottled, dusky skin -Depressed fontentelles in infants -Sunken eyes in infants -Poor skin turgor, tenting

Which of the following statements about sodium imbalance are correct? 1. Hypernatremia will cause water to shift out of the cells 2.Both hyper & hyponatremia can cause neurological problems 3 .hyponatremia will cause an increase of vascular fluid volume 4.Patients with SIADH do not have problems with fluid excess 5. Hypertonic 3% NaCl is given slowly

1.Hypernatremia will cause water to shift into the cells 2. Both Hyper/hypo can cause neurological problems 5. Hypertonic 3% NaCl is given slowly

The blood pressure for a patient who is hypovolemic is usually A) Low B) Normal C) High

A) low

What are the manifestations of fluid volume excess:

Any causative factor that reduces renal blood flow, will trigger the RAAS system, leading to sodium and water retention. Manifestations: -Weight gain -Dependent and/or generalized edema -Full bounding pulses -Venous distention -Pulmonary edema, crackles, shortness of breath -Cough -HTN -JVD -Decrease in hematocrit, and possibly Na+ due to hemodilution. -Ascites

Hypovolemic shock

Decreased pre load, decreased cardiac output

Which of the following are clinical signs of hypervolemia? Choose all that apply: -Poor skin turgor -Dry mucous membrane -Difficulty breathing -Edema -Third spacing

Difficulty breathing, Edema, Third spacing

Edema

Excess extracellular fluid

Ascities

Excess fluid accumulation in the abdominal cavity

T/F When serum mag levels increase so does serum calcium levels

False Elevated mag levels may result in low calcium levels. The more mag that is absorbed the less calcium will be absorbed.

T/F Potassium is the major anion within the cell

False: K+ is the major cation within the cell

The following data is from an individual who recently finished a 12 mile run at 1700 on July 28th . Following the run, the individual went home, drank some water, and went to sleep. Q: What data tell the story, suggesting clinical dehydration? What mechanisms likely lead to the change in data? BUN: 48 36 Creatinine 1.9 1.1 Sodium 148 144 Potassium. 5.0 4.7 Calcium 9.5 9.3 Chloride 95 99 CO2 30 28 Osmolality 329 298 HR 112 98 BP 92/54 114/70

Her kidney lab values are showing that she is dehydrated. I think that she didn't drink enough water prior to her run, she she had excessive sweating which caused he too lose too much fluid. the water after the run helped a little bit but the 8 hour repeat labs still aren't great. I think she would need. When she drank water the osmolality evened out. she lost her fluid thru sweating and thru the heart.

Tetany, low blood pressure, and shortening QT interval may occur with_______________________.

Hyperphosphatemia

Sodium imbalances: Hyponatremia/Hypernatremia select the correct term for each Items: Hypertonic feedings Psychogenic polydipsia Sweating and drinking water Unconscious thirst Excessive administration of 5% dextrose in water Frequent tap water enemas Rapid infusion of 3% NaCl Trauma to the thirst center

Hypertonic feedings---- Hypernatremia Psychogenic polydipsia-----Hyponatremia Sweating and drinking water-----Hyponatremia Unconscious state------Hypernatremia Excessive administration of 5% dextrose in water----Hyponatremia Frequent tap water enemas----Hyponatremia Rapid infusion of 3% NaCl-----Hyponatremia Trauma to the thirst center------Hypernatremia

Identify the causes that correspond to which calcium imbalance: Renal failure immobilization Hyperphosphatemia Vitamin D deficient Thyroxicosus Excessive use of citrated blood

Hypocalcemia: Hyperphophatemia(if phos is high mag is low) Vitamin D deficiency Excessive use of citrated blood Hypercalcemia: Thyrotoxicosis renal failure immobilization

Potassium balance/imbalance: decide whether they are hypokalemic or hyperkalemic: third degree burns metabolic alkalosis loop diuretics acidosis Excessive steroid use anorexia rapid infusion of K+ anuria

Hypokalemia: metabolic alkalosis, loop diuretics, excessive steroid use, anorexia nervosa Hyperkalemia: rapid infusion of potassium chloride, third degree burns, anuria, acidiosis

A serum calcium level of 8.9 mg/dL is ____________.

Normal normal calcium is 8.5-10.5 mg/dl

What effect does the hormone ANP have on the nephron within the kidney?

Pressure-Sensitive receptors within the kidney detect when blood flow and glomerular filtration rate is low, and promote the release of renin.

The two most important assessments to make for evaluating fluid balance are accurate I's & O's and daily weight T/F

True

T/F Prolonged gastric suction may cause hypokalemia

True Prolonged gastric suction, vomiting, draining fistulas and diarrhea may result in hypokalemia

T/F Hypermagnesmia can cause cardia arrhythmias and arrest

True common ECG changes include: ventricular ectopy, prolonged PR interval, widening of the QRS complex, Tall T wave, complete heart block & cardiac arrest

T/F Hypoparathyroidism can cause hypokalemia

True hypoparathyroidism is a condition characterized by reduced secretion of the parathyroid hormone may cause hypocalcemia

GI fluid loss

Vomiting and diarrhea

50 year old patient with brain swelling, what is the treatment?

hypertonic solution with osmotic diuretic

Trousseu sign, Chvostek sign and tetany are clinical manifestations of_____________ & __________________

hypocalcemia & low serum calcium

Clinical manifestations of ___________ include anorexia, lethargy, and disorientation

hyponatremia

Dysphagia

inability to consume oral fluids

•Conditions such as SIADH, provokes ongoing water reabsorption in the nephron and a dilution of sodium. Decreased serum osmolality and hemodilution is going cause fluid to move ___________.

into the cell. this can be extremely dangerous and problematic in the brain, where space is limited when cells swell, their functions are impaired