Chapter 2 Lesson objectives

Hyponatremia S/SX

anorexia, nausea, cramps, fatigue, lethargy, muscle weakness, decreased blood pressure

Hypercalcemia S/SX

apathy, lethargy, anorexia, nausea, constipation, polyuria, thirst, kidney stones, arrhythmias, prolonged strong cardiac contractions, increased BP

Hypercalcemia causes

Uncontrolled relesa of Ca ions from the bones due to neoplasms, Hyperparathyroidism, Immobility, increased intake of Ca, milk-alkali syndrome

Hypercalcemia

the serum Ca > 5 mEq per liter or 2.5 mmol per liter

Explain the meaning of 3rd spacing

A situation in which fluid shifts out of the blood into a body cavity or tissue where it is no longer available as circulating fluid.

Explain the normal function of atrial natriuretic peptide in maintaining fluid and electrolyte balance

ANP is a hormone synthesized and released by myocardial cells in the atrium of the heart by regulating fluid, Na and K levels.

Hyperkalemia S/SX

Arrythmias, cardiac arrest, nausea, diarrhea, muscle weakness, paralysis beginning in legs, paresthesias- fingers, toes, face, tongue, oliguria, serum pH decreased- 7.35 acidosis

Hypokalemia S/SX

Cardiac arrhythmias, cardiac arrest, anorexia, nausea, constipation, fatigue, muscle twitch, weakness, legs cramp, shallow respirations, paresthesias, postural hypotension, polyuria, and nocturia, serum pH elevated-7.45 alkalosis

Describe the causes and effects of dehydration

Causes: vomiting, diarrhea, excessive sweating, loss of Na and water, diabetic ketoacidosis with loss of fluids/electrolytes/glucose in urine, insufficient water intake, and use of concentrated formula in an attempt to provide more nutrition to an infant. Effects: Dry mucous membranes in the mouth, decreased skin turgor, Low BP, weak pulse, fatigue, increased hematocrit, decreasing mental function, confusion, loss of consciousness- develop brain cells lose water and reduce function, less urine.

Respiratory alkalosis

Decreased PCO2

Explain the movement of water between body compartments that results in edema.

Edema refers to an excessive amount of fluid in the interstitial compartment, which causes swelling or enlargement of tissues. It may be localized in one area or generalized through the body. Depending on the area, edema may or may not be visible.

Hyperchloremia

Excess Cl ion

Hypocalcemia causes

Hypoparathyroidism, malabsorption syndrome, deficient serum Albumin, increased serum pH= alkalosis

Explain how decomposition develops and its effects on the CNS

If the kidneys and lungs cannot compensate adequately, the ratio changes, and serum pH moves out of the normal range, thus affecting cell metabolism and function. Imbalance may impair neurologic functions. Respiratory acidosis during decomposition causes the CNS depression

Respiratory acidosis develops ________

acute problems such as pneumonia, airway obstruction (aspiration or asthma), chest injuries, opiates, chronic respiratory acidosis, decompensated respiratory acidosis

Hypomagnesemia causes

chronic alcoholism, low serum levels may occur from use of diuretics, diabetic ketoacidosis, hyperparathyroidism, and hyperaldosteronism

Metabolic acidosis

decreased in serum bicarbonate

Hypokalemia causes

diarrhea, diuresis associated w/ diuretic drugs, presence of excessive aldosterone or glucocorticoids in the body, decreased dietary intake, TX of diabetic ketoacidosis w/insulin

Hypernatremia

excessive Na level in the blood and extracellular fluids 145mEq per liter

Hyperchloremia causes and effects

excessive NaCl intake, hypernatremia due to other causes leading to edema and weight gain

Metabolic acidosis develops because of________

excessive loss of bicarbonate ions, increased utilization of serum bicarbonate to buffer increased acids, when large amounts of acids are produced in the body b/c buffer bicarbonate binds with such acids until they can be removed by the kidneys, renal disease, decomposition metabolic acidosis which may develop when an additional factor interferes with compensation

Hyponatremia causes

excessive sweating, vomiting, and diarrhea, use of certain diuretic drugs combined with low salt diets, hormonal imbalances such as insufficient aldosterone, adrenal insufficiency and excess ADH secretion, early chronic renal failure, excessive water intake.

Respiratory alkalosis develops ________

hyperventilation (head injuries and brainstem tumors may lead to hyperventilation), stress-related alkalosis

The body attempts to compensate for the fluid loss by_________

increase thirst, increase HR, constricting the cutaneous blood vessels, leading to pale and cool skin

Respiratory acidosis

increased PCO2 (carbon dioxide)

Hypernatremia causes

insufficient ADH, diabetes insipidus, loss of the thirst mechanism, watery diarrhea, prolonged periods of rapid respiration

Hypophosphatemia

low levels of phosphate

Hypomagnesemia effects

low serum Mg leads to neuromuscular hyperirritability, with tremors or chorea (involuntary repetitive movements), insomnia, personality changes, and increased HR with arrhythmias

Hypochloremia

low serum chloride

Hypomagnesemia

malabsorption or malnutrition

Hyperkalemia causes

renal failure, deficit of aldosterone, use of "K-sparing" diuretic drugs, leakage of intracellular K into the extracellular fluids in pts w/extensive tissue damage, displacement of K from cells by prolonged or sever acidosis

Hypophosphatemia causes and effects

result from malabsorption syndromes diarrhea, excessive use of antacids., alkalosis, hyperparathyroidism, neurologic function is impaired, tremors, weak reflexes, paresthesias, confusion and stupor, anorexia, and difficulty in swallowing (dysphagia)., blood cells function less effectively.

Hypocalcemia

serum Ca level <2.2 mmol per liter or below 4mEq per liter

Hyponatremia

serum Na concentration below 3.8 to 5mmol per liter or 135 milliequivalent per liter.

Hypokalemia

serum level of K <2 mmol per liter or 3.5 mEq per liter

Hyperkalemia

serum level of K > 2.6mmol per liter or 5mEq per liter

Hypocalcemia S/SX

tetany- involuntary skeletal muscle spasm, carpopedal spasm, laryngospasm, tingling fingers, mental confusion, irritability, arrhythmias, weak heart contractions

Hypernatremia S/SX

thirst, tongue and mucosa are dry and sticky, weakness, lethargy, agitation, edema, elevated BP

Hypochloremia causes and effects

usually associated with alkalosis in the early stages of vomiting when hydrochloric acid is lost from the stomach, excessive perspiration>fever or strenuous labor on a hot day= NaCl loss > hyponatremia and hypochloremia, dehydration