Final exam Flashcards by Audrey Mejia

Surgical body position

lithotomy

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Surgical body position

Reverse Trendelenburg

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Surgical body position

Orthopneic

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Surgical body position

Trendelenburg

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Surgical body position

Sims

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Surgical body position

Fowler’s

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Surgical body position

Semi-Fowler’s

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Surgical body position

Kraske or Jackknife

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Urine osmolality

50 -1200 osmos per kg (the higher, the more dehydrated)

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Urine specific gravity norm

1.010 to 1.020

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Controls/regulates volume of body fluids

Na+ (sodium)

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Regulator of enzymes & H2O content

K+ (potassium)

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Controls nerve impulse, blood clotting, muscle contraction, B12 absorption

Ca2+ (calcium ion)

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Controls metabolism of carbohydrates & proteins, vital actions involving enzymes

Mg2+ (Magnesium ion)

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Maintains osmotic pressure in blood, produces hydrochloric acid

Cl- (chloride ion)

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Body’s primary buffer system

HCO3- (bicarbonate ion)

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chemical involving cell division, energy metabolism, and hereditary traits

Phosphate

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Normal sodium level is

135 to 145 mEq/L

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Na+

Sodium

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Normal potassium level is

3.5 to 5.0 mEq/L

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K+

Potassium

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Normal calcium level is

8.9 to 10.1 mEq/L

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Ca2+

Calcium

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Normal magnesium level is

1.4 to 1.75 mEq/L

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Mg2+

Magnesium

Normal Chloride level is

96 to 106 mEq/L

Cl-

Chloride

Normal Bicarbonate level is

22 to 26 mEq/L

HCO3-

Bicarbonate

Normal Phosphate level is

2.5 to 4.5 mEq/L

Insulin transports

potassium

Diabetics may have too much

potassium

Fluid movement occurs primarily by

Osmosis & Filtration

Osmosis & Filtration goes from

lower to higher

Electrolytes move via

diffusion, filtration & active transport

diffusion, filtration & active transport goes from

higher to lower

Types of passive transport

diffusion, filtration, and osmosis

Movement of solvent or solutes (molecule) move from an area of higher concentration to lesser concentration

Diffusion

Movement of fluid through a semi permeable membrane

Osmosis

A condition in which the blood has a high concentration of salt (sodium), glucose, and other substances.

Hyperosmolar

An abnormal decrease in the osmolarity of the body fluids.

Hypoosmolar

Transfer of water and dissolved substances through a permeable membrane

Filtration

Occurs within the kidney's glomerular capillaries

Filtration

This is the energy required to move substances through the membrane(lesser to greater concentration- the Na K in the cell( sodium –potassium pump)

Active Transport

Prevents too much sodium in the cell so the cell won't burst

Active transport

Force of attraction for water by undissolved particles helps keep fluid within blood vessels

Osmotic Pressure

Plasma proteins help osmotic pressure

– they attract water

_____, ______, and ______are major Extracellular substances that help move water between ECF and Cell

Sodium, chloride, & Glucose

Fluids affect on cell wall

Tonicity

_______ ________ enters- there is no movement of water across membranes …so cells maintain their normal size

Isotonic Solution

NORMAL SALINE IS

ISOTONIC (0.9% NaCl)

NORMAL SALINE causes

Vascular expansion, electrolyte replacement

concentration is less than blood plasma

HYPOTONIC SOLUTION

Moves fluid into cells & interstitial space | Cellular dehydration

Hypotonic solution

Isotonic, Hypotonic, & Hypertonic are

Crystalloid Solutions

Increase intravascular osmotic pressure (pressure of plasma proteins) within the intravascular space

Colloid Solutions

Restores serum protein

Colloid solutions

The pressure gradient pulls fluids into the vascular space.

Colloid solutions

Normal saline is a

Volume expander

Saline and electrolyte IV

Lactated Ringer

IV solution ordered when you lose extracellular volume

Lactated ringer

Isotonic solution but sugar metabolizes making it a hypotonic solution

D5 Water

Solution that is given for cerebral edema

Hypertonic

Causes filtration from an area of higher pressure to an area of lower pressure

Hydrostatic Pressure

Is created by the weight or force of a solution e.g.. The pressure caused by BP against the walls of vessels causes fluid to move out depending on the BP

Hydrostatic Pressure

Hydrostatic pressure minus osmotic pressure and tries to push fluids into tissue spaces

Filtration Pressure

ECF is a ____% solution

0.9%

Signs and symptoms of ECF Volume Deficit

Orthostatic/postural changes in Pulse &BP. | Decreased Urine Output

Signs and symptoms of decreased interstitial volume

Dry mucous membranes & poor skin turgor | Thirst

Treatment for ECF Volume Deficit

Oral Replacement IV replacement Safety

Treatment of of Fluid volume excess

Restrict NA & saline & diuretics, find cause

Happens when water intake is increased or decreased | Or when water is retained or excreted excessively

Water or Osmolality Imbalance

Occurs when decrease in H2o intake, an increase in water loss, or excess intake of solute Serum Na greater than 145 mEq/L

Water deficit (ICF Deficit) or Hyperosmolaltiy or Hypernatremia

Signs and Symptoms of Hyperosmolality or Hypernatremia

Confusion, agitation Seizures, coma maybe death,

SIADH

Syndrome of inappropriate ADH

Treatment for Hyperosmolality or Hypernatremia

Replace orally or IV D5W

Happens when there is an increase in water intake, abnormal secretion of ADH, or decreased urinary output of water Serum Na of less than 135 mEq/L

Water Excess or Hypoosmolality or Hypnotremia

Treatment of Water Excess or Hypoosmolality or Hypnotremia

water restriction

Potassium is maintained by

sodium-potassium pump in the cells

K+ changes lead to

altered excitability of muscles, cardiac cells and neuro

Potassium is eliminated by

The kidneys

______ causes K+ to move out of ECF & into cells esp. skeletal muscle & liver cells!!!

Insulin

Potassium higher than 5 mEq/L is called

Hyperkalemia

Hyperkalemia is caused by:

renal failure, acidosis, massive tissue injury e.g. burns, self med errors, rapid IV infusion

Hyperkalemia signs and symptoms

muscle irritability, EKG changes

Treatment for Hyperkalemia

low Na+ diet, Kayexalate enemas or by po. IV Calcium Gluconate, IV Insulin. Can give diuretics if moderately elevated

Hypokalemia is

Potassium below 3.5 mEq/L

Hypokalemia can be caused by

vomiting, diarrhea, diuretics, aldostreone, alkalosis

Signs and symptoms of Hypokalemia

Impaired neuromuscular transmission which leads to decrease in reflexes, muscle weakness which can lead to muscle paralysis, anorexia, N/V, EKG changed, greater risk of digoxin toxicity

Treatment of Hypokalemia

Orally with Foods 2000-5500mg daily Po supplements IV

Phosphorus level below 2.5 is called

Hypophosphatemia

Hypophosphatemia is caused by

Alcoholism, Renal wasting, Uncontrolled diabetes Mellitus

Hypophosphatemia signs and symptoms

Neuromuscular dysfunction, weakness (especially respiratory muscles), Fatigue, Ventricle dysrhythmias, confusion

Hypophosphatemia treatment

Treat underlying cause, foods high in phosphorous, oral phosphorous replacement

Major functions of Calcium

Transmission of nerve impulses, cardiac contractions, blood clotting, formation of teeth & bone, and muscle contraction

Calcium is controlled by

Vit D, parathyroid hormone, and Calcitonin

Patients who've had thyroidectomy have problems

with calcium

Improper absorption from the GI tract, decreased fat soluble vitamins. Pancreatitis no parathyroids renal disease, & massive transfusions

Hypocalcemia

cells increased excitability- which leads to muscle twitching , tingling & parasthesias of face fingers & toes increased reflexes, chvostek’s sign & tetany

Signs and symptoms of hypocalcemia

Bone cancer, immobility, excessive antacid use hyperparathyroidism, and increase in Vit D

Causes of hypercalcemia

impaired nerve and muscle conduction, decreased tone, bone pain, kidney stones(calculi), confusion, memory impairment & lethargy

Signs and symptoms of hypercalcemia

Causes: prolonged malnutrition, surgery, alcohol abuse

hypomagnesium

tremors, cramps, increased BP, tachycardia, confusion & convulsions

Signs and symptoms of hypomagnesium

60% of this goes to the bones and the rest in tissues

Magnesium

Causes: kidney failure, excess ingestion of laxatives/ antacids

Hypermagnesium

lethargy, coma when > 2.5, weak, paralysis, decreased reflexes, bradycardia

Signs and symptoms

Plasma osmolality norm

280-300 osmos per kg

Final exam Flashcards

(107 cards)