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FINALS F&E

Adult Health I

Question	Answer
is responsible for the reduction of urine production	antidiuretic hormone
is released in response to decreased blood flow or decreased renal pressure and is sensed by receptors in the nephrons	renin
is produced by the adrenal cortex in response to stimulation by angiotensin II causing the tubules to excrete K+ while retaining Na2+, adding to the reabsorption of water back into the vascular system	aldosterone
body loses both water and electrolytes from the EFC	hypovolemia
water is lost from the body, but there is no loss of electrolytes	dehydration
what are 3 risk factors for dehydration?	hyperventilation, diabetic ketoacidosis, and enteral feeding without sufficient water intake
what are 6 risk factors for hypovolemia?	GI losses, skin losses, renal losses. third spacing (burns, ascites, obstruction), hemorrhage, and altered intake
hgb and hct are ____ during hypovolemia	LOW
hgb and hct are ____ during dehydration	HIGH
serum osmolarity, sp. gravity, serum sodium are all ___ during dehydration	HIGH
common vital signs for hypovolemia and dehydration are:	hyperthermia, tachycardia, thready pulse, hypotension, orthostatic hypotension, < central venous pressure
occurs when both water and sodium are retained in abnormally high proportions	hypervolemia
occurs when more water is gained than electrolytes	overhydration
risk factor for overhydration	water replacement without electrolyte replacement such as strenuous exercise with profuse diaphoresis
risk factors for hypervolemia	chronic stimulus to the kidney (heart failure, cirrhosis, glucocorticosteriods), abn renal function, fluid shifts (burns, hypertonic fluids), age-related changes, excessive sodium intake
hgb and hct are ___ with overhydration	LOW
serum osmolarity and serum sodium are ___ with overhydration	LOW
electrolytes, BUN, and creatinine are ___ with hypervolemia	HIGH
what are vital signs for overhydration and hypervolemia?	tachycardia, bounding pulse, HTN, tachypnea, > central venous pressure
what position is best for pt with overhydration or hypervolemia?	semi-fowler's
pt with pulmonary edema should be in what position?	fowler's
a pt with hypovolemic shock should be placed in what position?	on back with legs elevated
major electrolyte found in EFC	sodium
essential for the maintance of acid-base balance, active and passive transport mechanisms, and maintaining irritability and conduction of nerve and muscle tissue	sodium
normal sodium values	135-145
is the major cation in ICF	potassium
plays vital role in cell metabolism, transmission of nerve impulses, functioning cardiac, lung, and muscle tissues, and acid-base balance	potassium
___ has reciprocal action with sodium	potassium
normal potassium values	3.5-5
normal calcium values	8.5-10.5
normal magnesium values	1.3-2.1
is a gain of water or the loss of sodium-rich fluids	hyponatremia
delays and slows the depolarization of membranes	hyponatremia
water moves from ECF into the ICF	hyponatremia
risk factors for hyponatremia	abn GI losses, renal losses, skin losses, > or normal ECF volume, edematous state (heart failure, cirrhosis), excessive hypotonic IV, age-related factors
vital signs of hyponatremia	hypothermia, tachycardia, thready pulse, hypotension, orthostatic hypotension
is a serious electrolyte inbalance and can cause significant neurological, endocrine, and cardiac disturbances	hypernatremia
cells are dehydrated with ___	hypernatremia
risk factors for hypernatremia	water deprivation, excessive Na intake, excessive Na retention, fluid losses, age-related changes
vital signs of hypernatremia	hyperthermia, tachycardia, orthostatic hypotension
is the result of increased loss of K from the body ot movement of K into the cells	hypokalemia
risk factors for hypokalemia	< K thru GI losses, renal losses, skin losses, <intake, ICF shift, age-related factors
with hypokalemia the body is in a ____ state	alkalosis state
vital signs for hypokalemia	hyperthermia, weak irregular pulse, hypotension, resp distress
NEVER PUSH ____ IV	potassium
phlebitis	tissue irritant
is the result of > intake of K, movement of K out of the cells, or inadequate renal excretion	hyperkalemia
risk factors for hyperkalemia	ECF shift (< insulin, acidosis, fever, surgery, sepsis), < excretion (renal failure, dehydration, NSAIDS), age-related factors
with hyperkalemia the body is in a ____ state	acidosis
vital signs for hyperkalemia	slow, irregular pulse, hypotension
foods with potassium	avocado, broccoli, dairy, dried fruit, cantaloupe, bananas
risk factors for hypocalcemia	malaborption (chrons disease), end-stage renal disease, post thyroidectomy
+ chvostek's sign and + trousseau's sign	hypocalcemia and hypomagnesmia
vital signs for hypocalcemia	< heart rate, hypotension, dysrhythemia
what food has high calcium and magnesium?	dairy and dark green veggies
risk factors for hypomagnesmia	malnutrition, alcohol ingestion
greater concentration of H+ ions the more ____ the body fluids are with a ___ pH	acidic, LOW
lesser concentration of H+ ions the more ____ the body fluids are with a ___ pH	alkaline, HIGHER
occurs when the body attempts to correct changes and imbalances in pH levels	compensation
occurs when pH returns to normal	full compensation
pH is not able to normalize	partial compensation
risk factors for respiratory acidosis	resp. depression, inadequate chest expansion, airway obstruction, alveolar-capillary blockage, inadequate mechanical ventilation
risk factors for respiratory alkalosis	hyperventilation and hypoxemia
risk factors for metabolic acidosis	excess production of H+ (DKA, stravation, heavy exercise, seizures, fever, hypoxia), inadequate elimination of H+ions (renal failure), inadequate production of bicarb (renal failure, pancreatitis, liver failure, dehyration), and excess elim of bicarb
risk factors for metabolic alkalosis	base excess, acid def (loss of GI secretions from vomiting or suction and K+ depletion due to diuetics, laxatives, cushings syndrome)
vital signs and cardiovascular for resp acidosis	tachycardia and tachypnea, dysrthmias
vital signs and cardiovascular for resp alkalosis	tachypnea, palpitations, chest pain, dysrhytmias
vital signs and cardiovascular for metabolic acidosis	bradycardia, tachypnea, hypotension, dysrhymias
vital signs and cardiovascular for metabolic alkalosis	tachycardia, hypotension,dysrhytmias
what are common neurological s/s for resp alkalosis	tetany and convulsions
what are common neurological s/s for metabolic alkalosis	tetany and muscle weakness
impaired gas exchange or ineffective breathing pattern	respiratory acidosis/alkalosis
decreased cardiac OP related to dysrhythmias	metabolic acidosis/alkalosis
what is a med that puts older adults at risk for hyperkalemia?	lisinopril (prinivil)
normal ionized Ca values	4.5-5.5
normal bicarb (HCO3-) values	22-26
normal CO2 values	35-45
normal base (blood buffer) that exists	+ or - 2
normal range for PaO2	80-100
normal O2 sats	95-100%
normal Chloride values	95-105
normal Magnesium values	1.5-2.5
normal Phosphate (PO43-)	2.8-4.5
normal serum osmolality values	275-295
movement of solvent across semipermeable membrane from an area of LOWER concentration to an area of HIGHER concentration	osmosis
membrane allows solvent in, but not the solute so there is a fluid shift	osmosis
movement of solute in a solution across semipermeable membrane from an area of HIGHER concentration to an area of LOWER concentration	diffusion
during diffusion, what effects the movement?	size, concentration, and temp of solution
process by which water and diffusible substances move together across a membrane in repsonse to fluid pressure, and area of HIGHER pressure to an area of LOWER pressure	filtration
example of filtration?	edema
requires metabolic activity and expenditure of energy to move substances across cell membranes	active transport
average adult fluid intake	2200-2700 mL daily
where is the antidiuretic hormone stored?	posterior pituitary gland
when is the antidiuretic hormone released?	response to changes in blood osmolarity
makes renal tubules and collecting ducts more permeable to H2O	antidiuretic hormone
what initiates the renin-sngiotensin-aldosterone mechanism?	renal perfusion
proteoltic enzyme that responds to decrease renal perfusion secondary to decrease ECF volume	renin
what produces angiotension I?	renin
what happens when angiotension I turns into angiotension II?	massive vasoconstriction of vessels and relocates and increases blood flow to kidneys to improve perfusion
what releases aldosterone and why?	adrenal cortex in response to increase plasma K+ levels ot when helping counteract hypovolema
helps maintain vascular tone?	atrial natriuretic peptide
where and why is atrial natriuretic peptide secreted?	from atrial cells of heart in response to atrial stretching and an increase in circulating blood vloume
average adult fluid loss daily	2200-2700
where are most fluids lost?	kidneys (then lungs, skin, GI)
essential for enzyme activities, neurochemical activites, and cardiac and skeletal muscles	magnesium
where is 50-60% of Mg found?	bone
nescessary for glycogen deposits in liver and muscles, transmission and conduction of nerve impulses	potassium
substance or group of substances that can absorb or release H+ to correct acid-base balance	buffer
regulated by lungs	CO2
regulated by kidneys	HCO3
normal pH range	7.35-7.45
what are the 3 acid-base regulators?	chemical, biological, and physiological regulations
largest chemical buffer in ECF	carbonic acid and bicarb buffer system
when CO2 increases ___ increases	H+ ions
when H+ ions increase ____ increasees	CO2
what are 2 physiological regulators?	lungs and kidneys
pH is ____ during hyperventalation	< 35
pH is ____ during hypoventalation	> 45
when bicarb is < 22 _____	metabolic acidosis
when bicard is > 26 _____	metabolic alkalosis
metabolic ALKALOSIS takes place when pH _____, PaCO2 ______, PaO2 ______, O2 sats _______, HCO3- ____,ionized Ca _____, and K+ _____	pH- >7.45-----------PaCO2- norm or >45---------PaO2-norm----------O2 sats-norm------------HCO3---->26-------ionized Ca+----<4.5------------K+- <3.5
metabolic ACIDOSIS takes place when pH _____, PaCO2 _____, PaO2 _____, O2 sats _____, HCO3 _____, K+ ______	pH- <7.35--------PaCO2- norm or <35------PaO2- norm--------O2 sats- norm-----HCO3- <22------K+- >5
respiratory ALKALOSIS takes place when pH _____, PaCo2 ____, PaO2 ____, O2 sats ____, HCO3- _____, ionized Ca+ ______, K+ _____	pH- >7.45------PaCO2- <35-----PaO2-norm-----O2 sats- norm------HCO3- <22----ion Ca+- <4.5-----K+- <3.5
respiratory ACIDOSIS takes place when pH _____, PaCO2 _____, PaO2 ____, O2 sats ____, HCO3- ____, K+ _____	pH- <7.35------PaCO2- >45--------O2 PaO2- norm or <80----sats- norm or <95%-------HCO3- norm or >26-----K+- >5.0
aldoserone holds in ___	Na (sodium)
polydipsia	excessive thrist (ex:DM)
hormone that prevents from going to BR	antidiuretic hormone
diabetes insipidis	go, go, go prob with antidiuretic hormone
disorder that holds in too much fluid b/c if inappropriate amount of antidiruetic hormone	SIADH (syndrome of inappropriate ADH)

Created by: TayBay15

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