Rush Nursing Patho: Acid Base Imbalances
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| Etiology of respiratory acidosis? | Hypoventilation: patient is not blowing off enough CO2. Caused by anything that causes depressed respirations, such as drugs, neurological damage or disease.
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| Etiology of respiratory alkalosis? | Hyperventilation: classic case is an anxious person breathing rapidly, and blowing off all their CO2, thus become alkalotic.
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| What are some signs and symptoms of respiratory acidosis? | Warm, flushed skin, CNS symptoms such as confusion, lethargy, disorientation, headache, ventricular dysrhythmias.
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| Would a patient in respiratory alkalosis become hypercalcemic or hypocalcemic? | Hypocalcemic, because as pH goes up, more Ca ions become protein bound, and are not available.
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| What are some signs and symptoms of respiratory alkalosis? | Confusion, dizziness, numbness, and tetany (due to hypocalcemia)
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| What is the etiology of metabolic acidosis? | If patient has normal anion gap, it is due to GI loss of bicarb, as with diarrhea. Renal loss of bicarb, or elevated acid production due to diabetic ketoacidosis. If elevated anion gap, due to exogenous ingestions involving stuff like methanol, salicylat
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| What are some signs/symptoms of metabolic acidosis? | Warm, flushed skin, rapid deep respirations (Kussmaul), confusion, lethargy, headache. vemtricular dysrhythmias.
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| What causes metabolic alkalosis? | Least common. Caused by loss of H+ ions, ingestion of alkaline substances (very hard to do), or loss of fluids low in bicarb, such as vomiting, GI suction.
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| What are the signs/symptoms of metabolic alkalosis? | confusion, dizziness, tetany, muscle cramps, dysrhythmias.
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| What is the cause of Isotonic fluid volume deficit? | Hemorrhage, GI losses, burns, fever, 3rd space fluid shifts.
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| In isotonic fluid volume deficit, what happens to serum sodium concentration? | It stays the same.
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| In Isotonic fluid volume deficit, where is the fluid loss coming from? | ECF
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| What are some signs/symptoms of isotonic fluid volume deficit? | Cool, clammy skin, tachycardia, thready pulse, thirst, dry skin.
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| What is the cause of isotonic fluid volume excess? | Too much IV fluids, heart failure, renal failure, hypersecretion of aldosterone.
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| What are signs/symptoms of isotonic fluid volume excess? | Full, bounding pulse, galloping heart rate, tachycardia, pulmonary edema,
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| Etiology of hypernatremia | Inadequate fluid intake, diabetes insipidus, not enough ADH, fluid losses
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| Signs/symptoms of hypernatremia | Thirst, dry, sticy mucous membranes, fever, twitching, tremor, etc.
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| Etiology of hyponatremia | Increses in etracellular water, inadequate intake of sodium, loss of body fluids from GI tract
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| What are the signs/symptoms of hyponatremia? | Sodium level 120-125: nausea, malaise, 115-120, headache, lethargy, 110-115, seizures, coma
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| What is the etiology of hyperkalemia? | Potassium-sparing diuretics, metabolic acidosis, renal failure, crush injuries
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| What does the ECG for hyperkalemia look like? | Tall, tented T wave.
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| What is the etiology of hypokalemia? | Potassium-wasting diuretics, vomiting or NG suction, burns
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| What does the ECG for hypokalemia look like? | Flattened T-wave, presence of U wave
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