ATI Fundamentals: Fluid, Electrolyte, and Acid-Base Regulation

i know nothing about this :D

indicators of kidney function from CMP:

• blood urea nitrogen (BUN)

• creatinine (CR)

indicators of liver function from CMP:

• calcium (Ca+)

• bilirubin (total)

• albumin

• liver enzymes

  • alkaline phosphate (ALP)

  • alanine transaminase (ALT)

  • aspartate aminotransferase (AST)

serum osmolarity

a lab test that measures the concentration of solutes to water, indicates body’s fluid status

• as body water decreases, serum osmolarity increases

serum osmolarity expected range

285- 294 mOsm/kg

expected range for urine osmolarity:

50-1200 mOsm/kg

RDA for potassium: females

2600 mg

RDA for potassium: males

3400 mg

mild hypokalemia (3-3.5 mEq/L)

may or may not present w/ any symptoms

hypokalemia (<3 mEq/L) common manifestations

• muscle weakness

• cardiac arrhythmias

• constipation

• fatigue

severe hypokalemia (<2.5 mEq/L)

• respiratory paralysis/failure

• paralytic ileus

• hypotension

• tetany

• rhabdomyolysis (muscle tissue breakdown)

• life-threatening cardiac arrhythmias

foods high in potassium

potato, prune juice, carrot juice, white beans, plain nonfat yogurt, sweet potato, salmon, banana, spinach, avocado

high potassium levels manifestations

• life-threatening cardiac arrhythmias

• muscle weakness

• paralysis

severe life threatening hyperkalemia (>7 mEq/L) manifestations

• paralysis

• heart failure

• possible death if untreated

intervention if hyperkalemia is d/t kidney failure:

hemodialysis

calcium gluconate or calcium choride

given during hyperkalemia to decrease the effects of excess potassium levels on the heart

loop + thiazide diuretics

cause the body to excrete excess potassium via urination

sodium polystyrene sulfonate

a resin medication that binds to the potassium in the body and are then excreted through stool

how does insulin help w/ hyperkalemia

causes potassium to enter the cells, lowering the serum potassium level

mild hyponatremia manifestations

• a feeling of general unwellness

• nausea

• fluid shifts in the brain → cerebral edema

moderate hyponatremia

• first lethargy

• then confusion

• headache

• restlessness

• irritability

manifestations of severe hyponatremia:

• muscle twitching

• further decreases in LOC

• seizures

• coma

• death if untreated

high sodium levels manifestations

• similar to hyponatremia

• confusion

• lethargy

• irritability

severe hypernatremia manifestations

• muscle twitching

• further changes in LOC with seizures and coma

• eventually death if untreated

• elevated serum osmolarity

foods high in sodium

roasted ham, shrimp, frozen pizza, canned soup, vegetable juice, cottage cheese, instant vanilla pudding

RDA for vitamin D: adults

600 international units

RDA vitamin D: older adults

800 international units

RDA vitamin C: adults

1000 mg

hypocalcemia: cardiovascular manifestations

• chest pain

• dysrhythmias

• heart failure

• syncope

hypocalcemia: neuromuscular manifestations

• numbness/tingling of fingers + toes + around mouth

• muscle cramping/spasms (back + lower extremities)

hypocalcemia: neurologic manifestations

• confusion

• depression

• psychosis

• dementia

• lethargy

• seizures

• personality changes

hypocalcemia: respiratory manifestations

• wheezing

• spasms of larynx/airway

• dysphagia

• voice changes

hypocalcemia: integumentary + other manifestations

• coarse hair

• alopecia

• brittle nails

• dry skin

• itching

• vision difficulties

• dental problems

foods high in calcium

• american cheese

• parmesan cheese

• plain yogurt, nonfat

• almond milk

• orange juice (fortified w/ calcium)

• soy milk

• low-fat milk (1%)

• cheddar cheese

• whole chocolate milk

• whole milk

mild hypercalcemia: manifestations

rarely produces symptoms

hypercalcemia manifestations

• constipation

• flank pain d/t kidney stones

• n/v

• anorexia

• confusion

• behavioral changes (lethargy, malaise)

• polyuria

• bone pain

• muscle weakness

hypercalcemia: critical levels manifestations

• arrhythmias

• delirium

• coma

• renal failure

moderate hypomagnesemia manifestations

• n/v

• decreased appetite

• fatigue

• weakness

severe hypomagnesemia manifestations

• muscle cramps

• spasticity

• numbness + tingling

• seizures

• tetany

• personality change

• cardiac dysrhythmias + spasms

mild hypermagnesemia manifestations

• nausea

• dizziness

• weakness

• confusion

moderate hypermagnesemia manifestations

• increasing confusion

• sleepiness

• blurred vision

• headache

• decreased reflexes

• bladder paralysis

• flushing

• constipation

severe hypermagnesemia manifestations

• muscle flaccid paralysis

• decreased respiratory rate

• hypotension

• bradycardia

• dysrhythmias

• seizures

• coma

• cardiac arrest

• death

foods high in magnesium

• cooked spinach

• pumpkin seeds

• black beans

• cooked soybeans

• cashews

• dark chocolate

• avocados

• tofu

• salmon

• banana

RBC expected range: male

4.7 - 6.1 RBC x 10^12/L

RBC expected range: female

4.2 - 5.4 RBC x 10^12/L

hemoglobin expected range: male

14 -18 g/dL

hemoglobin expected range: female

12 -16 g/dL

hematocrit expected range: male

42 - 52%

hematocrit expected range: female

37 - 47%

WBC count expected range: male + female

5,000 to 10,000/mm³

platelet count expected range: male + female

150,000 to 400,000/mm³

expected pH range of blood

7.35-7.45

PaCO₂ expected range

35-45 mm Hg

HCO₃^- expected range

22-26 mEq/L

PaO₂ expected range

80-100 mm Hg

acidosis

a pH < 7.35

alkalosis

pH > 7.45