Disrupted Homeostasis, Electrolyte Imbalances, and Acid-Base Disturbances Flashcards

Flashcards testing concepts of fluid volume disruption, electrolyte imbalances, EKG findings, and acid-base disturbances based on lecture notes.

How is osmosis defined in the lecture notes?

The movement of water from an area of high water concentration (low solute concentration) to an area of low water concentration (high solute concentration).

Which organ is ultimately responsible for fluid imbalance in the body?

The kidneys, because they are responsible for either holding on to or releasing fluid.

Which patient populations are at high risk for Fluid Volume Excess (FVE)?

Patients with heart failure, renal or kidney disease, pregnancy, and the geriatric population.

What visual descriptive analogy is given for a patient with Hyponatremia?

A Swollen Grape.

What three factors or systems control sodium and water balance in the body?

Antidiuretic hormone (ADH, released by the posterior pituitary), thirst, and the renin-angiotensin-aldosterone system (RAAS).

What primary clinical manifestation must be monitored for both Hypernatremia and Hyponatremia?

Neurological changes, including lethargy, irritability, altered level of consciousness, hallucinations, seizures, or coma.

When caring for a patient with severe hyponatremia with sodium levels in the teen digits, what intervention and setting are indicated?

Administration of high-concentration hypertonic saline at $3\times 10^{-2}$ ($3\times 10^{-2}$ NaCl / 3\text{\textpercent} saline) and transfer to the ICU (or telemetry with a 1:1 sitter ratio).

What IV fluid is recommended for free fluid loss replacement in hypernatremia without hypovolemic shock?

0.45\text{\textpercent}\text{ NaCl} ($\frac{1}{2}\text{ NS}$).

What is the maximum safe infusion rate for peripheral IV (PIV) potassium administration?

It cannot exceed $10\text{ mEq/HR}$.

What EKG change is specifically highlighted for Hypokalemia?

ST-depression.

What EKG change is specifically highlighted for Hyperkalemia?

Peaked T-waves.

How do ACE inhibitors lead to Hyperkalemia?

ACE inhibitors decrease aldosterone levels, causing the kidneys to retain potassium ($\text{K}^+$), which leads to potassium buildup in the blood.

What lethal cardiac rhythm is associated with Hypomagnesemia?

Torsades de pointes ("twisting of the snake").

Why does administering multiple blood transfusions (after $4\text{ units}$) put a patient at risk for Hypocalcemia?

Citrate (an anticoagulant in banked blood) binds to ionized calcium, making it less available in circulation.

What clinical assessment signs and EKG finding indicate Hypocalcemia?

Positive Chvostek's sign, positive Trousseau's sign (held for $3\text{ to }5\text{ min}$), and a prolonged QT interval.

What laboratory findings define Metabolic Acidosis?

A decreased pH ($\text{pH} \rightarrow \text{low}$) and decreased bicarbonate ($\text{HCO}_3^- \rightarrow \text{low}$).

What are the common causes of Metabolic Acidosis?

Kidney failure (inability to excrete acid), severe diarrhea (loss of bicarbonate), DKA, lactic acidosis (sepsis/seizures), and toxic ingestions (salicylates, iron, metformin).

What laboratory findings define Metabolic Alkalosis?

An increased pH ($\text{pH} \rightarrow \text{high}$) and increased bicarbonate ($\text{HCO}_3^- \rightarrow \text{high}$).

What are the common causes of Metabolic Alkalosis?

Loss of stomach acid through severe vomiting or prolonged NG suction, excessive bicarbonate intake, and loop or thiazide diuretic usage.