Quiz 3

Urine Specific Gravity

Normal range is 1.005 to 1.030; high indicates decreased renal perfusion or dehydration, while low indicates dilute urine.

BUN (Blood Urea Nitrogen)

Normal range is 8 to 21 mg/dL; levels are high in dehydration and low in fluid overload.

Creatinine

Normal ratio is 10:1 to 20:1; slightly high or normal in dehydration, normal or low in fluid overload.

Hematocrit level

Increased in dehydration due to less plasma volume relative to red blood cells. (AMAB- 41% to 50%) (AFAB- 36% to 44%)

Symptoms of Dehydration

Dizziness, weakness, pale skin, confusion, possible syncope due to decreased blood pressure.

Signs of Fluid Volume Overload

Edema, rapid weight gain, increased blood pressure, bounding pulses, JVD, crackles in lungs.

Sensible losses

Fluid lost that can be measured, such as urine and feces.

Insensible losses

Fluid lost that cannot be easily measured, such as through sweating and breathing.

Hyponatremia

Sodium less than 135 mEq/L; symptoms include lethargy, headache, confusion, and nausea.

Hypernatremia

Sodium greater than 145 mEq/L; symptoms include irritability, agitation, and dehydration.

Hypokalemia

Serum potassium less than 3.5 mEq/L; may cause weakness, lethargy, and cardiac symptoms.

Hyperkalemia

Serum potassium greater than 5.0 mEq/L; may lead to bradycardia and cardiac disturbances.

Hypomagnesemia

Low magnesium levels (<1.3 mEq/L); signs include muscle cramps, seizures, and cardiac arrhythmias.

Hypermagnesemia

High magnesium levels (>2.1 mEq/L); signs include muscle weakness, bradycardia, and respiratory depression.

Hypocalcemia

Low calcium levels (<8.5 mg/dL); presents with neuromuscular excitability, seizures, and Trousseau's/Chvostek's signs.

Hypercalcemia

High calcium levels (>10.5 mg/dL); symptoms include fatigue, kidney stones, and increased risk of arrhythmias.

Arterial Blood Gas (ABG)

Test to assess acid-base balance, oxygenation, and ventilation status.

Metabolic Acidosis

Characterized by decreased pH, normal or decreased PaCO₂, and decreased HCO₃⁻; causes include DKA and kidney failure.

Metabolic Alkalosis

Characterized by increased pH, normal or increased PaCO₂, and increased HCO₃⁻; causes include vomiting and diuretics.

Respiratory Acidosis

Characterized by decreased pH, increased PaCO₂, and normal or increased HCO₃⁻; causes include COPD and hypoventilation.

Respiratory Alkalosis

Characterized by increased pH, decreased PaCO₂, and normal or decreased HCO₃⁻; causes include hyperventilation.

Hypovolemic Shock

Severe fluid loss leading to decreased cardiac output and tissue hypoxia.

Treatment for Hyperkalemia

Administration of insulin and dextrose helps shift potassium into cells.

Supplemental Potassium Administration

Given orally or IV (must be diluted), NEVER as a direct IV push.

Age-related changes impacting fluid balance

Include decreased thirst, reduced kidney function, and increased risk for imbalances.