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53 Cards in this Set
- Front
- Back
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Intracellular fluid percentage
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2/3
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Extracellular fluid percentage
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1/3
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3 Types of extracellular fluid
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1. Other ECF
2. Interstitial 3. Intravascular |
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2 types of other ECF
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1. Lymph
2. Transcellular fluids |
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Why are fat people are at greater risk for dehyrdation?
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Adipose contains little water, fat is water repelling
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3. Why are infants susceptible to significant losses in total body water (dehydration)?
a. Because more than half of an infant’s body weight is water b. Because infants have a slow metabolic rate c. Because an infant’s kidneys are not mature enough to counter fluids losses d. Because they are unable to communicate adequately when they are thirsty |
Because an infant’s kidneys are not mature enough to counter fluids losses
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4. The total body water increases with age because older age kidneys become less efficient in producing _________________ ___________________, responses for conserving ______________ become sluggish, and impaired ___________________ perception.
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Concentrated Urine
Sodium Thirst |
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4. __________________ is the most abundant ECF (Extracellular) ion and is responsible for the osmotic balance of the ECF
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Sodium
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4. __________________ maintains osmotic balance of the ICF (intracellular)
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Potassium
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4. What plasma protein maintains the effective osmolality by generating plasma oncotic pressure?
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Albumin
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4. List the 4 most common mechanisms that result in excess fluid accumulation with in interstitial spaces (edema)
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Decrease Capillary Oncotic Pressure
Lymph Obstruction Increase Capillary Hydrostatic Pressure Increased Capillary Permiability |
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4. Venous obstruction can increase hydrostatic pressure. List 4 common causes of venous obstruction
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Thrombophlebitis
Tight Clothing around extremitieis Hepatic Obstruction Prolonged Standing |
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5. Excessive salt and water retention (volume overload) increases venous pressure and results in edema. List 3 conditions associated with salt/water retention.
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CHF
Renal Failure Cirrohsis of the Liver |
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5. Decreased production of plasma albumin occurs with _________________ disease or protein ____________________. Losses of plasma protein occur with _____________________ disease of the kidney (nephrotic syndrome), serous drainage of open ______________, hemorrhage, ________________ and cirrhosis of the liver.
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Liver
Malnutrition Glomerular Wounds Burns |
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5. Lymphedema results when the lymphatic channels are blocked because of ______________ or ____________ or are surgically removed
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Infection or Tumor
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6. Supportive measures for treating a patient with edema (until the underlying problem is corrected) include ___________________ edematous limbs, using ___________________ _______________, avoiding prolonged ______________________, restricting salt intake, taking _________________ and avoiding long/hot showers.
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Elevating
Compression Stockings Standing Diuretics |
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6. The ________________ regulates sodium balance primarily through renal tubular reabsorption
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Kidneys
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7. _________________ an enzyme, stimulates ________________, an inactive polypeptide which is converted into ______________________ which intern stimulates a hormone called ____________________ (from the adrenal cortex) and ultimately restores sodium levels, fluid volume and renal perfusion. This inhibits further release of ____________
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Renin
Angiotensin I Angiotensin II Aldosterone Renin |
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7. Natriurectic pepetides are natural antagonists to the ____________ _____________ _______________ system
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Renin Angiotensin Aldosterone
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8. Three factors in sodium regulation include ______________ filtration rate, aldosterone, and ________________ ______________.
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Glomerular
Natriuretic Peptides |
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8. All of the following cause hypernatremia EXCEPT?
a. Inadequate water intake b. Cushing disease c. hyperaldosteronism d. Prolonged vomiting or diarrhea e. Inappropriate administration of hypertonic saline solutions |
d. Prolonged vomiting or diarrhea
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8. What causes the clinical manifestations of confusion, convulsions, cerebral hemorrhage and coma in hypernatremia? (Table 3-6)
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a. The high sodium in the blood vessels pulls water out of the brain cells into the blood vessels, causing brain cells to shrink
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8. Which are indications of dehydration?
a. Decreased hemoglobin and hematocrit b. Muscle weakness and decreased deep tendon reflexes c. Tachycardia and weight loss d. Polyuria and hyperventilation |
tachycardia and weight loss
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9. True or False Hyponatremia and Hypernatremia can both cause symptoms of confusion
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True
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10. Hyperglycemia contributes to hypertonic hyponatremia by increasing the extra cellular fluid _______________ and attracts water from the ICF compartment into the ECF which dilutes the concentration of ______________ and other electrolytes
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Osmalality
Sodium |
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11. All of the following influence potassium (a major intracellular electrolyte) EXCEPT?
a. Dietary intake of potassium b. Vitamin B12 intake c. Function of the proximal tubule and loop of Henle in the kidney d. Sodium potassium pump e. Changes in the pH f. Hormonal influence of aldosterone, insulin and epinephrine g. Glucagons (blocks entry of potassium into cells) h. Glucocorticoids (promote potassium excretion) i. Diarrhea (from any cause – including laxatives) |
Vitamin B12
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11. During acidosis, the body compensates for the increase in hydrogen ions in the blood by shifting hydrogen ions into the cell in exchange for which electrolyte?
a. Oxygen b. Sodium c. Potassium d. Magnesium |
Potassium
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11. In hypokalemia, cardiac rhythm changes are a direct result of
a. Cardiac cell hypopolarization b. Depression of the sinoatrial (SA) node c. Cardiac cell repolarization (ventricular) |
Cardiac Cell Repolarization
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11. The calcium and phosphate balance is influenced by which three substances?
a. Parathyroid hormone, vasopressin, and vitamin D b. Parathyroid hormone, calcitonin, and vitamin D c. Thyroid hormone, vasopressin and vitamin A d. Thyroid hormone, calcitonin and vitamin A |
PTH
Calctitonin Vitamin D |
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Electrolyte - Regulation of osmolality
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Sodium
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Inversely related to HCO3 concentration - electrolyte
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Chloride
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Major determinant of resting membrane potential - electrolyte
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Potassium
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An intracellular metabolic form is ATP - electrolyte
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Phosphate
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Changes in hydrogen ion concentration affect this electrolyte
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Potassium
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Pulmonary edema, seizures, coma, thirst, fever dry mucous membranes, tachycardia, restlessness
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hypernatremia
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Head ache, confusion, tachycardia, seizures coma, decreased urine output, weight gain, edema, ascites
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hyponatremia
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Polyuria, polydypsia, skeletal muscle weakness, smooth muscle atony, cardiac dysrhythmias
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hypokalemia
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Muscle weakness, loss of tone or paralysis, tingling of lips & fingers, cardiac arrhythmias
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hyperkalemia
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neuromuscular excitability, confusion, parasthesias (tingling) of lips and digits, caroppedal spasms, hyperreflexia, Chvostek & trousseau signs.
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hypocalcemia
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Fatigue, weakness, leathery, anorexia, nausea & constipation, kidney stones
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hypercalcemia
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13. All of the following contribute to hypocalcemia EXCEPT?
a. Repeated blood administration b. Inadequate intestinal absorption c. Decreases in vitamin D d. Decreases in parathyroid hormone e. decreased dietary phosphorus intake |
decreased dietary phosphorus intake (cola)
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13. A positive Chvostek sign (in Hypocalcemia) is elicited by tapping on the facial nerve just below the temple and seeing a ______________ of the __________ or lip.
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twitching of the nose or lip
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13. A positive Trousseau sign (in ____________________) is contraction of the hand and fingers when the ________________ _________________ _______________ in the arm is occluded for _______________ minutes.
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hypocalcemia
arterial blood flow 5 minutes |
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13. Acid base balance and hydrogen ion concentration must be regulated within a narrow range for the body to ________________ __________________
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function normally
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Regulates retention or elimination of CO2 and therefore H2Co3 concentrations
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Lungs
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Exchange of intracellular potassium and sodium for hydrogen
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Ionic Shifts
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Bicarbonate reabsorption and regeneration , ammonia formation, phosphate buffering
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Kidneys
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Exchanges of calcium, phosphate, and release of carbonate
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Bone
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15. Acidemia is a state in which the pH of arterial blood is less than
a. 7.35 b. 5.35 c. 9.35 d. None of the above |
7.35
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15. What is the significance of deep, rapid breathing (Kussmaul respirations) in metabolic acidosis?
a. It indicates that anxiety, with rapid breathing, is a cause of respiratory acidosis b. It indicates the excessive carbon dioxide is exhaled to compensate for metabolic acidosis c. It indicates that diabetic ketoacidosis is the cause of the metabolic acidosis d. It indicates that more oxygen is necessary to compensate for respiratory acidosis |
Indicates the excessive CO2 is exhaled to compensate for metabolic acidosis
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15. How does the loss of chloride during vomiting cause metabolic alkalosis?
a. Loss of chloride stimulates the release of aldosterone, which causes the retained sodium to bind with the chloride b. Loss of chloride causes hydrogen to move into the cell and exchange with potassium to maintain cation balance c. Loss of chloride cause retention of bicarbonate to maintain the anion balance d. Loss of chloride causes hypoventilation to compensate for the metabolic alkalosis |
Loss of chloride causes retention of bicarbonate to maintain the anion balance
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15. Conditions that cause respiratory acidosis include depression of the ___________ _____________, respiratory muscle __________________, chest wall disorders, and lung parenchyma disorders (peumonitis, pulmonary edema, emphysema, __________________, bronchitis)
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Respiratory Center
Paralysis Asthma |
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15. Respiratoy alkalosis, like metabolic alkalosis, is irritating to the central and peripheral ______________ _____________
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Nervous System
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