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Questions and Answers
What results from an electrolyte intake that is greater than output?
What results from an electrolyte intake that is greater than output?
Which factor can lead to a blood plasma deficit?
Which factor can lead to a blood plasma deficit?
What occurs when calcium levels in blood rise?
What occurs when calcium levels in blood rise?
Which substance affects cellular metabolism by shifting phosphate into cells?
Which substance affects cellular metabolism by shifting phosphate into cells?
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What is the consequence of an electrolyte intake being less than output?
What is the consequence of an electrolyte intake being less than output?
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What physiological change occurs in metabolic acidosis due to the inability of kidneys to excrete metabolic acids?
What physiological change occurs in metabolic acidosis due to the inability of kidneys to excrete metabolic acids?
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Which of the following factors can contribute to electrolyte deficits?
Which of the following factors can contribute to electrolyte deficits?
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Which condition is associated with increased levels of CO2 and results in hypoventilation?
Which condition is associated with increased levels of CO2 and results in hypoventilation?
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What is a common risk associated with gastroenterological issues like diarrhea or vomiting?
What is a common risk associated with gastroenterological issues like diarrhea or vomiting?
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In elderly patients, which condition is more likely to occur, resulting in either excess or deficit of extracellular volume (ECV)?
In elderly patients, which condition is more likely to occur, resulting in either excess or deficit of extracellular volume (ECV)?
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Which sign is commonly associated with metabolic acidosis?
Which sign is commonly associated with metabolic acidosis?
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What acid-base imbalance is characterized by a pH decreased below 7.35?
What acid-base imbalance is characterized by a pH decreased below 7.35?
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Which condition is a common cause of metabolic alkalosis?
Which condition is a common cause of metabolic alkalosis?
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What is a possible lab finding in a patient with metabolic acidosis?
What is a possible lab finding in a patient with metabolic acidosis?
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What symptom would most likely indicate a patient is experiencing hypokalemia in metabolic alkalosis?
What symptom would most likely indicate a patient is experiencing hypokalemia in metabolic alkalosis?
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In the context of respiratory alkalosis, which statement is true?
In the context of respiratory alkalosis, which statement is true?
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Which of the following lab values indicates metabolic alkalosis?
Which of the following lab values indicates metabolic alkalosis?
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Which of the following conditions can lead to a high anion gap metabolic acidosis?
Which of the following conditions can lead to a high anion gap metabolic acidosis?
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What is a common cause of respiratory acidosis related to muscle function?
What is a common cause of respiratory acidosis related to muscle function?
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Which laboratory finding confirms the presence of respiratory alkalosis?
Which laboratory finding confirms the presence of respiratory alkalosis?
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What symptom is NOT typically associated with metabolic acidosis?
What symptom is NOT typically associated with metabolic acidosis?
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In the context of metabolic alkalosis, what condition may arise due to excessive vomiting?
In the context of metabolic alkalosis, what condition may arise due to excessive vomiting?
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Which of the following conditions can lead to respiratory alkalosis?
Which of the following conditions can lead to respiratory alkalosis?
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What is a primary reason for increased PaCO2 levels in respiratory acidosis?
What is a primary reason for increased PaCO2 levels in respiratory acidosis?
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Which situation is likely to lead to impaired gas exchange and potentially respiratory acidosis?
Which situation is likely to lead to impaired gas exchange and potentially respiratory acidosis?
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What physiological response occurs during hyperventilation?
What physiological response occurs during hyperventilation?
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Which condition is associated with a high anion gap metabolic acidosis?
Which condition is associated with a high anion gap metabolic acidosis?
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Which of the following laboratory results would indicate uncompensated metabolic acidosis?
Which of the following laboratory results would indicate uncompensated metabolic acidosis?
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What can excessive ingestion of bicarbonate lead to?
What can excessive ingestion of bicarbonate lead to?
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What is a common neurological cause of respiratory acidosis?
What is a common neurological cause of respiratory acidosis?
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Which of the following is NOT a classic sign of respiratory alkalosis?
Which of the following is NOT a classic sign of respiratory alkalosis?
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In cases of metabolic acidosis due to renal disease, which laboratory finding is expected?
In cases of metabolic acidosis due to renal disease, which laboratory finding is expected?
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Which of the following best describes a key characteristic of anorexia nervosa?
Which of the following best describes a key characteristic of anorexia nervosa?
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What is considered a primary emotional feature of bulimia nervosa?
What is considered a primary emotional feature of bulimia nervosa?
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What is NOT a neurogenic cause of dysphagia?
What is NOT a neurogenic cause of dysphagia?
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Which of the following dietary restrictions is commonly observed during Passover?
Which of the following dietary restrictions is commonly observed during Passover?
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Which condition characterized by dysphagia involves structural issues in the esophagus?
Which condition characterized by dysphagia involves structural issues in the esophagus?
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What is not included in the diagnostic criteria for anorexia nervosa?
What is not included in the diagnostic criteria for anorexia nervosa?
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Which of these is a warning sign of dysphagia?
Which of these is a warning sign of dysphagia?
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Which dietary restriction is common among Baptists in relation to alcohol?
Which dietary restriction is common among Baptists in relation to alcohol?
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In relation to fasting during Ramadan, what conduct is permitted?
In relation to fasting during Ramadan, what conduct is permitted?
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What potential consequence is associated with the compensatory behaviors of bulimia nervosa?
What potential consequence is associated with the compensatory behaviors of bulimia nervosa?
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What kind of dietary practice involves mixing milk or dairy products with meat dishes?
What kind of dietary practice involves mixing milk or dairy products with meat dishes?
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Which method of animal slaughter is typically ritualized in certain faiths?
Which method of animal slaughter is typically ritualized in certain faiths?
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In Yom Kippur, what dietary regulation must be followed?
In Yom Kippur, what dietary regulation must be followed?
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Study Notes
Factors Affecting Electrolyte Imbalance
- Intake greater than output or shift of electrolytes from cells or bone into the ECF causes plasma electrolyte excess.
- Intake less than output or shift from ECF into cells and bones causes a blood plasma deficit.
Acid Base Imbalances
-
Respiratory Acidosis - Caused by excessive carbonic acid due to alveolar hypoventilation.
- Impaired gas exchange can lead to this.
- Causes: COPD, pneumonia, airway obstruction, atelectasis, severe asthma, neuromuscular dysfunction like muscle weakness, respiratory muscle fatigue, chest wall injury, brainstem respiratory control dysfunction like drug overdose or head injury.
- Signs and Symptoms: Headache, lightheadedness, decreased consciousness, confusion, lethargy, coma, dysrhythmias.
- Lab Findings: Decreased pH, increased PaCO2, normal or increased HCO3- depending on compensation.
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Respiratory Alkalosis - Caused by deficiency of carbonic acid due to alveolar hyperventilation.
- Causes: Hypoxemia, acute pain, anxiety, psychological distress, inappropriate mechanical ventilator settings, stimulation of brainstem respiratory control.
- Signs and Symptoms: Light headedness, numbness, tingling in fingers and toes, increased rate and depth of respirations, excitement, confusion, decreased consciousness, dysrhythmias
- Lab Findings: Increased pH, decreased PaCO2, normal or decreased HCO3- depending on compensation.
-
Metabolic Acidosis - Caused by excessive metabolic acids or decreased base bicarbonate.
- Causes: Increased metabolic acids (high anion gap) from ketoacidosis, hypermetabolic states, oliguric renal disease, circulatory shock, or acid ingestion; or loss of bicarbonate (normal anion gap) from diarrhea, pancreatic fistula, intestinal decompression or renal tubular acidosis.
- Signs and Symptoms: Decreased consciousness, lethargy, confusion, coma, abdominal pain, dysrhythmias, increased rate and depth of respirations.
- Lab Findings: Decreased pH, normal or decreased PaCO2 depending on compensation, decreased HCO3-.
-
Metabolic Alkalosis - Caused by an increase in bicarbonate or a loss of metabolic acid.
- Causes: Increased bicarbonate from sodium bicarbonate administration, blood transfusion, mild ECV deficit; or loss of metabolic acid from excessive vomiting, gastric suctioning, hypokalemia, excessive aldosterone.
- Signs and Symptoms: Lightheadedness, numbness, tingling, muscle cramps, excitement, confusion, decreased consciousness, dysrhythmias, concurrent hypokalemia.
- Lab Findings: Increased pH, normal or increased PaCO2 depending on compensation, increased HCO3-.
Risk Factors of Imbalances
- Age: Young children are at risk for ECV deficit, osmolality imbalances, and clinical dehydration. Older adults at risk for ECV excess or deficit, osmolality imbalances.
- Environmental: Sodium-rich diet can cause ECV excess, electrolyte-poor diet can cause deficits, hot weather can lead to dehydration.
- Gastrointestinal Output: Diarrhea, drainage, and vomiting can lead to electrolyte imbalance.
- Chronic Disease: Cancer, COPD, cirrhosis, heart failure, oliguric renal disease can contribute to imbalances.
- Trauma: Burns, crash injuries, head injuries, hemorrhage can lead to electrolyte imbalance.
- Therapies: Diuretics, IV therapy, and PN can cause imbalances if not carefully monitored.
Different Types of RN Diagnoses
- Fluid Imbalance
- Dehydration
- Acid Base Imbalance
- Lack of knowledge of fluid regimen
Enteral Fluid Replacement (By Mouth)
- Remember ice chips represent ½ of a volume measurement.
Religious Dietary Restrictions
- Pork: Some faiths, like Baptists, allow minimal or no pork consumption.
- All meats: Fish, shellfish, and fowl are allowed, with some restrictions, on many diets.
- Predatory fowl: Only fish with scales allowed.
- Alcohol: Consumed in some faiths.
- Caffeine: Present in some faiths, such as in teas, coffees, and sodas.
- Shellfish: Allowed in some faiths, prohibited in others.
- Vegetarian and Ovolactovegetarian diets: Practiced by some religions.
Ramadan
- Ramadan fasting occurs from sunrise to sunset.
- Observed for a month.
Jewish Dietary Restrictions
- Kosher food preparation required.
- Mixing of milk or dairy products with meat dishes prohibited.
- 24 hours of fasting on Yom Kippur. Day commemorates atonement.
- No leavened bread eaten during Passover (8 days).
Sabbath
- No cooking on Sabbath from sundown Friday to sundown Saturday.
Anorexia Nervosa
- Characterized by significantly low body weight.
- Intense fear of gaining weight.
- Distorted body image.
- Self-evaluation is influenced by body weight and shape.
Bulimia Nervosa
- Recurrent episodes of binge eating.
- Feeling of lack of control during binge eating periods.
- Inappropriate compensatory behaviors.
- Self-evaluation influenced by body shape and weight.
Dysphagia - Causes
-
Myogenic (Muscle-related):
- Myasthenia gravis
- Aging
- Muscular dystrophy
- Polymyositis
-
Neurogenic (Nerve- related):
- Stroke
- Cerebral palsy
- Guillain- Barre Syndrome
- Multiple Sclerosis
- Amyotrophic Lateral Sclerosis
- Diabetic Neuropathy
- Parkinson's Disease
-
Obstructive (Blockage):
- Benign peptic stricture
- Lower esophageal ring
- Candidiasis
- Head and neck cancer
- Inflammatory masses
- Trauma/surgical restriction
-
Other:
- Gastrointestinal or esophageal resection
- Rheumatological disorders
- Connective tissue disorders
- Vagotomy
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Description
This quiz covers the factors affecting electrolyte imbalance and delves into the specifics of respiratory acidosis and alkalosis. It highlights causes, symptoms, and lab findings related to these imbalances. Test your understanding of critical concepts in acid-base balance and electrolyte management.
