Electrolyte & Acid-Base Imbalances Quiz

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Questions and Answers

What results from an electrolyte intake that is greater than output?

Plasma electrolyte excess (correct)

Decreased renal excretion

Calcium decrease in blood

Blood plasma deficit

Which factor can lead to a blood plasma deficit?

Diarrhea (correct)

Endocrine disorders with increased insulin

Increased calcium levels

Medications that increase absorption

What occurs when calcium levels in blood rise?

Decreased levels of FGF-23

Increased insulin secretion

Increased renal excretion of phosphate (correct)

Decreased absorption of antacids

Which substance affects cellular metabolism by shifting phosphate into cells?

Insulin Signup and view all the answers

What is the consequence of an electrolyte intake being less than output?

Blood plasma deficit Signup and view all the answers

What physiological change occurs in metabolic acidosis due to the inability of kidneys to excrete metabolic acids?

Accumulation of metabolic acids in the blood Signup and view all the answers

Which of the following factors can contribute to electrolyte deficits?

Hot weather conditions Signup and view all the answers

Which condition is associated with increased levels of CO2 and results in hypoventilation?

Respiratory acidosis Signup and view all the answers

What is a common risk associated with gastroenterological issues like diarrhea or vomiting?

Electrolyte imbalance due to fluid loss Signup and view all the answers

In elderly patients, which condition is more likely to occur, resulting in either excess or deficit of extracellular volume (ECV)?

Age-related fluid imbalance Signup and view all the answers

Which sign is commonly associated with metabolic acidosis?

Increased rate and depth of respirations Signup and view all the answers

What acid-base imbalance is characterized by a pH decreased below 7.35?

Metabolic Acidosis Signup and view all the answers

Which condition is a common cause of metabolic alkalosis?

Excessive vomiting Signup and view all the answers

What is a possible lab finding in a patient with metabolic acidosis?

HCO3 below 21 Signup and view all the answers

What symptom would most likely indicate a patient is experiencing hypokalemia in metabolic alkalosis?

Muscle cramps Signup and view all the answers

In the context of respiratory alkalosis, which statement is true?

It is short-lived and typically resolved quickly Signup and view all the answers

Which of the following lab values indicates metabolic alkalosis?

HCO3 increased above 28 Signup and view all the answers

Which of the following conditions can lead to a high anion gap metabolic acidosis?

Ketoacidosis Signup and view all the answers

What is a common cause of respiratory acidosis related to muscle function?

Respiratory muscle weakness from hypokalemia Signup and view all the answers

Which laboratory finding confirms the presence of respiratory alkalosis?

PaCO2 below 35 mm Hg Signup and view all the answers

What symptom is NOT typically associated with metabolic acidosis?

Increased muscle strength Signup and view all the answers

In the context of metabolic alkalosis, what condition may arise due to excessive vomiting?

Elevated bicarbonate levels Signup and view all the answers

Which of the following conditions can lead to respiratory alkalosis?

Acute pain and anxiety Signup and view all the answers

What is a primary reason for increased PaCO2 levels in respiratory acidosis?

Excessive carbonic acid production Signup and view all the answers

Which situation is likely to lead to impaired gas exchange and potentially respiratory acidosis?

Severe acute asthma attack Signup and view all the answers

What physiological response occurs during hyperventilation?

Decreased carbonic acid concentration Signup and view all the answers

Which condition is associated with a high anion gap metabolic acidosis?

Diabetic ketoacidosis Signup and view all the answers

Which of the following laboratory results would indicate uncompensated metabolic acidosis?

pH below 7.35 with normal HCO3− Signup and view all the answers

What can excessive ingestion of bicarbonate lead to?

Metabolic alkalosis Signup and view all the answers

What is a common neurological cause of respiratory acidosis?

Cerebral hemorrhage Signup and view all the answers

Which of the following is NOT a classic sign of respiratory alkalosis?

Coma Signup and view all the answers

In cases of metabolic acidosis due to renal disease, which laboratory finding is expected?

Arterial HCO3− levels decreased Signup and view all the answers

Which of the following best describes a key characteristic of anorexia nervosa?

Restriction of energy intake relative to requirements, resulting in significantly low body weight Signup and view all the answers

What is considered a primary emotional feature of bulimia nervosa?

Recurrent inappropriate compensatory behaviors to prevent weight gain Signup and view all the answers

What is NOT a neurogenic cause of dysphagia?

Muscular dystrophy Signup and view all the answers

Which of the following dietary restrictions is commonly observed during Passover?

No leavened bread is eaten Signup and view all the answers

Which condition characterized by dysphagia involves structural issues in the esophagus?

Benign peptic stricture Signup and view all the answers

What is not included in the diagnostic criteria for anorexia nervosa?

Binge eating at least once a week Signup and view all the answers

Which of these is a warning sign of dysphagia?

Recurrent coughing during meals Signup and view all the answers

Which dietary restriction is common among Baptists in relation to alcohol?

Complete avoidance of alcohol is encouraged Signup and view all the answers

In relation to fasting during Ramadan, what conduct is permitted?

Minimal or no alcohol consumption Signup and view all the answers

What potential consequence is associated with the compensatory behaviors of bulimia nervosa?

Severe dehydration Signup and view all the answers

What kind of dietary practice involves mixing milk or dairy products with meat dishes?

Kosher dietary laws Signup and view all the answers

Which method of animal slaughter is typically ritualized in certain faiths?

Slitting the throat while invoking a blessing Signup and view all the answers

In Yom Kippur, what dietary regulation must be followed?

No eating or drinking for 24 hours Signup and view all the answers

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.
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.