Patho Workshop 2: Fluid Imbalances

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Questions and Answers

What is the main function of potassium in the body?

Aiding digestion

Heart & muscle contraction (correct)

Regulating body temperature

Boosting immunity

Hypokalemia is characterized by 'low & slow' manifestations.

True

What are some causes of Hyponatremia?

too much water or not enough Na

Magnesium imbalance can lead to increased neuromuscular activity and ___________ reflexes.

decreased Signup and view all the answers

Match the following terms with their descriptions:

Anuria = No urine production Pyuria = Pus in urine Glycosuria = Glucose in urine Proteinuria = Protein in urine Signup and view all the answers

Where is the heart's natural pacemaker?

SA node Signup and view all the answers

What is the pathophysiology of angina?

A deficit of oxygen to the heart muscle. Signup and view all the answers

What are modifiable factors that increase the risk for atherosclerosis? (SELECT ALL THAT APPLY)

Sedentary lifestyle Signup and view all the answers

A patient with a left below the knee amputation is complaining of pain to the left foot. What type of pain is this patient experiencing?

Phantom pain Signup and view all the answers

Which of the following is true about older adults?

Impaired circulation. Signup and view all the answers

Poor perfusion can lead to kidney failure / injury.

True Signup and view all the answers

The Glasgow coma scale is a tool used to measure cardiac function.

False Signup and view all the answers

Which of the following dysrhythmias listed below are bradycardic rhythms?

Heart blocks Signup and view all the answers

Which lab tests are helpful in evaluating the etiology of hypertension in a newly diagnosed client? (SELECT ALL THAT APPLY)

Serum creatinine Signup and view all the answers

After obtaining an ECG on a client, you notice ST depression, inverted T wave, and a prominent u wave. What do you expect?

Hypokalemia Signup and view all the answers

Which of the following confirms the presence of a myocardial infarction?

Serum isoenzymes released from necrotic cells and an ECG. Signup and view all the answers

Which of the following is a cause of respiratory acidosis?

COPD (chronic obstructive pulmonary disease) Signup and view all the answers

What are the causes of Acute Renal Failure?

Short-term, high dose of toxins Signup and view all the answers

Which of the following organs are affected by uncontrolled hypertension?

Kidney Signup and view all the answers

A nurse is educating clients on preventing Urinary Tract Infections (UTIs). What should the nurse include?

Empty the bladder before and after sexual intercourse Signup and view all the answers

Study Notes

Fluid Imbalances

Potassium imbalance (3.5-5.0):
- Function: heart and muscle contraction
- Hypokalemia (low potassium): causes include vomiting, NG suctioning, wound drainage, malnutrition, and diuretics; manifestations include "low and slow" symptoms such as diarrhea, decreased motility, constipation, paralytic ileus, weakness, muscle twitching, and muscle cramping
- Hyperkalemia (high potassium): causes include adrenal and kidney disease, respiratory acidosis, and Cushing's; manifestations include "tight and contracted" symptoms such as tall peaked T waves, abdominal cramping, and vomiting
Sodium imbalance (135-145):
- Function: blood pressure, blood volume, conduction of nerve impulse, and muscle contraction
- Hyponatremia (low sodium): causes include too much water or not enough sodium, vomiting, NG tube suctioning, diarrhea, edema, and diuretics; manifestations include "depressed and deflated" symptoms such as hypotension, weak thready pulses, edema, abdominal cramping, nausea, and vomiting
- Hypernatremia (high sodium): causes include not enough water or too much sodium, heat stroke, excessive sodium intake, kidney failure, and Cushing's; manifestations include "big and bloated" symptoms such as thirst, hypertension, and neuro changes
Magnesium imbalance (1.5-2.5):
- Function: helps maintain normal nerve and muscle function
- Hypomagnesemia (low magnesium): causes include diarrhea, NG suctioning, excessive laxatives, chronic alcoholism, DKA, and diuretics; manifestations include "buck wild" symptoms such as increased neuromuscular activity, shallow respirations, tremors, and lethargy
- Hypermagnesemia (high magnesium): causes include kidney failure, meds with magnesium, and antacid use; manifestations include "calm and quiet" symptoms such as decreased neuromuscular excitability, decreased reflexes, and muscle paralysis
Calcium imbalance (9-11):
- Function: for muscles to move and for nerves to carry messages between the brain and body
- Hypocalcemia (low calcium): causes include diarrhea, excessive laxatives, rapid blood transfusion, thyroidectomy, and hyperphosphatemia; manifestations include increased neuromuscular excitability, weak heart, decreased neuromuscular excitability, hyperactive bowel sounds, and kidney stones
- Hypercalcemia (high calcium): causes include thiazide diuretics, excessive antacid use, hypophosphatemia, and bone cancer; manifestations include "slow, moans, groans, and stones" symptoms such as strong heart, decreased neuromuscular excitability, and kidney stones

Acid-Base Imbalances

pH: 7.35-7.45
PaCO2: 35-45
HCO3: 22-26
Alkalosis: pH > 7.45
Acidosis: pH < 7.35

Respiratory and Metabolic Acidosis/Alkalosis

Respiratory acidosis: PaCO2 > 45
Respiratory alkalosis: PaCO2 < 35
Metabolic acidosis: HCO3 < 22
Metabolic alkalosis: HCO3 > 26

GI Manifestations

Anorexia: loss of appetite
Nausea: subjective
Vomiting: forceful expulsion of chyme from the stomach or intestine
Diarrhea: excessive frequency of stools (loose or watery)
Constipation: less than normal bowel movements
Steatorrhea: fatty stools
Frank blood, occult blood, melena: types of stools
Bowel obstruction: manifestations include abdominal distention, vomiting, and risk factors such as immobility, surgery, older adults, cancer, and inflammatory bowel disease

Elimination

Kidneys: responsible for removing waste
Types of incontinence: oliguria, anuria, pyuria, hematuria, and glycosuria
UTI: manifestations include burning upon urination, cloudy and foul-smelling urine, and risk factors such as women, poor hygiene, and older adults
Glomerulonephritis: manifestations include coffee-colored urine, flank or back pain, oliguria, and fatigue
Urolithiasis: manifestations include intense spasms of pain, vomiting, and risk factors such as diet and diminished fluid intake

Pathophysiology

Acute renal failure (ARF): reversible, causes include ischemia, inflammation, and nephrotoxins
Chronic renal failure (CRF): gradual and irreversible, causes include diabetes, hypertension, and nephrotoxins
Cognition: determined by cerebral cortex and RAS
Altered level of consciousness (LOC): causes include stroke, brain injury, infection, hypoxia, toxic drug levels, and hypoglycemia
Brain death: criteria include cessation of brain function, absence of spontaneous respiration, and absence of brain stem reflexes

Neurology

Neuropathy: damage to peripheral nerves affecting sensation, pain, pressure, and temperature; causes include diabetes, trauma, and peripheral vascular disease
Dementia: progressive chronic disease, impairing cognitive skills, judgment, and motor coordination; causes include vascular disease, infections, toxins, and genetic disorders
Seizures: random electrical activity in the brain; causes include epilepsy, and risk factors such as age, genetics, and certain medical conditions

Pain

Types of pain: somatic, visceral, ischemic, neuropathic, and referred
PQRST: pain assessment tool

Substance Abuse

Chronic pattern of substance use: impaired health, causes include trauma, stress, and socio-economic status
Types of substances: stimulants, depressants, hallucinogens, opioids
Complications: acute overdose, injury, organ failure, infections

Perfusion

Flow of blood in the microcirculation to supply oxygen and nutrients to cells
Risk factors: age, smoking, hypertension, hyperlipidemia, obesity, genetics, atherosclerosis, and diabetes
Complications: ischemia, infarction, and organ failure

Ischemia vs Infarction

Ischemia: cell hypoxia and inflammation due to lack of blood flow
Infarction: cell death due to lack of blood flow

CAD

Narrowing of coronary arteries: poor perfusion
Risk factors: age, smoking, hypertension, hyperlipidemia, obesity, genetics, atherosclerosis, and diabetes
Complications: MI, cardiac arrest, and heart failure

Angina vs MI

Angina: ischemia (partial blockage)
MI: infarction (total blockage)

DVT

Blood clot formation in the leg: causes include immobility, hip or knee surgery, traveling, OC use, and postpartum period
Complications: pulmonary embolism

HTN

Increased blood pressure: causes include age, genetics, poor diet, sedentary lifestyle, obesity, smoking, and excessive sodium
Complications: atheroma formations, aneurysm, stroke, CHF, and chronic renal failure

Cardiac Dysrhythmias

Electrical problem in the heart: causes include atherosclerosis, hypertension, and cardiomyopathy
Types of dysrhythmias: atrial fibrillation, atrial flutter, sinus tachycardia, ventricular tachycardia, and ventricular fibrillation

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Description

This quiz covers fluid imbalances, specifically potassium imbalance, its causes, manifestations, and effects on the body.