4F-A (Sir Auza's Discussion) Notes PDF

’ Notes are verbatim WATER There is 70% water in our body  To get water: o Ingestion (90%)- food, water, IV o Metabolic water (10%)- by production  Excreted through: o Urine o Sweat o Fe...

’ Notes are verbatim WATER There is 70% water in our body  To get water: o Ingestion (90%)- food, water, IV o Metabolic water (10%)- by production  Excreted through: o Urine o Sweat o Feces o Insensible loss- it is not felt or seen like respiration and evaporation FUNCTIONS OF WATER o Temperature regulation o Cell shape maintenance o Lubrication (synovial fluids or fluids of the joints) o Absorption and digestion – starts with saliva o Transports nutrients through O2  Blood is made up of 83% water o Waste excretion Extracellular Intracellular Interstitial Intravascular TYPES OF CELLULAR TRANSPORT MECHANISMS 1. Osmosis- LOW TO HIGH; holds water molecules 2. Diffusion- HIGH TO LOW  Both osmosis and diffusion is passive to transport aka no energy is required 3. Filtration- Found in the kidneys 4. Active transport- requires energy (ATP) 1|M.S.T.L  ELECTROLYTES LOW NORMAL HIGH Sodium Hyponatremia 135-145 meq/L Hypernatremia Chloride Hypochloremia 95-105 meq/L Hyperchloremia Potassium Hypokalemia 3.5-5.0 meq/L Hyperkalemia Calcium Hypocalcemia 8.5-10.5 mg/dL hypercalcemia Magnesium Hypomagnesemia 1.5-2.5 mg/dL Hypermagnesemia Phosphate Hypophosphatemia 2.25-4.5 mg/dL Hyperphosphatemia  Where sodium goes, water follows  BFFS- Sodium & chloride, Calcium and phosphate  Hypermagnesemia is RARE- only through health care workers trying to elevate Mg levels o Usually given to pre-eclampsia but once overdoses it can cause further complications  Which electrolyte is the main regulator of fluid? SODIUM  Ca = P,  Ca (contract) and Mg (relax) - compete for muscle, Ca & Mg- Affect the Na+ K+ pump ALDOSTERONE  Keeps Na, Excretes K DECREASE aldosterone Addison’s’ disease INCREASE aldosterone Conn’s disease INCREASE CORTISOL Cushing syndrome INCREASE HDH(?) SIADH CALCIUM  CALCIUM- Bone health and stored in bone o Complication:  Osteoporosis- related to how medications slowdowns the release of calcium from the bone. Without much calcium in the blood, the bone will excrete more calcium into the blood leaving it less dense in the bone causing fragility.  PHOSPHATE- bone building HYPO CA & MG POSITIVE SIGNS  Trousseau’s sign- involuntary contraction of the muscles in the hand and wrist o It can be triggered by placing a blood pressure cuff, on an individual’s arm and inflating it to a pressure greater than their systolic blood pressure for 2 to 3 minutes. The cuff will block the brachial artery  Chvostek’s sign- a twitch of the facial muscles that occurs when gently tapping an individual's cheek, in front of the ear. 2|M.S.T.L  FLUID TYPES ISOTONIC HYPOTONIC HYPERTONIC Definition  Equal concentration  Low concentration  Excessive concentration  To  extracellular volume  “Cell swelling”  “Cell shrinking”  STAY THE SAME  Via central line Indication  Dehydration (limited fluid  Cell Dehydration volume outside the cells)  DKA  Blood loss  hypovolemia Types  0.9% saline  0.45% Saline (1/2)  3% saline  5% dextrose in water  0.225% saline (1/4)  5% saline  5% dextrose in 2.25%  0.33% saline (1/3)  10% dextrose in water saline  5% dextrose in 0.9  Lactated ringer’s solution  below 0.9%-hypotonic saline  5% dextrose in 0.45%  D5W- starts out as saline isotonic ends up as  5% dextrose in LR hypotonic  Whole number 0.9% above-hypertonic Watch  Increased intracranial  hypervolemia out for pressure  edema  Burns  HPN  hypovolemia  Hyponatremia  Phlebitis ATRIAL BLOOD GAS ACIDOSIS NORMAL ALKALINE pH 7.45 7.40 (absolute value) Co2 >45 35- 45 mmHg