Free online NCLEX Review for the Complete Idiot. LVN/LPN. Labs Values #2: Electrolytes and acid base balance. Metabolic & respiratory acidosis & alkalosis, hypo & hyper: Natremia, kalemia, calcemia, magnesemia. K, foods, blood gas values, etc.
Metabolic Acidosis, Metabolic Alkalosis, Respiratory Acidosis, Respiratory Alkalosis. Causes & S/S of: Hyper and Hypernatremia, Hypo and Hyperkalemia, Hypo and Hypercalcemia, Hypo and Hypermagnesemia, pH, Blood gas values, aldosterone, renin.
pH < 7.35 , PaCO3 normal or < 35, HCO3 < 22
pH > 7.45, PaCO2 normal or > 45, HCO3 > 26
pH < 7.35, PaCO2 > 45, HCO3 >26
pH > 7.45, PaCO2 < 35, HCO3 < 22
causes of Hyponatremia
GI loss - NG suction, vomit, diarrhea, Renal loss
causes of Hypernatremia
Excess aldosterone secretion, water deprivation or increased water loss.
causes of Hyperkalemia
Fluid Volume Deficit, Renal Failure, Acidosis
causes of Hypokalemia
Diuretics (Lasix), Diarrhea, GI loss, polyuria
causes of Hypercalcemia
Osteoperosis, hyperparathyroidism, immobilization
causes of Hypocalcemia
chronic alcoholism, chronic renal failure, Vitamin D deficiency
electrolyte imbalance in which cardiovascular is always a concern.
Signs and symptoms of Fluid volume excess
1)weight gain 2)High BP 3)shallow, rapid respirations 4)crackles 5)Fluid intake > outake 6)weakness, fatigue, dyspnea 7)edema, taut shiny skin 8)JVD 9)bounding pulse
Foods high in potassium
potatoes, raisins, bananas, spinach, avacados, carrots
causes of Hypermagnesemia
Renal failure, excess intake
causes of Hypomagnesemia
Malnutrition, alcoholism, diarrhea, vomiting, polyuria
S&S of Hypokalemia
muscle weakness & cramps, irregular pulse
S&S of Hypocalcemia
pathological fractures, Trousseau's sign, Chvostek's sign
S&S of Hypomagnesemia
hyperactive deep tendon reflexes, muscle tremors
Renal system (kidneys)
3rd line of defense for acid base balance.
S&S of Hypercalcemia
hypoactive reflexes, cardiac arrest
causes Hypervolemia - crackles, SOB
Too much fluid to patient with kidney failure or CHF.
concentration of solutes in a solution.
causes loss of potassium. (hypokalemia)
examples of Isotonic solutions
1)Lactaid Ringers 2) NS (0.9% NaCl) 3) 5% Dextrose
measures hydrogen ion concentration in the body fluids.
causes of Fluid Volume Deficit
1) decreased intake 2) increased excretion 3) fluid shift 4) strenuous exercise 5) extreme heat/dryness 6) fever (increased metabolic rate)
Blood gas values - pH, PO2, HCO3, PCO2
1)7.35-7.45 2) 80-100 mm Hg 3) 22-27 mEq/L 4)35-45 mm Hg
Bicarbonate (PCO2) concentration corresponds with pH.
Fluid Regulation of GI tract
Absorbs nutrients H2O.
Acid Base regulatory mechanisms
Blood, Lungs, Kidneys
Renin-Angiotensin mechanism initiates
1) low blood volume 2)low serum Na 3) low BP 4)high serum K
5) low cardiac output
Result of hyperventilation.
Results from severe diarrhea or renal disease.
Water moves into cell and causes cell to swell. Fluid shift out of blood vessels into interstitial spaces.
Expands ECF volume. (same concentrate as plasma.)
Respiratory system (lungs)
2nd line of defense for acid base balance.
Increases reabsorption of Na and water and excretion of K in kidneys. Causes vasoconstriction, increases BP. (main Na-retaining hormone)
Fluid Volume Excess
Excessive retention of water and Na in extracellular fluid.
Net gain of water or loss of Na-rich fluids.
S&S of Fluid Volume Excess
1)weight gain 2)weakness, fatigue 3)dyspnea with exertion 4)pitting edema 4)JVD 5)taut, shiny skin 6)bounding pulse 7)shallow, rapid respiration 8)crackles 9)high BP 10)fluid intake > outake
Occurs through kidneys, skin, lungs and GI tract.
Bicarbonate (PCO2) has opposite response of pH.
Renal System (kidneys)
Primary system in regulating fluid and electrolyte balance.
Fluid Regulation of Nervous System
Hypothalamus controls thirst - thirst center.
Fluid Regulation of Kidneys
1)Filters blood 2)Excretes urine 3)Secretes aldosterone - reabsorbs Na, H2O and Cl and exceretes K.
Fluid Regulation of Lungs
1)Regulates O2 and CO2 2)Eliminates H 3)Acid/Base Balance
Foods high in Magnesium
Vegetables, nuts, fish
serum Magnesium level
1.3 - 2.1 mEq/L
serum Potassium level
3.5 - 5 mEq/ L
serum Calcium level
4.5 - 5.5 mEq/L
Result of hypoventilation.
Results from vomiting, gastric suction, K deficiency, increased renal excretion of acid.
S&S of Hypernatremia
Extreme thirst, sticky tongue and mucous membranes, postural hypotension.
serum sodium greater than 145 mEq/L
solution with greater concentration than plasma.
Blood - Bicarbonate
1st line of defense of acid base balance. (immediate response, only small fluctuations)
Vomiting, diarrhea, abnormal drainage, excessive use of laxatives, enema, diuretics, blood loss, diaphoresis, burns
Water moves out of cell and causes cell to shrink.
S&S of Fluid Volume Deficit
1)Increased pulse and respirations 2)decreased BP 3)output > intake 4)dry oral mucosa 5)increased thirst 6)weight loss (5lbs.) 7)scanty or concentrated urine 8)collapsed neck veins
Fluid Regulation of Thyroid Gland
Increases blood flow in the body and increases output.
serum Sodium level
135 - 145 mEq/L
serum Sodium level less than 135 mEq/L
Point at which hemoglobin is saturated by O2.
loss that is perceived or is measurable. (wound drainage, GI tract, urine)
S&S of Hyperkalemia
life threatening dysrhythmias
major electrolyte found in extracellular fluid
Water lost from body - no loss of electrolytes.
Continuous loss occurring through skin and lungs.
Fluid Regulation of Lungs
Regulates O2 and CO2, Acid/Base Balance and eliminates H+.
Effects of Aldosterone
Excretes K and retains Na.
Body loses both water and electrolytes from the ECF.
Fluid Regulation of Cardiovascular system
Distributes nutrients and water throughout the body.
Major cation in the intracellular fluid.
potassium has action with sodium.
Released in response to decreased blood flow or decreased pressure in nephrons.
S&S of Hyponatremia
personality change, postural hypotension
S&S of Hypermagnesemia
hypoactive deep tendon reflexes
cause of decreased excretion
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