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A loss of fluid volume to the point the body is unable to compensate. Angio-tensin system leads to increased systemic vascular resistance. Fatal if loss continues.
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Hypovolemic shock
Osmolality is the concentration of molecules per _______ of water. Osmolarity is the concentration of molecules per _______ of water.
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Osmolality - molecules per weight (ie. kg). Used in assessment. Osmolarity= molecules per volume.
The overall osmotic effect of colloids (like plasma proteins) is called...
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oncotic or colloid osmotic pressure.
Colloid oncotic pressure keeps water/fluids ______.
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in
The mechanical force of liquid pushing against the cellular membrane; blood pressure...
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Hydrostatic Pressure
Hydrostatic pressure keeps water/fluid ______.
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out
IVF=ECV in...
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healthy people
Diabetic ketoacidosis, hypoxia, digitalis overdose, renal failure and Addison's disease can cause ______.
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hyperkalemia
What can cause hyponatremia?
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Pituitary cancer; oat cell lung cancer; water intoxication.
Hypertonic fluid alterations develop when the osmolality of the ECF is greater than _______ mOsm.
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294
What are the signs of hyponatremia?
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Serum less than 135; muscular weakness; headache; abdominal cramps; n/v.
The kidney maintains normal serum _______ concentrations. It keeps it within ______ to _______mEq/L.
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sodium; 136-145 (mostly thru renal tubular reabsorption)
The most common cause of hypokalemia is ...
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respiratory alkalosis
Increased Na levels are caused by what conditions?
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Inappropriate administration of hypertonic saline solution (like HCO3 for acidosis); Oversecretion of aldosterone (like in hyperaldosteronism or Cushings); Water loss (diarrhea, diabetes, fever, respiratory infections, hyperglycemia).
Hypokalemia can be caused by ...
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Reduced intake of potassium; increased entry of K+ in cells; increased losses of body potassium (diarrhea, intestinal drainage tubes/fistulae, laxative abuse/K+ wasting diuretics, vomiting, NG oversuction).
What is a cardinal sign of poor ECV?
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Fluid accumulation in the feet.
What is the disease process of Hyperkalemia?
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Increased H ions outside of cells, causing K+ to leave as well. Increases resting membrane potential, making it easier for an action potential to occur. Muscles wear out (from increased contracture). Weakness and paralysis.
What conditions contribute to water excess?
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Compulsive water drinking; decreased urine formation (from renal disease or decreased renal blood flow).
What are the signs of hypocalcemia?
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Anxiety; irritability; tetany.
ECF is controlled by...
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the serum sodium concentration.
What are the signs and symptoms of hypokalemia?
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Slowing down symptoms, shallow respirations, irritability, confusion, weakness, arrhythmias.
What are causes of hypernatremia?
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Diabetes, tumor, pituitary trauma, surgical mishap, water deficit, dehydration.
What are signs and symptoms of water excess?
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Confusion, convulsions, weakness, nausea, muscle twitching, headache, weight gain.
What causes metabolic alkalosis?
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Over-NG suction; vomiting
How is hyperkalemia treated?
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Restricting potassium foods, sodium bicarbonate, 10% calcium gluconate, insulin and glucose, Kayexalate (oral: 10-20g, 3-4 xs) (rectal: 30-50g).
_______ is required for glycogen and glucose deposition in liver and skeletal muscle cells.
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Potassium
Increase in ECF sodium causes symptoms of _______, decrease in water in ECF causes _______.
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Hypervolemia caused by increase in sodium; hypertonic caused by H20 loss.
An increase or decrease in carbonic acid or bicarbonate releases H ions...
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Buffering System
The neurological manifestations of hyponatremia are related to...
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swelling of neurons.
What are signs and symptoms of Hyperkalemia?
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Muscle cramping, abdominal cramping, diarrhea, kidney damage, oliguria (scant urine output), peaked T wave, long QRS wave.


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