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Exam (elaborations)

Acid base imbalance and fluid and electrolytes

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Goes into acid base imbalance and every kind and into different electrolytes along with their symptoms and side effects. also dives into AKI, CKD

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  • October 31, 2024
  • 2
  • 2024/2025
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Acid-base:

● COPD- chronic respiratory acidosis
● Low carb/no carb diet will put you into, ketosis (metabolic acidosis) - people with
renal/kidney failure will go into meta-acidosis from not eating carbs
● BUN and Cr are markers to see renal function and if kidneys are not working properly
● We do the Allen test to determine blow flow and assess if it is safe to perform an arterial
puncture
● Daily weights are the most accurate measure of fluid balance
● Respiratory alkalosis causes mouth, hands, and feet numbness and tingling
● Choking is an acute cause of respiratory acidosis

Fluid/electrolyte:

● Isotonic- 0.9(normal) saline, lactated ringers, plasmalyte (given in blood loss situation)
● Hypotonic- 0.45%, D5W
● Hypertonic- anything above 0.9% saline
● Intake 2 liters and output 30ml an hr
● Chvostek: cheek and face flinch
● Trousseau: BP cuff and arms hooks in
● Fluid typically moves from an area of low concentration to an area of high concentration
● Know the cardiac affects of electrolyte loss:
○ Hypomagnesium: fatal dysrhythmias
○ Kalemia: EKG changes and fatal dysrhythmias
● Hypermag: floppy, slow, flaccid
● Hypocalcemia: nose, mouth, hand, feet, toes numbness and tingling and TETANY
● For hyperkalemia:
○ 1. Give IV dextrose/glucose
○ 2. IVP insulin
○ 3. Hang calcium
● Hyperkalemia: polystyrene sulfate (kayexelate)- takes all K into colon and gives extreme
diarrhea
● Hyponatremia: seizures
● KNOW K SHOULD BE INTRACELLULAR

FVE/FVD:

● Fve meds:
○ Loop diuretics (furosemide) : strongest - pee lot of K
○ Thiazide diuretics (hydrochlorothyoxide) : pee lot of K
○ Potassium-sparing diuretics (spironolactone) : helps keep K

● Clinical manifestations w FVD:

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