Electrolytes and Acid Base Balance

	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
	GI loss - NG suction, vomit, diarrhea, Renal loss
	Excess aldosterone secretion, water deprivation or increased water loss.
	Fluid Volume Deficit, Renal Failure, Acidosis
	Diuretics (Lasix), Diarrhea, GI loss, polyuria
	Osteoperosis, hyperparathyroidism, immobilization
	chronic alcoholism, chronic renal failure, Vitamin D deficiency
	electrolyte imbalance in which cardiovascular is always a concern.
	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
	potatoes, raisins, bananas, spinach, avacados, carrots
	Renal failure, excess intake
	Malnutrition, alcoholism, diarrhea, vomiting, polyuria
	reverses dehydration.
	muscle weakness & cramps, irregular pulse
	pathological fractures, Trousseau's sign, Chvostek's sign
	hyperactive deep tendon reflexes, muscle tremors
	3rd line of defense for acid base balance.
	hypoactive reflexes, cardiac arrest
	Too much fluid to patient with kidney failure or CHF.
	concentration of solutes in a solution.
	causes loss of potassium. (hypokalemia)
	1)Lactaid Ringers 2) NS (0.9% NaCl) 3) 5% Dextrose
	measures hydrogen ion concentration in the body fluids.
	1)decreased intake 2)increased excretion 3)fluid shift 4)strenuous exercise 5)extreme heat/dryness 6)fever (increased metabolic rate)
	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.
	Absorbs nutrients H2O.
	Blood, Lungs, Kidneys
	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.)
	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)
	Excessive retention of water and Na in extracellular fluid.
	Net gain of water or loss of Na-rich fluids.
	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.
	Primary system in regulating fluid and electrolyte balance.
	Hypothalamus controls thirst - thirst center.
	1)Filters blood 2)Excretes urine 3)Secretes aldosterone - reabsorbs Na, H2O and Cl and exceretes K.
	1)Regulates O2 and CO2 2)Eliminates H 3)Acid/Base Balance
	Vegetables, nuts, fish
	1.3 - 2.1 mEq/L
	3.5 - 5 mEq/ L
	4.5 - 5.5 mEq/L
	Result of hypoventilation.
	Results from vomiting, gastric suction, K deficiency, increased renal excretion of acid.
	Extreme thirst, sticky tongue and mucous membranes, postural hypotension.
	serum sodium greater than 145 mEq/L
	solution with greater concentration than plasma.
	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.
	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
	Increases blood flow in the body and increases output.
	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)
	life threatening dysrhythmias
	major electrolyte found in extracellular fluid
	Water lost from body - no loss of electrolytes.
	Continuous loss occurring through skin and lungs.
	Regulates O2 and CO2, Acid/Base Balance and eliminates H+.
	Excretes K and retains Na.
	Body loses both water and electrolytes from the ECF.
	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.
	personality change, postural hypotension
	hypoactive deep tendon reflexes
	renal disease,cancer