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Class notes PNP (PNP401) Study Guide for Gould's Pathophysiology for the Health Professions
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- PNP (PNP401)
Class notes for nursing students about fluid and electrolytes
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Sodium Imbalance – NORMAL range 3.8 – 5 mmol/L or 135-145mEq1.What is Sodium?
-Is mainly a cation in ECF. Diffusion of Na occurs b/t vascular and ISF
-GOAL: MAINTAIN BP + BLOOD VOL
2. Why is Na important?
-for maintenance of ECF vol thru its effect on osmotic pressure b/c it makes up 90% of the solute in ECF
-is essential in conduction of nerve impulses and in muscle contraction
2. How is Na transported?
-transport across the cell membrane via Na-K pump, or active transport resulting in Na levels that high in ECF
and low in ICF.
3. What does Na do to the body?
-is secreted into mucus and others.
-it exists in the body inn form of salt sodium chloride and sodium bicarbonate.
4. How is Na ingested and expelled?
-ingested via food and bev; lost from the body in perspiration, urine and feces
5. How is Na controlled in body?
-Na is primary controlled by the kidneys thru action of aldosterone (RAAS)
6. What are the causes of hyponatremia
-Losses from excessive sweating, vomiting and diarrhea
-Use of certain diuretic drugs combined with low-salt diets
-Hormonal imbalances like insufficient aldosterone, adrenal insufficiency, and excess ADH secretion d/t
inappropriate ADH hormone secretion
-Early chronic renal failure
-Excessive water intake
7. Effects of Hyponatremia
-low Na can impair nerve conduction resulting in fluin imbalance
-decreased osmotic pressure in ECF resulting fluid shift into cells causing hypovolemia and decrease in bp
-due to fluid shift to the cells it can cause swell resulting confusion, headache, weakness or seizures
8. Manifestation of Hyponatremia: WEAK + SHAKEY
-cramps, anorexia, nausea (CAN)
-fatigue, lethargy, muscle weakness
-headache, confusion, seizures (SCH)
-decreased bp
9. Effects of Hypernatremia – occurs d/t lack of water intake or too much water loss; fluid shifts out of cells d/t increases
osmotic pressure of ECF
-lack of ADH resulting in a large volume of dilute urine (diabetes insipidus)
-loss of thirst mechanism which means that you are not getting thirst signals; hence, you don’t drink water
-watery diarrhea for some reason
-prolonged period of rapid respiration as when you exhale, water evaporates
10. Manifestation of hypernatremia: BIG AND BLOATED
-weakness, agitation, firm SUBQ tissue, lethargy, edema, elevated bp
-increase thirst, with dry, rough mucus membranes
-decrease urine output b/c ADH is secreted
Potassium Imbalance – major cation in ICF; normal range 3.5-5mEq/L or 2-5 mmol/L
1.What is K+ purpose?
-vital in nerve conduction and contraction of all the muscle. Has serious effect on contraction of cardiac muscle
causing changes in ECG and may cause cardiac arrest
-GOAL: CONTRACTION of smooth muscle like GI, heart
-REGULATEF BY: kidneys
2. How is K+ excreted?
-via urine under the influence of hormone aldosterone (K+ excreted = Na retain)
3. What is the connection of insulin hormone and K+?
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