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Exam (elaborations)

BMS EXAM REVIEW

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BMS EXAM REVIEW
Expected lab values...



Na+

K+

Mg++

Hgb

Hct

BUN

Creatinine - ANS Na+ 136-145 mEq/L

K+ 3.5-5 mEq/L

Mg++ 1.3-2.1 mEq/L

Hbg...

male = 14-18 g/dL

female = 12-16 g/dL

Hct...

male = 42-52%

female = 37-47%

BUN 10-20 mg/dL

Creatinine...

male = 0.6-1.2 mg/dL

female = 0.5-1.1 mg/dL



Our total body water volume, L + % bw:

,intracellular VS extracellular makeup:



interstitial VS plasma volume: - ANS TBWV: 40L, 60% BW.



intracellular fluid volume = 25L, 40% BW.

extracellular fluid volume = 15L, 20% BW.



interstitial fluid volume = 12L, 80% ECF

plasma volume = 3L, 20% ECF



Where does sodium reside?

5 things it controls?



3 hormones which regulate sodium absorption/excretion:



How does thirst regulate sodium?

How do kidneys regulate? - ANS most abundant extracellular ion.

- controls water distribution

- controls plasma volume

- controls blood pressure

- affects cardiac + muscle contraction

- transmission of nerve impulses



regulated by ADH, Natriuretic peptide, Aldosterone

,thirst is initiated if eat salty foods, body wants water to dilute the sodium.



kidneys jumpstart renin AND slows urine production + conserves water to dilute salt & maintain
sodium/water ratio.



Describe the renin-angiotensin system. - ANS - kidneys sense BP decrease, releases Renin from
juxtaglomerular apparatus

- Renin converts angiotensinogen to angiotensin I (vasoconstriction hormone)

- in lungs, angiotensin-converting enzyme (ACE) converts angiotensin I to II

- angiotensin II causes vasoconstriction (BP) + stimulates adrenal glands to release Aldosterone

- Aldosterone in kidneys promotes reabsorption of sodium + water

- circulating blood volume increases



How can low O2 trigger renin-angiotensin system? - ANS Low O2 can be due to decreased circulating
blood volume, so system activated to increase blood volume oxygen carrying capacity (more O2 to body)



Hyponatremia...

- values

- etiology

- S/S

- TX - ANS HYPONATREMIA:

<136 mEq/L

- typically fluid imbalance from overhydration/hypervolemia or loss of body fluids (excess diuresis). not
Na+ decrease

- cerebal (confusion, seizures), neuromuscular (muscle weakness), intestinal (increased motility of
nausea, cramp, diarrhea), cardiac (decrease vol= rapid + weak pulse, decrease BP; increase
vol=bounding pulse, increase BP)

, - correct cause, monitor response. sodium replacement. hypertonic IV solutions. nutrition therapy.



Hypernatremia...

- value

- etiology

- S/S

- TX - ANS HYPERNATREMIA:

>145 mEq/L

- excess Na+, fluid imbalance dehydration/hypovolemia, kidney fail

- cerebal (confusion, agitation, lethargy), neuromuscular (twitching, muscle weak, decrease DTRs),
cardiac (low contractility. low vol = tachycardia, BP; high vol = slow bounding pulse, high BP)

- correct cause, monitor response, sodium restriction, hypotonic IV solution, dietary manage + water
intake



Where does potassium reside?

what does it regulate?



___% potassium excreted through ___?



which two labs evaluate kidney function?



what does elevated serum creatinine mean? - ANS intracellular

- regulates neuromuscular system + skeletal &cardiac muscle function



80% electrolytes excreted through kidneys.

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