Exam 4 Chemistry Review/Study Questions Part 3

Match the Electrolyte Imbalance with the following:
Aldosterone deficiency
Water retention or water intoxication
Potassium deficiency (kidneys will retain K, excrete Na)
Diuretics
Nausea, vomiting, weakness, headache, seizures, coma
Hyponatremia
Match the Electrolyte Imbalance with the following:
Dehydration-#1 cause
Diabetes insipidus
Increased Na intake
Hypothalmic disease or head trauma
Decreased thirst (ex. Hypothalamic dz, elderly, infants, mentally impaired)
Mental changes, restlessness, twitching, fever, thirst, nausea
Hypernatremia
Match the Electrolyte Imbalance with the following:
GI loss
Urinary loss (renal disease)
Insulin overdose (K and gluc move into cells)
Alkalosis (as H moves out to maintain pH, K and Na move in)
Muscle weakness, paralysis, arrhythmia
Hypokalemia
Match the Electrolyte Imbalance with the following:
Red cell lysis / muscle injury
Chemotherapy and leukemia
Diabetes: low insulin causes serum buildup of K
Acidosis (H moves in, K moves out)
Muscle weakness, tingling, numbness, confusion, arrhythmias
Hyperkalemia
Match the Electrolyte Imbalance with the following:
Prolonged vomiting
Aldosterone deficiency (along with Na)
Hypochloremia
Match the Electrolyte Imbalance with the following:
Bicarbonate loss (acidosis)
Hyperchloremia
Match the Electrolyte Imbalance with the following:
Increased Levels of Bicarbonate HCO3-
Metabolic alkalosis
Match the Electrolyte Imbalance with the following:
Decreased Levels of Bicarbonate HCO3-
Metabolic acidosis
Match the Electrolyte Imbalance with the following:
Hypoparathyroidism
Vitamin D deficiency
Albumin deficiency ( affects total calcium only)
Cardiac irregularities, tetany and seizures
Hypocalcemia
Match the Electrolyte Imbalance with the following:
Hyperparathyroidism
Malignancies, Multiple myeloma
Drowsiness, depression, coma
Hypercalcemia
Cardiac arrest may result in both hypo
and hyper_____
kalemia
By what 3 mechanisms regulate Potassium?
1. Aldosterone, in exchange for Na
2. Na-K pump
3. insulin, which promotes the entry of K into cells
Match the Electrolyte Imbalance with the following:
Poor diet / starvation
Malabsorption
Hyperparathyroidism and other dzs with
Increased Calcium
-kidneys excrete Mg to balance cations
Arrhythmias, tetany, psychiatric symptoms
Hypomagnesemia
Match the Electrolyte Imbalance with the following:
Renal failure, especially in combination with antacids
Bradycardia (slow heartbeat), decreased reflexes, lethargy
Hypermagnesemia
Match the Electrolyte Imbalance with the following:
Common in hospitalized patients
Diabetic ketoacidosis
Hyperparathyroidism
Malaise, confusion, coma due to ATP depletion
Hypophosphatemia
Match the Electrolyte Imbalance with the following:
Renal failure
Avoid hemolysis
Hyperphosphatemia
What tubes should you avoid when determining Calcium levels?
EDTA
Calcium exists in the plasma as what?
*Free calcium ions or “ionized calcium”
*Bound to Albumin or other anions
As Calcium Increases, what happens to PO4?
Decreases
As Calcium Decreases, what happens to PO4?
Increases
As PTH Increases, what happens to PO4?
Decreases
True or False:
Lactate (Lactic acid) is used to monitor critically ill patients for severity of illness and prognosis
True
What are the sample requirements when testing for Lactate (Lactic Acid)?
Don’t use a tourniquet
Use heparinized blood or fluoride on ice
What is the formula for the Anion Gap?
(Na + K) – (Cl + HCO3)
What is the reference range for (Na + K) – (Cl + HCO3)?
10-20 mmol/L
What is the reference range for Na – (Cl + HCO3)?
7-16 mmol/L
What is the cause of a Decreased AG?
Rare, usually instrument error
What is the cause of an Increased AG?
Lactic acidosis
Alcohol or salicylate intoxication
Ketoacidosis (diabetes / starvation)
Renal failure
What is the following considered:
The presence of low blood pH, elevated AG, and elevated ?Osmo (>15)
Medical Emergency
As a QC tool, an increased AG on a normal sample may indicate what?
Instrument Error
Give the acid-base disorder (uncompensated) associated with the following results:
Increased pH, Increased HCO3
Metabolic Alkalosis
Give the acid-base disorder (uncompensated) associated with the following results:
Decreased pH, Increased CO2
Respiratory Acidosis
Give the acid-base disorder (uncompensated) associated with the following results:
Decreased pH, Decreased HCO3
Metabolic Acidosis
Give the acid-base disorder (uncompensated) associated with the following results:
Increased pH, Decreased CO2
Respiratory Alkalosis
Match the cause with the likely acid-base disorder:
Pneumonia
Respiratory acidosis
Match the cause with the likely acid-base disorder:
Anxiety
Respiratory alkalosis
Match the cause with the likely acid-base disorder:
Diabetic ketoacidosis
Metabolic acidosis
Match the cause with the likely acid-base disorder:
Emphysema
Respiratory acidosis
Match the cause with the likely acid-base disorder:
Vomiting
Metabolic alkalosis
Match the cause with the likely acid-base disorder:
Morphine or alcohol
Respiratory acidosis
Match the cause with the likely acid-base disorder:
Tissue hypoxia
Metabolic acidosis
Match the cause with the likely acid-base disorder:
Salicylate overdose
Metabolic acidosis & Respiratory alkalosis
Match the cause with the likely acid-base disorder:
Diuretics
Metabolic alkalosis
What is the preferred anticoagulant for arterial blood gas collection?
Heparin
Are there any other special handling requirements for Blood Gas Analysis?
Cap the needle, put on ice, test within 30 min
List the effect of an air bubble and a delay in testing on ABG results for:
pO2
Air Bubble – Increased
Delay in Testing – Decreased
List the effect of an air bubble and a delay in testing on ABG results for:
pCO2
Air Bubble – Decreased
Delay in Testing – Increased
List the effect of an air bubble and a delay in testing on ABG results for:
pH
Air Bubble – Increased
Delay in Testing – Decreased
What methodology measures current that flows through a system?
Amperometry
Name the blood gas commonly measured by this method
O2
What methodology measures the voltage difference between 2 electrodes?
Potentiometry
What are the two types of electrodes used in the Potentiometry system?
Reference and Sample (indicator)
Name the analytes commonly measured by the Potentiometry system method
pH, electrolytes, pCO2
x

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