At this point procrastination is my middle nameeeee
I donāt have such a long neck.
oh trueā¦
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Writing kills my arm
At this point my mind is mush
Liquefactive necrosis
Iām so doneeee
Too bad itās not open book
So many CM & etiologies to memorize
Alright, lets see what all I can remember with out looking at my slides.
Fluids
Fluid Volume EXCESS
Etiologies:
Increase intake of water or sodium
Inadequate elimination of water or sodium
Renal Failure
Liver Failure
Heart Failure
SIADH
Psychogenic Polydipsia
Cushingās syndrome
Hyperaldosteronism
High Sodium Diet
Hypertonic fluid administeration
Free Water
Enteral Feeding not balanced
CMās:
Tachycardia
Bounding Pulse
JVD
Rapid weight gain
Crackles
Dyspnea
Polyuria
Generalized Edema
Localized Edema
Hypervolemic
Hypotonic
Hypoosmolality
Fluid Volume DEFICIT
Etiologies:
Inadequate fluid intake
Excessive loss of fluid or sodium
Diabetes Insipidus
Diabetes Mellitus
Low Sodium Diet
Hemorrhaging
Burns
Ascites
GI losses (vomiting, diarrhea)
Nephrotic syndromes
Open wounds
Excessive Diaphoresis
Prolonged Hyperventialtion
Excessive use of diuretics
Inadequate IV fluid replacement
Poor oral intake
CMās:
Dehydration
Flat Jugular Veins
Rapid Weight Loss
Tachycardia
Thirst
Poor Skin Turgor
Altered levels of consciousness
Weak Thready pulse
Dry Mucous membranes
Oliguria
Hypovolemic
Hyperosmolality
Hypertonic
Sodium Na+
136 - 145 (normal range)
Primary ECF electrolyte
Roles:
Acid Base Balance
Regulates water balance & plasma osmolality
Generation and Transmission of nerve Impulses
Muscle contractibility
Cellular Chemical Reactions
Membrane transports
Hyponatremia (too little sodium)
etiologies:
Low sodium diet
Inadequate intake of sodium
SIADHs
Loop diuretics
Vomiting
Diarrhea
Renal Disease
Adrenal Insufficiency
Water Intoxication
CMās:
Lethargy
Convulsions
Coma
Confusion
Seizures
Decreased reflexes
Muscle cramps & fatigue
Severe:
Cerebral edem
Increased Intracranial pressure
Hypernatremia (too much sodium)
etiologies:
Diabetes Insipidus
Inadequate water intake
Excessive sweating
Renal concentrating disorders
Diarrhea, Vomiting
CMās
Thirst
Weight loss
Bounding pulse
Increase blood pressure
Severe:
Muscle twitching and hyperactive reflexes
Coma
Convulsions
Confusion
Cerebral hemorrhaging
Potassium K+
3.5 - 5
Primary ICF electrolyte
98% is in the cell
Roles:
Transmission & Conduction of nerve impulses
Acid Base balance
Normal Cardia Contraction
Skeletal & Smooth muscle contraction
Hypokalemia:
Etiologies:
Decreased intake
Increased uptake of K+ into the cell
Acid base balance
Insulin overuse
Increased levels of aldosterone
Vomiting
Diarrhea
Burns
use of non-sparing K+ Diuretics
NG suction
CMās:
Skeletal muscle weakness
Loss of smooth muscles tone
Cardiac dysrhythmias
Leg cramps
Constipation
EKG: prolonged PR, flat T waves, prominent U waves
(Neuromuscular excitability increases then decreases)
Hyperkalemia
Etiologies:
Increased uptake
Cell trauma
shift of K+ out of cell & into blood
decreased renal excretions
Insulin deficiency
Large infusion of stored blood
CMās
tingling of the lips and fingertips
restlessness
diarrhea
intestinal cramping
Tall peaked T waves
when the cell canāt repolarize
muscle weakness
loss of muscle tone
flaccid paralysis
cardiac dysrhythmia
Calcium Ca2+
9 - 10.5
Roles:
Structure of Bones and teeth (mainly found in)
blood clotting, blood vessel and cardiac contractility
hormone secretion
neuromuscular excitability & skeletal contraction
Hypocalcemia
etiologies:
insufficient GI absorption
Decrease in PTH
Vit D deficiency
CMās:
Neuromuscular irritability
Hyperactive reflexes
tetany
Positive chvostek
Positive trousseau
Cardiac dysrhythmia
Hypercalcemia (TOO MUCH IN BLOOD NOT IN TISSUES)
etiologies:
tumors that produce PTH
sarcadosis
overdose of Vit D
some cancers
prolonged immobilization
Hyperparathyroidism
CMās:
muscle weakness
Osteoporosis
Pathological Fractures
kidney stones
Cardiac dysrhythmia
Impaired renal functions
Slow reflexes
Phosphate P04-
3.5 - 4
Roles:
provides energy for muscle contraction
component of RBC
acid base regulator
hypophosphatemia
etiologies
decreased intestinal absorption
increased excretion by kidneys
intracellular shift
CMās
mild cases usually asymptomatic
severe:
CNS depression
muscle weakness
numbness
convulsions
possible respiratory or cardiac failure
bone reabsorption
hyperphosphatemia
etiologies
acute or chronic renal failure
hypoparathyroidism
chemotherapy
Long term use of laxatives or enema containing phosphate
CMās
Tetany
Muscle cramps
parathesia
seizures
when prolonged: calcification of soft tissues in the lungs, kidneys, and joints
Magnesium mg ++
1.3 - 2.1
roles:
acts as cofactor in intracellular enzymatic reactions
increases neuromuscular excitability
Hypomagnesmia
etiologies:
alcohol abuse
laxative abuse
urine output
malnutrition
malabsorption syndrome
CMās:
tachycardia
nystagmus
postive troussue
positive chvostek
tetany
ataxia
convulsions
hyperactive deep tendon reflexes
muscle cramps
behavioral changes
Hypermagnesmia
etiologies:
abuse of milk of magnesium
renal disease
adrenal insufficiency
increased intake
bone demineralization
CMās:
loss of deep tendon reflexes
bradycardia
muscle weakness
respiratory distress
skeletal smooth muscle contraction
excessive nerve functions
A convo between the three heads of the housesā¦
Ambassadors have been chosen! & an argument breaks out?
@/astrophile: Now that Academy Ambassadors have been picked, I can take a short breakā¦
@/JJJ000YYY: Are you kidding me. Why are they here too?
@/astrophile: Iām still a student here. I have every right to be here.
J: What happened to being busy?
A: I can take a break when I want to.
J: Oh? Why? The newbies tiring you out over elections? Or is it something else that you arenāt telling me.
A: My very capable Academy Ambassador, @/Theora, is keeping the common room warm right now, soā¦ I can afford to sit here from time to time.
J: I bet @/flyingCouch is doing a way better job than your ambassador. Mine did a thank you speech and everything.
A: Well, so did mine but you wouldnāt know that.
J: Oh? Were your votes unanimous too?
A: Noā¦ we still had to do phase two. There was almost a tie. I hate ties.
@/Spider-Hawk: Jordania, Luca! What is going on here?
A: I was trying to relax when thisā¦ thisā¦ person accosted me again !
J: Ha! We didnāt even have to go to a round two.
J: Luca is being a jerky jerkface is what.
A: Iām sure your student learned plenty about how to bribe the voters from you.
J: Whatās that supposed to mean? You dared me to become head student. I didnāt want to be in this position in the first place but no one else ran.
S: Luca isāthis is ridiculous. It doesnāt even matter how the elections came about.
A: Wellā¦ you knowā¦ the whole reason youāre even in The Order to begin withā¦ and the fact you have such aā¦ prestigious mentorā¦
J: Oh? So how did Crowsquill do? Did everything go swimmingly? (to Spider-Hawk)
J: I dare you to say that again. (to Luca)
A: Your family bribed the school. (To Jordina)
S: Of course! Crowsquill all voted for @/lst-my-shp-sil because we can work well together to get the best results.
S: Now I will not be having you two going around spreading rumors about each other! Didnāt you come here to relax?
J: Itās called generously donating to uphold the schoolās environment. We wouldnāt have a renovated courtyard if we hadnāt donated.
A: Wellā¦ she started it! I might as well end it.
J: You were the one that disappeared and didnāt explain anything!
A: Not everyone is as rich as your family.
A: I had important business to take care of.
S: Nevermind that. This is ending right here, or Iāll be calling Mervin to convince you.
J: Oh, so now you finally talk about what happened. You have to be kidding me. Couldnāt you have said that whenā¦ I donāt knowā¦ WHEN YOU CAME BACK?!?
A: Oh goshā¦ no. I donāt want to talk to your mentor.
J: For the love of Merlin, not Mervin.
A: All will be revealed in due time.ā¦ I should take my leave now. Too many eyes.
J: ā¦ whatever.
S: Alright, both of you go settle down on your own. Weāll talk about this another time
J: Fine, okay. We have to work on paperwork anyways. Care to help me?
S: Oh alright. At least then I can keep an eye on you. I donāt know whatās gotten into you lately.
J: Alright, letās go.
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Sadria not in the Greenhouse? 
Sadria not in the GreenHouse? o-o
J: Hey, Sadria. I brought some moreā¦ fertilizer? I donāt even know at this point.
Huh? Why is it locked? Is she doing something in there? Good thing Imelda gave me a key.
J: unlocks greenhouse door
J: Sadriaaaaaaa. Mervin gave me more of his weird fertilizer. I may have had a key to the greenhouse but I donāt for the place you lock this stuff up in.
J: Alright, sticking this in a corner it is.
Soā¦ if she didnāt lock herself inā¦ sheās not here? But sheās always here around this time.
J: Oh what the-- The plants look sick.
No! No. Jordania is not food. Down, er, plant.
@/flyingCouch: I think she usually locks it up when sheās not around so the plants donāt escape or something
J: Yeesh, you snuck up on me min-- ambassador. I know why she locks up but why isnāt she here?
F: maybe sheās with alix? They did profess their love the other day and the last I saw of her they were talking I think.
J: Yeesh, slacking off her duties is really not like her. These plants look like they havenāt been tended to for days.
F: Itās been 3 days since it was locked. Has she not been here since?
J: Looks like she hasnāt. If she has then sheās not caring for the plants. But she really loves the plants soā¦ I donāt think she would allow for that. Maybe. I actually donāt know her too well so like I got the impression she really likes her plants.
J: Alright, weāre heading out. Ambassador, come with me to Larksong. Weāre going to ask around.
J: locks greenhouse
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@lst-my-shp-sil whoops, didnāt mean to tag youā¦ goes to edit xD
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