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Level III - NCM 112: MEDICAL SURGICAL NURSING > FLUIDS AND ELECTROLYTES - First Topic > Flashcards

FLUIDS AND ELECTROLYTES - First Topic Flashcards

1
Q

What is the percentage of water to body weight of an adult?

A

60%

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2
Q

What is the percentage of water to the bodyweight of an older adult?

A

45-55%

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3
Q

What is the percentage of water to bodyweight of a newborn?

A

70-80%

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4
Q

What is the percentage of water to bodyweight of an embryo?

A

97%

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5
Q

What are changes in fluids when the person is becoming old?

A 
Fluid changes with aging
 Skeletal muscle mass declines
Proportion of fat increases
Water content drops to 45% at age 60
Distribution changes
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6
Q

The percentage of extracellular fluids in the total body weight is?

A

20

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7
Q

The percentage of intracellular fluids in the total body weight is?

A

40

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8
Q

What are the functions of body water?

A 
Transportation
Excretion
Regulation
Lubrication
Medium
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9
Q

What is the movement of fluids and solute at the cellular level?

A

Osmosis
Diffusion
Active Transport?

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10
Q

Define osmosis.

A

The movement of fluids from a lower solute concentration to a higher solute concentration

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11
Q

Define diffusion.

A

the movement of
molecules/solutes across a selectively permeable membrane along with their own pathway, irrespective of all other molecules

The smaller ones move faster than the larger ones.

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12
Q

Define active transport.

A

Movement of solute from lower concentration to higher concentration using energy. (ATP)

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13
Q

The part of the vascular system which has walls thin enough to let
solutes through?

A

Capillaries

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14
Q

Define capillary filtration.

A

Results from the hydrostatic pressure and the oncotic pressure in the capillaries.

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15
Q

Define hydrostatic pressure.

A

Force exerted by the fluids same as the cardiac output etc.

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16
Q

Define hydrostatic pressure concentration gradient.

A

The difference in HP in the vascular and the interstitial allows the fluid tp flow among compartments.

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17
Q

Define plasma colloid osmotic pressure.

A

Force exerted by the proteins such as the albumin to keep the fluids inside the vascular system.

The pulling force.

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18
Q

What are the four measurable fluid that allows the flow of fluid between the intravascular and interstitial spaces

A

The colloid osmotic pressure in the vessel.
The hydrostatic pressure in the vessel.
The colloid osmotic pressure in the tissue spaces.
The hydrostatic pressure in the tissue spaces.

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19
Q

What is insensible respiration?

A

Body water loss by
diffusion through the skin that is immeasurable
and independent of sweat gland and activity.

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20
Q

What is sensible respiration?

A

Sweat gland activity occurs as caused by heat and activity.

Measurable.

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21
Q

Identify the regulators of fluid balance.

A

Electrolytes
Non-electrolytes
Hormones and enzymes
Body tissues and organs

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22
Q

What are the electrolytes?

A 
Sodium
Potassium
Magnesium
Chloride 
Bicarbonate
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23
Q

What are non-electrolytes?

A

Protein - albumin
Urea
BUN

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24
Q

What is the function of sodium?

A

Allows water retention.
Most common electrolyte.
With a water deficit, less sodium is excreted via kidneys,
thus, more water is retained.

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25
Q

What happens when the hydrostatic pressure is greater than the osmotic pressure?

A

Fluid goes out of intravascular space to the interstitial space.

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26
Q

What happens when the osmotic pressure is greater than the H pressure?

A

Fluid goes in the intravascular space from the interstitial space.

If plasma colloid osmotic pressure exceeds
hydrostatic pressure, water and solutes return to capillaries

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27
Q

Who proposed the startling law?

A

Earnest H. Starling

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28
Q

Define the startling law.

A

equilibrium exists at the
capillary membrane when the fluid leaving circulation
and the amount of fluid returning to circulation are
exactly equal.

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29
Q

What is the ADH?

A

Hormone that promotes water reabsorption from

the distal tubules of the kidneys.

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30
Q

Where is ADH produced and stored?

A

Hypothalamus and posterior pituitary respectively.

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31
Q

How is the process of water retention by the ADH done?

A

Produced in hypothalamus and stored in posterior pituitary. This goes to the kidney which promotes water retention in the distal tubule.

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32
Q

What is the function of aldosterone?

A

Promotes sodium, chloride, and water

reabsorption from the renal tubules.

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33
Q

Where is aldosterone made?

A

Adrenal cortex

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34
Q

How is aldosterone made?

A

Decreased BF in glomerulus - juxtaglomerular cell secretes renin - goes to the liver becomes angiotensin I - goes to the lungs becomes angiotensin II - goes to the adrenal glands - makes aldosterone.

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35
Q

How does aldosterone works?

A

Aldosterone causes the kidneys to retain water and Na+ - increase fluid volume and Na+ levels.

36
Q

What happens in the decreased renal blood flow?

A

Increase in renin production.

37
Q

What is atrial natriuretic peptide?

A

Cardiac hormone stored in atrial cell.

38
Q

When is atrial natriuretic peptide released?

A

Released when atrial pressure increases.

39
Q

What is the action of atrial natriuretic peptide?

A 
Suppresses serum renin levels
Decreases aldosterone release
Increases glomerular filtration
Decreases ADH release
Causes vasodilation
40
Q

How does lymphatics help in fluid retention?

A

Collects the fluid in the intravascular space and return to circulation.

41
Q

How does skin help in fluid balance?

A

Excretes approximately 300-500 ml of

water daily through normal perspiration

42
Q

How does lungs help in fluid balance?

A

Excrete approximately 400-500 ml of

water daily through normal breathing

43
Q

How does kidney help in fluid balance?

A

Filter blood, produce urine, excrete excess water, and constantly work to maintain fluid balance

44
Q

What is the amount that kidney secretes everyday?

A

1000-1500 ml of body water daily.

May vary depending on fluid balance intake and output.

45
Q

Define the function of glomerulus.

A

Cluster of capillaries that filters blood.

46
Q

Define the function of tubule

A

Ends in collecting duct

47
Q

True or false:

A

Depending on body’s needs, water and electrolytes either excreted or retained along tubule.

48
Q

What is the filtrate from kidney function?

A

Resulting filtrate eventually flows into the

bladder as urine

49
Q

What is the glomerular filtration rate?

A

Normally, about 125 ml

of blood every minute, or about 180 L/day

50
Q

What is the daily urine amount?

A

1-2 L/day

20-30 cc/hour

51
Q

What is homeostasis?

A

Dynamic internal balance.

52
Q

What is osmolality?

A

The pull exerted by all particles per unit of water.

53
Q

How is osmolality determined?

A

determined by the number of
dissolved particles e.g. sodium, urea, and glucose per
kilogram of water

54
Q

Hyper - osmolar measurement?

A

A solution containing >295 mOsm of solutes.

55
Q

Hypo - osmolar measurement

A

A solution containing <280 mOsm of solutes

56
Q

Iso - osmolar measurement?

A

A solution containing between 280 - 295 mOsm of solutes.

57
Q

Difference between osmolality and tonicity?

A

Osmolality is the concentration of body fluids and tonicity is the effect of fluid on cellular volume.

58
Q

What is the unit of osmolality?

A

Osmols

A milliosmol or mOsm is 1/1000th of an osmol and will determine the osmotic activity.

59
Q

How is the serum osmolality is determined?

A

In serum, sodium, urea, and glucose are the most plentiful solutes and are the major contributors of serum osmolality.

60
Q

The normal serum

osmolality range is _____?

A

280-295 mOsm/kg or milliosmols

per kilogram

61
Q

What is the formula to estimate the osmolality?

A

Double the serum sodium.

62
Q

What is the formula to accurately determine the osmolality?

A

2 x serum Na+ (BUN/3) + (Glucose/18) = Serum osmolality

63
Q

What is the relationship of the hydroxyl ions and hydrogen ions in relation to acid-base balance?

A

The OH- and H+ is inversely proportional.

High H+ = low OH+, increased acid
High OH+ = low H+, solution is more base

64
Q

What is the neutral pH?

A

A solution of pH 7 is neutral since at this
concentration the number of hydrogen ions is exactly balanced by the number of hydroxyl ions. It should be noted that being balanced does not mean that the hydrogen and hydroxyl ions are of the same concentration

65
Q

Define the types of IV fluids.

A
  • Isotonic
  • Hypotonic
  • Hypertonic
66
Q

Define isotonic solutions.

A

Have equal solute concentrations
• In adjacent compartments, result in no net fluid shift
• Example: Normal Saline solution, Lactated Ringer’s solution

67
Q

Normal Na+ level

A

135-145 mL

68
Q

What does milligram measure?

A

Measure the weight of ions and give no information concerning the number of ions or the electrical charges of the ions.

69
Q

What does milliequivalent measure?

A

Measure the chemical activity of ions; provide a better method of measuring the concentration of ions in the serum than milligrams.

70
Q

What is a protein?

A

A nitrogenous compound, essential to all living organisms.

71
Q

What is the content of plasma protein?

A

Relates to albumin, globulin, and fibrinogen.

72
Q

What is the content of serum protein?

A

Relates to albumin and globulin.

73
Q

What is the content of serum albumin?

A

Constitutes about 50%

of the blood protein.

74
Q

What is the characteristics of hypotonic solution?

A

Have lower solute concentrations than other solutions
• In adjacent compartments, result in fluid shifting from the compartment with the lower concentration to the compartment with the higher concentration
• Example: half-normal saline solution,
D5W

75
Q

Half-normal saline solution is indicated for ________?

A

Indication: For replacement of fluids and electrolytes

76
Q

D5W solution is indicated for ________?

A

Indication: For fluid and caloric maintenance

77
Q

What is the characteristics of hypertonic solution?

A

Have higher solute concentrations than other solutions
• In adjacent compartments, result in fluid shifting from the compartment with the lower concentration to the compartment with the high concentration

78
Q

Provide IV fluids that are hypertonic solutions.

A

D5 0.3 NaCl: For replacement and maintenance of fluid and electrolyte.

D5 Lactated Ringer’s: For replacement of fluids and electrolytes.

Balanced solution (D5NM): Every 100 ml contains 5 grams of Dextrose monohydrate

10% Dextrose in water (D10W): For fluid and caloric maintenance

Mannitol: Osmotic diuresis

Peritoneal Dialysis solution with 1.5% Dextrose: For use in peritoneal dialysis

79
Q

Define membrane

A

A layer of tissue separating spaces or covering a surface or organ

80
Q

Define permeability.

A

A capability of a substance, molecule, or ion to diffuse through a
membrane.

81
Q

Define osmolarity.

A

Osmotic pull exerted by all particles per unit of solution, expressed as osmols or mOsm/L of solution.

82
Q

Define plasma.

A

Contains blood minus the blood cells.

83
Q

Define serum.

A

Consists of plasma minus fibrinogen.

84
Q

What is the function of osmoreceptor?

A

detects changes in
osmotic pressure or the concentration of body
fluids

85
Q

True or false: Hypothalamus and kidneys which sends signals thirst center; contributes to sense of thirst in hind brain and mid brain, most importantly the
hypothalamus.

A

True.

86
Q

What is hormones?

A

Chemical messengers secreted by ductless glands directly into the bloodstream carried to the organ to carry out their function.

87
Q

What is the unit of kidney?

A

Nephron

Level III - NCM 112: MEDICAL SURGICAL NURSING (4 decks)

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