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med-surg > Fluid and Electrolytes > Flashcards

Fluid and Electrolytes Flashcards

1
Q

Body fluid composition = ___ % of body weight

A

50-60%

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2
Q

Body fluid composition consists of

A

water, electrolytes, glucose, urea, creatinine

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3
Q

What is in the intracellular fluid

A

potassium, phosphate, protein, magnesium

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4
Q

What is in extracellular fluid

A

plasma (intravascular fluid), interstitial fluid (between cells or tissues), transcellular fluid (cerebral, peritoneal, synovial)

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5
Q

Water balance exists when . . .

A

total water intake and total water loss are equal

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6
Q

what mechanism maintains water balance

A

homeostatic

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7
Q

An average adult living in a moderate environment takes in about how many ml of water

A

2500 ml

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8
Q

How does the nervous system regulate fluid balance?

A

the hypothalamus - thirst and renal excretion

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9
Q

How do arterial baroreceptors regulate fluid balance?

A

when arterial bp decreases the SNS responds with vasoconstriction; vasoconstriction of renal arteries = a decreased GFR which = reduced urine output which means an increased blood volume

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10
Q

How does the endocrine system regulate fluid balance?

A

adrenocorticotropic hormone (ACTH)
antidiuretic hormone (ADH or vasopressin) and renin-angiotensin-aldosterone system

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11
Q

What is osmolality?

A

An estimation of the osmolar concentration of plasma, is expressed as mmol/kg

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12
Q

What is normal range for serum osmolarity?

A

280-330 mmols/kg

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13
Q

What are crystalloid solutions?

A

Saline and dextrose solutions

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14
Q

What are examples of colloids?

A

blood, plasma, albumin, synthetics (such as dextron)

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15
Q

Clinical signs of fluid volume deficit

A
  • decrease skin and tongue turgor
  • decreased moisture in mouth (dry mucous membranes)
  • severe body fluid loss marked by hematocrit, hemoglobin, creatinine, and BUN are elevated
  • decreased urinary output
  • specific gravity of urine increased
  • postural hypotension - drop in systolic bp of 20mmHg accompanied by tachycardia
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16
Q

what is normal specific gravity of urine?

A

1.010 - 1.020

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17
Q

Causes of fluid volume excess

A

increased retention of Na and water and/or decreased excretion of Na and water

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18
Q

What is increased retention of Na and water caused by

A

HF, liver failure, nephrotic syndrome, glucosteroids, SIADH

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19
Q

What is decreased retention of Na and water caused by

A

renal failure

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20
Q

What causes edema in fluid volume excess?

A

accumulation of fluid in the interstitial space - when there is excess in volume, fluid pressure is greater than the colloidal osmotic pressure, therefore more fluid is pushed into the interstitial spaces

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21
Q

increase in hydrostatic pressure in capillaries forces fluid into the interstitial spaces which can occur because of a

A

mechanical blockage

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22
Q

decrease plasma colloid osmotic pressure from decrease protein content of places leads to fluid flowing from ____ to ____

A

plasma to interstitial spaces

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23
Q

increase permeability of capillaries allows protein to seep into the ____ ____ and create an ____ pull

A

interstitial spaces; osmotic pull

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24
Q

What are hypertonic fluids used to treat and why?

A

symptomatic hyponatremia b/c they have a heavier solute volume

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25
Q

Why are hypotonic fluids used?

A

Gives more water than electrolytes

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26
Q

what does isotonic mean?

A

osmotic equilibrium; osmolarity of ICF and ECF are the same means no movement of water

27
Q

What is the typical fluid requirement for adult per day?

A

35ml/kg/day

28
Q

why are electrolytes important

A

enzyme activities, muscle contraction, and metabolism

29
Q

What are the extracellular ions

A

sodium, chloride, calcium

30
Q

what are the intracellular ions

A

potassium, magnesium, phosphorus

31
Q

Normal sodium

A

135-145

32
Q

Normal potassium

A

3.5-5.0

33
Q

Normal calcium

A

2.14 - 2.66

34
Q

Normal magnesium

A

0.70 - 1.10

35
Q

Normal chloride

A

95 - 105

36
Q

Normal phosphorus

A

0.8 - 1.6

37
Q

What is the most abundant extracellular cation

A

sodium

38
Q

What is sodium responsible for

A

amount of water retained or excreted

39
Q

what is sodium required for

A
  • transmission of impulses across muscles and nerves
  • important in acid-base balance
40
Q

what does sodium combine with to increase or decrease pH

A

combines with chloride to increase, bicarb to decrease

41
Q

what is sodium maintained by

A

GFR and the release of aldosterone

42
Q

changes in sodium levels alter ____ ____

A

water balance

43
Q

low sodium causes kidneys to activate the __________ system

A

renin-angiotensin aldosterone system

44
Q

excessive sodium is excreted by the ____

A

kidneys

45
Q

what is the most abundant anion in ECF

A

chloride

46
Q

chloride works with ____ to regulate body fluids through osmotic pressures

A

sodium

47
Q

acid base balance requires that ____ is in balance with ____ and ____

A

sodium; chloride; bicarb

48
Q

Potassium is a major intracellular

A

anion

49
Q

why is close monitoring of potassium important

A

b/c the body is intolerant to abnormal levels

50
Q

what is potassium vital in

A

cardiac and neuromuscular function b/c it affects muscle contraction

51
Q

abnormal levels of ____ are the most common electrolyte imbalance in the high acuity patient

A

potassium

52
Q

Magnesium ensures ____ and ____ transport across cell membranes

A

sodium and potassium

53
Q

what magnesium required for

A

protein and carbohydrate metabolism

54
Q

magnesium is important in

A

nerve cell conduction, transmitting CNS messages, and maintaining neuromuscular activity

55
Q

phosphate is contained in

A

bone

56
Q

phosphate is involved in

A

energy metabolism

57
Q

phosphate has an inverse relationship with

A

calcium

58
Q

loss of phosphate =

A

diuresis, malabsorption, overuse antacids

59
Q

increased phosphate =

A

renal failure, increased serum calcium

60
Q

most calcium is located in ____

A

bone

61
Q

Calcium is required for

A

blood coagulation, neuromuscular contraction, enzymatic activities, and bone integrity

62
Q

serum calcium levels are maintained by ____

A

kidneys excretion, GI absorption, and bones (mobilization)

63
Q

calcium is absorbed in intestines only in the presence of

A

vitamin D

med-surg (15 decks)

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