Fluid Balance Flashcards

1
Q

filtration

A

liquids moved by pressure (ex: COP, hydrostatic pressure)

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2
Q

normal serum osmolarity

A

275-295 mOsm/kg

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3
Q

hyperosmolarity

A

> 295 mOsm/kg

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4
Q

hypoosmolarity

A

<275 mOsm/kg

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5
Q

osmolarity affects

A

tonicity

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6
Q

osmotic pressure

A

pressure needed to prevent osmosis through a semipermeable membrane
-proportional to the osmolarity of a solution

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7
Q

hypotonic solutions

A

lower osmotic pressure than blood-fluid goes into the ICF and causes cell swelling
-1/2 normal saline
-2.5 dextrose

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8
Q

hypertonic solutions

A

higher osmotic pressure than blood-fluid goes into the ECF and causes cell shrinkage
-5% dextrose normal saline
-5% dextrose lactated ringer

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9
Q

fluid is balanced through:

A

thirst, RAAS, ADH, ANP

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10
Q

renin-angiotensin-aldosterone system (RAAS)

A

decreased perfusion to kidneys>kidneys release renin>renin and angiotensinogen makes angiotensin I>in lungs becomes angiotensin II>angiotensin II makes adrenal cortex (kidney) release aldosterone>aldosterone tells kidney to reabsorb Na+ and excrete K+>water follows Na+ into ECF

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11
Q

hyperaldosteronism causes:

A

too much water because of an excessive amount of Na+

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12
Q

antidiuretic hormone (ADH)

A

secreted by posterior pituitary from increased osmolarity in blood
-increases water retention/ECF water volume

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13
Q

atrial natriuretic peptide (ANP)

A

released by atria, decreases water retention
-inhibits renin secretion
-blocks secretion/action of aldosterone (less Na+ absorption, less water)

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14
Q

total gains/losses of fluid in body

A

2500mL in, 2500mL out

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15
Q

hypovolemia causes

A

excessive fluid losses
-ex: GI losses, hemorrhage, excessive NG suctioning,
inadequate fluid intake
-ex: dysphagia, unconsciousness, reduced thirst sensation, lack of fluids with tube feedings
third-spacing
ex: burns, intestinal obstruction, edema, ascites

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16
Q

hypovolemia manifestations

A

decreased vascular volume
-ex: hypotension, shock, tachycardia
increased serum osmolarity
-ex: thirst, increased hematocrit+blood urea nitrogen
ADH compensation
-ex: decreased urine output, increased osmolarity
impaired body temperature regulation
-ex: fever

17
Q

hypovolemia treatment

A

oral/parenteral fluids, blood (from hemorrhage), antidiarrheals (from diarrhea), antiemetics (from vomiting), vasopressors (for hypovolemic shock)

18
Q

hypervolemia causes

A

inadequate Na+ and water elimination
-ex: heart failure, renal failure, hyperaldosteronism, liver failure
excessive Na+ and water intake

19
Q

hypervolemia manifestations

A

increased ECF, edema, increased vascular volume
-ex: full, bounding pulse, pulmonary edema, shortness of breath, dyspnea (difficulty breathing), crackles+cough, venous distension (bulging)

20
Q

capillary fluid exchange

A

fluid filtered out of capillary into interstitium at arterial end>most fluid is reabsorbed at venous end>rest goes into lymphatics and returns to circulation
-hydrostatic pressure=PUSH
-COP=PULL

21
Q

edema

A

excessive fluid in interstitial space (ECF)
-increased COP “pull”
-decreased hydrostatic “push”
-increased capillarity permeability (proteins leak out, fluid drowns in)
-decreased or obstructive lymph flow
-localized or generalized
-pitting or non-pitting

22
Q

third-spacing

A

excess ECF fluid in body cavities
-ex: ascites (peritoneal), pleural effusion, pericardial effusion

23
Q

hypervolemia treatment

A

restrict fluid/Na+ intake
-serious: O2 therapy, morphine, intravenous diuretics, ventilation