Ch 8: Altered Fluid and Electrolyte Flashcards Preview

Pathophysiology for PN > Ch 8: Altered Fluid and Electrolyte > Flashcards

Flashcards in Ch 8: Altered Fluid and Electrolyte Deck (47)
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1

Body fluids are solutions composed of:

▫️water
▫️electrolytes
▫️non electrolytes

2

Electrolytes:
▫️cations: Na+; K+; anions: Cl-

Nonelectrolytes - glucose, urea

3

Plasma proteins:

▫️Albumin
▫️globulins
▫️prothrombin
▫️fibrinogen

4

Intracellular proteins: large quantity

▫️Myoglobin
▫️Hormones
▫️NT
▫️Enzymes

5

Electrolytes Imbalances
🔘Major ions:

▫️sodium
▫️potassium
▫️chloride
▫️calcium
▫️magnesium
▫️phosphate

6

Variations in distribution of body fluids
▫️infants
▫️childhood
▫️adolescents
▫️adults
▫️elderly

▫️infants: 75-85% TBW
▫️childhood: 60-65%
▫️adolescence: similar to adults
▫️adults: lean and muscular frame 70%
Female 50%
Male 60%
Obese 40-45%
▫️elderly: 45%

7

Function of water:

▫️solvent/transporter of nutrients, gases and wastes
▫️cushioning
▫️major components of mucus
▫️body temperature regulation (evaporative heat loss)
▫️medium for chemical reactions

8

Function of electrolytes: concentration must be tightly regulated

▫️Na+ and K+ for action potentials along neurons and muscle cells (♥️ and brain)
▫️Zn, Cu and Mg2+ are co-factors for enzymes
▫️Ca2+ for blood clotting, muscle contraction, bone and teeth mineralization, and neurotransmission.

9

Water movement occurs by osmosis- passive transport

▫️Na+
▫️Albumin

10

Hormonal Regulation of fluid and electrolytes:

▫️ADH (act on kidneys ⬆️H20 absorption)
▫️Aldosterone (stimulates reabsorption of Na+ as well as secretion of K+ and H+)
▫️ANP-Atrial natriuretic peptide (Adrenal medulla inhibits aldosterone release)

11

Body fluids are divided between two main compartments:

▫️ICF - fluid inside cells, about 1/2 to 2/3 of total body fluids
Helps maintain cell shape. Assists with transport of nutrients across cell membrane, in and out of the cell.
Major ions are: K+, Mg and phosphate (and proteins)

▫️ECF -fluid outside cell, 1/3 of body fluid. Mostly as interstitial fluid and intravascular (plasma).
Major ions are: Na+, Cl- and carbonate

12

The watery fluid in blood known as plasma

Intravascular fluid

13

The volume of ECF is the most important regulated aspect of body fluid balance. Without adequate ECF, the body cannot maintain _______

Normal blood pressure

14

Too much ECF can place a person in a fluid overload state, leading to a ______

HBP and risk for CHF

15

_____is the fluid that is that is most important in fluid balance

ECF

16

Factors which move fluid from plasma to interstitial space:

▫️blood hydrostatic pressure
▫️increased capillary permeability (inflammation)

17

Factors which move fluid from interstitial space to plasma:

▫️Blood osmotic pressure
- plasma proteins, mainly albumin

18

Excess fluid in interstitial space

▫️Edema

19

Mechanism involved in the development of edema can also lead to:

▫️third-space shifts

20

Fluid in the peritoneal cavity

Ascites

21

Fluid in interstitial space of respiratory or in alveoli

Pulmonary edema

22

Fluid in pleural space

Pleural effusion

23

Fluid in the pericardial space

Pericardial effusion

24

Four major processes in the development of edema

1. Increase in capillary hydrostatic pressure
2. Increase in capillary permeability
3. decrease in colloid onconic pressure (loss of albumin)
4. Obstruction in lymphatic drainage

25

Consequences of edema:

▫️increased distance for diffusion of nutrients, oxygen, and wastes between tissue cells and circulatory system
▫️compression of nerves, blood vessels, other hollow tubes
▫️can be disfiguring

26

Alteration in fluid and electrolyte balance

▫️sodium imbalance - hyponatremia and hypernatremia
▫️negative fluid balance - hypovolemia

27

Causes of Dehydration:

▫️⬇️fluid intake
▫️⬆️fluid output (heat exposure/ heavy exercise)
▫️extreme Na+ loss or lack of Na+ intake (hyponatremia)
▫️excessive Na+ intake (hypernatremia)
▫️fluid shift between compartments
▫️SIADH-syndrome of inappropriate antidiuretic hormone secretion

28

Manifestation of Dehydration:

▫️thirst
▫️dry mucous membranes
▫️decreased or absent tears
▫️change in vital signs
⬆️ respiration rate
⬇️ blood pressure
Weak pulse
▫️prolonged capillary refill time
▫️depressed fontanels
▫️⬇️ or absent urine output
▫️⬇️level of consciousness

29

Attempts to compensate for fluid loss:

▫️⬆️ing thirst
▫️⬆️ing ♥️ rate
▫️constriction of cutaneous blood vessels
▫️producing less urine
▫️concentrating urine

30

Dehydration treatment:

▫️rehydration
Oral
Intravenous
▫️correction of electrolyte imbalances