Ch 8: Altered Fluid and Electrolyte Flashcards by Lysza Sabanal

Body fluids are solutions composed of:

▫️water
▫️electrolytes
▫️non electrolytes

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Electrolytes:

▫️cations: Na+; K+; anions: Cl-

Nonelectrolytes - glucose, urea

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Plasma proteins:

▫️Albumin
▫️globulins
▫️prothrombin
▫️fibrinogen

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Intracellular proteins: large quantity

▫️Myoglobin
▫️Hormones
▫️NT
▫️Enzymes

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Electrolytes Imbalances

🔘Major ions:

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

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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%

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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

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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.

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Water movement occurs by osmosis- passive transport

▫️Na+

▫️Albumin

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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)

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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

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The watery fluid in blood known as plasma

Intravascular fluid

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

Normal blood pressure

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

HBP and risk for CHF

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

ECF

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Factors which move fluid from plasma to interstitial space:

▫️blood hydrostatic pressure

▫️increased capillary permeability (inflammation)

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Factors which move fluid from interstitial space to plasma:

▫️Blood osmotic pressure

- plasma proteins, mainly albumin

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Excess fluid in interstitial space

▫️Edema

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

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▫️third-space shifts

Fluid in the peritoneal cavity

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Ascites

Fluid in interstitial space of respiratory or in alveoli

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Pulmonary edema

Fluid in pleural space

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Pleural effusion

Fluid in the pericardial space

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Pericardial effusion

Four major processes in the development of edema

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Increase in capillary hydrostatic pressure
Increase in capillary permeability
decrease in colloid onconic pressure (loss of albumin)
Obstruction in lymphatic drainage

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

Alteration in fluid and electrolyte balance

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

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

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 ```

Attempts to compensate for fluid loss:

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

Dehydration treatment:

▫️rehydration Oral Intravenous ▫️correction of electrolyte imbalances

Causes of hyponatremia:

``` ▫️losses from excessive sweating, vomiting, diarrhea ▫️use of certain diuretic drugs combined with low-salt diets ▫️hormonal imbalances 🔸insufficient aldosterone 🔸adrenal insufficiency 🔸excess ADH secretion ▫️Diuresis ▫️Excessive water intake ```

Effects of hyponatremia:

▫️low Na+ levels ▫️decreased osmotic pressure in ECF compartment

▫️cause is balance in Na+ and water 🔸insufficient ADH (diabetes insipidus) -results in large volume of dilute urine 🔸loss of the thirst mechanism 🔸watery diarrhea 🔸prolonged periods of rapid respiration 🔸ingestion of large amounts of sodium without enough water.

Hypernatremia

Effects of hypernatremia..

``` ▫️weakness, agitation ▫️dry, rough mucous membranes ▫️edema ▫️⬆️thirst ▫️⬆️ BP ```

K+ has two main roles:

1. Nerve impulse conduction and muscle contraction | 2. Maintain acid-base balance

Acidemia leads to ______ Alkalemia leads to ______

Hyperkalemia Hypokalemia

Common causes of hyperkalemia:

▫️released from ICF to ECF 🔺injury to cells: burns, trauma 🔺acidosis ▫️inadequate elimination 🔺kidney failure: no longer able to excrete K+ ions ▫️excessive intake 🔺K+ supplements or too much dietary K+ 🔺use of salts substitutes (contain K+) ▫️K+ sparring diuretics ▫️deficit of aldosterone

Common causes of Hypokalemia:

▫️excessive losses 🔺vomiting, diarrhea 🔺abnormal loss through kidneys: diuretics or tubular disease. ▫️Excessive aldosterone or glucocorticoids (I.e. Cushing syndrome) ▫️Decreased dietary intake 🔺alcoholism, eating disorders, starvation ▫️treatment of diabetic ketoacidosis with insulin (insulin causes increased K+ uptake by the Na+ pump)

Effects of hypercalcemia

▫️depressed neuromuscular activity ▫️interference with ADH function ▫️Increased strength in cardiac contractions

Four main functions of Magnesium

1. enzyme activity [co-factor] 2. energy production and ATP - cofactor 3. DNA and RNA protection and repair 4. Mineral balance - regulates other ions

▫️results from malabsorption or malnutrition often associated with alcoholism ▫️use of diuretics, diabetic ketoacidosis, hyperthyroidism, hyperaldosteronism

Hypomagnesimia

▫️Occurs with renal failure ▫️depresses neuromuscular function ▫️decreased reflexes

Hypermagnesemia

Numerous phosphate functions

▫️ bone and tooth mineralization ▫️important in metabolism of ATP ▫️phosphate buffer System - acid base balance ▫️integral part of the cell membrane ▫️reciprocal relationship with serum calcium

Malabsorption syndromes, diarrhea, excessive antacids

Hypophosphatemia

This phosphate imbalance is caused by renal failure... others: hypocalcemia,

Hyperphosphatemia

Chloride imbalance usually associated with alkalosis. 🔺early stages of vomiting - loss of hydrochloric acid

Hypochloremia

Is an excessive sodium chloride intake

Hyperchloremia

Ch 8: Altered Fluid and Electrolyte Flashcards

(47 cards)