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115 LEC > Ch.10 Fluid/Electrolytes > Flashcards

Ch.10 Fluid/Electrolytes Flashcards

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1
Q

Acidosis

A

an acid-base imbalance characterized by an increase in H+ concentration

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2
Q

Active transport

A

physiologic pump that uses energy to move fluid or electrolytes from one region to another

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3
Q

Alkalosis

A

an acid-base imbalance is characterized by a reduction in H+ concentration or an increase in bicarbonate concentration

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4
Q

Colloid

A

A fluid containing particles that are nonsoluable and evenly distributed throughout the solution

ALBUMIN

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5
Q

Colloid oncotic pressure

A

osmotic pressure created by the protein in the bloodstream

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6
Q

Crystalloid

A

a fluid containing soluble MINERAL IONS and water in a solution

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7
Q

Diffusion

A

the process by which solutes move from an area of higher concentration to one of lower concentration; does not require expenditure of energy

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8
Q

Homeostasis

A

maintenance of constant internal equilibrium in a biologic system

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9
Q

Hydrostatic pressure

A

the pressure created by the weight of fluid against the walls that contain it

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10
Q

Hypertonic solution

A

a solution with an osmolality higher than that of serum

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11
Q

Hypotonic solution

A

a solution with an osmolality lower than that of serum

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12
Q

isotonic solution

A

a solution with the same osmolality as blood

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13
Q

Osmolality

A

the number of milliosmoles per kilogram of solvent; espressed as milliosmoles per kilogram

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14
Q

osmolarity

A

the number of milliosmoles per liter of solution; expressed as milliosmoles per liter; describes the concentration of solutes or dissolved particles

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15
Q

Osmosis

A

the process by which fluid moves across a semipermeable membrane from an area of low solute concentration to an area of high solute concentration; process continues until equal concentrations

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16
Q

Tonicity

A

ability of solutes to cause an osmotic driving force that promotes water movement from one compartment to another

*most commonly refers to NaCl content of solution & how to compares to the physiologic fluid

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17
Q

A solution is a mixture of

A

SOLVENT, fluid medium and SOLUTES, which are particles

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18
Q

Plasma is composed of _____water and contains what solutes?

A

Plasma is 92% water + proteins, glucose, lipoproteins, and mineral ions (electrolytes)

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19
Q

an adult’s weight is how much fluid?

A

60%

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20
Q

What 2 compartments is body fluid located?

A

40% or 2/3’s in Intracellular space (in cells)
20% or 1/3 in Extracellular space (outside of cells)

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21
Q

*The extracellular compartment is further divided into what and %

A

3L -Intravascular (fluid within blood vessel)
11-12L - Interstitial (fluid surrounding cells/LYMPH)
1L - transcellular (outside epithelial membrane)

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22
Q

What is the fluid in the intravascular space?

A

plasma, which is 3 L of 6L of blood volume

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23
Q

What are examples of transcellular fluids?

A

cerebrospinal, pericardial, synovial, intraocular, pleural fluids, sweat, digestive secretions

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24
Q

What is third spacing?

A

Fluid is lost into a space in the body that does not contribute to equilibrium.

Accumulates within membrane-bound spaces such as the peritoneal cavity and pleural space

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25
Examples of third space fluid conditions
Ascites - fluid build up in abdomen Pleural effusion - fluid in lungs pericardial effusion - fluid around heart angioedema - fluid/swelling under skin
26
What is early evidence of third-space fluid shift?
^HR, decreased bp, decreased central venous pressure, edema, ^body weight. Decrease in urine output despite adequate fluid intake. / *kidneys receive less blood and attempt to compensate by decreasing urine
27
Cation Anion
Cation - positive charge Anion - negative charge
28
What are the major cations?
Sodium Potassium Calcium Magnesium Hydrogen ions
29
What are the major anions?
Chloride Bicarbonate Phosphate sulfate Negatively charged protein ions
30
Electrolyte concentration is expressed in
mEq - milliequivalents per liter, a measure of chemical activity *mEq - being equivalent to the electrochemical activity of 1 mg of hydrogen.
31
What is the major electrolyte in ICF and ECF? How does the body maintain these 2 electrolytes?
ICF - potassium ECF - sodium *Sodium potassium pump
32
Hydrostatic pressure pushes fluids Osmotic pressure pushed
Hydrostatic - pushes fluids OUT toward ICF Osmotic - pulls fluid INTO capillary from ICF
33
Crystalloid or colloid solutions can be used to temp replace blood or replenish fluid loss. What are examples of crystalloid solutions? What are examples of colloid solutions?
CRYSTALLOID - replace fluids Normal saline half normal saline Lactated ringers solution COLLOID - temp blood replacement Albumin hyper oncotic starch dextran
34
The tonicity of a solution can be used to *refers to the _____content of solution Physiologic fluid is ________
drive water movement between compartments to change the state of cellular hydration and cell size *refers to NaCl content of the solution **Physiologic fluid is 0.9% NaCl
35
Isotonic solution?
Isotonic solutions are 0.9% Nacl- same as bloodstream. Do not provoke water movement, just expand plasma volume of blood
36
Hypotonic solution Used for
Composed of less sodium chloride compared to blood. Less solute but more water than the bloodstream. Used to move water from ECF into ICF. Used to hydrate
37
Hypertonic solutions Used to treat
Composed of a greater concentration of NaCl compared to blood *Contains more solute and less water than blood /Pulls water from ICF to ECF =dehydration of cells Used for disorders of severe edema, cerebral edema (Sodium, glucose, mannitol)
38
Sodium potassium pump is powered by Performs ______transport
Powered by enzyme Na+K+ ATPase Performs active transport
39
What are organs of fluid loss
Kidneys Skin Lungs GI tract
40
In healthy adults, normal serum osmolality is
275 to 290 mOsm/kg
41
Serum osmolality primarily reflects Urine osmolality reflects
Serum - concentration of sodium Urine - urea, creatinine and uric acid
42
What is BUN and what is normal range
BUN - lab value that measures amount of urea in blood stream 10-20 mg/dL *can be increased in GI bleed, fever, sepsis *can decrease in end-stage liver disease, low protein diet, starvation
43
What is creatinine and what is normal level
Breakdown product of muscle metabolism - better indicator of renal funcation than BUN Normal - 0.7-1.4mg/dL *increases when renal function decreases
44
Hematocrit measures Normal values Conditions that increase Conditions that decrease
The % of red blood cells in the volume of whole blood *ranges from 42%-52% in men and 35%-47% in women -Dehydration and polycythemia can increase -Overhydration & anemia can decrease
45
Urine-specific gravity measures *normal range
the density of urine compared to water **measure the concentration of solutes in urine *one way to assess the kidney's ability to excrete or conserve water **1.005-1.030 1.005 is very higher in water content 1.030 is very concentrated
46
What are the organs involved in homeostasis?
Kidneys, heart, lungs, pituitary gland, adrenal gland, parathyroid glands
47
The kidneys filter how much plasma every day?
180 L of plasma
48
Major functions of the kidneys in maintaining normal fluid balance include:
-Reg of ECF volume & Osmolality by selective retention and excretion -Reg of electrolyte levels in ECF -Reg of PH in ECF -Excretion of metabolic waste and toxins
49
Major functions of the kidneys in maintaining normal fluid balance include:
-Reg of ECF volume & Osmolality by selective retention and excretion -Reg of electrolyte levels in ECF -Reg of PH in ECF -Excretion of metabolic waste and toxins
50
The hypothalamus manufactures ADH which is stored and used for?
- Stored in posterior pituitary gland - Released as needed to conserve water - acts on nephrons (causes increased reabsorption of water from tubules into bloodstream)
51
Increased secretion of aldosterone causes?
Sodium retention (thus water retention) and potassium loss
52
What is the function of the parathyroid glands?
regulate calcium and phosphate balance by means of PTH PTH influences reabsorption of calcium from bones into the bloodstream, calcium absoprtion from intestine and from renal tubules
53
What is Renini-Angiotensin-Aldosterone system
When kidneys sense low pressue they secrete Renin from juxta which triggers RAAS Renin converts angiotensinogen into angiotensin I which ACE converts into II. II stimulates peripheral vasoconstriction which ^BP. II also stims adrenal gland to secrete aldosterone = increase absorption sodium/water
54
Function of Osmoreceptors?
Located on hypothalamus Sense change in sodium concentration Talks to pituitary to release ADH to increase reabsoprtion
55
Function of Natriuretic peptides
Stimulated by stretching of heart: (high bp/volume) Inhibit aldosterone Inhibit renin and RAAS -Natriuresis(excrete sodium) -vasodilation *decrease water and sodium in circulatory = decreased bp ///direct opposite of RAAS
56
Define HYPOVOLEMIA
when loss of ECF volumes exceeds the intake -abnormal fluid losses (diarrhea, vomiting, gi suctioning, sweating, decreased intake, third-space shifts. Diabetes, adrenal insufficiency, osmotic diuresis, hemorrhage and coma
57
Define HYPOVOLEMIA
when the loss of ECF volumes exceeds the intake -abnormal fluid losses (diarrhea, vomiting, gi suctioning, sweating, decreased intake, third-space shifts, burns, Diabetes, adrenal insufficiency, osmotic diuresis, hemorrhage and coma
58
Signs and labs for hypovolemia
-Concentrated urine, cap refill prolonged, decreased BP, flattened neck veins, dizzy, weak, thirst, confusion, increased pulse, muscle cramps, sunken eyes, increased temp, cool, clammy pale skin ^Hg,^hct, ^serum and urine osmolality, decreased urine sodium, ^ BUN and creatinine
59
Signs and labs for hypervolemia
acute weight gain, edema, distended jugular veins, crackles, sob, ^bp, bounding pulse, ^RR, ^urine output Lab- decreased BUN & hematocrit *aldosterone is constantly stimulates
60
Hypervolemia refers to
Expansion of the ECF by abnormal retention of water and sodium
61
SODIUM Most abundant where? Range Role Regulated by affects body?
-Most abundant in ECF -135-145 mEq/L -Primary determinant of ECF volume and osmolality / Controlling water distrub in body -Reg by ADH, thirst, RAAS -Muscle contraction and transmission of nerve impulses
62
What is intravascular fluid
fluid inside the blood vessles contains plamsa
63
What is interstitial fluid
Fluid that surrounds the cells *Lymph
64
What is transcellular fluid?
cerebrospinal fluid, pericardial, synovial, intraocular, pleural, sweat, digestive fluids
65
How do lungs maintain fluid homeostasis?
remove approx. 300ml of water acid/base balance
66
Where is aldosterone secreted from?
Adrenal cortex
67
Cortisol produced in large quantities can cause?
sodium and fluid retention
68
ADH is manufactured where?
Hypothalamus
69
ADH is released for
in reaction to dehydration or blood loss tells kidneys to retain water
70
What does the parathyroid gland regulate?
calcium & phosphate
71
What is PTH
Parathyroid hormone - influences reabsorption of calcium from bones, intestine and renal tubules into the bloodstream
72
Where are the baroreceptors? and function
left atrium, carotid and aortic arches respond to changes in circulating blood volume reg para and sympthatetic, endocrine activity
73
Where is 98% of the bodies potassium?
inside the cells
74
WHat does potassium influence?
both skeletal and cardiac muscle activity
75
What alkalosis is present what does potassium do?
temp shift into the cells
76
What are 3 medications that can lead to hypokalemia?
corticosteriods sodium penicillin amphotericin B
77
Potassium deficit is related to stomach how
large amounts are in intestinal fluids
78
How does hyperaldosteronism affect potassium?
potassium is constantly secreted into the nephron and lost in urine
79
what are the clinical manifestations of hypokalemia?
flat T wave elevated U wave Metabolic alkalosis fatique, aneroxia, weakness, decreased bowels, arrhythmias
80
What are the major causes of hyperkalemia
decreased renal excretion of potassium rapid admin of potassium Acidosis commonly seen in patients with untreated kidney injury / also patients with hypoaldosterone or Addison disease
81
What is phase 1 of postanesthesia?
Immediate recovery Intensive nursing Transitions to inpatient or PACU
82
What is phase 2 of postanesthesia
prepared to transfer to inpatient or extended care or discharge
83
What are the indicators of hypovolemic shock/hemorrhage
Pallor Cool moist skin rapid respirations cyanosis rapid, weak thready pulse Decreased pulse pressure low BP concentrated urine

115 LEC (5 decks)

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