Chapter 17 Fluids: Med Surg Flashcards Preview

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Flashcards in Chapter 17 Fluids: Med Surg Deck (56):
1

what does water content vary with?

gender, age, body mass

2

percentage of body weight of water greater in men or women?

men

3

who would have more water content as compared to body weight?

infants 70%-80%

4

intracellular fluid

2/3 of body water and 40% of body weight

5

extracellular fluid

1/3 of body water, consisits of intravascular, interstitial and transcellular spaces

6

intravascular space

1/3 of ECF located here as plasma

7

interstitial space

2/3 of ECF

8

transcellular space

1 L of ECF; CSF, fluid in GI, pleural, synovial, peritoneal fluid

9

why is body water needed?

fluids are in constant motion and transport nutrients, electrolyes, oxygen, regulate temperatures, lubricate joints and membranes, and aids digestion

10

how much does 1 L of fluid weigh?

2.2 kg

11

electrolytes

molecules dissociate (split into ions) when placed in water

12

ions

electrically charged particles

13

cations

positive charged ions

14

anions

negative charged ions

15

valence

electrical charge of an ion

16

ECF cation

sodium

17

ECF anion

chloride

18

ICF cation

potassium

19

ICF anion

phosphate

20

diffusion

movement of molecules from an area of high concentration to one of low concentration; membrane must be permeable; no energy

21

facilitated diffusion

same as diffusion, but some molecules diffuse slowly into the cell and need some help so a carrier molecule accelerates the rate; no energy

22

active transport

molecules move against the concentration gradient, external energy is required; e.g. sodium potassium pump: potassium in and sodium out

23

osmosis

water movement through a semipermeable (favors water not solutes) membrance from an area of low solute concentration to an area of high solute concentration; no external energy, stops when equal

24

osmolality

describes fluids (water balance) inside the body, typically performed to evaluate the concentration of plasma in urine

25

normal plasma osmolality

275-295

26

increased plasma osmolality

concentration is too high or water is too low aka water deficit -> dehydrated

27

decreased plasma osmolality

concentration is too low or water is too high aka water excess

28

major determinant of plasma osmolality

sodium and glucose

29

ECF and ICF are:

isotonic to each other, hence no movement of water occurs and no gain or loss of water occurs although ECF expands e.g. lactated ringers, 0.5% saline

30

if the cell is surrounded by hypotonic fluid:

water moves into the cell and causes it to swell and possibly burst ECF -> ICF e.g. 0.45% saline

31

if the cell is surrounded by hypertonic fluid:

water leaves the cell to dilute the ECF and the cell shrinks and may eventually die ICF -> ECF e.g. 3% saline

32

hydrostatic pressure

force within the fluid compartment, blood pressure generated by the contaction of the heart and pushes water out of the vascular system

33

oncotic pressure

osmotic pressure exerted by colloids in solution, pulls fluid from the tissue space to the vascular space

34

major colloid

protein, which does not dissolve completely since they are too large of molecules

35

what two pressures move water into the capillaries?

plasma oncotic pressure and interstitial hydrostatic pressure

36

what two pressures move water out of the capillaries?

capillary hydrostatic pressure and interstitial oncotic pressure

37

first spacing

normal distribution of fluid in ECF and ICF

38

second spacing

abdnormal accumulation of interstitial fluid (edema)

39

third spacing

fluid accumulates in a portion of the body (transcellular fluid) from which it is not easily exchanged with the rest of the ECF, not functional e.g. ascites, edema with burn, trauma

40

how does the hypothalamus, pituitary, and adrenal cortex respond in water regulation?

the hypothalamus recognizes a fluid deficit and increases plasma osmolality sending osmoreceptors to the posterior pituitary and releasing ADH, which acts in the distal tubules to cause water reabsorption

41

decreased ADH

diabetes insipidus

42

increased ADH

SIADH

43

dextrose solutions

osmolarity changes once dextrose is metabolized

44

at the arterial end of the capillary:

capillary hydrostatic pressures exceeds plasma oncotic pressure, which draws fluid into interstitium (EDEMA)

45

at the venous end of the capillary:

capillary hydrostatic pressure is lower than plasma oncotic pressure and fluid is drawn back into the capillary

46

glucorticoids

cortisol, which has an antiinflammatory effect and increases glucose levels

47

mineralocorticoids

aldosterone, which enhances sodium retention and potassium excretion

48

primary organ that controls f&e balance

kidneys

49

insensible water loss

600-900 mL lost a day, ONLY water, sweating is sensible perspiration and causes f&e loss

50

how do you calculate fluid requirement for a pediatric patient?

convert weight to kg, 100 mL/kg for first 10 kg, 50 mL/kg for second 10 kg, and 20 mL/kg for the remainder of weight. IF ASKED FOR IN ML/HR SIMPLY DIVIDE ANSWER BY 24

51

fluid volume deficit

restless, drowsy, thirst, decreased skin turgot and capilarry refill, increased pulse, decreased urine, increased respirations, weight loss

52

fluid volume excess

headache, edema, venous distention, bounding pulse, increased blood pressure, dyspnea, crackles, muscle spasms, weight gain

53

assess neurologic fx

LOC, pupillary response to light and equality of size, voluntary movement of extremities, degree of muscle strength, reflexes

54

assess skin turgor where?

clavicle!

55

first signs of deficit:

tachycardia, decreased blood pressure, increased respirations

56

late signs of deficit:

hypotension and decreased capillary refill