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Nurs316-Unit 3 > Chapter 8 > Flashcards

Chapter 8 Flashcards

1
Q

ICF Compartment

A

Consists of fluids contained within all cells in the body and constitutes approximately two thirds of the body water in healthy adults

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2
Q

ECF Compartment

A

Remaining one third of body water. Contains all the fluids outside the cells, including those in the interstitial or tissue spaces and blood vessel

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3
Q

What components are part of the ECF?

A

Contain large amounts of sodium and chloride, moderate amounts of bicarbonate, and small amounts of potassium, magnesium, calcium, and phosphorus

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4
Q

What components are part of the ICF?

A

No calcium
Small amounts of sodium, chloride, bicarbonate, and phosphorus
Moderate amounts of magnesium, and large amounts of potassium

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5
Q

What is the most abundant intracellular electrolyte?

A

Potassium

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6
Q

Diffusion

A

Movement of charged or uncharged particles along a concentration gradient

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7
Q

Milligrams per deciliter

A

Expresses the weight of the solute in one tenth of a liter

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8
Q

Milliequivalent

A

Used to express the charge equivalency for a given weight if an electrolyte

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9
Q

Electroneutrality

A

Total number of cations in the body equals the total number of anions

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10
Q

Osmosis

A

Movement of water across a semipermeable membrane. Diffuses down it concentration gradient moving from the side of the membrane with lesser number of particle and greater concentration f water to the side with the greater number of particles and lesser concentration of water

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11
Q

Osmotic pressure

A

AS water moves across the semipermeable membrane

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12
Q

A dehydrated persons urine-serum ratio

A

4:1

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13
Q

Tonicity

A

Refers to the tension or effect that the effective osmotic pressure of a solution with impermeable solutes exerts on cell size because of water movement across the cell membrane.

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14
Q

Capillary filtration

A

Refers to the movement of water through capillary pores because of a mechanical rather than an osmotic force

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15
Q

Capillary hydrostatic pressure

A

Pressure pushing water out of the capillary into the interstitial spaces. It reflects the arterial and venous pressures, he precapillary (arterioles) and postcapillary (venules) resistance, and the force of gravity

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16
Q

Capillary colloidal osmotic pressure

A

Osmotic pressure generated by the plasma proteins that are too large to pass through the pores of the capillary wall

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17
Q

Factors that increase Capillary pressure

A

-Increased arterial pressure
-Decreased resistance to flow through the precapillary sphincters’
-An increase in venous pressure or increased resistance to outflow at the postcapillary sphincter
-Capillary distention because of increased vascular volume

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18
Q

Localized edema

A

Occurs in a limited anatomic site/space

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19
Q

Generalized body edema

A

Anasarca
Frequently the result of increased vascular volume
Common conditions such as congestive heart failure that produce fluid retention and venous congestion

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20
Q

Dependent Edema

A

Fluid accumulates in the dependent parts of the body

Edema of the ankles and feet becomes more pronounced during periods of standing

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21
Q

Decreased Capillary Colloidal Osmotic Pressure

A

Edema usually is the result of inadequate production or an=abnormal loss of plasma proteins, mainly albumin. Plasma proteins are lost in the liver due to impaired synthesis of albumin in sever liver disease, the kidneys dye to albumin loss in urine, and capillary injury as a result of burns

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22
Q

Increased Capillary Permeability

A

Capillary pores becomes enlarged or the integrity of the capillary wall is damaged, capillary permeability is increased
Burn injury, capillary congestion, inflammation, and immune responses

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23
Q

Obstruction of lymph flow

A

Osmotically active plasma proteins and other large particles that cannot be reabsorbed through the pores in the capillary membrane rely on the lymphatic system for movement back into the circulatory system.

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24
Q

Lymphedema

A

Edema due to impair lymph flow cause by disruption or malformation of the lymphatic system develops as a result of high-protein swelling in an area of the body

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25
Q

Pitting edema

A

Occurs when the accumulation of interstitial fluid exceeds the absorptive capacity of the tissue gel.

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26
Q

Nonpitting edema

A

Reflects a condition in which plasma proteins have accumulated in the tissue spaces and coagulated.

Most commonly in areas of localized infection and trauma.
The area is often firm and discolored.

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27
Q

What IV medication can be administered to treat edema?

A

Albumin to raise the plasma colloidal osmotic pressure when edema is caused by hypoalbuminemia

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28
Q

Third Spacing

A

Represents the loss or trapping of ECF into the transcellular space

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29
Q

Third Space

A

Serous cavities are part of the transcellular compartment

he pericardial sac, the peritoneal cavity, and the pleural cavityhi

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30
Q

Third Space fluids

A

Represent an accumulation or trapping of body fluids that contribute to body weight but not to fluid reserve or function

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31
Q

Causes of third spacing

A

Systemic inflammatory response syndrome
Leaky capillary syndrome in pancreatitis, hypoalbuminemia (occurs with severe liver failure), and third degree burns

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32
Q

Hydrothorax

A

Excessive fluid in the pleural cavity

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33
Q

Ascites

A

Accumulation of fluid in the peritoneal cavity

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34
Q

Effusion

A

Transudation of fluid into the serous cavities
Can contain blood, plasma proteins, inflammatory cells (pus), and ECF

35
Q

Obligatory urine loss

A

300-500 mL/day

36
Q

Insensible water losses

A

Water losses that occur through the skin and lungs

37
Q

Effective circulating volume

A

Major regulator of sodium and water balance

38
Q

Baroreceptors

A

Respond to pressure-induced stretch of the vessel walls

39
Q

Aldosterone

A

Acts at the level of the cortical collecting tubules of the kidneys to increase sodium reabsorption while increasing potassium elimination

40
Q

Two stimuli for true thirst

A

Cellular dehydration cause by an increase in ECF osmolality
Decrease in blood volume

41
Q

One of the earliest symptoms of hemorrhage

A

Thirst

42
Q

Third important stimulus for thirst

A

Angiotensin II
Backup system for thirst should other systems fail

43
Q

Hypodipsia

A

A decrease in the ability to sense thirst
Associated with lesions in the area of the hypothalamus (head trauma, meningiomas, occult hydrocephalus, and subarachnoid hemorrhage)

44
Q

Polydipsia

A

Excessive thirst

45
Q

Increased thirst and drinking behavior can be classified into three categories

A

1) Symptomatic or true thirst
2) Inappropriate or false thirst that occurs despite normal level of body water
3) Compulsive water drinking

46
Q

Symptomatic thirst

A

Develops when there is a loss of body water and resolves after the loss has been replaces

47
Q

Psychogenic polydipsia

A

Compulsive water drinking and is usually seen in people with psychiatric disorders, most commonly schizophrenia

48
Q

Vasopressin

A

Reabsorption of water by the kidneys regulated by ADH

49
Q

ADH

A

synthesized in the supraoptic and paraventricular nuclei of the hypothalamus and transported along a neural pathway to the posterior pituitary gland where it is stored. Nerve impulses travel down the hypothalamohypophyseal tract to the posterior pituitary gland causing stored ADH to be released into circulation.V

50
Q

V1

A

Can increase BP through V1 receptors when ADH levels are very high

51
Q

V2

A

Located on the tubular cells of the cortical collecting duct
Control water reabsorption by the kidney

52
Q

Diabetes Insipidus

A

Caused by a deficiency of or a decreased response to ADH
Unable to concentrate their urine during periods of water restriction and thy excrete large volumes of urine

53
Q

Individuals with DI are at risk for

A

Hypertonic dehydration and increased serum osmolalityT

54
Q

Two types of DI

A

Neurogenic/central
nephrogenic

55
Q

Neurogenic DI

A

Defect in the synthesis or release of ADH

56
Q

Nephrogenic DI

A

Kidneys do not respond to ADH
Most people have an incomplete form of the disorder and retain some ability to concentrate their urine

57
Q

Syndrome of Inappropriate Antidiuretic Hormone

A

Results from a failure of the negative feedback system that regulates the release and inhibition of ADH

ADH secretion continues even when serum osmolality is decreased, causing marked water retention and dilutional hyponatremia

58
Q

Triggers for SIADH

A

Surgery, pain, stress, temperature changes

Chronic: lung tumors, chest lesions, and CNS disorders

59
Q

S&S of SIADH

A

Urine osmolality is high and serum osmolality is low
Urine output decreases despite adequate or increased fluid intake
Hematocrit, plasma sodium, and BUN levels are decreased

60
Q

5 cardinal features of SIADH

A

1) Hypotonic hyponatremia
2) Natriuresis (< 20 mEq/l)
3) Urine osmolality in excess of plasma osmolality
4) Absence of edema and volume depletion
5) Normal renal, thyroid, and adrenal function

61
Q

Isotonic disorders

A

Confined to the ECF compartment, producing a contraction (fluid volume efecit) or expansion (fluid volume excess) of the interstitial and vascular fluids

62
Q

Etiology of Isotonic Fluid Volume Deficit

A

Results when water and electrolytes are lost in isotonic proportions
Caused by a loss of body fluids and acoompanied by a decrease in fluid intake
Loss of GI fluids, polyuria, or sweating

63
Q

Addison Disease

A

Condition of chronic adrenocortical insufficiency
Unregulated loss of sodium in the urine, resultant loss of ECF, and increased potassium retention

64
Q

Clinical Manifestations of Fluid Volume Deficit

A

Thirst, loss of body weight, signs of water conservation by the kidney, impaired temperature regulation, and signs of reduced interstitial and vascular volume

65
Q

Isotonic Fluid Volume Excess

A

Represents an isotonic expansion of the ECF compartment with increases in both interstitial and vascular volumes

66
Q

Etiology of Isotonic fluid volume excess

A

Increased total body sodium accompanied by a proportionate increases in body water

Most commonly caused by a decrease in sodium and water elimination by the kidney

67
Q

What disorders cause Isotonic fluid volume excess

A

Disorders of renal function, heart failure, liver failure, and corticosteroid excess

68
Q

Hyponatremia

A

Represents a plasma sodium concentration blow 135 mEq

69
Q

Hypertonic hyponatremia

A

Osmotic shifts of water from the ICF to ECF such as that occuring in hyperglycemia. The sodium in th ECF becomes diluted as water moves out of cells in response to the osmotic effects of elevated blood glucose levels

70
Q

Hypotonic hyponatremia

A

Most common type of hyponatremia caused by water retention

71
Q

Hypovolemic hypotonic hyponatremia

A

OCcurs when water is lost along with sodium resulting in low plasma level but to a lesser extent.

Sweating in hot weather

72
Q

S&S of Hyponatremia

A

Muscle cramps, weakness, fatigue,
Nausea, vomiting, abdominal cramps, and diarrhea

72
Q

Hypernatremia

A

Plasma sodium level above 145 mEq/L and a serum osmolality greater than 295 mOsm/kg

Characterized by hypertonicity of ECF and almost always causes cellular dehydration

73
Q

S&S of Hypernatremia

A

Thirst is an early symptom
Urine output is decreased and urine osmolality is increased
Body temp is elevated and skin becomes warm and flushed
Pulse becomes rapi and thready
BP drops
Skin and mucous membranes become dry
Coma and seizures may devlop as hypernatremia progresses

74
Q

Most common cause of hypokalemia

A

Diuretic therapy
Both thiazide and loop diuretics increase the loss of potassium in the urine

75
Q

Genetic disorders that can result in hypokalemia

A

Bartter, Gitelman, and Liddle syndrome

76
Q

S&S hypokalemia

A

Alteration in renal, GI, and cardiovascular, and neuromuscular function
Urine output and plasma osmolality are increased, urine specific gravity is decreased
Polyuria, nocturia, and thirst
Anorexia, nausea, vomiting, constipating, abdominal distention

Postural hypotension

Prolongation of the PR interval, ST segment depression, T-wave flattening, and appearance of a prominent U wave

77
Q

Hypokalemic familial periodic paralysis

A

Cause attack of severe muscle weakness and flaccid paralysis that last 6-48 hours if untreated

78
Q

3 major causes of hyperkalemia

A

1) Decreased renal elimination
2) excessively rapid administration
3) Movement of potassium from the ICF to ECF

79
Q

Most common cause of hyperkalemia

A

Decreased renal functionS

80
Q

&S of hyperkalemia

A

Paresthesia
Generalized muscle weakness or dyspnea secondary to respiratory muscle weakness
Cardiac conduction (most serious)

81
Q

Cardiac concerns with Hyperkalemia

A

Peaked narrow T waves and widening of the QRS complex
If plasma levels continue to rise the PR interval becomes prolonged, followed by disappearance of P waves

82
Q
A

Nurs316-Unit 3 (1 decks)

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