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Nurs316-Unit 3 > Chapter 8 > Flashcards

Chapter 8 Flashcards

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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
Pitting edema
Occurs when the accumulation of interstitial fluid exceeds the absorptive capacity of the tissue gel.
26
Nonpitting edema
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.
27
What IV medication can be administered to treat edema?
Albumin to raise the plasma colloidal osmotic pressure when edema is caused by hypoalbuminemia
28
Third Spacing
Represents the loss or trapping of ECF into the transcellular space
29
Third Space
Serous cavities are part of the transcellular compartment he pericardial sac, the peritoneal cavity, and the pleural cavityhi
30
Third Space fluids
Represent an accumulation or trapping of body fluids that contribute to body weight but not to fluid reserve or function
31
Causes of third spacing
Systemic inflammatory response syndrome Leaky capillary syndrome in pancreatitis, hypoalbuminemia (occurs with severe liver failure), and third degree burns
32
Hydrothorax
Excessive fluid in the pleural cavity
33
Ascites
Accumulation of fluid in the peritoneal cavity
34
Effusion
Transudation of fluid into the serous cavities Can contain blood, plasma proteins, inflammatory cells (pus), and ECF
35
Obligatory urine loss
300-500 mL/day
36
Insensible water losses
Water losses that occur through the skin and lungs
37
Effective circulating volume
Major regulator of sodium and water balance
38
Baroreceptors
Respond to pressure-induced stretch of the vessel walls
39
Aldosterone
Acts at the level of the cortical collecting tubules of the kidneys to increase sodium reabsorption while increasing potassium elimination
40
Two stimuli for true thirst
Cellular dehydration cause by an increase in ECF osmolality Decrease in blood volume
41
One of the earliest symptoms of hemorrhage
Thirst
42
Third important stimulus for thirst
Angiotensin II Backup system for thirst should other systems fail
43
Hypodipsia
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
Polydipsia
Excessive thirst
45
Increased thirst and drinking behavior can be classified into three categories
1) Symptomatic or true thirst 2) Inappropriate or false thirst that occurs despite normal level of body water 3) Compulsive water drinking
46
Symptomatic thirst
Develops when there is a loss of body water and resolves after the loss has been replaces
47
Psychogenic polydipsia
Compulsive water drinking and is usually seen in people with psychiatric disorders, most commonly schizophrenia
48
Vasopressin
Reabsorption of water by the kidneys regulated by ADH
49
ADH
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
V1
Can increase BP through V1 receptors when ADH levels are very high
51
V2
Located on the tubular cells of the cortical collecting duct Control water reabsorption by the kidney
52
Diabetes Insipidus
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
Individuals with DI are at risk for
Hypertonic dehydration and increased serum osmolalityT
54
Two types of DI
Neurogenic/central nephrogenic
55
Neurogenic DI
Defect in the synthesis or release of ADH
56
Nephrogenic DI
Kidneys do not respond to ADH Most people have an incomplete form of the disorder and retain some ability to concentrate their urine
57
Syndrome of Inappropriate Antidiuretic Hormone
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
Triggers for SIADH
Surgery, pain, stress, temperature changes Chronic: lung tumors, chest lesions, and CNS disorders
59
S&S of SIADH
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
5 cardinal features of SIADH
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
Isotonic disorders
Confined to the ECF compartment, producing a contraction (fluid volume efecit) or expansion (fluid volume excess) of the interstitial and vascular fluids
62
Etiology of Isotonic Fluid Volume Deficit
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
Addison Disease
Condition of chronic adrenocortical insufficiency Unregulated loss of sodium in the urine, resultant loss of ECF, and increased potassium retention
64
Clinical Manifestations of Fluid Volume Deficit
Thirst, loss of body weight, signs of water conservation by the kidney, impaired temperature regulation, and signs of reduced interstitial and vascular volume
65
Isotonic Fluid Volume Excess
Represents an isotonic expansion of the ECF compartment with increases in both interstitial and vascular volumes
66
Etiology of Isotonic fluid volume excess
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
What disorders cause Isotonic fluid volume excess
Disorders of renal function, heart failure, liver failure, and corticosteroid excess
68
Hyponatremia
Represents a plasma sodium concentration blow 135 mEq
69
Hypertonic hyponatremia
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
Hypotonic hyponatremia
Most common type of hyponatremia caused by water retention
71
Hypovolemic hypotonic hyponatremia
OCcurs when water is lost along with sodium resulting in low plasma level but to a lesser extent. Sweating in hot weather
72
S&S of Hyponatremia
Muscle cramps, weakness, fatigue, Nausea, vomiting, abdominal cramps, and diarrhea
72
Hypernatremia
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
S&S of Hypernatremia
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
Most common cause of hypokalemia
Diuretic therapy Both thiazide and loop diuretics increase the loss of potassium in the urine
75
Genetic disorders that can result in hypokalemia
Bartter, Gitelman, and Liddle syndrome
76
S&S hypokalemia
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
Hypokalemic familial periodic paralysis
Cause attack of severe muscle weakness and flaccid paralysis that last 6-48 hours if untreated
78
3 major causes of hyperkalemia
1) Decreased renal elimination 2) excessively rapid administration 3) Movement of potassium from the ICF to ECF
79
Most common cause of hyperkalemia
Decreased renal functionS
80
&S of hyperkalemia
Paresthesia Generalized muscle weakness or dyspnea secondary to respiratory muscle weakness Cardiac conduction (most serious)
81
Cardiac concerns with Hyperkalemia
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

Nurs316-Unit 3 (1 decks)

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