CLASS 5 - FLUID + ELECTROLYTES (Na, K, Albumin), DIURETICS + RELATED THERAPIES Flashcards
(46 cards)
What is homeostasis?
Maintenance of a constant internal environment despite changes in the external environment.
It is important than Na is ____ in plasma but ____ in cells and than K is ____ in plasma and ____ in the cell
Na: high in plasma, low in cells
K: low in plasma, high in cells
Why is protein considered to be more important for OP balance than glucose?
B/c glucose changes fast which protein is more stable.
What is the normal blood plasma value for Na?
K?
Albumin?
Na - 125-145 mmol/L
K - 3.5 - 5 mmol / L
Albumin - 35-50 g / L
Define the following:
- Hypernatremia
- Hyponatremia
- Hyperalbuminemia
- Hypoalbuminemia
- Hypervolemia
- Hypovolemia
- Hypernatremia: high sodium levels in the blood
- Hyponatremia: low sodium levels in the blood
- Hyperalbuminemia: high albumin levels in the blood
- Hypoalbuminemia: low albumin levels in the blood
- Hypervolemia: volume excess
- Hypovolemia: volume defecit
what is osmolality? what is normal osmolality?
measure of the osmotic force of solutes in the plasma (done by a blood test)
280-300 mmol / kg
What is osmotic pressure?
What are the main particles that determine plasma osmotic pressure?
Force that pulls / keeps fluids in the plasma.
Na, protein, and glucose.
What is hydrostatic pressure?
What does a high hydrostatic pressure indicate?
Where is hydrostatic pressure higher in the capillary bed: arterial end or venous end?
Force of pressure pushing fluid against the vessel wall.
High hydrostatic pressure indicates that the fluid is more likely to move out of the vessel.
Higher at the arterial end of the capillary.
What is oncotic pressure?
What is the main protein that determines plasma oncotic pressure?
Oncotic pressure = osmotic pressure of proteins
Albumin
What is fluid spacing?
fluid mvmt between ECF and ICF
Fluid spacing:
What does first spacing indicate?
What does second spacing indicate?
What does third spacing indicate?
first spacing indicates a normal fluid balance.
second spaacing indicates edema in tissues.
third spacing indicates that fluid is accumulating in body spaces such as ascites, blisters, pleural effusion (buildup of water outside of the lungs in the pleural space).
do volume imbalances always have Na imbalances?
yes.
What role does the Hypothalamus-Pituitary Gland in the brain play in the regulation of water?
Hypothalamic osmoreceptors sense the increased osmolality (meaning there are too many particles and not enough fluid); triggers thirst; ADH is released from pituitary gland which facilitates free water absorption (not Na) therefore diluting existing NA in the blood.
What role does the adrenal gland (on top of the kidney) play in the regulation of water?
RAAS (Renin Angiotensin Aldosterone System)
look at diagram in notes
Describe the renal regulation of water
- adjusts urine volume
look at diagram in notes
What is insensible water loss?
- water loss from breathing and insensible perspiration (water only)
- excessive sweating
- water used in metabolic preocesses
What is the main determinant of IVF/IF osmolality?
Na
What are the 2 main hormones that aid in the regulation of Na and ECF balances? What are their fucntions?
main hormone: ADH (keep water)
secondary: Aldosterone (keep Na and water)
What does a Hypertonic IVF/IF (high Na : low water) have on the cell?
water moves out of the cell into the ECF to dilute the concentration which results in cell shrinkage.
What does a Hypotonic IVF / IF (low Na: high water) have on the cell?
causes water to move into the cell which results in cell swelling and hemolysis.
How does BP change with hypervolemia + hypovolemia?
Hypervolemia = increased BP Hypovolemia = decreased BP, postural hypotension
How does pulse rate change with a decreased and elevated BP?
- When BP drops (hypovolemia) –> HR increases to compensate
- When BP is elevated (hypervolemia) –> HR may lower
How does pulse strength change with hyper and hypovolemia?
hypovolemia –> weak, thready pulse (+1)
hypervolemia –> bounding pulse (+3)
What could result from hypovolemia and decreased BP?
Peripheral vasoconstriction (blood will move to central body and organs) which will result in pallor, cool skin, and decreased capillary refill
