Facts Fluids and Electrolytes

Question 1

a pediatrics total body water is ________% of their body weight

Answer 1

75-80%

Question 2

pediatrics are susceptible to significant changes in body fluids such as

Answer 2

dehydration

Question 3

total body water is affected by aging by:

Answer 3

decreased percent of TBW
* decreased free fat mass and decreased muscle mass
* renal decline
* diminished thirst perception

Question 4

at the arterial end of the capillary, hydrostatic pressure _______ oncotic pressure and fluid moves ______ the interstitial space. what is this called?

Answer 4

exceeds
into
filtration

Question 5

at the venous end of the capillary, hydrostatic pressure ______ oncotic pressure and fluid moves ______ the interstitial space. what is this called?

Answer 5

is less than
out of
reabsorption

Question 6

______ maintains the osmotic balance of the ECF

Answer 6

sodium

Question 7

______ maintains the osmotic balance of the ICF

Answer 7

potassium

Question 8

causes of edema

Answer 8

increase capillary hydrostatic pressure
* venous obstruction or salt and water retention
decrease plasma oncotic pressure
* albumin production is lost or diminished - albumin attracts and holds water within blood vessels
increase capillary permeability
* inflammation
lymph obstruction (lymphedema)

Question 9

sodium role

Answer 9

primary ECF cation
regulates osmotic forces, thus water
nerve impulse conduction
cellular chemical reactions
acid-base balance
membrane transport

Question 10

chloride role

Answer 10

primary ECF anion
provides electroneutrality

Question 11

increases and decreases in chloride concentration are _______ to changes in sodium concentration

Answer 11

proportional

Question 12

water balance is regulated by the secretion of

Answer 12

antidiuretic hormone (ADH), a vasopressin
produced in the posterior pituitary

Question 13

sodium Na balance is regulated by

Answer 13

aldosterone
from adrenal cortex

Question 14

what creates thirst

Answer 14

when there is a decrease in water or excess concentration of sodium in relation to total body water, an increase in osmolality is created which stimulates osmoreceptors, resulting in thirst

Question 15

volume receptors are located in

Answer 15

right and left atria and thoracic vessels

Question 16

baroreceptors are located in

Answer 16

the aorta, pulmonary arteries, and carotid sinus

Question 17

isotonic fluid loss causes

Answer 17

dehydration and hypovolemia

Question 18

signs and symptoms of isotonic fluid loss

Answer 18

weight loss
increased thirst
dry skin

Question 19

symptoms of hypovolemia

Answer 19

increased heart rate
decreased urine output
decreased BP
flat neck veins

Question 20

isotonic fluid excess causes

Answer 20

hypervolemia

Question 21

causes of isotonic fluid excess

Answer 21

excessive IV therapy
increases in aldosterone
drugs like cortisone (prednisone)

Question 22

symptoms of isotonic fluid excess

Answer 22

weight gain
decreased albumin
increased BP
distended neck veins
crackles heard in lungs
edema - pulmonary edema - heart failure

Question 23

hypernatremia occurs when serum sodium levels are

Answer 23

ABOVE 145 mEq/L

Question 24

hypernatremia caused by

Answer 24

increase in sodium
water loss

Question 25

hypernatremia causes

Answer 25

water movement from ICF to ECF (intracellular dehydration)

Question 26

causes of hypernatremia

Answer 26

inadequate water intake excessive sweating fever (increased ventilatory rate) vomiting diarrhea burns respiratory tract infections (increased ventilatory rate)

Question 27

manifestations from hypernatremia

Answer 27

clinical: thirst, weight gain, bounding pulse, increased blood pressure central nervous system: muscle twitching and hyperactive reflexes, confusion, coma, convulsions, cerebral hemorrhage

Question 28

hyponatremia occurs when serum sodium levels are

Answer 28

BELOW 135 mEq/L

Question 29

causes of hyponatremia

Answer 29

sodium loss (vomiting, diarrhea, GI suction, diuretic use) large water intake, acute renal failure, SIADH

Question 30

symptoms of hyponatremia

Answer 30

alters cell's ability to depolarize and repolarize cerebral cell swelling changes in levels of consciousness - lethargy, confusion, seizures, coma

Question 31

chloride is a major ____ of the ECF

Answer 31

anion

Question 32

causes of hypochloremia

Answer 32

loss of sodium Na (hyponatremia) elevated bicarbonate (metabolic alkalosis) vomiting and the loss of HCl

Question 33

causes of hyperchloremia

Answer 33

occurs with hypernatremia bicarbonate deficit (metabolic acidosis)

Question 34

potassium is a major _____ of the ICF

Answer 34

cation

Question 35

normal range of potassium

Answer 35

3.5-5.0 mEq/L

Question 36

potassium concentration maintained by

Answer 36

Na+/K+ pump

Question 37

potassium involved in

Answer 37

cell membrane potential (especially cardiac and nerve cells) buffering systems for acidosis and alkalosis

Question 38

major route loss for K is

Answer 38

kidneys

Question 39

distribution of K influenced by

Answer 39

acid-base balance

Question 40

aldosterone affects potassium concentration by

Answer 40

increasing secretion into the urine and from sweat glands

Question 41

hypokalemia occurs when serum potassium levels are

Answer 41

BELOW 3.5 mEq/L

Question 42

causes of hypokalemia

Answer 42

reduced intake of potassium (more common in elderly) increased movement of potassium into cells increased losses of potassium * upper GI loss: create alkalosis from stomach acid loss * lower GI loss: diarrhea * renal losses: diuretics

Question 43

clinical manifestations of hypokalemia

Answer 43

muscle weakness dysrhythmias (resting membrane potential becomes more negative - requires greater stimulus to trigger action potential, also delays repolarization) glucose intolerance

Question 44

hyperkalemia occurs when serum potassium levels are

Answer 44

ABOVE 5.5 mEq/L

Question 45

causes of hyperkalemia

Answer 45

increased intake shift of potassium from ICF to ECF decreased renal excretion (oliguria - low urine output) insulin deficiency (insulin facilitates movement of K into cell) cell trauma (K can leak from cell)

Question 46

clinical manifestations of hyperkalemia

Answer 46

mild attacks - restlessness, intestinal cramping, diarrhea severe attacks - muscle weakness, loss of muscle tone, paralysis (resting membrane potential from -90 to -70) dysrhythmias and cardiac arrest