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1400 > Fluid and Electrolyte > Flashcards

Fluid and Electrolyte Flashcards

1
Q

Important characteristics of fluid are

A

volume (amount) and its degree of concentration (osmolality).

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2
Q

Fluid is water plus

A

the substances dissolved and suspended in it.

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3
Q

Fluid and electrolyte distribution is the process of moving fluid and electrolytes between the

A

various body fluid compartments.

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4
Q

Normal extracellular fluid (ECF) is isotonic Na+-containing fluid. The Na+ is necessary to hold

A

the water in the extracellular compartment.

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5
Q

Normal saline, which is 0.9% sodium chloride, is

A

isotonic.

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6
Q

A decrease in fluid volume (hypovolemia) and a corresponding decrease

A

in blood pressure

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7
Q

A decrease in fluid volume (hypovolemia) and a corresponding decrease in blood pressure stimulate the

A

release of the enzyme renin by the kidneys.

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8
Q

Angiotensin-converting enzyme (ACE), found in the lungs and kidneys, then changes angiotensin I to

A

angiotensin II.

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9
Q

Angiotensin II is a hormone that causes several things to occur

A
  • Vasoconstriction
  • Water reabsorbed
  • Stimulation of the adrenal cortex releases the hormone aldosterone.
  • ADH is secreted.
  • The thirst mechanism is stimulated.
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10
Q

135-145mEq/L

A

Sodium (Na+)

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11
Q

3.5-5mEq/L

A

Potassium (K+)

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12
Q

Normal Calcium (Ca2+) level

A

8.5-10.5mg/dL

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13
Q

Normal Magnesium (Mg2+) level

A

1.3-2.1mEq/L

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14
Q

Sources of K+

A

Fish, excluding shellfish; whole grains, nuts, broccoli, cabbage, carrots celery, cucumbers, potatoes with skins, spinach, tomatoes, apricots, bananas, cantaloupe, nectarines, oranges, tangerines

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15
Q

D5W, 0.9% NS,LR Solutions are

A

Isotonic

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16
Q

Tonicity of 280-300 MOSM0l/ KG

A

Isotonic

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17
Q

> 300mosmolkg IS

A

hypertonic

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18
Q

0.45 NS and 0.33 NS is

A

hypotonic

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19
Q

D5 0.45% NS; D5 0.9% NS; D5 LR; 3% NS Solutions are

A

hypertonic

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20
Q

lower osmolaruty fluid moves from intravascular to intracellular

A

hypotonic

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21
Q

Higher osmolarity fluid moves out of intracellular to intravascular to try to balance out high particles

A

hypertonic

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22
Q

What solution type replaces fluid; sodium/ chloride replacement; blood transfusions and is the fluid of choice for resuscitation

A

Isotonic-D5W; 0.9% NS; LR

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23
Q

What solution type Is best to handle hypernatrema, dehydration; hydrate the cells but decreases the intravascular bed volume

A

hypotonic

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24
Q

This solution helps with hypovolemia; calorie replacement (dextrose); severe hyponatremia

A

hypertonic

25
Q

Continued use of hypotonic solutions lead to

A

cellular and brain swelling

26
Q

What’s insensible water loss

A

Sweat, respiration, stool

27
Q

I.V. solutions for fluid replacement may be placed in two general categories:

A

colloids and crystalloids.

28
Q

Colloids contain large molecules that don’t pass through semipermeable membranes. When infused, they remain

A

in the intravascular compartment and expand intravascular volume by drawing fluid from extravascular spaces via their higher oncotic pressure.

29
Q

Arterial hydrostatic pressure(caused by the pumping action of the heart)

A

pushes fluid to capillaries

30
Q

Venouscolloid osmotic pressure (created by plasma proteins)

A

pulls fluid to capillaries

31
Q

Interstitialfluids lie between the blood vessels and the cells. This area is also considered a

A

“third space.”

32
Q

It is in thedistal tubulewhere … and …act to influence water andelectrolyte balance.

A

ADH andaldosterone

33
Q

aldosterone

A

a hormone produced by the adrenal cortex. Acting in the renal tubule, it promotes retention of sodium and excretion of potassium.

34
Q

Generally, if either blood volume or pressure is low, the GFR (glomerular filtration rate) will be low, and less filtrate will enter the tubules. To preserve blood volume, the kidney

A

reabsorb water and urinary output will go down. The opposite will happen if renal blood flow is increased.

35
Q

ADHrelease from the pituitary gland is triggered by

A

The osmolarity of the blood in the internal carotidartery.

36
Q

ADHalters renal collecting duct permeability to water causing

A

water to be reabsorbed or eliminated.

37
Q

Sodium is the dominant particle in the

A

ECF.

38
Q

Potassium is the dominant particle in the

A

ICF.

39
Q

The moreelectrolytesin the solution, the

A

higher theosmolarity. Likewise, the fewer electrolytes in solution, the lower the osmolarity.

40
Q

TheANS enables the body to respond to changes in blood volume or composition. It does not

A

directly regulate fluid orelectrolytebalance.

41
Q

Hypervolemia involves retention of both water andelectrolytes(especially sodium). There is usually an increase in the serum sodium which causes water retention. Other causes include:

A

CHF, Cushing’s, renal failure, cirrhosis,

Excessive use of corticosteroids, salt (sodium chloride) or sodium-containing IV fluids

42
Q

Hypervolemiamay be manifested by:

A

weight gain, increased abdominal girth, peripheraland pulmonary edema, JVD, bounding pulse, polyuria, moist rales, ascites, pleurisy, elevated central venous pressure (CVP) serum sodium may be normal or decreased hematocrit may be decreased lowBUN (bloodureanitrogen)

43
Q

Management of fluid volume excess includes:

A

treat the problem, if possible limit fluid intake using clinical situation as guide diuretics to promote fluid and sodium loss and restrict sodium intake to reduce thirst

44
Q

Hypovolemiaresults in

A

lower cardiac output, reduced blood pressure and decreased renal blood flow.

45
Q

ADH secretion increases, and the renin-aldosterone-angiotensin mechanism is

A

Triggered

46
Q

The lower blood volume reduces the stretch on the carotid baroreceptors which then triggersADH(antidiuretic hormone) from the .

A

anteriorpituitarygland.

47
Q

Decreased plasma proteins reduce the vascularcolloid osmotic pressureand the ability to pull water into the vascular bed. This may be due to

A

Malnutritionprotein loss from burn wounds, the kidney, inflammationinability to makealbumin(liver disease)

48
Q

Hypovolemia(a reduce circulating blood volume) can be caused by:

A

blood loss, reduced fluid intake, excessive water loss, fluid lost to the interstitial space, loss of excessive water and sodium from GI track or via the urine or skin

49
Q

Clinical indications of fluid volume deficit may include:

A

urine output

50
Q

Treatment of fluid deficit (hypovolemia) may include:

A

determine renal function (may use a fluid challenge test) isotronic electrolyte solutions (Lactated Ringer’s), followed by hypotonic solution (half-strength saline) continue with fluids, evaluate lung sounds and blood pressure for indications of fluid overload monitor renal output/function

51
Q

The ECF has large amounts of

A

sodium, chloride and bicarbonate

52
Q

The ICF has large amounts of

A

potassium, phosphate, sulfate, and protein,

53
Q

Potassium (K+) is dominant

A

intracellularelectrolyte.

54
Q

If theK+balance changes, it changes:

cell excitability or ability of cells to fire thus why it effects

A

Heart and skeletal muscle

55
Q

Hypokalemiaoccurs from:

A

excessive fluid loss from diarrhea, vomiting, nasogastric suction diuretic drugs (especially loop diuretics like Lasix) inadequate intake of potassium-rich foods (along with abnormal losses) draining wounds/fistulas, loss ofK+in urine when the kidney does not reabsorb it diuresis in uncontrolled diabetes mellitus, excessaldosteronesecretion (hyperaldosteronism), malabsorption syndromes, malnutrion acid-base imabalances, heart failure (asNa+and water retained,K+it lost) laxative abuse, K+free intravenous fluids while N.P.O., trauma with loss ofK+in urine intravenous insulin and glucose, stress reaction (excess adrenocortical hormone secretion)

56
Q

The findings ofhypokalemia(decreased serum potassium) include:

A

serumK+

57
Q

foods high inK+, some of these include

A

bananas, pears, fresh dried apricots, fruit juices, tea, cola beverages, milk, meat, fish, baked potato, dried beans (cooked)

58
Q

influences the movement of K+

A

The pH of the blood affects K+movement.

59
Q

To aid in control of potassium, which hormone is essential?

A

aldosterone

1400 (3 decks)

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