Fluid and Electrolyte

Question 1

Important characteristics of fluid are

Answer 1

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

Question 2

Fluid is water plus

Answer 2

the substances dissolved and suspended in it.

Question 3

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

Answer 3

various body fluid compartments.

Question 4

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

Answer 4

the water in the extracellular compartment.

Question 5

Normal saline, which is 0.9% sodium chloride, is

Answer 5

isotonic.

Question 6

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

Answer 6

in blood pressure

Question 7

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

Answer 7

release of the enzyme renin by the kidneys.

Question 8

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

Answer 8

angiotensin II.

Question 9

Angiotensin II is a hormone that causes several things to occur

Answer 9

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

Question 10

135-145mEq/L

Answer 10

Sodium (Na+)

Question 11

3.5-5mEq/L

Answer 11

Potassium (K+)

Question 12

Normal Calcium (Ca2+) level

Answer 12

8.5-10.5mg/dL

Question 13

Normal Magnesium (Mg2+) level

Answer 13

1.3-2.1mEq/L

Question 14

Sources of K+

Answer 14

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

Question 15

D5W, 0.9% NS,LR Solutions are

Answer 15

Isotonic

Question 16

Tonicity of 280-300 MOSM0l/ KG

Answer 16

Isotonic

Question 17

> 300mosmolkg IS

Answer 17

hypertonic

Question 18

0.45 NS and 0.33 NS is

Answer 18

hypotonic

Question 19

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

Answer 19

hypertonic

Question 20

lower osmolaruty fluid moves from intravascular to intracellular

Answer 20

hypotonic

Question 21

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

Answer 21

hypertonic

Question 22

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

Answer 22

Isotonic-D5W; 0.9% NS; LR

Question 23

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

Answer 23

hypotonic

Question 24

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

Answer 24

hypertonic

Question 25

Continued use of hypotonic solutions lead to

Answer 25

cellular and brain swelling

Question 26

What's insensible water loss

Answer 26

Sweat, respiration, stool

Question 27

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

Answer 27

colloids and crystalloids.

Question 28

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

Answer 28

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

Question 29

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

Answer 29

pushes fluid to capillaries

Question 30

Venous colloid osmotic pressure (created by plasma proteins)

Answer 30

pulls fluid to capillaries

Question 31

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

Answer 31

"third space."

Question 32

It is in the distal tubule where ... and ... act to influence water and electrolyte balance.

Answer 32

ADH and aldosterone

Question 33

aldosterone

Answer 33

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

Question 34

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

Answer 34

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

Question 35

ADH release from the pituitary gland is triggered by

Answer 35

The osmolarity of the blood in the internal carotid artery.

Question 36

ADH alters renal collecting duct permeability to water causing

Answer 36

water to be reabsorbed or eliminated.

Question 37

Sodium is the dominant particle in the

Answer 37

ECF.

Question 38

Potassium is the dominant particle in the

Answer 38

ICF.

Question 39

The more electrolytes in the solution, the

Answer 39

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

Question 40

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

Answer 40

directly regulate fluid or electrolyte balance.

Question 41

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

Answer 41

CHF, Cushing's, renal failure, cirrhosis, | Excessive use of corticosteroids, salt (sodium chloride) or sodium-containing IV fluids

Question 42

Hypervolemia may be manifested by:

Answer 42

weight gain, increased abdominal girth, peripheral and 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 low BUN (blood urea nitrogen)

Question 43

Management of fluid volume excess includes:

Answer 43

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

Question 44

Hypovolemia results in

Answer 44

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

Question 45

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

Answer 45

Triggered

Question 46

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

Answer 46

anterior pituitary gland.

Question 47

Decreased plasma proteins reduce the vascular colloid osmotic pressure and the ability to pull water into the vascular bed. This may be due to

Answer 47

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

Question 48

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

Answer 48

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

Question 49

Clinical indications of fluid volume deficit may include:

Answer 49

urine output

Question 50

Treatment of fluid deficit (hypovolemia) may include:

Answer 50

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

Question 51

The ECF has large amounts of

Answer 51

sodium, chloride and bicarbonate

Question 52

The ICF has large amounts of

Answer 52

potassium, phosphate, sulfate, and protein,

Question 53

Potassium (K+) is dominant

Answer 53

intracellular electrolyte. 

Question 54

If the K+ balance changes, it changes: | cell excitability or ability of cells to fire thus why it effects

Answer 54

Heart and skeletal muscle

Question 55

Hypokalemia occurs from:

Answer 55

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 of K+ in urine when the kidney does not reabsorb it diuresis in uncontrolled diabetes mellitus, excess aldosterone secretion (hyperaldosteronism), malabsorption syndromes, malnutrion acid-base imabalances, heart failure (as Na+ and water retained, K+ it lost) laxative abuse, K+ free intravenous fluids while N.P.O., trauma with loss of K+ in urine intravenous insulin and glucose, stress reaction (excess adrenocortical hormone secretion)

Question 56

The findings of hypokalemia (decreased serum potassium) include:

Answer 56

serum K+ 

Question 57

foods high in K+, some of these include

Answer 57

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

Question 58

influences the movement of K+

Answer 58

The pH of the blood affects K+ movement.

Question 59

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

Answer 59

aldosterone