Fluid Balance Flashcards
(113 cards)
1
Q
Percentage of water in premature babies
A
83%
2
Q
Percentage of water in infants
A
77%
3
Q
Percentage of water in adults
A
60%
4
Q
Percentage of water in elderly
A
50%
5
Q
Do fat cells hold more water
A
No
6
Q
How much TBW is in the intracellular fluid
A
2/3 of TBW or 28L
7
Q
How much TBW is in the extracellular fluid
A
1/3 TBW or 14L
8
Q
What is the ECF (extracellular fluid) composed of
A
ICF (interstitial fluid) and IVF (intravascular fluid)
9
Q
Where is the interstitial space
A
Between tissues
10
Q
Where is the intravascular space
A
Within blood vessels
11
Q
Intra-
A
Within
12
Q
Inter-
A
Between
13
Q
Extra-
A
Outside
14
Q
Cation
A
Positive charge
15
Q
Anion
A
Negative charge
16
Q
How much water is in the interstitial space
A
75% of extracellular water or ~15% of body weight
17
Q
Pedal edema
A
Swollen ankles
18
Q
How much water is in the intravascular space (blood)
A
25% of extracellular water or ~5% of body weight
19
Q
What is the only fluid compartment that can be measured directly
A
Intravascular space or blood
20
Q
What is blood made of
A
Water mixed with
- Molecules (glucose, creatinine, lipids, vitamins)
- Electrolytes (K+, Na+, Cl-)
- Blood cells (RBCs, WBCs)
- Platelets (not a cell but a piece/fragment of a cell)
- Proteins (albumin, globulin, fibrinogen)
21
Q
Globulin
A
A blood protein responsible for immune functioning
22
Q
Fibrinogen
A
A blood protein responsible for blood clotting
23
Q
Albumin
A
A blood protein that maintains colloid osmotic pressure in the extracellular space
24
Q
Colloid osmotic pressure
A
Osmotic (water) pressure from proteins (albumin) in a blood vessel that exerts a greater pull than smaller molecules
- Water will follow the protein
25
Where does the diffusion of oxygen in nutrients from the blood go into tissues occur
Capillaries
26
Where does the diffusion of waste products from metabolism from the tissues in the blood occcur
Capillaries
27
Plasma
- Water
- Molecules
- Electrolytes
- Proteins (minus RBC & WBCs)
- Platelets
28
Serous
Clear fluid without blood, pus, or debris
29
Sanguinous
Bloody or red drainage
30
Serosanguinous
Watery pale red to pink fluid
31
Osmotic pull
Proteins exerting a pull of water back into the blood vessel and the small molecules
32
Hydrostatic pressure
Push from the heart and out through the capillary walls
33
Osmotic pressure
Push or pull of the large molecules (albumin) which pull water with them wherever they're located
34
Cardiac output
The amount of blood pumped by the heart through the intravascular system (blood vessels) per minute
35
Cardiac output equation
CO = SV x HR
36
Stroke volume
The amount of blood pumped by the heart per beat
37
Anuria
No urine output
38
Oliguria
Limited urine output
- Less than 400 mL of urine in 24 hours
39
Normal osmolality (n)
270 - 295 mosm/kg +/- -5 of body weight
40
Osmolarity
Measures the amount of solutes to water using liters
- mOsm/L
41
Osmolality
Calculates the amount of solutes to water using weight or kilograms
- mOsm/kg
42
Clysis
Injection of fluid into the body when venipuncture is not possible
- Route chosen is the subcutaneous infusion (under the skin) which is also known as hypodermoclysis
43
Systolic pressure
Pressure exerted by circulating blood on the walls of blood vessels while the heart is pumping
44
Hydrostatic pressure
Pressure of water
- Blood pressure
45
Isotonic
Same concentration inside and outside the cell - cells in this solution do not lose or gain fluid
- 0.9% NS or 0.9% NaCl
46
Hypotonic
Less concentraiton outside the cell - water moves into the cell
- 0.5% NS or 0.45% NS
47
Hypertonic
More concentration outside the cell - water from cells and interstitial spaces goes into the blood or intravascular space
- 3% NaCl
48
Indentation of < 1/4 inch
1+ pitting edema
49
Indentation between 1/4 and 1/2 inch
2+ pitting edema
50
Indentation between 1/2 inch and 3/4 inch
3+ pitting edema
51
Indentation between 3/4 and 1 inch
4+ pitting edema
52
Eclampsia
Condition that causes convulsions and is assess early by checking for proteinuria (protein in urine)
53
Nephrotic syndrome
Albumin is not filtered and all of it is allowed to pass right through the tubular system and is lost in the urine which causes low plasma proteins
54
Osmosis
Movement of water across a semi-permeable membrane from an area of LESSER concentration of molecules to an area of GREATER concentration of molecules
55
Diffusion
Movement of molecules from an area of HIGHER concentration of molecules to LOWER concentration of molecules
56
Active transport
Pushing of substances across/against a concentration of electric gradients using energy
- Glucose
- Na/K pump
57
Aldosterone
The major regulator of sodium balance (ECF) that causes resorption of Na+ and water - removes Na+ and water from renal tubules and returning it to blood increased ECF volume
58
Antidiuretic hormone (ADH)
Controls excretion of water in urine by causing renal cells to reabsorb water, taking it from the renal tubular fluid and putting it back into blood - decreases urine volume
59
Atrial natriuretic peptide (ANP)
In response to stress (cardiac), causes diuresis (increased excretion of urine) and decreases cardiac workload - weak hormone that increases the loss of Na+ and water in urine
- Opposite effect of aldosterone
60
MAP
Mean arterial pressure which reflects the average perfusion pressure
- Normal: 70-105 mmHg
- Major organs require a MAP of 65 mmHg to maintain blood flow
61
Brain natriuretic peptide (BNP)
Initiated from too much strain on the heart (ventricles) due to increased water so it blocks aldosterone
- Natriuretic hormone initially identified in the brain but released primarily from the heart, particularly in the ventricles
- More common than ANP
- Normal: 100
- Heart failure: 300
62
Insensible loss
Fluid losses that are unnoticed
- Process of respiration causes water loss
- Simple evaporation off the skin (not only sweat)
63
What is normal urinary output for 24 hours
~1500 mL/day
64
What is calculated insensible loss (lung, sweat, solid stool) for 24 hours
1000 mL/day
65
Crystalloid IVs
Solutions with fluids and electrolytes
66
Colloid IVs
Solutions with proteins (albumin), dextran, or blood
67
Total parenteral nutrition (TPN) & partial parenteral nutrition (PPN)
- IV solutions that are high in glucose, amino acids, vitamins, and fats
- Nutritious solutions that are ready for use → the gut doesn’t have to break it down → ready for cellular use
- Contain carbohydrates in the form of sugar or glucose, protein in the useable form of amino acids, and fats in the form of lipids
- Vitamins are added to the solution
68
Central line
A catheter placed in a very large vein (subclavian or jugular) that is advanced to the superior vena cava (right side of the heart)
69
Peripherally inserted central catheter (PICC)
An IV in the arm but ends in the superior vena cava because it's a central line
70
Air embolism
A blockage of blood supply caused by air bubbles in a blood vessel or the heart
71
Ischemia
Inadequate blood supply to a local area due to blockage of blood vessels leading to that area
- Temporary
72
Infarction
Death of tissue
- Permanent
73
Enteral
To feed someone via their GI tract
- Anywhere from mouth, esophagus, stomach, or small intestine
74
Parenteral
Any route of administration of a substance other than via the digestive tract
- Intravenous
- Subcutaneous
75
Nasogastric (NG) tube
A tube that goes through the nares into the stomach
76
Nasojejunal/intestinal (NJ) tube
A tube that goes through the nares into the jejunal or intestine
77
Single lumen feeding tube
Are only used to put food/fluid/medication in and CANNOT be used to decompress (or take fluid/air out of the stomach)
78
Double lumen feeding tube
Can decompress (take fluid/air out) the stomach
- One lumen is an air vent
79
Euvolemic
Normal fluid balance
80
Hypervolemic
High fluid balance
81
Hypovolemic
Low fluid balance
82
What is the Parkland formula and what is it used for
Used for burns
4 mL x %TBSA (total body surface area) x kg
83
Jugular vein distention (JVD)
When the jugular vein is full which indicates FVE and right ventricular failure
84
Dependent edema
Edema that's specific to different parts of the body that are influenced by gravity
- Legs
- Feet
- Arms
85
Symmetric edema
Symmetrical swelling
- Both legs
- Both feet
- Both arms
86
Baroreceptors
Specialized sensory nerves that are sensitive to changes in blood pressure
87
Pulse pressure
The difference between the systolic and the diastolic pressure (typically 60-80 mL/beat)
- BP = 120/70 = 50 mmHg pulse pressure
88
How many mL in a pound
500 mL
89
Hemoconcentration
Increased concentration of cells and solids in the blood usually resulting from loss of fluid in the tissues
- More molecules and less water
90
Normal hemoglobin/hematocrit for a man
42-50%
91
Normal hemoglobin/hematocrit for a woman
36-48%
92
Hemodilution
Removing RBCs to lower the hematocrit
93
Hematocrit
The proportion of RBCs present in the blood stream or intravascular space
- HCT of 45% = 45% of the whole blood is comprised of RBCs
94
Hemoconcentration
Increase in hematocrit which means there's less water in the blood stream = increase in RBCs in blood
95
Blood urea nitrogen (BUN)
Reflects protein metabolism
96
Creatinine (Cr)
Reflects muscle metabolism
97
Normal BUN levels
7-18 mg/dL
98
Normal Cr levels
0.6-1.2 mg/dL
99
Normal BUN/Cr ratio
10-15:1
100
Uremia
Excess urea in blood but also includes s/s associated with lab abnormalities
- Associated with kidney failure
101
Central venous pressure (CVP) or right atrial pressure (RAP)
Measure of right ventricular preload (volume of blood returning to heart) and is measured via a catheter that sits in the superior vena cava or right atrium
- Measures pressure filling of right ventricle and is related to the interplay of blood volume, vessel tone, and right ventricular function (pump capability)
102
Pulmonary Artery Wedge Pressure (PAWP)
Measure of the left ventricular preload or volume going to the left ventricle of a patient with a pulmonary catheter which sits in the pulmonary artery
103
Periorbital edema
Edema around the eyes
104
How to calculate urinary output per hour
.5 - 2 mL/kg/hr of urine
105
Poor Man's method to guesstimate serum osmolality
(2(Na+) + Glucose) / 18 + BUN / 2.8 = serum osmolality
106
Diabetes insipidus
The body produces too much urine and people often feel thirsty
107
Third spacing
Occurs when fluid moves from the IVS (blood vessels) into the interstitial or transcellular space ("third" space)
108
Syncope
Temporary loss of consciousness due to fall in blood pressure
109
What is normal pulse range
60 - 100 bpm
110
What is normal blood pressure
120 / 80
111
Diastolic pressure
Pressure exerted on the walls of the blood vessels when the heart is in filling/relaxed phase
112
Diastolic pressure
Pressure exerted on the walls of the blood vessels when the heart is in filling/relaxed phase
113
Diastolic pressure
Pressure exerted on the walls of the blood vessels when the heart is in filling/relaxed phase
