Fluid Balance & Electrolytes

Question 1

we give ________ to pregnant women who go into labor early or have preeclampsia

Answer 1

magnesium

Question 2

older adults are more prone to dehydration/have a lower total body water because of…

Answer 2

loss of muscle and fat, which hold water

Question 3

2/3 of body water is in the…

Answer 3

intracellular space

Question 4

1/3 of body water is in the…

Answer 4

extracellular space

Question 5

20% of ECF is ______ and 80% is ________

Answer 5

plasma

interstitial fluid

Question 6

movement of water is based on _______ and ________

Answer 6

osmosis and net filtration

Question 7

osmosis: “water follows _____”

Answer 7

“salt” (or other solutes in high concentration)

Question 8

isotonic, hypertonic, hypotonic

Answer 8

isotonic = normal
hypertonic = higher concentration outside cell
hypotonic = lower concentration outside cell

Question 9

hypotonic solutions lead to…

Answer 9

cellular edema
causes rough ER to lose ribosomes
decrease in protein synthesis

Question 10

hypertonic solutions lead to…

Answer 10

crenation

cell shrinks up and dies

Question 11

we may give hypertonic solutions to patients who…

Answer 11

need blood volume STAT

Question 12

net filtration regulates exchange between which 2 compartments?

Answer 12

interstitial

vascular

Question 13

net filtration affected by which pressures?

Answer 13

hydrostatic

oncotic

Question 14

hydrostatic pressure moves water…

Answer 14

out of capillaries

Question 15

oncotic pressure

Answer 15

osmotic pressure generated by presence of proteins/solutes

Question 16

hypernatremia drawing water from the interstitium into the vascular compartment is an example of ______ pressure

Answer 16

oncotic

Question 17

which capillaries have high/low water permeability?

Answer 17

high - glomerulus

low - brain capillaries

Question 18

function of lymphatic system r/t fluid balance

Answer 18

Returns large volumes of fluid from interstitial space to intravascular space

Question 19

blood volume (increases/decreases) if the lymphatic system fails

Answer 19

decreases

Question 20

edema

Answer 20

excessive amount of fluid in the interstitial space

Question 21

flesh holds its shape when you squish it down

Answer 21

pitting edema

Question 22

etiology of edema (4)

Answer 22

Increased capillary hydrostatic pressure (BP)
Obstruction of lymphatic circulation
Increased capillary permeability
Certain bacterial toxins or large burn wounds

Question 23

pink frothy sputum can indicate…

Answer 23

pulmonary edema

Question 24

lymphedema

Answer 24

edema associated c failure of lymphatic system

Question 25

what can increase capillary permeability, leading to edema?

Answer 25

histamines & other inflammatory mediators

Question 26

what is edema resulting from increased capillary permeability associated with?

Answer 26

inflammation/infection

Question 27

edema of face mainly beneath the skin almost entirely caused by medications, allergies, or autoimmune response

Answer 27

angioedema

Question 28

s/s of edema (7)

Answer 28

``` local skin change functional impairment/decreased ROM pain impaired arterial circulation pitting increased body weight dental complications ```

Question 29

Compartment syndrome | what is it a concern with?

Answer 29

swelling does not allow bloodflow through | casts

Question 30

third-spacing

Answer 30

Fluid shifts into a body cavity & cannot re-enter blood or be used again

Question 31

example of third-spacing

Answer 31

ascites

Question 32

hormone released in response to high blood volume

Answer 32

natriuretic peptide

Question 33

how do the effects of natriuretic peptide affect fluid balance? what is the goal?

Answer 33

goal: decrease blood volume decreases aldosterone - leads to diuresis decreases ADH - leads to diuresis & decreased thirst

Question 34

dehydration

Answer 34

excessive loss of body water

Question 35

sites for turgor test

Answer 35

child - abdomen adult - back of hand elder - infraclavicular skin

Question 36

tenting indicates...

Answer 36

dehydration

Question 37

risk factors for dehydration (6)

Answer 37

``` extremes of age (young, old) decreased fluid intake excessive fluid output chronic disease acute illness medications ```

Question 38

clinical manifestations of dehydration (12)

Answer 38

``` Hypernatremia Inability to tear Decreased urine output Elevated urine specific gravity Sunken fontanels (babies) Try mucous membranes Decreased skin turgor Lower BP Weak pulse Fatigue Increased hematocrit Decreased mental function ```

Question 39

between natriuretic peptide and RAAS, which responds to low BP? which to high blood volume?

Answer 39

high blood volume - natriuretic peptide | low BP - RAAS

Question 40

5 ways body responds to dehydration

Answer 40

``` Increased thirst Increased HR - needs to rise because volume has decreased Constriction of cutaneous blood vessels Less urine production RAAS ```

Question 41

function of RAAS

Answer 41

increases BP

Question 42

____ secreted by kidney in direct response to decreased blood flow to kidney

Answer 42

renin

Question 43

renin activates _______

Answer 43

angiotensin

Question 44

2 effects of angiotensin

Answer 44

vasoconstriction | triggers aldosterone production

Question 45

effects of aldosterone

Answer 45

Na+ retention | draws water into vascular space

Question 46

3 effects of ADH

Answer 46

vasoconstriction water retention increased thirst

Question 47

electrolytes

Answer 47

minerals in the body that have an electrical charge

Question 48

4 extracellular electrolytes

Answer 48

Na+ Ca+ HCO3- Cl-

Question 49

intracellular electrolytes

Answer 49

K+ Mg+ P-

Question 50

Na/K pump function

Answer 50

uses ATPase to maintain normal distributions of Na and K Pumps 3 Na out for every 2 K in

Question 51

Na+ functions

Answer 51

cellular excitation | ECF fluid volume maintenance

Question 52

K+ function

Answer 52

muscle contraction nerve conduction renal function

Question 53

Ca+ functions

Answer 53

muscle & nervous excitation membrane permeability exocrine, endocrine, neurocrine function

Question 54

Mg+ functions

Answer 54

activation of enzyme systems role in ATP production regulation of Ca actions

Question 55

Cl- function

Answer 55

acid-base balance

Question 56

P- function

Answer 56

``` buffer system cellular metabolism (atP) ```