FLUID, ELECTROLYTE, AND ACID-BASE BALANCE

Question 1

▪ Within vascular system
▪ Accounts for approximately 20% of ECF

Answer 1

Intravascular or plasma

Question 2

(positive charge),

Answer 2

Cations

Question 2

Surrounds cells

Answer 2

Interstitial

Question 2

o Charged particles

Answer 2

• Electrolytes

Question 3

▪ refers to the chemical combining power
of the ion, or the capacity of cations to
combine with anions to form molecules

Answer 3

milliequivalents (mEq)

Question 3

(negative
charge)

Answer 3

anions

Question 4

• Mostly sodium, chloride, and
  bicarbonate

Answer 4

ECF

Question 5

• Potassium, magnesium,
  phosphate, sulfate

Answer 5

▪ ICF

Question 5

Electrolytes
o Charged particles
o Cations (positive charge), anions (negative
charge)
o Usually measured in

Answer 5

milliequivalents (mEq)

Question 6

(salts that dissolve readily into true
solutions)

Answer 6

Crystalloids

Question 6

• component of a solution that can dissolve a solute.

Answer 6

Solvent

Question 7

▪ has the same osmolality as ECF
▪ Normal saline, 0.9% sodium chloride

Answer 7

Isotonic

Question 7

(substances such as large protein
molecules that do not readily dissolve into true
solutions)

Answer 7

Colloids

Question 8

o concentration of solutes in body fluids

Answer 8

• Osmolality

Question 9

▪ 3% sodium chloride
▪ have a higher osmolality than ECF

Answer 9

Hypertonic

Question 10

▪ 0.45% sodium chloride
▪ have a lower osmolality than ECF.

Answer 10

Hypotonic

Question 11

o power of a solution to pull water across a
semipermeable membrane.

Answer 11

Osmotic pressure

Question 12

o holding water in plasma, and when necessary
pulling water from the interstitial space into the
vascular compartment.
o an important mechanism for maintaining vascular
volume.

Answer 12

• Colloid osmotic pressure (oncotic pressure)

Question 13

• Water moves across cell membranes from the less
  concentrated solution (the solution with less solute and
  more water) to the more concentrated solution (the solution
  with more solute and less water).

Answer 13

OSMOSIS

Question 14

• process whereby fluid and solutes move together across a
  membrane from an area of higher pressure to an area of
  lower pressure.

Answer 14

FILTRATION

Question 15

o pressure exerted by a fluid within a closed system
on the walls of the container in which it is
contained.

Answer 15

Hydrostatic pressure

Question 16

FLUID INTAKE
__ mL/day through fluids and food

Answer 16

• 2,500

Question 17

o thirst center is located in the _____ of the
brain

Answer 17

hypothalamus

Question 18

Normal urine
output for an adult is

Answer 18

1,400 to 1,500 mL

Question 19

▪ neuroendocrine control mechanism that contributes to maintaining fluid balance.

Answer 19

Renin-angiotensin-aldosterone system

Question 20

The net effect of the renin-angiotensin- aldosterone system is to increase ____ volume (and _ ) through sodium and water retention.

Answer 20

blood renal perfusion

Question 21

o charged ions capable of conducting electricity, are present in all body fluids and fluid compartments.

Answer 21

* Electrolytes

Question 22

* most abundant cation in ECF and a major contributor to serum osmolality.

Answer 22

SODIUM (NA+ )

Question 23

* major cation in ICF, with only a small amount found in the ECF

Answer 23

POTASSIUM (K+ )

Question 24

* vast majority (99%) of calcium (Ca2+) in the body is stored in the skeletal system, with a relatively small amount in extracellular fluid

Answer 24

CALCIUM (CA2+)

Question 25

o Conservation and excretion by kidneys

Answer 25

MAGNESIUM (MG2+)

Question 26

o Excreted and reabsorbed along with sodium in the kidneys o Aldosterone increases ____ reabsorption with sodium

Answer 26

CHLORIDE (CL− )

Question 27

'* Major body buffer involved in acid–base regulation

Answer 27

BICARBONATE (HCO3 − )

Question 28

* Prevent excessive changes in pH

Answer 28

BUFFERS

Question 29

▪ Loss or gain of water and electrolytes in equal proportions

Answer 29

Isotonic

Question 30

▪ Loss or gain of only water

Answer 30

Osmolar

Question 31

o fluid is initially lost from the intravascular compartment,

Answer 31

* Hypovolemia

Question 32

▪ edema that leaves a small depression or pit after finger pressure is applied to the swollen area

Answer 32

Pitting edema

Question 33

o Excess interstitial fluid

Answer 33

* Edema

Question 34

▪ sodium deficit, or serum sodium level of less than 135 mEq/L

Answer 34

Hyponatremia

Question 35

excess sodium in ECF, or a serum sodium of greater than 145 mEq/L.

Answer 35

Hypernatremia

Question 35

▪ potassium excess, defined as a serum potassium level greater than 5.0 mEq/L

Answer 35

Hyperkalemia

Question 36

calcium deficit, defined as a total serum calcium level of less than 8.5 mg/dL or an ionized calcium level of less than 4.5 mEq/L.

Answer 36

Hypocalcemia

Question 36

▪ potassium deficit, defined as a serum potassium level of less than 3.5 mEq/L.

Answer 36

Hypokalemia

Question 37

▪ calcium excess, defined as a total serum calcium level greater than 10.5 mg/dL, or an ionized calcium level of greater than 5.5 mEq/L

Answer 37

Hypercalcemia

Question 38

magnesium deficiency, defined as a serum magnesium level of less than 1.5 mEq/L

Answer 38

Hypomagnesemia

Question 39

▪ magnesium excess, defined as a serum magnesium level above 2.5 mEq/L, due to increased intake or decreased excretion

Answer 39

Hypermagnesemia

Question 40

▪ chloride deficit, defined as a serum chloride level below 95 mEq/L, and is usually related to excess loss of chloride through the GI tract, kidneys, or sweating.

Answer 40

o Hypochloremia

Question 41

▪ chloride excess, defined as a serum chloride level above 108 mEq/L

Answer 41

Hyperchloremia

Question 42

▪ phosphate deficit, defined as a serum phosphate level of less than 2.5 mg/dL.

Answer 42

Hypophosphatemia

Question 43

▪ phosphate excess, defined as a serum phosphate level greater than 4.5 mg/dL

Answer 43

Hyperphosphatemia

Question 44

* Any condition that causes carbon dioxide retention, either due to hypoventilation or impaired lung function * causes carbonic acid levels to increase and pH to fall below 7.35

Answer 44

RESPIRATORY ACIDOSIS

Question 45

* When a person hyperventilates, more carbon dioxide than normal is exhaled, carbonic acid levels fall, and the pH rises to greater than 7.45.

Answer 45

RESPIRATORY ALKALOSIS

Question 46

* bicarbonate levels are low in relation to the amount of carbonic acid in the body, pH falls

Answer 46

METABOLIC ACIDOSIS

Question 47

* amount of bicarbonate in the body exceeds the normal 20- to-1 ratio.

Answer 47

METABOLIC ALKALOSIS

Question 48

▪ useful in determining whether the kidneys are responding appropriately to acid–base imbalances

Answer 48

Urine pH

Question 49

inflammation of the vein

Answer 49

Phlebitis

Question 49

caused by too large of a catheter in a small vein causing irritation of the vein.

Answer 49

Mechanical phlebitis;

Question 49

▪ performed to evaluate a client’s acid– base balance and oxygenation

Answer 49

Arterial blood gases (ABGs)

Question 50

o unintended administration of a nonvesicant drug or fluid into the subcutaneous tissue.

Answer 50

* Infiltration

Question 51

o unintended administration of vesicant drugs or fluids into the subcutaneous tissue

Answer 51

Extravasation

Question 51

inflammation of the vein and a bacterial infection, which can be caused by poor aseptic technique during insertion of the IV catheter and/or breaks in the integrity of the IV equipment.

Answer 51

Bacterial phlebitis;

Question 52

; occurs when a vein becomes inflamed by irritating or vesicant solutions or medications.

Answer 52

Chemical phlebitis

Question 53

o Risk for antigen–antibody reaction and hemolysis of RBCs

Answer 53

* Rhesus (Rh) factor

Question 54

* to increase the oxygen-carrying capacity of blood in anemias, surgery, and disorders with slow bleeding

Answer 54

Packed red blood cells (PRBCs)

Question 55

* Used for blood replacement following planned elective surgery

Answer 55

Autologous RBCs (client's own blood)

Question 56

▪ causes destruction of the transfused RBCs and subsequent risk of kidney damage or failure

Answer 56

o Hemolytic transfusion reaction

Question 57

▪ sensitivity of the client’s blood to white blood cells, platelets, or plasma proteins; does not cause hemolysis

Answer 57

Febrile Reaction