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Block 1 Nursing SCC > Fluid & Electrolytes > Flashcards

Fluid & Electrolytes Flashcards

(115 cards)

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1
Q

Define Electrolyte

A

A solute that develops an electrical charge (sodium and potassium).

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2
Q

Intracellular fluid

A

Fluid contained within the cells. 40% of body weight and is responsible for cell function and metabolism. ~28L in adult

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3
Q

Extracellular fluid

A

Fluid outside the cells. 20% body weight, carries water, oxygen, electrolytes, nutrients to cells and removes waste products from cellular ,metabolism. ~14L in adult

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4
Q

Major electrolytes in ICF; cations and anion

A

Cations: Potassium, magnesium
Anion: phosphate

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5
Q

Main electrolytes in ECF; cations and anion

A

Cations: sodium, chloride
Anion: bicarbonate

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6
Q

Define interstitial fluid

A

ECF located in the spaces between the cells. Excess fluid here is called edema. Second spacing

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7
Q

Define intravascular fluid

A

ECF located within the blood vessels. It is the plasma located in the blood. Transports blood cells

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8
Q

Define transcellular fluid

A

ECF that includes specialized fluids that are contained in body spaces ( cerebrospinal, pleural, peritoneal, and synovial fluids) and digestive juices. ~1L

Fluid movement into a compartment is known as third spacing (Ascities).

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9
Q

Define osmolality (tonicity)

A

The concentration of solutes creating pressure in body fluid.

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10
Q

Isotonic solution

A

Of the same osmolality of blood ; no osmosis will occur

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11
Q

Hypotonic solution

A

Of lower osmolality than blood ; water will move into cells by osmosis from vascular system

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12
Q

Hypertonic solution

A

Contains a higher concentration of solutes than blood ; water moves by osmosis out of cells into ECF

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13
Q

Define osmosis

A

The movement of water (passive) from a lower solute concentration to a higher solute concentration to achieve dilution of higher solute concentration to reach equilibrium

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14
Q

Define diffusion

A

Movement (passive) of molecules of a solute from a higher concentration to a lower concentration to reach equilibrium

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15
Q

Factors affecting rate of diffusion

A

Size of molecule, concentration of solution, and temperature of solution.

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16
Q

What are crystalliods

A

Solutes that readily dissolve ( electrolytes)

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17
Q

What are colloids

A

Larger molecules that do not dissolve readily ( proteins)

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18
Q

Define filtration

A

The movement of both water and smaller solutes from an area of high pressure to area of low pressure

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19
Q

Define hydrostatic pressure

A

The force created by fluid within a closed system ; responsible for normal circulation of blood

High pressure (arteries) to low pressure (capillaries and veins)

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20
Q

Define osmotic pressure

A

The power of a solution to draw water.

A highly concentrated solution draws water and has a high osmotic pressure.

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21
Q

Filtration pressure

A

When hydrostatic pressure exceeds osmotic pressure fluid leaves the vessels.

Represents the net pressures that move fluid and solutes

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22
Q

Active transport

A

Occurs when molecules move across cell membranes against the concentration gradient with the use of ATP (from an area of low concentration to an area of high concentration)

Ex: sodium-potassium pump

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23
Q

Define Solute

A

Solid substance that dissolves in body fluids

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24
Q

Factors that increase plasma osmolality

A

excessive fluid loss, excessive sodium intake, and decreased fluid intake.

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25
changes in plasma osmolality signal which center in the brain
the thirst center in the hypothalamus
26
sensible fluid loss
measurable and perceived | ex: urine 1500mL, diarrhea, ostomy, gastric drainage, skin 300-600mL, feces 100-200mL
27
insensible fluid loss
loss that we do not perceive and cannot measure accounts for about 900mL per day ex: lungs about 300mL per day
28
what is the principal regulator of fluid and electrolyte balance
kidneys
29
what hormones are involved in regulation
ADH, Renin-Angiotensin System, Aldosterone, Thyroid, ANP & BNP & CNP
30
define ADH and function
pressure sensors from the vascular system stimulate or inhibit the release of antidiuretic hormone from pituitary gland. ADH causes kidneys to retain fluid. ADH is also produced in response to a rise in serum osmolality, fever, pain, stress, and some opioids. ex: if fluid volume in the vascular system is low, fluid pressures decrease, and more ADH is released to signal kidneys to retain more fluid.
31
define Renin-Angiotensin System and function
when intravascular fluid volume is decreased, receptors in the glomeruli respond to the decreased perfusion of the kidneys by releasing renin. Renin is responsible for a chain reaction that converts angiotensin into angiotensin 2. Angiotensin 2 acts on the nephrons to retain sodium and water and directs the adrenal cortex to release aldosterone.
32
define aldosterone and function
when released, it stimulates the distal tubules to reabsorb sodium and excrete potassium. with this, water is passively reabsorbed thereby increasing fluid volume and renin is not released and this process stops.
33
define thyroid hormone and function
affects fluid volume by influencing cardiac output. and increase in thyroid hormone causes increase in CO and increases glomerular filtration rate and urine output. a decrease does the opposite.
34
define Natriuresis (ANP, BNP, CNP) and functions
natriuretic is the discharge of sodium through urine BNP is released from brain and right atrium. can be measured to help determine presence of heart failure with fluid excess and to distinguish heart failure from pulmonary edema.
35
Sodium (Na+)
major cation in the ECF. primary function to regulate fluid volume. reabsorbed and excreted by kidneys. Moves by active transport via sodium-potassium pump, regulated by ADH and aldosterone levels (pituitary)
36
Potassium (K+)
major cation in the ICF (98% in icf). key electrolyte in cellular metabolism. necessary transmission/conduction of nerve and muscle impulses, maintenance of cardiac rhythms, cellular growth, acid-base balance. Na+ K+ pump (3sodiums out 2 potassiums in) regulated by aldosterone. excreted and conserved primarily by kidneys ~90% daily K+. Sodium retention = potassium loss in urine
37
Calcium (Ca++)
responsible for bone health, neuromuscular, and cardiac function. essential factor in blood clotting. 99% is found in bones and teeth, the remainder 1% circulates in the blood and affects system functions. as serum calcium levels drop, ca++ is leached from bones and into the blood to compensate.
38
Magnesium (Mg++)
mineral used in more than 300 biochemical reactions in the body. like calcium, only about 50-60% is found in the bone. 2% is in the ECF. coenzyme in metabolism of protein and carbs. required for nucleic acid and protein synthesis. necessary for na-K pump. skeletal muscle relaxation. Mistaken for Ca+ imbalance; if you replace K, also replace Mg++
39
Chloride (Cl-)
most abundant anion in the ECF. usually bound with other ions especially sodium or potassium. essential for hydrochloric production for gastric sectretions. found in food high in sodium
40
Phosphorus (Phosphate [Po4-])
Most abundant ICF anion. most phosphorous in the body is combined with oxygen forming phosphate-mostly bound with calcium in teeth and bones as calcium phosphate. phosphate and calcium exist in an inverse relationship. Phosphate in the ECF is known as phosphorus.
41
Bicarbonate (HCO3-)
present in both ICF and ECF. The kidneys regulate EC bicarbonate to maintain acid-base balance. when serum levels rise, kidneys excrete excess bicarbonate. It is not consumed in the diet but is produced by the body to meet current needs. a major buffer.
42
what is an acid
any compound that contains hydrogen ions that can be released. acids are referred to cation donors.
43
what is a base/alkali
a compound that combines with (accepts) hydrogen ions in solution. bases are referred to cation receptors.
44
what is pH
the amount of acid or base present in a solution; measured as 1-14. 1-6.9 as being acidic 7 is neutral and 7.1-14 is basic.
45
Hgb Female
12-16 g/dL
46
Hgb Male
14-18 g/dL
47
HCT
Hgb x 3 %
48
BUN
10-20 mg/dL
49
Creatinine
0.5-1.5 mg/dL
50
Urine Specific Gravity
1.003-1.03
51
Serum Osmolality
280-300 mOsm/kg of H2O
52
Glucose
70-100 mg/dL
53
Na+
135-145 mEq/L regulation of fluid volume, ECF, Most abundant electrolyte in the body
54
K+
3.5-5 mEq/L ICF, muscle contraction, cardiac conduction
55
Cl-
95-105 mEq/L ECF, bound to other ions
56
Mg++
1.5-2.5 mEq/L many cellular functions, ICF, bone 300 biochemical reactions
57
Phosphorous
2.5-4.5 mg/dL ICF anion, bound with calcium in teeth and bones, inverse relationship, combined with O2
58
Ca++
8.5-10.5 mg/dL bone health, neuromuscular function, cardiac function, insufficiency leads to osteoporosis
59
pH
7.35-7.45
60
PaCO2
35-45mmHg
61
HCO3
22-26 mEq/L
62
PaO2
80-100 mmHg
63
SaO2
95-100 %
64
Define nonelectrolyte
does not emit electrical charge when dissolved into water | ex: glucose, urea
65
Functions of body fluids
maintain blood volume, regulate body temp, transport materials to and from cells, medium for cell metabolism, assist with digestion of food, medium for excreting waste.
66
Infant, Adult, & Older Adult body water composition
70-80%, 50-60%, & 45-55%
67
First Spacing
normal distribution between ECF & ICF (homeostasis)
68
Second Spacing
abnormal accumulation of interstitial fluid (edema) -hypervolemic
69
Third Spacing
fluid is trapped and unavailable for functional use - loss of ECF - hypovolemic -increased fluid in peritoneal cavity = ascities
70
ICF Cations and Anions
Potassium, Magnesium, Sodium | Phosphate, Sulfate, Bicarbonate
71
ECF Cations and Anions
Sodium, Potassium, Calcium, Magnesium | Chloride, Bicarbonate, Sulfate, Phosphorous
72
IOM recommendation of fluid intake men and women
3500mL/day men ; 2700 mL/day women
73
Daily urine output
1500 mL
74
Daily skin output
650-900 mL - sensible 300-500mL (sweat) - insensible 350-400 mL (diffusion)
75
Daily lung output
300-400 mL
76
Daily feces output
100-200mL
77
Sources of electrolytes
fruit, veggies, grains, enriched foods, supplements
78
dietary sources of sodium
table salt (40% sodium), cheese, eggs, fish/shellfish, poultry, processed foods
79
dietary sources of potassium
fruits(bananas, oranges), veggies, salt substitutes(high potassium)
80
what are the 3 forms of calcium
ionized, bound to protein, complexed | when a lab calcium is drawn, a total of all 3 are shown as the result
81
ionized calcium
free, active calcium, important for neuromuscular transmission
82
bound to protein calcium
albumin ; alteration of albumin levels will alter the total calcium levels but ionized level will not be affected
83
complexed calcium
phosphate, citrate, carbonate
84
dietary sources of calcium
dairy - milk, yogurt, cheese dark leafy greens salmon
85
Calcium Regulation
PTH, Calcitonin, Vit. D, Phosphorus
86
Parathyroid hormone r/t calcium regulation
stimulates release of calcium from bones and reabsorption from the kidneys and intestines into blood
87
Calcitonin r/t/ calcium regulation
blocks bone breakdown and lowers calcium levels -thyroid -against PTH.
88
Vit. D r/t calcium regulation
sunlight and diet. stimulates calcium absorption. calcium will not work with out Vit. D
89
Phosphorus r/t calcium regulation
inversely proportional to calcium
90
Dietary sources for magnesium
green leafy veggies, nuts, legumes, whole grains, chocolate
91
Dietary sources of phosphate
meat, fish, poultry, diary products, legumes, whole grains
92
Hyponatremia
Na+
93
Hypernatremia
Na+ > 145 ; can affect cerebral cells, neuro changes
94
Hypokalemia
K+
95
Hyperkalemia
K+ > 5 ; can affect cardiac function
96
Hypomagnesemia
Mg++
97
Hypermagnesemia
Mg++ > 2.5
98
Hypophosphatemia
99
Hyperphosphatemia
> 4.5
100
Hypocalcemia
101
Hypercalcemia
> 10.5
102
Hypochloremia
103
Hyperchloremia
> 105
104
Dehydration
loss of water only
105
Hypovolemia (ECF volume deficit)
loss of water and electrolytes -blood volume loss
106
fluid volume deficit results from...
GI loss, burns, polyuria, loss of blood, inadequate intake, plasma to interstitial fluid shift.
107
S/Sx of Dehydration
thirst, dizziness/weakness, mental status change (mild confusion to coma), dry skin/mucous membrane, poor skin turgor, decreased urine output, weight loss, tachycardia, hypotension, seizures, fever
108
Labs of dehydrated pt
increased BUN, HCT, serum osmolality, urine specific gravity, sodium
109
Fluid volume excess Overhydration
retention of water only
110
Hypervolemia (ECF volume excess)
retention of water and electrolytes
111
fluid volume excess results from...
excess intake of fluids, abnormal retention of fluids (CHF, renal failure, increased intake sodium), interstitial to plasma fluid shift
112
S/Sx of fluid volume excess
elevated BP, bounding pulse, faster/shallow respirations, pale cool skin, edema (tissues and lungs), increase urine volume,
113
Labs of an overhydrated pt...
low hematocrit, bun, decreased urine specific gravity, serum osmolality, sodium, pulmonary congestion on cxr
114
MOST accurate way to evaluate fluid volume
daily weight
115
Fluid and electrolyte imbalances can severely affect ...
infants, older adults, the severely ill, disoriented, or immobile pts.

Block 1 Nursing SCC (11 decks)

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