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Nursing Semester 1 > Fluid/Electrolytes > Flashcards

Fluid/Electrolytes Flashcards

1
Q

Extracellular fluid (ECF)

A

fluid outside the cell

1/3 of body’s H20

more prone to loss

3 types

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2
Q

3 types of extracellular fluid:

A

Interstitial: fluid around/between cells

Intravascular: (plasma) fluid in blood vessels

Transcellular- CSF, synovial fluid, etc

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3
Q

Intracellular fluid (ICF)

A

Fluid inside the cell

Most 2/3 of body’s H20 is in the ICF

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4
Q

Infant fluid compartments:

A

60% of H20 is found in the ECF

40% of H20 is found in ICF

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5
Q

Adults or infants are more prone to fluid loss?

A

Infants!

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6
Q

Body tries to maintain homeostasis of fluids and electrolytes by regulating:

A

volumes

solute charge and osmotic load

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7
Q

What is the minimum output her hour necessary to maintain renal function?

A

30mL/hr

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8
Q

Loss of 10% body fluid= ______-weight loss and is _____

A

8% weight loss and is SERIOUS

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9
Q

Loss of 20% body fluid = _____ weight loss and is _____

A

15% weight loss and is FATAL

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10
Q

Electrolytes:

A

charged particiles

cations- positively charged ions
Na+, K+, Ca++, H+

Anions: negatively charged ions
Cl-, HCO3-, PO43-

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11
Q

Non electrolytes:

A

uncharged particles- proteins, urea, glucose, O2, CO2

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12
Q

Functions of body fluid (6)

A

medium for transport

cellular metabolism

solvent for electrolytes and other constituents

body temperature

digestion and elimination

lubricant

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13
Q

Hypothalamus:

A

thirst receptors

osmoreceptors monitor serum osmolarity.

If it rises, thirst mechanism is triggered

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14
Q

Sodium is found in the

A

extracellular compartment

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15
Q

Potassium is found in the

A

intracellular compartment

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16
Q

Magnesium is found more in the

A

intracellular compartment

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17
Q

Chloride is found in the

A

extracellular compartment

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18
Q

Solute homeostasis is maintained by

A

ion transport

water movement

kidney function

these functions act to keep body fluids:

electrically neutral
osmotically stable

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19
Q

Diffusion

A

movement of particles DOWN a concentration gradient

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20
Q

Facilitated diffusion

A

addition of specific carrier molecules to aid/accelerate diffusion (glucose transport into cell facilitated by insulin)

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21
Q

Osmosis

A

diffusion of water across a selectively permeable membrane

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22
Q

Active transport

A

movement of particles UP a concentration gradient; REQUIRES ENERGY

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23
Q

Osmolarity (tonicity)

A

concentration of particles in a solution

the greater the concentration (osmolarity) of a solution, the greater the pulling force (osmotic pressure)

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24
Q

A solution that has a HIGH osmolarity is a _____ solution

A

HYPERTONIC solution

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25
A solution that has a LOW osmolarity is a _____ solution
HYPOTONIC solution
26
A solution that has EQUAL osmolarity is a ________ solution
ISOTONIC (normal saline)
27
Hypertonic fluids have a _____ concentration of particles (high osmolality) than ICF
higher!
28
Higher osmotic pressure shifts fluid from the cells into the
ECF
29
Cells placed in a hypertonic solution will
SHRINK!!!!!!
30
Hypertonic solution is used to
temporarily treat hypovolemia expand vascular volume fosters normal BP and good urinary output (often used post op)
31
Hypotonic fluids have less concentration of particles than
ICF
32
The low osmotic pressure shifts fluid from
ECF into cells
33
Cells placed in a hypotonic solution will
SWELL!
34
Hypotonic solution is used to
dilute plasma particularly in hypernatremia treats cellular dehydration do not use for patients with increased ICP risk or third spacing risk- edema!
35
Isotonic fluids have the same concentration of particles (osmolality) as
ICF
36
Osmotic pressure is therefore the _____ inside and outside the ____
SAME cell
37
Cells do not ___ or ____ in an isotonic solution. They _____
DO NOT SWELL OR SHRINK THEY STAY THE SAME!
38
Isotonic solution expands...
both intracellular and extracellular volume used commonly for excessive vomiting and diarrhea 0.9% normal saline D5W Ringer's Lactate
39
Albumin is a
serum protein that has osmotic properties called colloid pressure
40
Albumin pulls...
H2O from the interstitial compartments into the intravascular compartments (serum) Helps to maintain BP
41
persons with low serum albumin levels tend to
retain fluid in their interstitial layers
42
What are abnormal assessments might you find in the client with low serum albumin levels?
EDEMA HYPOTENSION
43
Third spacing is
when tissue injury occurs, proteins pathologically leak from the intravascular space into the interstitial space
44
Fluid volume deficit FVD (Hypovolemia)
Loss of both H20 and electrolytes from ECF
45
Causes of FVD (Hypovolemia)
Increased output hemorrhage vomiting diarrgea burns OR fluid shift out of vascular space ("third spacing") into interstitial spaces
46
Isotonic dehydration:
H20 and electrolyte loss in equal amounts; diarrhea and vomiting
47
Hypertonic dehydration:
H20 loss is greater than electrolyte loss excessive perspiration diabetes
48
Assessment of fluid volume deficit Cardiovascular
Diminished peripheral pulses; quality 1+ decreased BP and orthostatic hypotension Increased HR Flat neck and hand veins in dependent position Elevated Hematocrit (HCT)
49
Assessment of fluid volume deficit Gastrointestinal
Thirst Decreased motility diminished bowel sounds possible constipation
50
Nursing diagnosis deficient fluid volume:
R/T loss of GI fluids via vomiting AEB elevated Hct, dry mucous membranes, decreased output, thirst
51
Interventions for deficient fluid volume (hypovolemia)
prevent further fluid loss oral rehydration therapy IV therapy Medications- antiemetics, antidiarrheals Monitor VS, resp, renal, GI status Monitor electrolytes- possible supplement Rx Monitor weight and I/O
52
Hypervolemia:
excess fluid volume in the intravascular area fluid overload is an excess of body fluid: over hydration
53
Excess fluid volume in interstitial spaces:
edema
54
Electrolyte functions:
work with fluids to keep the body in balance regulate water distribution muscle contraction nerve impulse transmission blood clotting regulate enzyme reactions (ATP) Regulate acid-base balance
55
Electrolytes are ___
solutes that are found in various concentrations and measured in milliequivalent units anions or cations- homeostasis body needs total body anions-total body cations
56
Electrolyte imbalance of Potassium (K+)
Hypokalemia Hyperkalemia
57
Electrolyte imbalance of Calcium (Ca2+)
Hypo/Hyper calcemia
58
Electrolyte imbalance of Magnesium (Mg2++)
Hypo/Hyper magnesia
59
Sodium normal range:
135-145mEq/L
60
Sodium facts!
MAJOR CATION Chief electrolyte of the ECF regulates volume of body fluids Needed for nerve impulse & muscle fiber transmission (Na/K pump) regulated by kidneys/hormones
61
Hyponatremia range:
Serum Na_ < 135mEq/L
62
Hyponatremia facts!
Results from excess of water or loss of Na+ Water shifts from ECF into cells S/S: abd cramps, confusion, N/V Tx: Diet/IV therapy/fluid restrictions
63
What are some medical conditions that may cause a dilution hyponatremia?
CHF Renal failure SIADH (cancer, pituitary trauma) Addisons Disease (hypoaldosteronism & Na loss)
64
What are some conditions that might cause actual loss of sodium from the body?
GI losses- nasogastric suctioning, vomiting, diarrhea Certain diuretic therapies
65
Permanent neurological damage can occur when serum Na levels fall below 110 mEq/L. Why?
Hypotonic environment swells cells, increasing ICP- brain damage
66
Hypernatremia range:
Serum Na+>145mEq/L
67
Hypernatremia facts
Results from Na+ gained in excess of H2O OR Water is lost in excess of Na+ water shifts from cells to ECF
68
Hypernatremia signs and symptoms:
thirst dry mucous membranes & lips oliguria increased temp & pulse flushed skin confusion
69
Treatment for hypernatremia
IV therapy/diet
70
Potassum:
3.5-5.0 mEq/L Chief electrolyte of ICF Major mineral in all cellular fluids
71
Potassium aids in
muscle contraction nerve/electrical impulse conduction regulates enzyme activity regulates IC h20 content assists in acid-base balance
72
Potassium is regulated by
kidneys/hormones inversely proportional to Na
73
ECF has which two major divisions? minor division?
Intravascular- liquid part of blood (plasma) interstitial- between cells and outside blood vessels Transcellular (minor)- cerebrospinal, pleural, peritoneal, synovial fluids are secreted by epithelial cells
74
Major cations in body
Sodium (Na+) Potassium (K+) Calcium (Ca2+) Magnesium (Mg2+)`
75
Major anions in body
Chloride (Cl-) Bicarbonate (HCO3-)
76
Osmolality
measure of the number of particles per kilogram of water. `
77
Isotonic
fluid with the same tonicity as normal blood
78
Hypotonic
solution is more DILUTE than the blood Cell will swell
79
Hypertonic
solution is MORE CONCENTRATED than normal blood cell SHRINKS
80
Processes that move water and electrolytes between body compartments
active transport diffusion osmosis filtration
81
Active transport:
cells maintain their high intracellular electrolyte concentration by active transport requires energy in form of ATP to move electrolytes across cell membrane AGAINST concentration gradient (low concentration to high concentration) Sodium-potassium pump
82
Diffusion
Passive movement of electrolytes DOWN a concentration gradient higher concentration to lower concentration requires proteins that serve as ion channels
83
Osmosis
water moves across cell membranes by osmosis. water moves through a membrane that separates fluids with different particle concentrations
84
Osmotic pressure
an inward pulling force caused by particles in the fluid
85
Hydrostatic pressure
force of the fluid pressing outward against a surface
86
Blood colloid osmotic pressure (oncotic pressure)
is an inward-pulling force caused by blood proteins that helps move fluid from the interstitial area back into capillaries)
87
Fluid homeostasis includes which three processes
fluid intake and absorption fluid distribution fluid output
88
Fluid output normally occurs through which 4 organs
skin, lungs, GI tract, kidneys
89
Insensible water loss is
NOT VISIBLE CONTINOUS through the skin and lungs
90
Approximately how many L of fluids moves into the GI tract daily and returns to the ______
3-6 L daily Returns to ECF
91
ADH regulates the ____
Antidiuretic hormone osmolality of the body fluids by influencing how much water is excreted in urine
92
ADH is released by
Posterior pituitary gland
93
More ADH is released if
body fluids become more concentrated
94
Factors that increase ADH levels include
severely decreased blood volume (dehydration, hemorrhage) pain stressors some medications
95
ADH causes
renal cells to RESORB water, taking water from the renal tubular fluid and putting it BACK INTO BLOOD
96
ADH levels decrease if
body fluids become TOO DILUTE This allows more water to be excreted in urine
97
The RAAS regulates
ECF volume by influencing how much sodium and water are excreted in urine

Nursing Semester 1 (24 decks)

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