FLUID, ELECTROLYTES AND ELIMINATION Flashcards
(97 cards)
1
Q
Water is vital to health and normal cellular function serving as?
A
- medium for metabolic reactions
- transporter for nutrients and waste products
- lubricant
- insulator and shock absorber
- regulating and maintaining temperature
2
Q
Why do we need to regulate electrolytes?
A
- fluid balance
- acid and base regulation
- enzyme reactions
- neuromuscular reactions
3
Q
What disturbs fluid volume and electrolyte?
A
- illness
- trauma
- surgery
- medications
4
Q
What are the two types of Fluid Imbalances?
A
A. Isotonic
B. Osmolar
5
Q
What are the 4 categories of Fluid Imbalances?
A
1 Fluid Volume deficit
2 Fluid Volume Excess
3 Dehydration/hyperosmolar
4 Overhydration/Hypo-osmolar
6
Q
How do we say that a patient already has a mild fluid deficit?
A
If the patient already lost 2 % of his/her weight.
7
Q
What do we call the feeling of dizziness upon abrupt standing?
A
Postural Hypotension
8
Q
We look at this to determine if the patient is dehydrated or hydrated.
A
Specific gravity of urine
9
Q
What is the normal specific gravity of urine?
A
1.0
10
Q
How many percentage of water is contained in the human body? Adult vs infant vs old?
A
Adult = 60%
Infant = 70% to 80%
Old age (>60) = 50%
11
Q
Total body fluid
A
40 liters
12
Q
Cell fluid
A
25 liters
A. plasma - 3L
B. Interstitial and transcellular fluid - 12L
C. Extracellular - 15L
13
Q
It is the fluid found within the cells of the body.
A
Intracellular Fluid (ICF)
14
Q
Found outside the cells and accounts 1/3 of the total body fluid.
A
Extracellular Fluid (ECF)
15
Q
What are the two main components of ECF?
A
a. Intramuscular fluid or plasma = 20% of ECF
B. Interstitial fluid = 75% of ECF which surrounds the cell
The other components are lymph and transcellular fluids
16
Q
What do we call charged particles?
A
Ions
17
Q
What do we call charged particles that are capable of conducting electricity?
A
Electrolytes
18
Q
Number of Ions that carries a positive charge
A
cations
ex: Na+, K+, Ca2+, Mg2+
19
Q
Number of Ions that carries a negative charge
A
anion
ex: Cl-, HCO-3,PO3-4 SO2-4
20
Q
What is the unit of electrolytes?
A
mEq/L (milliequivalents per liter) OR mg/100 mL (milligrams per 100 milliliters
21
Q
A protein primarily produced by the liver that plays a crucial role in maintaining fluid balance in the bloodstream and transporting various substances like hormones, vitamins, and enzymes. It is the most abundant protein in blood plasma.
A
Albumin
22
Q
What are the primary cations and anions present in ICF?
A
cations: potassium and magnesium
anions: phosphate and sulfate
23
Q
substances dissolved in liquid and it’s two kinds?
A
Solutes
a. crystalloids-salts that dissolve readily in true solutions
B. colloids-substances such as large protein molecules that do not readily dissolve into true solutions
24
Q
Component of solution that can dissolve a solute
A
Solvent
25
It is the concentration of solutes in body fluids which is expressed as?
Osmolality
- determined by the total solute concentration and is reported as mOsm/kg read as milliosmoles per kilogram
26
Used to refer to the osmolality of one solution in relation to another solution
Tonicity
27
Solution that has the same osmolality as the extracellular Fluid and normal saline which is made up of 0.9% sodium chloride is an example.
Isotonic Solution
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This solutions have higher osmolality than extracellular Fluid. 3% sodium chloride is an example.
Hypertonic Solution
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These solutions have lower osmolality than Extracellular Fluid. 0.45% sodium chloride is an example.
Hypotonic solution
30
It is the power of a solution to pull water across a semi permeable membrane.
Osmotic pressure
31
In the body, plasma proteins also exert osmotic pressure called?
colloid osmotic pressure or osmotic pressure
32
The 4 methods by which water and solutes move in the body:
diffusion
osmosis
filtration
active transport
33
Occurs when two solutes of different concentrations are separated by a semi permeable membrane.
Diffusion
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It is a specific kind of diffusion in which water moves across cell membrane, from a less concentrated solution to a more concentrated solution.
Osmosis
35
It is a process whereby fluid and solutes move together across a membrane from an area of higher pressure to an area of lower pressure
Filtration
36
The pressure that results in the movement of the fluid and solutes out of a compartment.
Filtration pressure
37
It is the pressure exerted by a fluid within a closed system on the walls of the container in which it is contained.
Hydrostatic pressure
38
It is the movement of solutes across cell membranes from a less concentrated solution to a more concentrated one.
Active Transport
39
40
How much water is needed to drank everyday for normal functioning?
2500 mL
41
It is the primary regulator of Fluid intake
thirst mechanism which is controlled by the thirst center located in the hypothalamus of the brain
42
A hormone released in response to decreased blood flow to te kidneys
Angiotensin
43
How long does it take for fluid to be absorbed and distributed throughout the body?
between 30 minutes to 1 hour
44
What are routes of Fluid output?
Urine
Feces
Insensible losses (perspiration and expired air)
45
46
Certain fluid losses that are requires to maintain normal body function is known as?
Obligatory losses, for example approximately 500 ml of Fluid must be excreted through the kidneys of an adult each day to eliminate metabolic waste products.
47
It is synthesized in the anterior portion of the hypothalamus which regulates water excretion from the kidney - acts on the collecting ducts of the nephron.
Antidiuretic Hormone
48
It is another neuroendocrine control mechanism that contributes to maintaining fluid balance which is aso stimulated by changes in Renal perfusion.
Renin-Angiotensin-Aldosterone System
49
What is released when blood flow or pressure to the kidney decreases?
Renin
50
Renin causes the conversion of what?
Renin causes the conversion of angiotensinogen to angiotensinogen I which is then converted to angiotensinogen II by the angiotensin-converting enzyme.
51
What is the function of Angiotensin II?
Angiotensin II acts directly on the nephrons to promote sodium and water retention. It also stimulates the release of aldosterone from the adrenal cortex which then promotes sodium retention in the distal nephron.
52
What is net effect of the Renin-Angiotensin-Aldosterone system?
To increase blood volume and Renal perfusion through sodium and water retention.
53
This is released from cells in the atrium of the heart in response to excess blood volume and stretching of the atrial walls.
Atrial Natriuretic Factor, it also promotes sodium wasting and acts as a potent diuretic thus decreasing blood volume. It also inhibit thirty reducing fluid intake.
54
When this occurs, the osmoreceptors in the hypothalamus stimulate posterior pituitary to secrete ADH which increases distal tube permeability.
Increase in blood osmolality
55
What happens when ADH or anti diuretic hormone increases distal tubule permeability?
There is an increase of water into blood which will decrease urine output.
56
Now what happens when blood osmolality is decreased?
Antidiuretic hormone is suppressed which causes distal tubules in the kidneys to become less permeable to water. Hence there is a decrease in the reabsorption of water into blood increasing the urine output.
57
It is the most abundant cation in the ECF and a major contributor to serum osmolality.
Sodium (Na+)
58
It is the major cation in the ICF with only a small amount found in the ECF which must be maintained for neuromuscular response to stimuli.
Potassium (K+)
59
99% of this in the body is stored in the skeletal system with a relatively small amount in extracellular fluid. This small amount is vital in regulating neuromuscular function, muscle contraction and relaxation as well as cardiac function.
Calcium (Ca2+)
60
What happens when the Calcium levels in the ECF falls?
The parathyroid hormone and calcitriol cause calcium to be released from bones into the ECF and increasing the absorption of calcium in teh intestines thus raising serum calcium levels.
61
What stimulates the deposition of calcium in bone, reducing the concentration of calcium ions in the blood?
Calcitonin
62
Why does osteoporosis and fractures of wrists, vertebrae, and hips prone to old men and women?
Because as age increases, the intestines absorb calcium less effectively and more calcium is excreted or flushed out by the kidneys. Calcium shifts then out of the bone to replace these ECF losses, increasing the risk of the conditions mentioned.
63
This is found primarily in the skeleton and ICF, where
it is the second most abundant intracellular cation. It is important for intracellular metabolism, particularly in the production and use of ATP. Also necessary for protein and DNA synthesis within the cells.
Magnesium (Mg2+)
64
Why is maintaining and ensuring adequate magnesium levels an important part of the care of clients with cardiac disorders?
Magnesium plays a vital role in regulating the heart's rhythm, nerve and muscle function, and blood pressure.
65
This is the major anion of ECF and functions with Sodium to regulate serum osmolality and blood volume. It is found in the same food as sodium.
Chloride (Cl-)
66
This is the major anion of ICF however it is also found in ECF, bone, skeletal muscle, and nerve tissue. Children and infants have higher levels of this anion compared to adults due to their higher levels of growth hormone and a faster rate of skeletal growth.
Phosphate (PO3-4)
67
This is present in both ICF and ECF. It regulates acid-base balance and unlike electrolytes that must be concumed in the diet, this are produced through metabolic processes.
Bicarbonate (HCO-3)
68
Define an acid.
Acid is a substance that releases hydrogen ions (H+) in solution. Strong acids releases all their hydrogen ions while weak acids only release some.
69
Define bases or alkalis
Bases or alkalis have a low hydrogen ion concentration and can accept hydrogen ions in solution.
70
Define pH
pH is the measurement of relative acidity or alkalinity of a solution through an inverse reflection of the hydrogen ion concentration of the solution.
71
The higher the hydrogen ion concentration, the what?
The higher the hydrogen ion concentration, the lower the pH. and vice versa.
72
73
How much pH does a water have?
Water has a pH of 7 and is neutral.
74
What do we call solutions with a PH lower than 7?
Acidic
75
What about the solutions with a PH higher than 7?
Alkaline
76
The pH scale is logarithmic, meaning?
A solution with a PH of 5 is 10 times more acidic than one with a PH of 6.
77
What is the normal pH of arterial blood?
Between 7.35 and 7.45
78
Define Buffers
Buffers prevent excessive changes in pH by binding with or releasing hydrogen ions.
79
Aside from the Bicarbonate-Carbonia acid buffer system, what are other buffers present in body fluids?
Plasma proteins
Hemoglobin
Phosphates
80
Although buffers and the respiratory system can compensate for changes in pH, what body part is the ultimate long-term regulator of acid-base balance?
The kidneys! Even though they are slower to respond to changes like hours to days to correct imbalances, their response is more permanent and selective compared to other systems.
81
Why are infants at high risk for fluid and electrolyte imbalance?
-kidneys are not fully developed to concentrate urine
-rapid RR and larger body surface leading to greater insensible losses
-inability to express thirst
82
Why are older adult at high risk for fluid and electrolyte imbalance?
Because of decrease in:
-thirst sensation
-ability of the kidneys to concentrate urine
-ICF and total body water
-Response to body hormones that help regulate fluid and electrolytes
83
What are other factors that may influence fluid and electrolyte balance in order adults?
- use of diuretics for hypertension and heart disease
-decreased intake of food and water especially with those who have dementia and are dependent
-NPO
-impaired Renal function
84
Why is sex and body size a factor affecting body fluid, electrolytes, and acid-base balance?
People who have a higher percentage of fat have less body water. Women generally have more body fat therefore less body water than men.
85
How about environmental temperature?
Fluid loss through sweating when the temperature is hot.
86
Why is lifestyle a factor? Such as diet, stress, and alchohol consumption?
Anorexia = inadequate intake
Malnourished = edema
Inadequate calorie intake = fatty acids are released
Stress = decrease urine production
Alcoholic = low Ca, Mg, and Phosphate leading
87
This occurs when the body loses both water and electrolytes from the ECF in similar proportions.
Isotonic Fluid Volume deficit
88
In fluid volume deficit or FVD, fluid is initially lost from the intravascular compartment so it is often called?
Hypovolemia
89
Why does FVD generally occurs?
a. abnormal losses through the skin, GI tract, or kidney
B. decreased intake of fluid
C. bleeding
d. movement of fluid into a third space
90
If the fluid in the vascular space of patient Rose shifts from the vascular space into an area where it is not accessible and becomes unavailable for use, what condition does she have?
Third Space Syndrome
91
Differentiate thtwo distinct Phases of third Spacing? loss vs reabsorption
The client with third space syndrome during loss phase has an isotonic fluid deficit while in reabsorption phase, tissues begin to heal and fluid moves back into the intravascular space.
92
When patient Caspian's body retains both water and sodium in similar proportions to normal ECF, what condition does he have?
Fluid Volume excess (FVE) also known as hypervolemia
93
What are the levels used to Evaluate edema and the condition of each?
1+ = barely detectable
2+ = 2 to 4mm
3+ = 5 to 7mm
4+ = more than 7mm
94
This occurs when there is a carbon dioxide retention either due to hypo ventilation or impaired lung function which causes carbonic acid levels to increase and PH to fall below 7.35
Respiratory Acidosis
95
When a person hyperventilates, more carbon dioxide than normal is exhaled, carbonic acid levels fall, and the pH rises to greater than 7.45 which is called?
Respiratory Alkalosis
96
What develops when Bicarbonate levels are low in relation to the amount of carbonic acid in the body and the PH falls?
Metabolic Acidosis
97
What are the possible causes of metabolic acidosis?
Can occur because of Renal Failure and the inability of the kidneys to excrete hydrogen ions and produce Bicarbonate.
