Fluid & Electrolytes Part 1 Flashcards
1
Q
Total Body Fluid =
A
60 % of Adult’s Total Body Weight (TBW)
2
Q
Intracellular Fluid (ICF) makes up how much of the body’s TBW?
A
40% of TBW
3
Q
Extracellular Fluid (ECF) makes up how much of the body’s TBW?
A
20% of TBW
4
Q
ICF is where in the body?
ECF is where in the body?
A
ICF = Inside the cells
ECF = Anywhere outside of the cells
5
Q
Extracellular Fluid is divided into-
A
Interstitial Fluid
Plasma (Intravascular)
Transcellular
6
Q
Interstitial fluid makes up what % of ECF?
A
15% of ECF
7
Q
Fluid in the spaces between the cells =
A
Interstitial Fluid
8
Q
Cushions the cells + Helps with cell transport =
A
Intracellular Fluid
9
Q
Plasma is -
A
Intravascular
10
Q
Plasma is fluid within-
A
The blood vessel
11
Q
Plasma makes up what % of ECF?
A
4% of ECF
12
Q
Transcellular fluid makes up what % of ECF?
A
1% of ECF
13
Q
Plasma is what part of the blood?
A
The liquid part of the blood
14
Q
Blood cells (Platelets, WBC’s, and RBC’s) are all suspended in-
A
Plasma
15
Q
Transcellular is fluid found in-
A
Body Cavities
16
Q
Places Transcellular Fluid can be found in body cavities like-
A
Cerebrospinal Fluid, GI Tract, Pleural Cavity (a cavity in the lungs), or the Pericardial Space
17
Q
% of TBW that is water:
Preterm =
A
~80% of TBW is water
18
Q
A Preterm is a-
A
Baby born before the 37 weeks of pregnancy are completed
19
Q
A Neonate is a baby under-
A
4 weeks old
20
Q
% of TBW that is water:
Neonate =
A
~74 %
21
Q
The TBW that’s water or Total Body Water decreases as you-
A
Age
22
Q
The % of Total Body Water for a child is-
A
~ 60%
23
Q
The average Total Body Water for an adult is -
A
~60 %
24
Q
The average Total Body Water for an older adult is -
A
~ 40% - 50%
25
The highest amounts of Total Body Water is found in-
Preterms + Neonates (~70% - 80%)
26
The lowest amounts of Total Body Water is found in-
Older Adults (~40% - 50%)
27
Why do neonates + preterms have so much body water?
It helps to cushion + protect.
Metabolism is increased with rapid growth.
There is an exchange of nutrients and wastes going on.
Kidneys are immature, so they excrete more water than an adult does.
There is an immature regulatory response that responds to illnesses with higher temps + longer durations.
28
Implications for children =
Their Daily Fluid Requirements are higher than an adults.
They have very little extra fluid to handle extra fluid loss. (Meaning that diarrhea, fever, and vomiting can all easily cause dehydration)
29
Why is there less Total Body Water in an older adult?
They have more cell death (apoptosis), they have less need for intracellular fluid, their metabolism is slowed, they have more body fat
30
Fat cells have less-
Water
31
Implications for adults:
Daily requirement of water is 40mL/kg per day. This makes people who are obese, women, or are an older adult at higher risk for fluid volume deficit / dehydration.
32
K+ =
Potassium
33
Na+ =
Sodium
34
Ca+ =
Calcium
35
Body water contains-
Electrolytes
36
Potassium, Sodium, Magnesium, and Calcium are all-
Electrolytes
37
Sodium helps to regulate the-
Body-Water Balance
38
Potassium Works with-
Muscle Function
39
Electrolytes maintain function of-
Body Systems
40
Electrolytes are what?
Molecules that disassociate (separate) in the fluid into electrically charged ions
41
Ions are-
Electrically charged particles
42
Cations have a -
Positive (+) Charge
43
Anions have a-
Negative (-) Charge
44
Is sodium positive or negative?
Positive
45
Cations have a current that-
Maintains cell function
46
Potassium is a major cation that maintains cell functioning in what way?
Effects your cardiac system.
47
If potassium gets out of whack, what occurs?
Dysrhythmias
48
mEq/L stands for=
Milliequivialent
49
mEq/L is a measurement for-
Electrolytes
50
Milliequivalence refers to-
the combining power of the ion
51
Sodium + Chloride are -
Equivalent
52
Why are Sodium + Chloride equivalent?
They combine equally
53
Primary intracellular cation =
Potassium (K+)
54
Primary Intracellular Anion =
Phosphate (PO^4-)
55
Primary Extracellular Cation =
Sodium (Na+)
56
Primary Extracellular Anion =
Chloride (Cl-)
57
You need an equal number of (+) and (-) for -
The Electrolyte Balance
58
Difference between the number of (+) and (-) =
Anion Gap
59
The Anion Gap is a kind of-
Lab Value
60
When viewing the Anion Gap, abnormal amounts of cations + anions means that there’s-
An Abnormal Electrical Charge
61
Hypokalemia or hyperkalemia, and other electrolyte imbalances are examples of-
An Abnormal Electrical Charge
62
Substance/ particle/ molecule that dissolves in liquid, such as water or IVF =
Solute
63
A type of solute that easily dissolves in solution =
Crystalloids
64
Sugar crystals dissolve easily in coffee, these are an example of-
Crystalloids
65
Electrolytes easily metabolize in -
Body Fluid
66
A type of solute that is a large particle and doesn’t dissolve easily =
Colloids
67
Electrolytes, Glucose, Protein (Albumin + Globulin) , Gases (Oxygen + Carbon Dioxide) , and Molecules are all-
Solutes
68
Solvent =
The thing doing the dissolving
69
Plasma Proteins (Albumin + Globulin) are what kind of solute?
Colloids
70
Colloids act as magnets that pull water towards themselves.
True or false?
True
71
Colloids are also called -
Blood Proteins or Serum Colloids
72
Act as a magnet that creates osmotic pressure =
Colloids
73
Osmotic Pressure is the-
Osmotic pull that “pulls” water to a colloid
74
In Diffusion, what’s moving?
Molecules
75
In diffusion, molecules are-
Solutes
76
In Diffusion, molecules move from an area of -
High concentration to an area of low concentration
77
Movement of solutes stop whenever the concentration of molecules is-
Equal on both sides (Equilibrium is reached between molecules)
78
In Osmosis, what’s moving?
The water
79
Water moves based on the-
Concentration of a solution
80
Water moves from an area of
Lower concentration to an area of high concentration of solutes across a semi-permeable membrane
81
What does osmosis cause?
Equal concentration of solution on both sides of a membrane
82
Power of solution to pull water across a semipermeable membrane =
Osmotic Pressure
83
A solution with more solutes has a greater -
Osmotic Pressure
84
Power of solution =
Osmotic Pressure
85
Strength of the “pull” or “draw” that depends on the number of solutes =
Osmotic Pressure
86
High Solute Concentration =
High Osmotic Pressure
87
High Osmotic Pressure =
Pulls water towards itself
88
The concentration of solutes is expressed as -
Osmolality
89
If something has a high Osmolality then it has-
A lot of solutes
90
If something has a low Osmolality then it has-
A low amount of solutes
91
Measures the number of milliosmoles per kg (mOsm/kg) of water or the concentration of molecules per weight of water =
Osmolality
92
Measures the total number of milliosmoles per liter (mOsm/L) of solution or the concentration of molecules per volume of solution =
Osmolarity
93
Measurement of solutes/kg in water =
Osmolality
94
mOsm/kg =
Osmolality
95
The normal serum osmolality is -
280-295 mOsm/kg
96
The solute that’s the biggest determinant of Serum Osmolality =
Sodium
97
Normal Serum Osmolarity is-
275-295 mOsm/kg
98
Measures the osmotic pressure of a solution =
Osmolarity
99
Serum Osmolarity is a lab measure that reflects-
Solute concentration in blood, urine, or other body fluids.
Total solute concentration in body fluids.
100
A serum osmolarity under 275 means that-
There’s too little solute for the amount of water OR there’s too much water for the amount of solute (water excess)
(To simplify, there’s not enough solute)
101
A serum osmolarity over 295 means that-
There’s too little water (a water deficit) OR the concentration of solute is too great
(To simplify, there’s not enough water)
102
Serum Osmolality is just a fancy word for-
Osmolarity
103
Serum Osmolality and Osmolality mean the same thing.
True or false?
False.
Serum Osmolality = Osmolarity
104
A Serum Osmolality of 288 mOsm/kg is what type of Osmolality?
Iso-Osmolality
105
A Serum Osmolality of 310 mOsm/kg is what type of Osmolality?
Hyper-Osmolality
106
A Serum Osmolality of 269 mOsm/kg is what type of Osmolality?
Hypo-Osmolarity
107
Water Deficit =
Hyper-Osmolality (Hypertonic)
108
Water Excess =
Hypo-Osmolality (Hypotonic)
109
Same Osmolality as inside cells (ICF) and outside the cells (ECF) =
Isotonic Solution
110
Equal concentration of solutes and water =
Isotonic Solution
111
Why is there no fluid shift in an isotonic solution?
Because everything is already equal, there’s nothing to correct.
112
Low solute concentration =
Hypotonic Solution
113
In a hypotonic solution, the cell is surrounded by hypotonic water and what does that water do?
It enters the cell until it bursts
114
In a hypertonic solution, the cell is surrounded by hypertonic water and what does that water do?
The cell’s water leaves the cell to dilute the Extracellular fluid. This causes it to shrink.
115
Isotonic IV Fluids (IVF) has the same concentration as-
Extracellular Fluid (ECF)
116
An isotonic IVF causes what change in cell size?
No change in cell size
117
0.9% NaCl is a-
Isotonic IVF
118
Normal Saline / NS / Sodium Chloride
All of these are just different names for-
0.9% NaCl
119
5% Dextrose Water (D5W) is -
Isotonic, then hypotonic as dextrose quickly metabolizes
120
5% Dextrose Water (D5W) is a good-
Hydrating Solution
121
Lactated Ringer’s =
Isotonic IVF
122
Balanced Electrolytes. Used a lot in surgery with fluid / blood loss =
Lactated Ringer’s (LR)
123
Hypertonic IVF is more concentrated than-
ECF
124
Hypertonic IVF causes fluid to shift from-
Inside the cells to outside the cells
125
Hypertonic IVF causes ICF to go to -
Interstitial fluid, then possibly into intravascular
OR
Directly into intravascular, if a blood cell
126
Used to decrease cell edema or replace electrolytes =
Hypertonic IVF
127
5% Dextrose in Normal Saline (D5NS) =
Hypertonic IVF
128
5% Dextrose in 0.45% Normal Saline (D5 1/2NS) =
Hypertonic IVF
129
5% Dextrose in Lactated Ringer’s (D5LR) =
Hypertonic IVF
130
Hypotonic ICF is less concentrated that-
ECF
131
Solution is pulled into cell + causes cells to swell =
Hypotonic IVF
132
Hypotonic IVF causes a fluid shift from ECF (Intravascular, Interstitial) into-
The cell (ICF)
133
Used to dilute ECF + treat cellular dehydration =
Hypotonic IVF
134
0.45% NaCl (1/2 Normal Saline) =
Hypotonic IVF
135
0.33% NaCl (1/3 Normal Saline) =
Hypotonic IVF
136
Movement of water AND solutes together across capillary bed =
Filtration
137
Filtration causes water and solutes to move from -
High pressure to low pressure
138
There is how many types of pressure?
2
139
What are the 2 types of pressure?
Oncotic + Hydrostatic
140
Oncotic Pressure =
Colloid Osmotic Pressure
141
Osmotic “Pull” =
Colloid Osmotic Pressure
142
Amount of pressure from plasma colloids in vascular system =
Oncotic Pressure
143
Colloids exert what?
“Pull” that attracts water
144
Oncotic pressure pulls fluid from -
Tissue space to vascular space
145
Does Oncotic pressure stay constant throughout the blood vessel?
Yes
146
Force of fluid that presses against a vessel wall =
Hydrostatic Pressure
147
The force of hydrostatic pressure is greater at-
The arterial end of a vessel than at the venous end
148
Hydrostatic pressure is greater at which end?
It’d greater at the arterial end of the vessel than the venous end
149
Oncotic Pressure (Colloid Osmotic Pressure) stays-
Constant in the vascular space
150
Hydrostatic pressure at which end overrides colloid osmotic pressure?
The Arterial End
151
At the venous end, -
Oncotic pressure is greater than the hydrostatic pressure
152
Colloid osmotic pressure is able to “pull” -
Fluid + electrolytes back into the vessel from tissue spaces
153
What’s the result of osmotic pressure at the venous end?
Waste products of cell metabolism “pulled” back into vessel.
Wastes can get excreted via circulatory system.
Maintains healthy cells; no destruction of tissue cells; no edema.
154
What’s the result of hydrostatic pressure at the arterial end overriding osmotic pressure?
Hydrostatic pressure “pushes” fluid out of the vessel (Intravascular space) to interstitial (tissue) spaces.
Tissue cells get nourished with nutrients + oxygen.
155
Average Daily Fluid Requirements:
Average Adult = How many ml/day?
~2,000 - 3,000 ml/day
156
Average Daily Fluid Requirements:
Average Adult = How many ml/kg/day?
~ 40 ml/kg/day
157
Average Daily Fluid Requirements:
Infant / Child = how many ml/day?
~1,150 ml/day
158
Average Daily Fluid Requirements:
Infant / Child = how many ml/kg/day?
~100 - 150 ml/kg/day
159
Sources per day:
Oral Liquids =
~ 1,200 ml
160
Sources per day:
Water in Foods =
~1,000 ml
161
Sources per day:
Metabolism =
~ 300 ml (H20 from oxidation)
162
Primary regulator for fluid intake =
Thirst
163
Osmoreceptors are stimulated by -
Volume Depletion
164
When Osmoreceptors are stimulated by volume depletion, what happens?
You feel thirsty
165
Who’s at risk for dehydration because of a decreased thirst sensation?
Older adults
166
Why are infants at risk for dehydration?
Because they can’t communicate that they are thirsty
167
When water is absorbed in the GI tract, name 2 things that happen:
Volume of Extracellular fluid increases.
Osmolality of Extracellular fluid decreases.
168
Average daily fluid output=
~2,500 ml/day
169
Fluid Output
Sources/day:
Kidneys (Urine) =
1,500 ml
170
Fluid Output
Sources/day:
Skin =
300 ml
171
Fluid Output
Sources/day:
GI (Fecal) =
100 ml
172
Insensible Fluid Losses =
Not Measurable
173
Skin via Diffusion =
Insensible Fluid Losses
174
Lungs via Exhalation =
Insensible Fluid Losses
175
Sensible Fluid Losses =
Measurable Fluid Losses
176
Name some examples of sensible fluid losses:
Urine; Feces; Vomiting; Excess Perspiration
177
What kind of patient’s would you not want to give LR to?
To PT’s with liver impairment (Cirrhosis or Hepatitis are examples)
178
Why can’t you give LR to PT’s with liver impairment (Cirrhosis or Hepatitis)?
Their body can’t process Lactate correctly
