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Flashcards in Fluid Systems Deck (66):
1

About how much of the body weight in the average adult is water?

60% (overall avg. is 45-60%)

2

Why do we lose water body weight percentage as we age?

As we age, we tend to lose muscle and gain fat

3

Where is most of the body's fluid located?

Intracellular fluid (70%) [extracellular intravascular (plasma) = 6%, extracellular extravascular (interstitial fluid) = 26%]

4

True or False:
ECF is quite similar to ICF

False; plasma and interstitial fluid are similar because they are both outside the cell - ICF in inside the cell, which is vastly different from outside the cell, which has much more negatively charged electrolytes

5

Movement of water through a semipermeable membrane toward an area of greater solute concentration is due to ___________.

Osmotic pressure

6

What accounts for the osmotic pressure in tissues and cells?

Osmotic pressure

7

Number of molecules of a substance in a kg of water

Osmolarity

8

What is the osmolarity of normal serum?

285-295 mOsm/kg

9

Water moves from an area of high pressure to an area of low pressure.

Hydrostatic pressure

10

Is BP higher or lower in an arteriole than tissue pressure? A venule?

Higher; lower

11

Affects osmotic pressure and can regulate how much fluid moves into the tissue and move it back into the capillary bed and out the venules

Capillary fluid dynamics

12

ECF is filtered through the renal _____.

Glomeruli

13

Selective reabsorption and excretion of water and solutes occur in renal _____.

Tubules

14

The mechanism that brings glucose and other nutrients back into the body after they are filtered out

Selective reabsorption

15

Severe hydration; decreases renal perfusion; causes release of aldosterone from the renal cortex

Hypovolemic state

16

What hormone directly conserves water and is released by the pituitary gland?

Antidiuretic hormone (ADH) aka Vasopressin

17

What hormone indirectly conserves water and is released by the adrenal cortex?

Aldosterone

18

Name the 3 steroidal hormone types that bind to intracellular receptors, all work to conserve water and all come from the adrenal gland?

1. Gonadal
2. Glucocorticoids
3. Mineralocorticoids

19

Formed in the hypothalamus; stored in the post. pituitary; area of storage and relate may overlap with the thirst center

ADH

20

What are the major stimuli for release of ADH?

1. Increased osmolarity
2. Decreased volume of ECF
3. Stress of trauma, surgery, pain, and some anesthetics and drugs

21

A significant decrease in ADH from lesions or trauma of the hydrophyseal tract causes __________.

Diabetes insipidus (massive increase in urine output)

22

Secreted by the adrenal gland; acts on renal tubules to increase Na+ uptake

Aldosterone

23

What are the stimuli for the release of aldosterone?

1. K+ concentration
2. Na+ concentration
3. Renin-angiotensin system

24

Naturally occurring fatty acids, fxns in the inflammatory response, BP control, uterine contractions, and GI mobility; causes vasodilation in kidneys, promoting Na+ excretion

Prostaglandins

25

Secreted by the adrenal cortex; weak activity for reabsorption of Na+ and water; increases blood volume and Na+ retention

Glucocorticoids

26

Causes increased kidney excretion of water and Na+; improved glomerular filtration rate; inhibits renin secretion; inhibits release of ADH

ANP

27

Extracellular volume depletion; abrupt decrease in fluid intake or extracellular volume decrease (hemorrhage, diarrhea,etc.); decreased extracellular space and circulatory collapse

Hypovolemia

28

Often from sodium retention due to excess ingestion or excess ADH secretion

Water excess

29

Extracellular volume excess; serum Na+ level is normal; excessive administration of isotonic solutions or adrenal glucocorticoids; may occur with diseases; expansion of extracellular space and vascular overload

Hypervolemia

30

Conscious desire for water; happens when osmolarity reaches 295 mOsm/kg

Thirst

31

What is thirst stimulated by?

1. Decreased renal perfusion
2. Osmoreceptors in the hypothalamus detect elevation of osmotic pressure
3. Local dry mouth from reduced salivation

32

Caused by loss of blood, loss of plasma, loss of body fluids; burns, vomiting, diarrhea

Fluid deficit

33

Expansion or accumulation of interstitial fluid; localized or general; pitting or non-pitting

Edema

34

Caused by not moving blood from body back into heart, so increased venous pressure and edema in the body

Right side CHF

35

Caused by pulmonary edema because blood is not being moved back into the heart from the lungs

Left side CHF

36

What is the most common cause of CHF?

Increase capillary hydrostatic pressure

37

What causes increased capillary permeability?

Think more fluid will be out in the tissue
1. Blood vessel damage (trauma, burns)
2. Localized edema from an allergen
3. Inflammation

38

What does the obstruction of lymphatics cause?

Excess fluid in the tissue; more water goes in than goes out; lymphs remove excess fluid from tissue

39

Edema from hypoproteinemia is usually generalized, but pronounced in ______ and ______ from recumbent positioning

Eyelids; face

40

Fluid shift:
From vascular to extracellular - similar to fluid volume _______
From extracellular to vascular - similar to fluid volume _______

deficit; excess

41

Electrolyte function:
Membrane potential; affects osmolarity of the blood

Sodium

42

Electrolyte function:
Membrane potential; muscle activity (heart, intestines, respiratory tract, and neural stem of skeletal m.)

Potassium

43

Electrolyte function:
Permeability of cell membranes; imbalances affect bones, kidneys, and GI tract

Calcium

44

Electrolyte function:
Neuromuscular integration and parathyroid hormone stim; imbalances cause irritability of nervous system

Magnesium

45

Signs and symptoms are paresthesias muscle weakness, muscle wasting, muscle tetany, and bone pain

Electrolyte imbalance

46

Normal range of sodium

135-145 mEg/L

47

Na+ deficit; Losses may be caused by nausea, vomiting, accumulation of fluid in the peritoneal cavity, sequestration of secretions in an obstructed GI tract, excessive sweating in conjunction with excessive water intake, and sequestration of sodium and fluid in burned skin

Hyponatremia

48

How would you treat hyponatremia?

Involves Na+ replacement, Na+ containing IV fluids, Lactated ringer's or .9% NaCl solution

49

Na+ excess; due to Na+ gain or water loss; occurs in individuals who are unable to respond to the sensation of thirst, which includes, infants, elderly, people who are mentally ill, and individuals who are immobile

Hypernatremia

50

How would you treat hypernatremia?

involves fluid replacement either orally or through an IV of 5% dextrose (isotonic) in water or hypotonic saline solution

51

What is the normal serum value for potassium?

3.5-5.0 mEg/L

52

K+ deficit; losses related to GI losses and renal losses

Hypokalemia

53

K+ excess; may rest from an increased intake of K+, or decreased output or a shift of K+ out of the cells; inadequate renal secretion; trauma that destroys cells and releases excess K+

Hyperkalemia

54

What is the normal adult levels of calcium?

9.0-10.5 mg/dL

55

When calcium levels increase, phosphate levels _____

decrease

56

Electrolyte function:
Works with calcium to support bone formation; primary intracellular ion; 85% in bones; works to keep Ca levels more in the blood

Phosphate

57

Calcium deficit; results from poor intake or absorption in GI tract; overcorrection of acidosis

Hypocalcemia

58

Calcium excess; due to hyperparathyroidism, hyperthyroidism, adrenal insufficiency, tumors, multiple fractures, excess intake

Hypercalcemia

59

What is the normal serum levels for chloride?

90-110 mEg/L

60

Electrolyte function:
Important in maintaining (along with Na+) osmolarity, body water balance, and acid-base balance

Chloride

61

Cl- deficit; result from gastric fluid loss, diarrhea, hypokalemia, hyponatremia, continuous IV infusion of 5% dextrose in water, etc.

Hypochloremia

62

Cl- excess; result from dehydration, hypernatremia, stomach cancer, adrenal gland hyperactivity, head injuries, and kidney dysfunctions

Hyperchloremia

63

What are normal adult magnesium levels?

1.2-2.0 mEg/L

64

Magnesium deficit

Hypomagnesemia

65

Magnesium excess; chronic renal and adrenal insufficiency, overuse of antacids and laxatives, severe dehydration, near drowning in sea water

Hypermagnesemia

66

Normal pH level of the body; limits of pH level?

7.35 - 7.45; 7.2-7.55