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Nur 170 Exam 2 (12.5.14) > Fluids & Electrolytes > Flashcards

Flashcards in Fluids & Electrolytes Deck (71):
1

Fluid found outside the cells. It accounts for about 1/3 of total body fluids and is subdivided into compartments. The 2 main compartments of ECF are Intra-vascular and Interstital. Principle electrolytes are Na, Cl, & HCO3.

Extracellular fluid (ECF)

2

Fluid found with in the body cells that contain solute vital to the metabolic processes of the cells. aka cellular fluid. transport system-waste from cells by the lymph system and directly into the blood plasma via capillaries.

Intracellular fluid (ICF)

3

A charged ion capable of conducting electricity.

Electrolytes

4

Substances that dissolve in liquid

Solutes

5

Salts that dissolve rapidly in true solutions

Crystalloids

6

Osmolality

A measure of the concentration of solutes in the body fluids. Osmolality is determined by the total solute concentration within a fluid compartment and is measred as parts of solute per kilogram of H2O. Na is greatest determinant.

7

Refers to solutions that have a higher osmolality than body fluids; 3% sodium choloride is a hypertonic solution.

Hypertonic

8

Substantial loss of both water and electrolytes in similar proportions from the extracellular fluid (ECF). Also called
hypovolemia

FVD; fluid volume deficit

9

Excessive fluid retained by the body. The retention of both water and sodium in similar proportions to normal extracellular fluid (ECF). Also called hypervolemia

FVE; fluid volume excess

10

A pulling force exerted by colloids that helps maintain the water content of blood by pulling H20 from the interstitial space into the vascular compartment. Also called oncotic pressure

Colloid Osmotic Pressure

11

A process whereby fluid and solutes move together across a membrane from a compartment with higher pressure to a compartment with lower pressure.
Filter

Filtration; filter

12

A method that requires additional energy (in the form of Adenosine triphosphate-ATP) to move substances against the concentration gradient. (from low concentration to high)

Active Transport

13

A condition that occurs when a body does not take in as much H20 as it loses or lack sufficient reserves to maintain proper function.

Dehydration

14

The body's ability to maintain a state of physiological balance in the presence of constantly changing conditions

Homeostasis

15

System initiated by specialized receptors in the juxtaglomerular cells of the kidneys nephrons that respond to changes in renal perfusion.

Renin-Angiotensin-Aldosterone System
(RAAS)

16

The proportion % of CELLS and PLASMA in blood. Also, refers to the laboratory tests that measures hematocrit.
This can be used to detect severe dehydration or overhydration.

Hematocrit; HCT

17

The most abundant cation in extra cellular fluid (ECF) & a major contributor to serum osmolality.
Norms; serum levels 135-145 mEq/L. Controls and regulates H20 balance.

Sodium; Na+

18

The chemical combining power of the ion, or the capacity of cations to combine with anions to from molecules.

Milliequivalent

19

Substances such as large protein molecules that do not readily dissolve into true solutions.

Colloids

20

The osmolality of a solution. Solutions maybe termed isotonic, hyper-tonic, or hypotonic.

Tonicity

21

Refers to solutions that have a lower osmolality than body fluids 0.9% , such as one half normal saline. 0.45%

Hypotonic

22

A pulling force exerted by colloids that helps maintain the H20 content of blood by pulling H20 from the interstitial space into the vascular compartment. Also called Colliod osmotic pressure.

Oncotic Pressure

23

The pressure a fluid exerts with in a closed system on the walls of its container. The hydrostatic pressure of blood is the force blood exerts against the vascular walls (ie. artery walls). The principle involved in hydrostatic pressure is that fluids move from an area of greater pressure to an area of lesser pressure

Hydrostatic pressure

24

Fluid loss that is not perceptible to the individual & cannot be measured.

Insensible Loss

25

Small molecule released by the pituitary gland that has an antidiuretic action that prevents the production of urine dilute.

ADH; anti-diuretic hormone

26

K+; a major cation in the intracellular fluids, with ony a small amount found in plasma and interstitial fluid. ICF levels of potassium are 125-140 mEq/L serum 3.5-5.3 mEq/L. Vital electrolyte for skeletal, cardiac, and smooth muscle activity. [acid-base balance]

Potassium

27

Cl`; major Anion of ECF and normal serum levels are 95-105 mEq/L. Functions with Na+ to regulate serum osmolality and blood volume. When Na is absorbed into the kidneys Cl` usually follows. [acid-base balance]

Chloride

28

The movement of water across cell membranes, from a less concentrated solution to a more concentrated solution.

Osmosis

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The component of a solution that can dissolve a solute.

Solvent

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A solution that has the same osmolality as body fluids. 0.9% Sodium Chloride, is a isotonic solution.

Isotonic

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The power of a solution to draw water across a semipermeable membrane.

Osmotic Pressure

32

The continual intermingling of molecules in liquids, gases or solids brought about by the random movement of the molecules.

Diffusion

33

Essential fluid losses required to maintain body functioning.

Obligatory (compulsory) loss

34

Vast majority (99%), of Ca in the body is in the skeletal system, with small amount of extracellular fluid. Vital in regulating muscle contraction and relaxation, neuromuscular function and cardiac function. In Dairy

Calcium; Ca2+

35

primarily found in the skeleton and intracellular fluid. 2nd most abundant. Mg2+

Magnesium; Mg2+

36

Major anion of ICF. (intracellular fluid) Also found in ECF, bone, skeletal muscle, and nerve tissue. Normal adult serum levels are 2.5 to 4.5 mg/dL. Children have much more higher PO4 levels than adults prob b/c of growth hormone. Calcium and Po`4 bind.

Phosphate; Po`4

37

present in both ICF & ECF; primary function is regulating Acid-Base Balance. an essential component of the carbonic acid-bicarbonate buffering system

Bicarbonate; HCO`3

38

Powerful vasodilator and protein hormone; secreted by the heart muscle cells. involved with homeostatic control of body water, sodium, potassium, and fat.

ANF; atrial natriuretic peptide hormone

39

movement of H2o across cell membranes; from the less concentrated solution to the more concentrated solution. H2O moves toward the higher concentration of solute in an attempt to equalize the concentrations on either side of the membrane.
This higher solute concentration draws H2o from the interstitial space and cells into the vascular compartment to equalize the concentration of solutes in all fluid compartments. Osmosis is an important mechanism for maintaining homeostasis and fluid balance.

Osmosis

40

monitors kidney & liver function, diabetes and parathyroid status, electrolyte-fluids and acid-base balance

BMP/CMP; Comprehensive metabolic panel (14 tests including BMP) & basic metabolic panel (glucose, electrolytes-na, chloride,potassium, CO2 & calcium) BUN, creatinine

41

Complete blood count
RBC, WBC, HCT, HGB, Platelets
Possible dehydration HCT up
Male: 41 to 50%
Female: 36 to 44%

CBC

42

Na+ 135-145 mEq/L
Maintains water balance throughout the body, controls and regulates the volumes and distribution of ECF.

Sources: Table salt, cheese, processed foods, snack foods
Recommended daily allowance: 0.5 to 2.4 g/day

Sodium+

43

Ca++ 4.25-5.25mg/dL ionized 9-11 mg/dL serum
Most abundant electrolyte in body, 99% found in bones and teeth
Necessary for strong bones & teeth, necessary for nerve impulse, and blood clotting, a catalyst for muscle contraction, is needed for B12 absorption

Sources: Milk, cheese, dairy products, dried peas, green leafy vegetables, fortified bev. like OJ

Calcium and phosphorus levels inversely proportional Ca & PO4 opposite ways!!

Calcium++

44

Mg++ 1.5-2.5 mEq/L

-Found in intracellular, in the heart, bone, nerve, and muscle tissue, 2nd most important anion in ICF
-Important in the metabolism of proteins and carbohydrates, important in many vital reactions that involve enzymes, maintains normal levels of potassium
-Helps maintain electrical activity in nervous and muscle tissue

Sources: most foods but esp. in Fish, Nuts, green leafy vegetables, whole grains, dried peas, and beans, chocolate and cocoa
RDA: 400-420 mg/day men
310-350 mg/day women

Magnesium++

45

Cl` 95-105 mEq/L

-Chief extracellular anion
Found in blood, interstitial fluid/lymph
-Acts with Sodium to maintain osmotic pressure of the blood.
-Is essential in the production of Hydrochloric acid in gastric juices

Sources: Foods high in sodium, processed food, dairy products, meat

Deficits lead to potassium deficits. potassium deficits lead to chloride deficits Cl & K Same way!

Chloride

46

PO4+ 2.5-4.5 mq/dL
Helps the body maintain acid-base balance, necessary for B Vitamins to be effective, helps promote nerve and muscle action, plays a role in carbohydrate metabolism. Bone and teeth formation.

Sources: All animal products (meats, poultry, eggs, milk), bread, ready to eat cereal

RDA: 700mg/day
Calcium and PO4 bind in blood

Important for cell division and transmission of hereditary traits
Serves as a catalyst for many intracellular activities
Excreted and reabsorbed by the kidneys

Phosphate

47

K+ 3.5-5.3 mEq/L

-Major cation of the intracellular fluid

-K+ & Cl- go hand in hand; one goes down so does the other

-Plays a vital role in processes like the transmission of electrical impulses, particularly nerve, heart, skeletal, intestinal and lung. Assist in acid base balance.
-Think Cardiac Rhythm Disturbances

causes of hypokalemia:
Diarrhea, loss of GI fluids, diuretics, steroid use, poor intake
S&S of hyporkalemia: Anorexia, fatigue, cardiac arrhythmia, increased sensitivity to digitalis muscle weakness, tender muscles, EKG changes

causes of Hyperkalemia: High Intake, renal failure, shift of K+ out of cells
S&S of hyperkalemia: Vague muscle weakness, cardiac arrhythmias, GI symptoms, parasthesias or tender muscles

Sources: Bananas, peaches, oranges, dates, figs, melons, broccoli, potatoes, dried peas, and beans, whole grains

Potassium+

48

constantly varies in 24hr; 0.5 lbs/0.2 kg

Body weight

49

Processes that regulate the balance of water and electrolytes and conditions that contribute to imbalances

Concepts of Fluid/Electrolytes

50

Total Body Weight (TBW) 45% to 75%
Varies with age, body fat, gender
Intake/Output should be equal

Composition/Distribution

51

Medium for transport
Facilitate metabolism and cellular function
Solvent for electrolytes and non-electrolytes
Maintain body temperature
Facilitate digestion
Promote elimination
Tissue lubricant

Primary function of water

52

Atom/molecule carrying an electric charge

Ion

53

Substance capable of breaking into electrically charged ions then dissolved in solution.
Measured in mEq/L (milliequivalents)

Electrolyte

54

Positively charged ions
Na, K, Mg, Ca

Cations

55

Negatively charged ions
Cl, PO4, HCO3

Anions

56

Fluid compartments

K+, Mg+, PO4-, other electrolytes

Intracellular ICF

57

Fluid compartments

Na+, Cl-, HCO3
-Interstitial-between the body cells
-Intravascular (Plasma)-transport blood cells
-Transcellular-Cerebrospinal, pleural, peritoneal, synovial, digestive

Extracellular ECF

58

Primary mode of movement
Water moving from less concentrated area to higher concentrated area

Isotonic
Hypertonic
Hypotonic
Osmolarity
Osmotic potential

Movement: Osmosis

59

Intermingling of molecules
-Liquids
-Gases
-Solids
Higher concentration; low concentration
Equalizer

Movement; Diffusion

60

Movement of molecules
Lower concentration higher concentration
Must have ATP to occur
Na+-K+ pump

Movement: Active Transport

61

Movement of water & particles
High pressure low pressure
Movement between vascular compartment and interstitial fluid
Hydrostatic pressure: pressure that builds in a closed container.
Osmotic pressure: power of a solution to draw water from a semipermeable membrane

Movement: Filtration

62

Intake of fluids a day: 1500-2000 ml/24hr
or 40-80 ml/hr need 2500 ml intake but some from food

Output: 1400-1500ml
take weight; 0.5ml/kg per hr.

Fluid balance: Gains & Losses

63

Thirst: regulated by the hypothalamus ev. 15-20 mins then thirsty again

Kidneys: main organ for excretion. Filter 1500 ml/day & 170 ml of plasma/day
Systolic below 60 mmHg-organ not getting enough blood.

Hormones:
-Antidiuretic hormone ADH- helps kidneys to retain fluid
fever, pain, stress, some opioids
-Renin-Angiotensin System:
-Aldosterone
-Thyroid hormone
-Natiuretic Peptide; Atrial (ANP), Brain (BNP), C-type (CNP)

Regulation of Fluid Volume

64

Regulation of water distribution
Transmission of nerve impulses
Clotting of blood
Regulation of acid-base balance

Electrolyte Function

65

HCO3- Normal 22-28
Major buffer
In both ICF & ECF

Function: Maintains acid-base balance by functioning as the primary buffer in the body
Regulation:
Lost through diarrhea, diuretics, renal insuffiency
Excess possible if person ingests quantities of acid neutralizers
Sources:
Acid neutralizers (sodium bicarbonate)
Tums, Rolaids, Malox, Mylanta

Kidneys conserve & secrete

Bicarbonate HCO3-

66

Carbonic Acid-Sodium bicarbonate system
Lungs=carbonic acid
Kidneys=bicarbonate

Respiratory system and Renal system balance

Kidneys conserve bicarbonate, and secrete bicarb. (long term fix)
pH too low-too acidic
pH too high-lungs conserve O2
Lungs get rid of 02 by quick breathing
Lungs conserve by slow, very shallow breaths

Systems that Regulate of Acid-Base Balance

67

7.35-7.45

pH blood

68

low blood volume
proportional loss of fluid/electrolyte from ECF

hypovolemia

69

heart rate
blood pressure
skin/mucous membranes
urine output
neck veins-flat, distended?
muscles, weak, fatigued?
temperature
Labs

Fluid Loss Assessment

70

Low K+ level-K rider-Magrider
Colloid & Crystalloids-IV fluids to expand blood volume
Diuretics to pull fluid off

Pharmacology Fluids/Electrolytes

71

Daily Weights
Vital Signs
I/O
1 kg=1L Fluid or 1, 000 ml fluid

Tachycardia sign of hypovolemia (decreased blood vol)

Clinical Measurements