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MS > FLUIDS AND ELECTROLYTES > Flashcards

FLUIDS AND ELECTROLYTES Flashcards

1
Q

A __, together with its environment in any part of the body, is primarily composed of __

A

cell
FLUID.

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2
Q

__ - The maintenance of the body’s internal environment within a narrow range of normal values.

__ - a solution of solvent and solute

__ - a liquid substance where particles can be dissolved

__ - a substance, either dissolved or suspended in a solution

A

Homeostasis

Fluids

Solvent

Solute

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3
Q
  • refers to any fluid produced by a living organism.
A

Body Fluids

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4
Q

Body Fluid Compartments (__)

  1. Intracellular (__ )
  2. Extracellular (___)
  • Interstitial (__)
  • plasma (__)
A

60% Total body water

40% 2/3 of TBW
20% 1/3 TBW

15%
5%

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5
Q

Body Compartment Volumes
➢ neonates reach adult values by 2 yrs and are about half-way by 3 months
➢ average values ~ 70 ml/100g of lean body mass
➢ percentage of water varies with tissue type,

A. __ ~ 60-80%
B. __ ~ 20-25%
C. __ ~ 10-15%

A

lean tissues
bone
fat

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6
Q

➢ ___ refers to the concentration of particles in a solution

A

Tonicity

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7
Q

➢ the weight in grams of a substance producing an osmotic pressure of 22.4 atm. when dissolved in 1.0 litre of solution
➢ (gram molecular weight) / (no. of freely moving particles per molecule)

A

Osmole

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8
Q

THE Normal DYNAMICS OF BODY FLUIDS

The methods by which electrolytes and other solutes move across biologic membranes are

A

Osmosis, Diffusion, Filtration and Active Transport.

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9
Q

___ are passive processes, while ___ is an active process.

A

Osmosis, diffusion and filtration

Active transport

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10
Q

➢ This is the movement of water/liquid/solvent across a semi-permeable membrane from a lesser concentration to a higher concentration

A

OSMOSIS

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11
Q

➢ The movement of particles/solutes/molecules from an area of higher concentration to an area of a lower concentration

Also called as___ or __

A

DIFFUSION

➢ “Brownian movement” or “downhill movement”

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12
Q

➢ This is the movement of BOTH solute and solvent together across a membrane from an area of higher pressure to an area of lower pressure

A

FILTRATION

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13
Q

➢ Process where substances/solutes move from an area of lower concentration to an area of higher concentration with utilization of ENERGY

➢ It is called an ____

➢ Usually, a ___ is required. An __ is utilized also.

A

ACTIVE TRANSPORT

“uphill movement”

carrier
Enzyme

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14
Q

___
➢ Energy is obtained directly from the breakdown of ATP
➢ One example is the ___

A

Primarily Active Transport

Sodium-Potassium pump

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15
Q

____

➢ This system regulates sodium and water balance in the ECF
➢ The formation of __ is the main mechanism
➢ Substance released to regulate water balance is ___.

RENIN activates Angiotensinogen to Angiotensin-I, A-I is enzymatically converted to ____ ( a powerful vasoconstrictor)

A
  1. Renal Regulation (RAS)

urine

Renin

Angiotensin-II

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16
Q

➢ The primary regulator of water intake is the ___, controlled by the thirst center in the hypothalamus (anterolateral wall of the third ventricle)

➢ ___ is synthesized by the hypothalamus and acts on the collecting ducts of the nephron

➢ ADH increases rate of water reabsorption

➢ The adrenal gland helps control F&E through the secretion of ___ - a hormone that promotes sodium retention and water retention in the distal nephron

A

thirst mechanism

Anti-diuretic hormone (ADH)

ALDOSTERONE

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17
Q

➢ The ____ digests food and absorbs water

A

GIT

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18
Q

➢ Healthy adult ingests ___ as part of the dietary intake.
➢ 90% of intake is from the ___
➢ 10% of intake results from the products of ____
➢ Usual intake of adult is about ___ per day
➢ The other sources of fluid intake are: __

A

fluid

ingested food and water
cellular metabolism

2, 500 ml

IVF, TPN, Blood products, and colloids

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19
Q

➢ The average fluid losses amounts to __ per day, counterbalancing the input:

➢ The routes of fluid output are the following:

➢ SENSIBLE LOSS- ___,___,___

➢ INSENSIBLE LOSS- though the __ & __

A

2, 500 ml

Urine, feces or GI losses, sweat
skin and lungs as water vapor

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20
Q
  • This is the loss of extra cellular fluid volume that exceeds the intake of fluid. The loss of water and electrolyte is in equal proportion.

➢ ____ refers to loss of __ alone, with increased solutes concentration and sodium concentration

A

Fluid Volume Deficit or Hypovolemia

Dehydration
WATER

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21
Q

➢ Refers to the isotonic expansion of the ECF caused by the abnormal retention of water and sodium

➢ There is excessive retention of water and electrolytes in equal proportion. Serum sodium concentration remains ___

A

FLUID VOLUME EXCESS: HYPERVOLEMIA

NORMAL

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22
Q

__ are charged ions capable of conducting electricity and are solutes found in all body compartments

A

Electrolytes

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23
Q
  • positively charged ions; examples are
A

➢ CATIONS

sodium, potassium, calcium

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24
Q

➢ ___ play a role in this type of regulation:

  • __ promotes Na retention and K excretion
  • __promotes Na excretion
  • __ promotes Ca retention and PO4 excretion
  • __ promotes Ca and PO4 excretion
A

hormones

Aldosterone
ANF
PTH-
Calcitonin

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25
Q

➢ occurs by the process of glomerular filtration, tubular reabsorption and tubular secretion

A

a) Renal Regulation

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26
Q

➢ The most abundant cation in the ECF
➢ Normal range in the blood is ___ mEq/L

A

SODIUM

135-145

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27
Q

➢ Refers to a Sodium serum level of less than 135 mEq/L. This may result from excessive sodium loss or excessive water gain.

A

SODIUM DEFICIT: HYPONATREMIA

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28
Q
  • Water intoxication, compulsive water drinking where sodium level is diluted with increased water intake
A

Dilutional hyponatremia

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29
Q

The serum sodium must NOT be increased by greater than 12 mEq/L because of the danger of __

A

pontine osmotic demyelination

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30
Q

➢ Serum Sodium level is higher than 145 mEq/L
➢ There is a gain of sodium in excess of water or a loss of water in excess of sodium.

A

SODIUM EXCESS: HYPERNATREMIA

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31
Q

CELLULAR SHRINKAGE

A

Hypertonic hypernatremia

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32
Q

A primary characteristic of hypernatremia is __.

A

thirst

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33
Q

➢ The most abundant cation in the ICF

➢ Normal range in the blood is ___ mEq/L.

A

POTASSIUM

3.5-5

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34
Q

Potassium should NEVER be given via

A

IV bolus or IM

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35
Q

➢ Serum potassium greater than 5.5 mEq/L

A

POTASSIUM EXCESS: HYPERKALEMIA

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36
Q
  1. Institute emergency therapy to lower potassium level by:

a. Administering ___ - antagonizes action of K on cardiac conduction

b. Administering ____ -causes temporary shift of K into cells

c. Administering ___ -alkalinizes plasma to cause temporary shift

d. Administering Beta-agonists

e. Administering ____ (cation-exchange resin)-draws K+ into the bowel

A

IV calcium gluconate
Insulin with dextrose
sodium bicarbonate
Kayexalate

37
Q

➢ Majority of __ is in the bones and teeth
➢ Small amount may be found in the &
➢ Normal serum range is ___ mg/dL

A

CALCIUM
ECF and ICF
8.5 – 10.5

38
Q

➢ Regulations:

  1. GIT- absorbs ca+ in the ___; Vitamin _ helps to increase absorption
  2. Renal regulation- Ca+ is filtered in the __ and reabsorbed in the __:
  3. Endocrine regulation:
    __ from the parathyroid glands is released when Ca+ level is __. PTH causes release of calcium from bones and increased retention of calcium by the kidney but __

__ from the thyroid gland is released when the calcium level is __. This causes excretion of both calcium and PO4 in the kidney and promoted deposition of calcium in the bones.

A

intestine
D

glomerulus
tubules

Parathyroid hormone
low
PO4 is excreted

Calcitonin
high

39
Q

➢ The major Anion of the ECF
➢ Normal range is mEq/L

A

CHLORIDE

95-108

40
Q

➢ The major Anion of the ICF
➢ Normal range is ___ mg/dL

A

PHOSPHATES

2.5 to 4.5

41
Q

➢ Present in both ICF and ECF
➢ Regulates __ balance together with hydrogen
➢ Normal range is ___ mEq/L

A

BICARBONATES

acid-base

22-26

42
Q

___
➢ substances that can donate or release protons or hydrogen ions (H+); examples are HCl, carbonic acid, acetic acid.
➢ __ or __
➢ substances that can accept protons or hydrogen ions because they have ___ concentration.

A

Acids

Bases or alkalis

low H+

43
Q

➢ __ are constantly produced in the body

➢ Because cellular processes need normal pH, __ & __ must be balanced continuously

➢ __ & __ are crucial in maintaining the balance

➢ A ratio of __ & __ is maintained at 20:1

➢ Several body systems (like the __,__,__) together with the chemical buffers are actively involved in the normal pH balance

➢ The major ways in which balance is maintained are the process of acid/base secretion, production, excretion and neutralization

A

Acids

acids and bases

CO2 and HCO3

HCO3 and Carbonic acid

respiratory, renal and GIT

44
Q

➢ ___ are present in all body fluids functioning mainly to prevent excessive changes in the pH.

A

Buffers

45
Q
  1. REGULATION OF ACID-BASE BALANCE BY RESPIRATORY SYSTEM

➢ ___ is the powerful stimulator of the respiratory center

A

Carbon dioxide

46
Q
  1. REGULATION OF ACID-BASE BALANCE BY THE KIDNEY

➢ When excess H+ is present (__), pH falls kidney reabsorbs and generates Bicarbonate and excretes H+

➢ When H+ is low and HCO3 is high (_). pH rises kidney excretes HCO3 and H+ is retained.

A

(acidic)

(alkalotic)

47
Q

Normal Arterial Blood Gas Values
1. pH –

A

7.35-7.45

48
Q

➢ Infants have higher fluid ___ due to immature kidney and rapid respiratory rate

➢ __ have higher body fat content but lesser water content
➢ __ body has higher water content

➢ ___ affect fluid balance

➢ ___ will lead to nutritional depletion
➢ ___ situations will increase metabolism, increase ADH causing water retention and increased blood volume

➢ Trauma and burns release __ in the blood
➢ Cardiac dysfunction will lead to __&__

➢ ___, ____&, ____ may cause imbalances

A

turn-over

Women
Lean

Climate and heat and humidity

Anorexia nervosa
Stressful

K+
edema and congestion

Suctioning, diuretics and laxatives

49
Q

➢ A base bicarbonate excess
➢ A result of a loss of acid and the
➢ accumulation of bases
➢ S/S - serum pH > 7.45, increased serum
➢ HCO3, serum K level less than 4, tetany, confusion and convulsions

➢ Nursing Interventions - watch for s/s of ___, LOC and __ precautions

A

Metabolic Alkalosis
hypokalemia
seizure

50
Q

➢ A base bicarbonate deficit
➢ Comes from too much acid from metabolism and loss of bicarbonate
➢ S/S - Serum pH <7.35, Increased K+ level, DKA (Kussmaul’s Respirations), Shock, stupor, coma

➢ Nursing Intervention - Give ___/Monitor __ levels

A

Metabolic Acidosis

HCO3
K+

51
Q

➢ A deficit of carbonic acid caused by hyperventilation
➢ S/S - decreased levels of CO2 and increased levels of pH, HCO3 near normal

➢ Nursing Interventions - monitor for ___ and observe for signs and symptoms of __

A

Respiratory Alkalosis

anxiety
tetany

52
Q

___
A carbonic acid excess Caused by an condition that interferes with the release of CO2 from the lungs (sedatives, COPD, narcotics etc.)
S/S - serum pH < 7.35, increased serum CO2 levels> 45 mm Hg, serum K increased, cyanosis

Nursing Interventions - Provide __, __ position, ___ precaution

A

Respiratory Alkalosis

O2
Semifowlers
seizure

53
Q

Interpretation Arterial Blood Gases
➢ If acidosis the pH is __
➢ If alkalosis the pH is
➢ The respiratory function indicator is the __
➢ The metabolic function indicator is the __

A

down
up
PCO2
HCO3

54
Q

➢ a homogeneous mixture of 2 or more substances of dissimilar molecular structure
➢ usually applied to solids in liquids but applies equally to gasses in liquids

A

Solution

55
Q

is the fluid within cells

A
  • The intracellular fluid (ICF)
56
Q

Interstitial space

A
  • is part of the extracellular fluid (ECF) between the cells not in the blood.
57
Q
  • the fluid component of the blood
A

Plasma

58
Q

➢ The normal tonicity or osmolarity of body fluids is ____ mOsm/L

A

250-300

59
Q

➢ Same as plasma tonicity

A

1.Isotonic

60
Q

➢ higher or greater concentration of solutes

A

Hypertonic

61
Q

➢ have a lesser or lowers solute concentration than plasma

A

2.Hypotonic

62
Q

➢ the number of osmoles of solute per kilogram of solvent

A

Osmolality

63
Q

➢ the number of osmoles of solute per litre of solution

A

Osmolarity

64
Q

➢ that number of molecules contained in 0.012 kg of C12, or,
➢ the molecular weight of a substance in grams = Avogadro’s number
= 6.023 x 1023

A

Mole

65
Q

➢ the number of moles of solute per kilogram of solvent

A

Molality

66
Q

➢ is the number of moles of solute per litre of solution

A

Molarity

67
Q

➢ is the power of a solution to draw water across a semi-permeable membrane

A

Osmotic pressure

68
Q

➢ ___ (also called ___) is the osmotic pull exerted by plasma proteins

A

Colloid osmotic pressure

oncotic pressure

69
Q

___ is a type of diffusion, which uses a carrier, but no energy is expended. One example is fructose and amino acid transport process in the intestinal cells. This type of diffusion is ___.

A

➢ Facilitated Diffusion

saturable

70
Q

➢ is the pressure exerted by the fluids within the closed system in the walls of the container

A

Hydrostatic pressure

71
Q

____
➢ Energy is derived secondarily from stored energy in the form of ionic concentration difference between two sides of the membrane.

➢ One example is the ____ co-transport; also the ____ counter-transport

A

Secondary Active Transport

Glucose-Sodium
Sodium-Calcium

72
Q

is released by the atrial cells of the heart in response to excess blood volume and increased wall stretching. It promotes sodium excretion and inhibits thirst mechanism

A

➢ ATRIAL NATRIURETIC factor (ANF)

73
Q

__
* Excessive secretion of ADH causing water retention and dilutional hyponatremia
➢ ___ of plasma water from the intravascular space will move out and go to the intracellular compartment with a higher concentration cell swelling
➢ Water is pulled ___ the cell because of decreased extracellular sodium level and increased intracellular concentration

A

SIADH

Hyponatremia hypotonicity

INTO

74
Q
  1. pO2 –
A

80-100 mmHg

75
Q
  1. pCO2 –
A

35-45 mmHg

76
Q
  1. Hco3 –
A

22-26 mEq/L

77
Q
  1. Base deficit/Excess –
A

(+/-)2

78
Q
  1. O2 saturation –
A

98-100%

79
Q

➢ ___ - is an ultra-filtrate of blood.

The normal output is __ ml/day or 30-50 ml per hour or 0.5-1 ml per kilogram per hour. Urine is formed from the filtration process in the ___

➢ FECAL loss- usually amounts to about ___ in the stool

➢ ___ - occurs in the skin and lungs, which are not noticeable and cannot be accurately measured. ___ goes out of the lungs and skin.

A

URINE

1,500
Nephrons

200 ml

Insensible loss
Water vapor

80
Q
  • negatively charged ions; examples are
A

ANIONS

chloride and phosphates

81
Q

➢ The major ICF cation is ____; the major ICF anion is ___

A

potassium (K+)

Phosphates

82
Q

➢ The major ECF cation is __; the major ECF anion is

A

Sodium (Na+)

Chloride (Cl-)

83
Q

➢ Major contributor of the plasma Osmolality

A

Sodium

84
Q
  • tight tourniquet and hemolysis of blood sample, marked leukocytosis
A

Pseudohyperkalemia

85
Q

The major base in the body is

A

BICARBONATE (HCO3)

86
Q

is considered to be acid or base depending on its chemical association

A

Carbon dioxide

87
Q

➢ When assessing acid-base balance, carbon dioxide is considered ___ because of its relationship with carbonic acid.
➢ Because ___ cannot be routinely measured, carbon dioxide is used.

A

ACID

carbonic acid

88
Q

➢ ___- is the measurement of the degree of acidity or alkalinity of a solution. This reflects the relationship of hydrogen ion concentration in the solution.

➢ The higher the hydrogen ion concentration, the acidic is the solution and pH is ___

➢ The lower the hydrogen concentration, the alkaline is the solution and the pH is ___

➢ Normal pH in the blood is between ____

A

pH

LOW
HIGH

7.35 to 7.45

MS (8 decks)

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