Lecture 1 Conditions of Fluid Imbalance Flashcards
(9 cards)
What is the approx makeup of water/fluid in the body, and how is it distributed?
about 45-60% of total body weight
divided into 2-3* compartments ⇒ ICF - mostly in muscle, ECF - can be classified as interstitial or intravascular
What does osmotic pressure do regarding fluid balance in the body?
maintains distribution of fluids in compartments - conc of dissolved ions, proteins, other large molecules, water moves freely across membranes to maintain equilibrium
Difference in fxn between ICF and ECF?
ICF volume critical for cell fxn, alterations in some cases can lead to dysfunction
ECF volume essential for tissue perfusion (delivery of O2 and nutrients, removal of waste)
What are the S&S of dehydration in children and adults?
dry mucous membranes, skin tenting, decrease in urine output, postural changes - lying ⇒ standing = dizziness, increase in HR, decrease in SBP
cool extremities, decrease in capillary refill, decrease in cognitive fxn, sunken eyes
What are the S&S of dehydration in infants and young children
dry mouth and tongue, lack of tears when crying, no wet diaper for 3 hours, sunken eyes/cheeks, sunken spot on fontanelle, listlessness or irritability (change in usual behaviour)
What is typical dehydration management?
around 2-3 L/day, if patient is mildly dehydrated encourage them to drink, depending on severity refer to medical attention for IV fluid replacement
What are the different types of fluids used in dehydration management and how do they affect ICF and ECF volume (per 1 L) (tonicity?)?
A. D5W - hypotonic, ICF: 666 mL, ECF: 333 mL
B. 0.45% NaCl ⇒ hypotonic, ICF: 333 mL, ECF: 666 mL
C. Lactated Ringer’s - isotonic, ICF: 30 mL, ECF: 970 mL
D. 0.9% NaCl - isotonic, ICF: 0 mL, ECF: 1 L
E. 3% NaCl - hypertonic, ICF: -2000 mL, ECF: 3000 mL
What are the S&S of edema and what is it?
excess fluid volume in ECF - usually caused by heart, kidney, liver failure, also in pregnancy and malnutrition
swelling in feet, ankles, lower legs (pitting edema)
pulmonary edema - increase in RR, SOB, crackles
weight gain, increased jugular venous pressure, positive hepatojugular reflux: firm pressure over liver temporarily increases venous return to heart
What is the typical management for edema?
correct underlying cause ⇒ ex. HF, Na+ restriction (1-2 g/day)
Meds: diuretics increase Na+ excretion ⇒ loop diuretics (furosemide, ethacrynic acid), thiazide diuretics (HCTZ, chlorthalidone, metolazone), K+ sparing diuretics (triamterene, amiloride, spironolactone)
