Lecture 5 Fluid And Electrolyte

Question 1

How much %of water makes up the body

Answer 1

60%

Question 2

What makes up the extracellular compartment

Answer 2

Interstitial (tissue) spaces
Plasma (vascular) compartment
Transcellular compartment

Question 3

What are the functions of fluid?

Answer 3

Transportation (nutrients, waste and heat)
lubrication and protection
digestion

Question 4

Intake of fluids is regulated by what

Answer 4

Regulated by thirst mechanism

Question 5

What does the hypothalamus monitor

Answer 5

Blood osmolality (osmolality inc, thirst stimulates)
BP (BP sec thirst increased)

Question 6

Intake includes what?

Answer 6

Oral and IV

Question 7

What is output determined by

Answer 7

Flirtation needs
Insensible water loss
Renal regulation

Question 8

Minimum Amount urine output

Answer 8

400-600 ml/day

Question 9

Insensible water loss

Answer 9

Respiration, veces, skin, sweating

Question 10

Diffusion

Answer 10

Movement of particles from area of higher to lower concentration

Question 11

Concentration gradient

Answer 11

A difference in concentration for one pt to another

Question 12

Albumin affect on blood

Answer 12

Total albumin in bloodstream= protein nutritional status

Exerts oncotic pressure= pulls fluid back to capillaries

Question 13

Edema

Answer 13

Excess fluid in ISF And ICF

Hypoalbuminemia= low albumin makes low oncotic pressure

OR elevated hydrostatic pressure by excess water

Question 14

Causes of fluid volume deficit

Answer 14

Inadequate intake 
Excessive fluid loss 
Third spacing (into interstitial space)

Question 15

S&S of fluid volume defect

Answer 15

Acute weight loss 
Dec. urinary output 
Inc. urine specific gravity 
Hemoconcentrarion 
Dec. vascular volume= tachycardia, hypotension, depressed fontanelle, sunken eyes, inc. body temp

Question 16

Causes of fluid volume excess

Answer 16

Excessive sodium and water intake

Inadequate renal loss

Question 17

S&S of fluid volume excess

Answer 17

Acute weight gain
Pitting and pulmonary edema
Puffy eyelids
Hypertension

Question 18

Third space fluid accumulation

Answer 18

Fluid (effusion) in cavities caused when ill

Question 19

Pitting edema

Answer 19

Occurs when pressure is applied to small area and indentation

Question 20

ADH affect on urine output

Answer 20

Increased levels of ADH decrease urine output because ADH reabsorbes water

Question 21

Dehydration

Answer 21

State of diminished water volume in the body
Deficit of ICF= cells shrink
Dec amount of water in ECF

Question 22

Oliguria

Answer 22

Urine production <400 ml/day or <20/30 mL/hr

Question 23

Assessment of fluid status

Answer 23

Daily weight
24 he intake and output
Assessment of skin turtle, mucous membrane, tears, fontanelles
BP and heart rate checked

Question 24

Orthostatic hypotension

Answer 24

Occurs in dehydration where BP drastically decreased when changing from laying to standing

Question 25

Symptoms of dehydration

Answer 25

``` Thirst Dry mucous membrane Poor skin turgor Hypotension/orthostatic hypotension Dark urine Depressed fontanelle ```

Question 26

Sodium

Answer 26

135-145 mEq/mL Target organ: brain Regulated in Kidneys, Gi, skin Main function= water regulation Oop

Question 27

Hyponatremia

Answer 27

<135 | Can occur in low blood volume (hypovolemic hyponatremia) or in high blood volume (dilutional hyponatremia)

Question 28

Causes of hyponatremia

Answer 28

Diarrhea, vomiting, excess sweating, burns/wounds, inc ADH (stress pain trauma)

Question 29

Symptoms of Hyponatremia

Answer 29

``` Headache lethargic apathy confusion nausea vomiting diarrhea muscle cramps/spasms ```

Question 30

Causes of hypernatremia

Answer 30

Excess sodium intake decrease extracellular losses decrease water intake

Question 31

Signs of hypernatremia

Answer 31

``` >145 High specific gravity, Liguria Dry mucous membranes tachycardia hypertension ```

Question 32

Hypernatremia relation with water retention

Answer 32

Weight gain | hypertension

Question 33

Hypernatremia with water loss

Answer 33

``` Dehydration thirst Irritability tachycardia flush skin dry mucous membranes oliguria ```

Question 34

Potassium

Answer 34

``` 3-5 mEq/mL Regulate in kidneys Bananas, orange, lentils, rasins Target organ; heart Main function: smooth electrical conduction of the muscles ```

Question 35

Causes of Hypokalemia

Answer 35

``` Diuretic therapy IV administration poor intake G.I. losses diuretic phase of renal failure ```

Question 36

S&S of hypokalemia

Answer 36

``` Muscle fatigue weakness leg cramps nausea vomiting cardiac arrhythmias postural hypotension Prominent U wave and flattened T wave ```

Question 37

Treatment of hypokalemia

Answer 37

Never give rapid potassium a.k.a. bolus IV potassium must always be diluted

Question 38

Hyperkalemia causes

Answer 38

excess intake massive crushing injuries inadequate renal losses

Question 39

S&S of hyperkalemia

Answer 39

``` Numbness muscle cramping nausea/diarrhea apathy mental confusion peaked T waves widening QRS complex cardiac arrest ```

Question 40

Calcium and phosphorus relationship

Answer 40

Reciprocal relationship when one increases the other decreases and vice versa

Question 41

Hypocalcemia

Answer 41

<8.5 and main function is bone development, blood clotting, smooth muscle contraction Causes: Inadequate vitamin D, abnormal ca binding, hypoparathyroidism S&S: muscle spasms (trousseau and Chvostek) seizures hypotension Arrhythmias

Question 42

Main function of magnesium

Answer 42

Maintains intracellular K and functions in enzyme reactions and proteins and DNA synthesis

Question 43

Hypomagnesemia

Answer 43

Mg stored in bone | Spasms cardiac arrhythmias similar to hyponkalemja disease