Nur 215 Flashcards
(109 cards)
1
Q
What is body fluid distribution?
A
Body fluid is distributed among functional compartments.
2
Q
Where is Intracellular Fluid (ICF) found?
A
Found inside the cells.
3
Q
Where is Extracellular Fluid (ECF) found?
A
Found outside the cells.
4
Q
What are the components of ECF?
A
Intravascular space, Interstitial space, and Transcellular space.
5
Q
What is Total Body Water (TBW)?
A
The sum of all body fluids (ICF + ECF).
6
Q
What factors influence TBW?
A
Age and body fat percentage.
7
Q
How does adipose tissue affect TBW?
A
More adipose tissue = less total body water.
8
Q
What is osmosis?
A
The primary mechanism that pulls water across a semi-permeable membrane.
9
Q
What is hydrostatic pressure?
A
The pushing force of water from the vascular system into the interstitial space.
10
Q
What is oncotic (colloidal osmotic) pressure?
A
The pulling force that draws water from the interstitial space back into the vascular system.
11
Q
What causes oncotic pressure in capillaries?
A
Plasma proteins (especially albumin).
12
Q
How does water move between plasma and interstitial fluid?
A
By osmosis, hydrostatic pressure, and oncotic pressure across capillary membranes.
13
Q
How do electrolytes move across membranes?
A
By diffusion and active transport.
14
Q
What is diffusion?
A
The passive movement of electrolytes from an area of higher to lower concentration.
15
Q
What is active transport?
A
The movement of electrolytes against a concentration gradient using energy (ATP).
16
Q
What are the main cations in intracellular fluid?
A
Potassium (K+) and Magnesium (Mg2+).
17
Q
What are the main anions in intracellular fluid?
A
Phosphate (PO4^3-) and Sulfate (SO4^2-).
18
Q
What is the most abundant cation inside cells?
A
Potassium (K+).
19
Q
What is the essential intracellular anion for energy metabolism?
A
Phosphate (PO4^3-).
20
Q
What are the main cations in extracellular fluid?
A
Sodium (Na+) and Calcium (Ca2+).
21
Q
What are the main anions in extracellular fluid?
A
Chloride (Cl-) and Bicarbonate (HCO3-).
22
Q
What is the most abundant cation in extracellular fluid?
A
Sodium (Na+).
23
Q
Which anion helps maintain acid-base balance in ECF?
A
Bicarbonate (HCO3-).
24
Q
What is the normal range of serum osmolality?
A
280-295 mOsm/kg.
25
What does serum osmolality measure?
The total number of dissolved particles per kilogram of fluid.
26
What is an isotonic solution?
It has an equal amount of solute and solvent.
27
What is the effect on cells in an isotonic solution?
No net movement of water; cells remain the same size.
28
What is a hypotonic solution?
The solution has less solute than solvent.
29
What is the effect on cells in a hypotonic solution?
Water moves into the cells; cells swell.
30
What is a hypertonic solution?
The solution has more solute than solvent.
31
What is the effect on cells in a hypertonic solution?
Water moves out of the cells; cells shrink.
32
What is first spacing?
Normal distribution of fluids in body including intracellular and intravascular
33
What is normal distribution of fluid?
Normal distribution of fluid in intracellular (ICF) and extracellular (ECF) compartments.
34
What is second spacing?
Abnormal accumulation of interstitial fluid, known as edema.
35
What is third spacing?
Fluid accumulation in spaces where there is normally little or no fluid (e.g., pleura, peritoneum).
36
What is edema?
Accumulation of fluid in the interstitial space due to increased forces favoring fluid filtration from capillaries or lymphatics.
37
What is localized edema?
Edema limited to a specific area or organ (e.g., brain, lungs, spleen); often non-pitting.
38
What is generalized edema?
Widespread, uniform distribution of fluid in the interstitial spaces.
39
What is dependent edema?
Fluid accumulation in gravity-dependent areas like legs, feet, or sacrum.
40
What is pitting edema?
A depression or 'pit' remains after pressure is applied to swollen tissue.
41
What causes increased capillary permeability?
Caused by inflammation, immune/allergic reactions, trauma, burns, neoplastic disease.
42
What causes decreased capillary oncotic pressure?
Caused by low plasma albumin due to liver disease, malnutrition, renal disorders, hemorrhage, or burns.
43
What causes increased hydrostatic pressure in capillaries?
Caused by venous obstruction, salt and water retention, heart failure, renal failure, hepatic obstruction, thrombophlebitis.
44
What causes lymphatic obstruction?
Caused by blockage or surgical removal of lymph nodes/channels (lymphedema).
45
What activates the RAAS system?
Activated by 'Renal blood flow', 'Renin', 'Angiotensin II', 'Aldosterone', and 'ADH'.
46
What is the role of aldosterone in fluid balance?
Promotes sodium and water reabsorption in the kidneys.
47
What is the function of ADH?
Promotes water retention and vasoconstriction.
48
What is Atrial Natriuretic Peptide (ANP)?
Released in response to atrial stretch; inhibits renin and aldosterone, opposing angiotensin II effects.
49
What hormone regulates water balance?
Antidiuretic hormone (ADH) increases renal water reabsorption.
50
What triggers the release of ADH?
Increased plasma osmolality or decreased blood volume (low blood pressure).
51
How does ADH affect water conservation?
Increases the permeability of renal tubules, allowing water and sodium to be reabsorbed.
52
What is the stimulus for thirst perception?
Increased plasma osmolality.
53
What is the role of Atrial Natriuretic Peptide (ANP)?
Reduces blood pressure and promotes sodium and water excretion.
54
What is dehydration?
Loss of body water that is not replaced.
55
What is hypovolemia?
Isotonic fluid loss from the extracellular fluid (ECF) compartment.
56
What are signs of dehydration?
Increased serum sodium, weight loss, dry mucous membranes, oliguria (low urine output), increased thirst.
57
What causes hypovolemia?
Loss of fluids & solutes, loss of circulating blood volume, third spacing fluid shift.
58
What are signs of severe hypovolemia?
Flattened fontanel in infants, increased hematocrit, hypovolemic shock (loss of > 40% blood volume).
59
What is hypervolemia?
Excess fluid volume in the extracellular compartment (ECF).
60
What causes hypervolemia?
Excessive IV fluid administration, hypersecretion of aldosterone, cortisone (glucocorticoids) effects, high sodium intake.
61
What hormone promotes sodium and water retention?
Aldosterone.
62
How does cortisone contribute to fluid retention?
It mimics aldosterone, promoting sodium and water retention.
63
What are clinical signs of hypervolemia?
Weight gain, increased blood pressure, bounding pulse, decreased hematocrit, distended neck veins, pulmonary/peripheral edema.
64
How much fluid does a 1 lb weight change represent?
Approximately 500 mL.
65
What is the weight of 1 liter of water?
2.2 pounds (1 kg).
66
What is a critical nursing intervention for monitoring fluid status?
Daily weights (same time, scale, clothing).
67
What should be monitored in clients with fluid imbalances?
I&O, urine specific gravity, vital signs, respiratory status/lung sounds, skin turgor and color, neurologic status, edema & mucous membranes.
68
What is the effect of low serum albumin?
'Oncotic pressure' fluid shifts into tissues, causing edema.
69
What serum sodium level defines hypernatremia?
Greater than 145 mEq/L.
70
How should sodium levels be adjusted in hypernatremia?
Slowly and steadily to prevent brain damage.
71
Where is potassium located in the body?
98% is intracellular (inside cells).
72
What is the normal serum potassium range?
3.5 - 5.0 mEq/L.
73
What are key functions of potassium?
Regulates intracellular osmolality, maintains resting membrane potential, deposits glycogen in liver and skeletal muscle cells.
74
How is potassium balance regulated?
By the kidneys, aldosterone, insulin, and pH changes.
75
What is aldosterone's effect on potassium?
Stimulates potassium excretion through urine and sweat.
76
What is hypokalemia?
Serum potassium less than 3.5 mEq/L.
77
What are common causes of hypokalemia?
Renal disorders, vomiting, diarrhea, laxative abuse, diuretics.
78
What are key clinical manifestations of hypokalemia?
Arrhythmias, weak irregular pulse, weakness, confusion, muscle cramps, paralysis.
79
How is hypokalemia treated?
Potassium supplements orally or diluted IV infusion (never IV push), rate 10-20 mEq/hr.
80
What is hyperkalemia?
Definition not provided in the notes.
81
What causes hyperkalemia?
Decreased renal elimination, increased intake, burns, trauma, insulin deficit, decreased aldosterone.
82
What are clinical signs of hyperkalemia?
Arrhythmias, cardiac arrest, muscle weakness, paresthesia, flaccid paralysis (late).
83
How is hyperkalemia managed?
Stop potassium intake, increase elimination (diuretics, dialysis, Kayexalate), shift potassium into cells with IV insulin or sodium bicarbonate, administer calcium gluconate IV to protect the heart.
84
What is the normal serum calcium range?
8.5-10.5 mg/dL.
85
Where is calcium stored in the body?
More than 99% in bones.
86
What is the biologically active form of calcium?
Ionized calcium.
87
What are the functions of calcium?
Transmission of nerve impulses, myocardial contractions, blood clotting.
88
What hormones regulate calcium balance?
Parathyroid hormone (PTH), calcitonin, vitamin D.
89
What is the most common cause of hypercalcemia?
Hyperparathyroidism.
90
What are clinical manifestations of hypercalcemia?
Confusion, muscle weakness, constipation.
91
What are key treatments for hypercalcemia?
Parathyroidectomy, calcitonin, diuretics, bisphosphonates.
92
What causes hypocalcemia?
Decreased PTH production, renal failure, thyroidectomy, vitamin D deficiency.
93
What signs indicate hypocalcemia?
Positive Trousseau's sign, Chvostek's sign.
94
What is the emergency treatment for severe hypocalcemia?
IV calcium gluconate or calcium chloride.
95
What should be considered when administering calcium supplements?
Check for drug interactions with calcium supplements.
96
What is the normal serum magnesium range?
1.4-2.1 mg/dL.
97
Where is magnesium stored in the body?
In the bones (50-60%).
98
What metabolic processes require magnesium?
Metabolism of proteins and carbohydrates.
99
What factors influence magnesium balance?
Factors that regulate calcium balance.
100
What are common causes of hypermagnesemia?
Increased intake in renal failure, overuse of magnesium-containing antacids or laxatives, dehydration.
101
What are clinical manifestations of hypermagnesemia?
Lethargy, hypoactive reflexes, hypotension.
102
What are emergency treatments for hypermagnesemia?
IV calcium chloride or calcium gluconate, dialysis, fluids to promote urinary excretion.
103
What is the normal serum phosphorus range?
2.5-4.5 mg/dL.
104
What are the primary functions of phosphorus?
Muscle, red blood cell, and nervous system function; bone and tooth structure; acid-base buffering; ATP production; glucose uptake.
105
What are common causes of hyperphosphatemia?
Renal failure, chemotherapy, excessive phosphate or vitamin D intake, muscle necrosis.
106
What are clinical manifestations of hyperphosphatemia?
Tetany, neuromuscular irritability, muscle weakness, anorexia, calcification in soft tissues.
107
What is the management approach for hyperphosphatemia?
Treat underlying cause, restrict phosphate intake, hydrate adequately, correct hypocalcemia, prevent injury.
108
What are clinical manifestations related to phosphorus deficiency?
CNS depression, confusion, irritability, muscle weakness, dysrhythmias, cardiomyopathy.
109
How is phosphorus deficiency managed?
Oral supplementation, foods high in phosphorus, IV sodium or potassium phosphate administration.
