NURS 215 Module 1

Question 1

Classification of body fluids and their compartments:

Answer 1

Intracellular Fluid
Extracellular Fluids

Question 2

3 sub-compartments of the Extracellular space:

Answer 2

intravascular space - blood vessels and plasma (transport system b/t cells and organs

interstitial space
transcellular space

Question 3

The sum of fluids is?

Answer 3

the total body water TBW
- varies with age, body fat
- increased adipose = less water –> the more lean you are, the more water in the body
- as you get older, the less amount of TBW one has

Question 4

How does water move between the plasma and interstitial fluid across semi-permeable capillary membranes?

Answer 4

1. osmosis
2. hydrostatic pressure
3. oncotic/colloidal osmotic pressure

Question 5

Osmosis

Answer 5

the pulling of water to even the concentration of solutes and water

Question 6

hydrostatic pressure

Answer 6

the pushing of water out of blood vessels and into the surrounding tissues

Question 7

oncotic/colloidal osmotic pressure

Answer 7

pulling of water from the interstitial space and into the vascular space
- pulling into the blood vessels
- albumin will be here

Question 8

How do electrolytes move?

Answer 8

through diffusion and active transport

Question 9

The primary electrolytes in the intracellular fluid:

Answer 9

cations:
- potassium
- magnesium

anions:
- phosphate
- sulfate

Question 10

the primary electrolytes in the extracellular fluid:

Answer 10

cations:
- sodium
- calcium

anions:
- chloride
- bicarbonate

Question 11

When drawing blood from a patient to analyze electrolytes, we would expect what type of fluid to dominate?

Answer 11

Would expect the ECF to dominate since the IV is in the ECF.

Question 12

Osmalality

Answer 12

the total number of dissolved particles/kg of fluid
- serum levels of 280-295 in the human body
- tells us how concentrated to the fluid is
- the fluids inside the body

Question 13

Isotonic solutions

Answer 13

the equal amount of solute and solvent
- no movement in or outside the cells
- the cells stay the exact same size
- ex. 0.9% NS

Question 14

Hypotonic solutions

Answer 14

fewer dissolved particles than inside the cell
- water will move inside the cell, causing the cell to swell
- solute < solvent
- ex. 0.45% NS

Question 15

Hypertonic solutions

Answer 15

more dissolved particles than in the cell
- water will leave the cell, causing the cell to shrink
- solute > solvent
ex. 50% dextrose

Question 16

1st spacing

Answer 16

the normal distribution of fluid in the ICF and ECF
- evenly distributed
- how the body balances fluid

Question 17

2nd spacing

Answer 17

EDEMA abnormal accumulation of interstitial fluid
- still in the ECF, just too much in certain spaces

Question 18

3rd spacing

Answer 18

fluid accumulates in areas that normally have no fluid or a minimum amount of fluid
- the fluid gets trapped, hard to get the fluid back into circulation
- ex. fluid in the abdomen or lungs

Question 19

How much fluid excess does it take for edema to be noticeable?

Answer 19

takes 2.5 - 3L of excess interstitial volume fluid

Question 20

localized edema

Answer 20

due to injury or trauma
- usually limited to the site of trauma or a particular organ system (ex. spleen, lungs, lymphatic system, brain)
- is usually not pitting

Question 21

generalized edema

Answer 21

the uniform distribution of fluid in the interstitial space

Question 22

dependent edema

Answer 22

when fluid accumulates in gravity-dependent areas of the body

Question 23

lymphedema

Answer 23

occurs when the lymphatic system is damaged or blocked, leading to swelling and skin damage

can be due to:
- axillary node removal through surgery
- chronic infection

Question 24

4 physiologic causes of edema:

Answer 24

1. increased capillary permeability
2. decreased capillary oncotic pressure - low protein in the blood
3. increased capillary hydrostatic pressure - from too much water in the blood vessel
4. blockage/surgical removal of lymphatic channels - lymph system is blocked which creates edema

Question 25

3 systems to help regulate blood balance:

Answer 25

1. ADH 2. RAAS 3. ANP

Question 26

RAAS

Answer 26

one of the systems that helps to regulate blood balance - renin angiotensin aldosterone system - when there's decreased blood flow to the kidneys, which then leads to increased levels of renin that's released by the kidneys - creates increased levels of angiotensin II, which then produces excessive amounts of vasoconstriction - end products: high levels of aldosterone and ADH

Question 27

aldosterone

Answer 27

helps the body hold on to sodium and water - due to the increased tubular reabsorption

Question 28

ADH

Answer 28

is a vasoconstrictor that prevents water from being lost in the urine - is a vasopressant

Question 29

atrial natriuretic peptide (ANP)

Answer 29

is a hormone that's released by the heart when there's too much pressure in the blood vessels - inhibits renin and aldosterone secretion = lowers BP, secreting sodium and water - is an antagonist to angiotensin II

Question 30

Angiotensin II

Answer 30

makes blood vessels narrow = increased BP

Question 31

ADH is secreted when

Answer 31

- there's an increase in plasma osmolality --> blood becomes more concentrated - decrease blood volume, decrease in BP

Question 32

fluid volume deficit

Answer 32

when the body loses too much water than it takes in can be caused by: 1. dehydration 2. hypovolemia

Question 33

S/S of dehydration:

Answer 33

- increase in concentration of blood solutes - increased sodium levels - weight loss - dry skin and mucous membranes - decreased urine output - oliguria - thirst

Question 34

Hypovolemia

Answer 34

is the isotonic fluid loss from the ECF volume - the decrease in circulating blood volume

Question 35

causes of hypovolemia:

Answer 35

loss of fluids and solutes - abdominal surgery - renal failure/diabetes - diuretic use - drainage: fistulas, NG loss of circulating blood volume - hemorrhage - trauma 3rd spacing fluid shift - burns - pleural effusions, fluid in the lungs - ascites, fluid in the abdomen

Question 36

S/S of hypovolemia:

Answer 36

- weight loss - tachycardia - dry skin - flattened fontanel in babies, top of the head - increased hematocrit, blood is thicker - severe S/S: hypovolemic shock when there is >40% of circulating blood volume that's lost

Question 37

Hypervolemia

Answer 37

when there's too much isotonic fluid of water and sodium in the ECF/space

Question 38

causes of hypervolemia

Answer 38

- excessive IV fluids - hypersecretion of aldosterone, retaining too much sodium and water - effects of drugs, ex. cortisone - excess of sodium in the diet

Question 39

S/S of hypervolemia:

Answer 39

- weight gain - increased BP - decreased hematocrit - diluted blood - distended neck veins - edema, both pulmonary and peripheral

Question 40

1L of water weighs how many lbs., and is equal to how many kg?

Answer 40

1L = 2.2 lbs. = 1kg

Question 41

1lb = to a fluid volume change of about how many mLs?

Answer 41

1lb = about 500 mL of fluid volume change - REMEMBER: small changes in weight = large shift of fluid gain or loss