Nx 102 Fluid, Electrolyte, and Acid-Base Balance Flashcards Preview

NURSING > Nx 102 Fluid, Electrolyte, and Acid-Base Balance > Flashcards

Flashcards in Nx 102 Fluid, Electrolyte, and Acid-Base Balance Deck (136):
1

Water makes up what percent of total adult body weight?

60%

2

Functions of water

-transport nutrients and wastes
-transport hormones, enzymes, and all blood cells
-facilitate cellular metabolism/functioning
-acts as solvent for electrolytes and nonelectrolytes
-helps maintain body temp
-helps in digestion and elimination
-acts as a tissue lubricant

3

2 body compartments for fluids

Intracellular: 70%
Extracellular:interstial, intravascular, and transcellular = 30%

4

Older people have more/less water than infants

older people have lower water content

5

fat cell contain a lot/little water

fat cells contain little water
-this is why older people have less water than infants, they have more fat

6

women have more/less water than men

women typically have less water bc of higher fat content

7

infants dehydrate more/less easily than older people

More easily - they have higher water content therefore it is easier to upset their balance

8

lean people have more/less water than obese people

More water - lean muscle has more water content than fat cells

9

Most common electrolytes

Na, K,. Ca, Mg, Cl, PO4, Bicarb

10

Nonelectrolytes

Required for proper functioning but only found in trace amounts - i.e. urea and glucose
Do NOT dissociate into ions

11

solvent

the liquid portion of a solution
water is the body's major solvent

12

solute

substances dissolved in a solution - electrolytes and nonelectrolytes

13

electrolytes are measured in

mEq/L
-a measure of an electrolytes chemical activity

14

1 mEq =

the chemical activity of 1 mg H

15

in homeostasis, total cations should equal....

total anions

16

fluid movement is

constantly in motion
method by which nutrients, wastes, and other substances are transported throughout the body

17

cell membranes are permeable to...

water and fluids

18

cell membranes are semipermeable to

some solutes

19

fluids move between compartments by (2)

filtration and osmosis

20

solutes move between compartments by (2)

diffusion and active transport

21

osmosis

-water moves from areas of lower solute conc and more water, to areas of higher solute conc and less water (stops when both sides are equal)

22

the pulling power of a solution is its...

osmolarity - the greater the number of solute particles the higher that solutions osmolarity

23

the greater a solutions osmolarity the greater the _____ ______ it exerts on surrounding solutions

osmotic pressure

24

isotonic

a solution with osmolarity = to plasma (275 - 295 mOsm/L)

25

hypertonic

greater osmolarity than plasma (>295)

26

hypotonic

lower osmolarity than plasma (<275)

27

diffusion

movement of particles from areas of high conc to lower, due to random particle motion
doesnt require energy
also called passive transport

28

active transport

movement of solutes from areas of low con to higher
requires energy (ATP)
amino acids, glucose, Na, K, Cl, H, PO4, and Ca all require active transport

29

filtration

movement of fluid from high pressure to low

30

hydrostatic pressure

the driving force behind filtration; the force of a fluid against the walls of its container

31

Under normal conditions, hydrostatic pressure is greater/less than plasma colloid pressure at arterial end

greater than (fluids move out of capillaries)

32

at venous end, hydrostatic pressure is greater/less than plasma colloid pressure

less than (fluid moves back into capillaries)

33

filtration pressure

the difference between colloid osmotic pressure and blood hydrostatic pressure

34

colloid osmotic pressure

also known as oncotic pressure; the osmotic pressure exerted by albumin as fluid moves out of the capillaries - eventually it becomes concentrated enough that it overpowers hydrostatic pressure and fluid move back into capillaries

35

desired fluid intake and output

1500-3500 mL/day

36

average fluid I

2600 mL/day
-1300 from fluids
-1000 from food
-300 from metabolism

37

urine output should be roughly equal to...

fluid intake

38

water gained from food and metabolism is roughly balanced by...

that lost through feces, skin, and respirations

39

thirst control center

hypothalamus

40

average fluid O

2600 mL/day
-1500 urine
-200 feces
-600 skin
-300 lungs

41

kidneys role in homeostasis

filters 180 L plasma and make 1-2 L urine per day, retains or excretes water and electrolytes

42

cardiovascular role in homeostasis

pumps water and nutrients, creates hydrostatic pressure

43

lungs role in homeostasis

regulates O2 and CO2 levels in blood

44

Adrenal glands role in homeostasis

aldosterone helps body conserve Na, Cl, and water and excrete potassium

45

what 2 things follow Na

Cl and water

46

What is the relationship between Na and K

they are reciprocal - gain one and lose the other and vice versa

47

Thyroid glands role in homeostasis

thyroxine increases blood flow leading to increased renal circulation (and increased urine output)

48

Parathyroid glands role in homeostasis

PTH draws Ca into the blood (bone reabsorption) and moves phosphorus

49

Pituitary glands role in homeostasis

ADH retains Na and water, excretes potassium

50

Osmoreceptors

neurons sensitive to changes in ECF - inhibits or stimulates secretion of ADH

51

fluid imbalances occur when...

volume or distribution of water or electrolytes are altered

52

fluid volume deficit/hypovolemia/isotonic fluid loss

loss of water and electrolytes in same proportion as ECF

53

Causes of FVD

loss of body fluids, esp when intake is low

54

Sx of FVD

weight loss, thready pulse, decreased BP, sunken eyes, few tears and salivation, poor skin turgor, pale cool skin, dry cracked lips, decreased urine output

55

FVD: weight loss of ___% in adults and ___% in infants can occur rapidly

5%, 10%

56

pronounced fluid deficit

5% weight loss

57

severe fluid deficit

8% or more weight loss

58

life threatening fluid deficit

+ 15% weight loss

59

third space shift defined

movement of fluids to peritoneal, pleural, pericardial, joints, bowel, interstitial spaces

60

characteristics of 3rd space shift

trapped, unavailable fluids
no decrease in body weight
caused by decrease in colloid osmotic pressure or increased capillary permeability (burns, bowel obstruction, hypoalbuminemia)

61

Fluid volume excess/hypervolemia defined

excessive retention of water and Na in near equal proportions

62

FVE is often caused by

malfunctioning kidneys and heart failure

63

FVE may accumulate in

intravascular or interstitial spaces

64

Sx of FVE

weight gain, bounding pulse, >BP, periorbital edema, > resps, crackles, ronchi, edema, jugular vein distention

65

edema

accumulation of fluid in interstitial space; most observable around eyes, fingers, ankles, and sacrum; may result in 5% weight gain

66

Major electrolytes (as opposed to most common)

Na, K, Cl, Ca, Mg

67

Na

chief electrolyte in ECF
moves easily between interstitial and intravascular spaces
moves by active transport

68

functions of Na

controls/regulates fluid volume
maintains water balance
primary regulator of ECF volume
generation and transmission of nerve impulses
Na/K pump

69

normal Na levels

135 - 145 mEq/L

70

hyponatremia

<135
loss of sodium or gain of water
when ECF NA drops, fluid moves into ICF (more concentrated)
cells swell

71

causes of hyponatremia

IV overload, fluid overload, hyperglycemia and SIADH (dilution of Na), diuretics, GI drainage, diarrhea, vomiting, excessive sweating

72

Sx of hyponatremia

Confusion, Nausea, Lethargy, Vomiting, Seizures, Hyperactive Bowel Sounds
(CaN LoVe Save Humanity)

73

Labs of hyponatremia

74

hypernatremia

surplus of Na in ECF caused by excess water loss or Na excess
>145
cells crenate (especially nerves)

75

Causes of hypernatremia

MODEL
M: meds, meals
O: osmotic diuretics
D: diabetes insipidus
E: excessive water loss
L: low fluid intake

76

Sx of hypernatremia

thirst, irritability, dry mucous membranes, weakness, coma (TIDWC)
FRIED - fever, restless, increased fluid retention, edema, decreased urine output and dry mouth

77

labs of hypernatremia

>serum Na
urine specific gravity and osmolarity

78

Potassium (K)

major cation of ICF
reciprocal with Na

79

functions of K

regulates enzyme activity and ICF volume
vital to electrical impulse transmission (heart, skeletal, nerve, lung, GI)
assists in acid-base balance by exchanging w/ H

80

Normal K values

3.5 - 5 mEq/L

81

hypokalemia

most dangerous electrolyte imbalance
<3.5
when ECF K falls, K moves out of cell to balance, cell retains Na and H to maintain isotonicity

82

causes of hypokalemia

GI losses, Meds (diuretics, aminoglycosides), metabolic alkalosis, GI suction, hyperaldosteronism
poor dietary intake
severe diaphoresis

83

dietary sources of K

bananas, potatoes w skin, plain yogurt

84

Sx of hypokalemia

fatigue, nausea, vomiting, dyshythmias (flat T), muscle weakness, leg cramps, decreased reflexes

85

hyperkalemia

excess of K in ECF
>5
rare but hazardous
affects nerve conduction and muscle contractility

86

causes of hyperkalemia

MACHINE
M: meds (hyperK is usually tx related)
A: acidosis & addisons
C: cell destruction
H: hypoaldosteronism, hemolysis
I: intake (too much salt substitute)
N: nephrons (renal failure)
E: excretion (decreased)

87

Sx of hyperkalemia

muscle weakness, oliguria, cardiac irregularities

88

hyperkalwmia is MURDER

M:muscle weakness
U: urine (oliguria)
R: respiratory distress
D: decreased cardiac contractility (irregularities)
E: ECG changes
R: reflexes (hyperreflexia, areflexia)

89

Calcium Ca

most abundant electrolyte in the body
99% found in bones and teeth
close link between calcium and phosphorous
controlled by PTH, Vit D, and calcitonin

90

Normal Ca levels

9 to 10.5

91

functions of Ca

nerve impulse transmission and blood clotting
muscle contractions
B12 absorption and usage
catalyst for many chemical activities
strong bones and teeth
determines thickness and strength of cell membranes

92

hypocalcemia

< 9

93

causes of hypocalcemia

low intake, impaired absorption, increased phosphorus (antacids), calcium loss (diuretics), removal of the parathyroid, renal failure hypoparathyroidism, dilantin

94

dietary sources of Ca

spinach, dairy, sardines

95

Sx of hypocalcemia

CATS
C:convulsions, confusion, paresthesias
A: arryhythmias
T: tetany, hyperreflexia
S: seizures, spasms
also + Chvostek's and Trousseaus

96

hypercalcemia

>10.5
>12 = coma
>13 = possibly fatal
Emergency situation - can lead to cardiac arrest

97

causes of hypercalcemia

*cancer
*hyperparathyroidism
*increased intake of Vit D & A
*bone loss related to immobility

98

Sx of hypercalcemia

muscle weakness, lethargy, dysrhythmias, kidney stones,

99

Magnesium Mg

mostly found in heart, bone, nerves, and muscles
second most important cation in ICF

100

Normal Mg levels

1.8 - 3 mEq/L

101

function of Mg

metabolism of protein and carbs
enzymatic reactions
*necessary for DNA and protein synthesis, DNA and RNA transcription, RNA translation
maintains normal potassium levels
helps maintain electrical activity in nervous and muscle membranes

102

hypomagnesemia

*DTR, resp paralysis

103

causes of hypomagnesemia

malabsorption disorders (inflammatory bowel disease, bowel resection, gastric bypass)
alcoholics in withdrawal
clients receiving insulin, diuretics, aminoglycosides (neprhotoxic)

104

Sx of hypomagnesemia

leg and foot cramps, twitching, dysrhythmias, difficulty swallowing, alterations in mood and LOC (level of consciousness), >DTR

105

hypermagnesemia

> 3
occurs in end stage renal failure, in pts w/ DM or leukemia, or excessive Mg intake (antacids or laxatives w/ magnesium)

106

Sx of hypermagnesemia

hypotension,

107

Phosphate PO4

major anion in ICF
buffers both ECF and ICF

108

normal PO4 levels

2.5 - 4.5

109

functions of PO4

helps maintain acid-base balance
important for cell division and transmission of hereditary traits

110

hypophosphatemia

<2.5
may indicate phosphorous deficiency (lower serum concentrations but normal total-body stores)
-occurs often w/ hyperventilation

111

causes of hypophosphatemia

alcoholism, refeeding pts after starvation, chronic diarrhea, vitamin D deficiency

112

dietary sources of PO4

fish, meat, whole grains, buttermilk, swiss cheese

113

Sx of hypophosphatemia

neurologic:acute: confusion, anxiety
neurologic:chronic: lethargy
decreased strength - difficulty speaking
decreased myocardial contractility
muscle weakness

114

hyperphosphatemia

>4.5
reciprocal relationship to calcium - as P goes up Ca goes down

115

causes of hyperphophatemia

kidney failure, chemotherapy, large intake of milk (vit D), excessive use of laxatives or enemas containing phosphate

116

Sx of hyperphosphatemia

short term: tingling in fingertips and around mouth, muscle spasms, seizures
long term - calcium deposits
inc PO4 = dec Ca = + chvosteks and trousseaus

117

chloride Cl

chief anion in ECF
found in blood, lymph, and interstitial fluid
attracted to sodium - if Na drops so to will Cl

118

normal Cl levels

98 - 106

119

functions of Cl

acts w/ Na to maintain blood osmotic pressure
acid-base balance
buffers exhange of O2 and CO2 in RBCs
essential for HCL production in stomach

120

hypochloremia

<98

121

causes of hypochloremia

hyponatremia or increased bicarb
vomiting, GI suctioning, prolonged diarrhea, excessive administration of bicarbs, excessive sweating, fever, burns, or basically anything that can cause hyponatremia

122

dietary sources of Cl

table salt, tomatoes, olives, fruits & veggies

123

Sx of hypochloremia

mirror those of hyponatremia
agitation, irritability, weakness, hypeexcitability of muscles, dysrhythmias, seizures, coma

124

hyperchloremia

>106
may occure with bicarb deficiency and dehydration (increased Na levels)
Cl levels controlled by kidneys

125

causes of hyperchloremia

dehydration, high levels of blood sodium, kidney failure, androgens, estrogens, diabetes insipidus

126

1 L of fluid = how much body weight?

2.2. lbs

127

Sx of hyperchloremia

tachycardia, lethargy, weakness, cognitive changes

128

acid

releases H ions

129

base

accepts H ions

130

pH is the measure of what?

hydrogen ion concentration
-a negative algorithm - as H increases, pH drops
1-14

131

pH of gastric juices

1 - 1.3

132

pH of plasma

7.35 - 7.45

133

pH of pancreatic secretions

10

134

acidosis

excessive H ions or loss of base (bicarb); pH drops below 7.35

135

alkalosis

lack of H ions or excessive base (bicarb); pH beyond 7.45

136

carbonic acid - sodium bicarb buffer system

buffers 90% of H of ECF
most important buffer system
lungs regulate carbonic acid
kidneys regulate bicarb