Pathpharm-Fluids and Electrolytes Flashcards Preview

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Flashcards in Pathpharm-Fluids and Electrolytes Deck (115):
1

Water makes up _________-__________% of an infant's total body composition

70-80

2

Water makes up _________-__________% of an adult's total body composition

50-60

3

Water makes up _________-__________% of anolder adult's total body composition

45-55

4

Within bodily fluid __________% is extracellular and ____________% is intracellular

20, 40

5

Within extracellular bodily fluid ________% is plasma, and _________% is interstitial fluid

5,15

6

Infants and elderly are both at risk for_________________

dehydration

7

List the 6 important properties of water (fluid)

1. Universal solvent 2. lubrication 3. Transports O2, nutrients, wastes 4. regulates body temp.(high heat capacity) 5. shock absorber (joints) 6. Gives the body form

8

Define intracellular fluid:

fluid within cells

9

Define extracellular (plasma/intravascular) water:

fluid inside vessels but outside cells

10

Define extracellular (interstitial/3rd spacing) water:

fluid outside vessels and cells

11

_____________ is responisble for causing edema.

interstitial/3rd spacing fluid

12

What are the 3 major ECF ions?

NA+(sodium), Cl-(chloride), HCO3-

13

What are the major ICF ions?

K+, Mg++, HPO4-

14

Define osmolarity:

The measure of solute concentration in a solution

15

T or F: ICF and ECF are in osmotic equilibrium.

TRUE

16

What are the limits for a normal serum osmolarity?

275-290 Osm/L

17

If you wanted to determine a patient's serum Osm without running a separate Osm test, what could you use to estimate the value?

Take the pt's Na+ level and multiply by two to get estimated Osm. Ex: Na+= 145. 145x2=290, 290 would be the estimated Osm/L.

18

Define electrolyte:

solutes that form ions

19

A cation will have a______ charge, while an anion has a ________ charge.

positive, negative

20

What are the body's major electrolytes that are cations?

Na+, K+, Ca++, Mg++

21

What are the body's major electrolytes that are anions?

Cl-, HCO3-, HPO4--, SO4-

22

What is the largest determinant of Osm?

sodium level

23

Sodium is necessary for regulation of: a. blood & body fluids b. transmission of nerve impulses c. heart activity d. metabolic functions e.all of the above

e

24

What is the normal values for Na+?

135-145 mEq/L

25

This electrolyte is important for controlling INTRACELLULAR Osm, esp. in heart cells.

potassium

26

Potassium is important because it:

1. regulates heart and muscle contractions 2. plays a role in nerve impulse conduction

27

Potassium is eliminated by:

the kidneys

28

T or F: Potassium affects the excitability of muscles.

TRUE

29

What is the normal potassium value?

3.5-5.0 mEq/L

30

Renal problems can cause __________ in relation to K+

hyperkalemia

31

Insulin will cause K+ to move from ____________ to _____________

ECF to ICF

32

Acidosis, trauma, and exercise cause K+ to move from ______________ to______________

ICF to ECF

33

Sugar, lipids, amino acids, uric acid, urea, and creatinine are examples of:

non-electrolytes

34

The major functions of HCO3 and H are:

acid/base balance

35

The electrolyte in charge of skeletal integrity, coagulation, neurotransmitters, and cardiac conduction is:

Calcium

36

The electrolyte involved in skeletal, energy/ATP is:

PO4

37

The electrolyte whose main functions include GI, neuro, and cardiac is:

Mg

38

T or F: Fluid/electrolyte disorders are when fluids and electrolytes interact with eachother to cause a harmful response for the host.

FALSE. Fluid/electrolyte disorders occur when there is a problem with the balance between electrolytes and fluids.

39

When a person drinks too much water they are at risk of________________in terms of electrolytes.

dilution

40

When a person does not drink enough water they are at risk of ________________ in terms of electrolytes.

increased concentration

41

What are the two main pressure gradients in our bodies?

hydrostatic pressure, oncotic pressure

42

What are two examples of hydrostatic pressure?

blood pressure, blood volume

43

Oncotic pressure refers to:

plasma proteins

44

ADH, aldosterone, renin-angiotensin, PTH, and naturietic hormone all work to:

regulate the fluid and electrolyte balance in our bodies

45

What is the main function of the kidneys?

to maintain a normal ECF level/concentration

46

T or F: Osmosis is the movement of solutes from an area of high to low concentration across a semi-permeable membrane.

FALSE! OSMOSIS refers to the movement of water NOT solutes.

47

Define diffusion:

The movement of SOLUTES from an area of high concentration to low concentration across a semi-permeable membrane.

48

What is the purpose of osmosis and diffusion?

to reach equilibrium on both sides of the membrane

49

Cell membranes have ______________________, which means some solutes cross freely, some cross with assistance, and others do not cross at all.

selective permeability

50

_______________ refers to an IV solution that contains small particles that can eventually cross semi-permeable membranes while a __________ IV solution contains large protein or sugar molecules that cannot cross membranes.

crystalloid, colloid

51

Define isotonic solution as it relates to IV fluids:

a solution that has a concentration of solute equal to that of normal body fluids

52

What is an example of an isotonic IV fluid?

Normal saline

53

Infusing a patient with an IV of .9%NSS (normal saline solution) will create what change in regards to body fluids?

No change-.9% is the same concentration as our body's fluids, so fluid will stay where it is.

54

Define hypotonic solution in terms of IV fluids:

A solution with a solute concentration less than normal body fluids

55

What is an example of a hypotonic IV solution?

D5.45%NS (5% dextrose in half normal saline)

56

When infusing a patient with D5.45%NS, what will happen internally in regards to body fluids?

The IV solution will move from the intravascular space(portal of entry) into the interstitial space and into body cells

57

What is the danger of a hypotonic IV solution?

can cause cells to rupture

58

Define hypertonic solution in terms of IV fluids:

The particle concentration of the solution is higher than that of normal body fluids

59

What is an example of a hypertonic IV solution?

3.0% NaCl

60

Infusing a patient with an IV of 3.0% NaCl will create what change in regards to body fluids?

Fluid will move out of cells into the intravascular space (poratl of entry for IV fluid)

61

What is the danger of using a 3.0% NaCl solution?

Can cause cells to shrivel up and die

62

Define hydrostatic pressure:

any pressure that is exerted by a liquid within a closed system

64

The overall osmotic effect of colloids, such as plasma proteins, is called the ________________ or _______________.

oncotic pressure, colloid osmotic pressure

65

Oncotic pressure tends to pull water__________________

into the circulatory system

66

Albumin cannot move through normal capillary pores, while water and smaller structures can move freely. Na+ is highly attracted to albumin, thus, together they maintain __________________ by attracting water into the intravascular space.

oncotic pressure (or colloid osmotic pressure)

67

This pituitary hormone controls water reabsorption-has direct control over how much fluid is excreted in urine

ADH

68

This adrenal hormone controls Na+ absorption and plays a major role in Na+ balance and volume

aldosterone

69

Aldosterone is stimulated by:

a decreased Na+ volume to the kidneys

70

This hormone is in charge of Na+ excretion

naturietic hormone

71

This hormone controls Ca++ levels

PTH

72

What is the function of erythropoietin?

stimulates bone morrow to produce RBC's in response to tissue hypoxia

73

List the steps that occur in the renin-angiotensin response

START: angiotensinogen circulates in blood stream ->Renin secreted by kidneys in response to low blood pressure -> renin converts angiotensinogen into Angiotensin I -> Enzyme in lungs -> Angiotensin II -> (2 effects) 1. aldosterone secretion stimulated =increased Na+ and water retention 2. vascular smooth muscle constricts

74

What is the goal of the renin-angiotensin response?

To increase blood volume, thus, increasing blood pressure

75

Kidney function is totally dependent on:

blood flow

76

What is the normal level for Cl?

95-104 mEq

77

What is the normal value for HCO3?

22-26

78

What is the normal serum Ca level?

8 to 10

79

What is the normal value of P?

2 to 4

80

What is the normal value of Mg?

1.5-2 mEq

81

What is a normal BUN?

10 to 20

82

What is a normal creatinine?

.5-1

83

What is a normal Osm?

280-300 mOsm/dl

84

What is a normal specific gravity?

1.0010-1.0020-the higher the #, the more diluted the urine

85

What is an absolute minimum urine output?

20-30 ml/hr

86

What are 2 examples of fluid status indicators one could sue during a physical exam?

mucous membranes, turgor

87

What is a fluid status indicator that could be used in a blood test?

hemotocrit

88

A BUN test measures:

plasma-a direct measure of kidney finction.

89

A high BUN indicates:

the kidneys are not concentrating urine

90

Fluid status indicators in urine include:

output (volume), specific gravity (concentration), electrolytes (Na+, K+)

91

Observable manifestations of fluid status may include:

Drop in urine output, dyspnea, hypertension, hypotension, shock, hemodilution, hemoconcentration

92

Excess fluid volume in intravascular compartment is known as:

hypervolemia

93

Excess interstitial fluid is called:

edema

94

Excess fluid inside cells is called:

Intracellular (IC) swelling

95

IC swelling can cause

hypoxia

96

Impeding movement between vascular & interstitial space, decrease in capillary flow d/t increase tissue pressure, and interference w/ organ function are all complications due to:

edema

97

Define interstitial edema(3rd spacing):

increase in filtration and/or decrease in reabsorption due to altered capillary forces

98

What are the 4 mechanisms of 3rd spacing(interstitial edema)?***know for test***

massive inflammation, venous obstruction, increased blood volume, low serum albumin

99

T or F: 3rd spacing is always due to a fluid excess in the body.

FALSE-a distribution problem, not necessarily related to amount of fluid in the body

100

3rd spacing can effect what regions inside the body?

interstitial spaces (edema) or potential spaces (effusion) ex: in heart, lungs, joint cavities, chest cavity

101

Dyspnea, crackles, decreased urine output, irregular RR, HR, BP, and peripheral edema are all signs of:

congestive heart failure

102

A decreased blood volume capable of causing hypotension, tachycardia, and decreased urine output is:

hypovolemia

103

Hypertension, thirst, CNS depression, and/or an increase in interstitial fluid can be caused by an excess of which electrolye?

Sodium

104

Hyponatremia and CNS deterioration may be caused by a decrease of which electrolyte?

Sodium

105

An _____________ of ________________ can cause hyperkalemia, ventricular fib, ECG changes, CNS changes, weakness

excess, potassium

106

A deficit of potassium could cause:

hypokalemia, bradycardia, ECG changes, CNS changes, fatigue

107

An excess of calcium causes:

hypercalcemia, thirst, CNS deterioration, increase in interstitial fluid

108

Muscle twitching, trousseau's signs, chrostek's, tetany, and hypocalcemia are due to:

A calcium deficiency

109

Spironolactone (Aldactone) is in what drug class?

Diuretics

110

T or F: Spironolactone (Aldactone) is a K+ sparing diretic

TRUE

111

What is the mechanism of action for Spironolactone (Aldactone)

Causes loss of sodium bicarbonate and calcium while saving potassium and hydrogen ions by antagonizing aldosterone.

112

What are the most serious side effects for Aldactone?

DRUG RASH WITH EOSINOPHILIA AND SYSTEMIC SYMPTOMS, STEVENS-JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS.

113

WhAt are the indications for Aldactone?

• Management of primary hyperaldosteronism.
• Management of edema associated with HF, cirrhosis and nephrotic syndrome.
• Management of essential hypertension.
• Treatment of hypokalemia (counteracts potassium loss caused by other diuretics).

113

What is an example within the body of hydrostatic pressure?

blood as it presses against vessel membranes in response to pumping of the heart

114

What is an example within the body of hydrostatic pressure?

blood as it presses against vessel membranes in response to pumping of the heart

115

What triggers erythropoietin?

decreased oxygen delivery in the kidneys