Week 8 Flashcards by mm mm

Total Body water

accounts for 60% of a healthy adult body weight

influenced by age, gender, and overall health

regulate body temp
lube joints
shock absorption for internal organ
transport nutrient and waste
metabolic reactions inside of cells

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TBW for ICF

67%

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TBW ECF

33%

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types of fluid

intracellular (inside cell)
interstitial (between the cell in the tissue)
extracellular (outside cell)
intravascular (inside the vessel)
transcellular (outside the vessel)

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composition of fluid

water is responsible for the transport of molecules throughout the body
water is the body’s major solvent

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solutes

particles that completely or partially dissolve in a solvent and can be classified as either crystalloid or colloid

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crystalloid sollute

small and completely dissolved in solvent

easily passed through capillary veins

intravenous fluids often referred to as crystalloid solution

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electrolyte

a type of crystalloid

charged atom molecules measured in milliequivalent per liter of water (mEq/L)

have a positive (cation) and negative
(anion) charge

examples are sodium, potassium, calcium, magnesium, and chloride

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nonelectrolytes

molecules without a charge
glucose, amino acid, gases (oxygen and carbon dioxide)

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colloid solute

particles that are too large and do not fully dissolved in a solvent

does not easily pass through walls and cell membrane

proteins and starches (albumin and clotting protein)

blood and blood product

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difference of TBW

males have 60%
females have 60%
elderly and obese have 45%

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osmosis

the passive transport of water between fluid compartments

movement of water in and out of the cells

from low concentration to high concentration

allow water to move across but not solutes

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osmotic pressure

solution exerts a force on either side of the selectively permeable membrane

pressure increases as concentration between compartments becomes greater

inward pulling force of solutes that move the water across a semipermeable membrane to an area of higher solute concentration

osmotic pressure in intravascular controlled by concentration plasma protein (albumin)

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osmolality

concentration of solute in body fluids

measured in milliosmoles/kilogram (mOsm/kg)

equalizes rapidly

dehydration increase concentration of solute extracellularly cause rapid movement of water from the cells

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Filtration

movement of water and solute together between vascular and interstitial compartments

move from high pressure to low pressure

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hydrostatic pressure

exerted by fluid in the blood vessel

controlled by arterial blood pressure (heart rate, strength of cardiac contraction, systemic vascular resistance) and blood flow in the capillary bed

capillary hydrostatic pressure is higher on the arterial side than on the venous side

osmotic pressure is lower in the arterial side than venous side

the net effect contribute to constant shifting of water and solute

blood cells and plasma protein does not get filtrated in kidney

oncotic pressure

a type of osmotic pressure (colloid osmotic pressure)

the pressure in intravascular space is controlled by concentration of plasma protein (albumin)

plasma proteins attract water molecules to them and are responsible for water in the intravascular space.

hydrostatic pressure

the outward-pushing force of water against the walls

as blood flows through the capillaries, it pushes (exerts pressure) against the vessel walls

hydrostatic pressure must be greater than oncotic pressure for filtration across capillaries to occur

Edema in patients

means imbalance where hydrostatic pressure is greater than intravascular osmotic pressure leading to a fluid accumulation in the tissue

fluid intake

comes from consumption of fluids or food

some generated from metabolic processes (digestion of carbs)

influenced by habit and social and cultural factors

thirst sensation decrease as a normal part of aging

fluid output

done through kidney (excreted as urine)

loss through diaphoresis, insensible perspiration, and respiration

small amount of loss through feces

aldosterone and natriuretic

regulate extracellular fluid volume

antidiuretic hormone (ADH)

regulate osmolality

high serum osmolality causes the secretion of ADH

cause reabsorption of water in the kidney leading to concentrated urine and less concentration of plasma

low osmolality will prevent secretion of ADH.

This cause a decrease in water reabsorption in the kidney, leading to a dilute urine and concentrated plasma

fluid volume and composition maintain homeostasis by which mechanism

renal system
renin-angiotensin system
secretion of ADH
thirst mechanism

renin-angiotensis-aldosterone system

regular BP and extracellular volum balance done through vasoconstriction (narrowing) of the arterioles excretion or reabsorption of sodium and water the liver releases angiotensinogen and the kidney release renin which turns angiotensinogen into angiotensin I. The lungs release angiotensin-converting enzyme which converts angiotensin I into angiotensin II. Angiotensin II regulates the release of ADH which causes the kidney to release aldosterone and vasoconstriction (increase BP). Aldosterone causes retention in sodium and water in the kidneys which increases extracellular fluid which also increase BP

aldosterone

conserves body water by reducing urine formation and maintaining fluid balance in the body secreted posterior pituitary gland in response to plasma osmolality which is stimulated in osmoreceptors in the Hypothalamus or decreased plasma volume which stimulates volume receptor maintain serum osmolality by controlling the amount of water excreted in the urine by having the kidney reabsorb water and reduce urine output ADH release causes water to move back to the bloodstream and plasma osmolality decreases and return to normal when osmolality is normalize, the posterior pituitary stop producing ADH (through negative feedback loop)

Thirst mechanism

1. osmoreceptor and volume receptor continuously monitor plasma osmolality and volume 2. if receptors detect dehydration ( increase in osmolality and decrease in volume) 3. posterior pituitary secrets ADH in response to dehydration 4. the osmoreceptor stimulates the thirst center in the hypothalamus 5. the cerebral cortex produces a conscious awareness of thirst 6. as the person drinks, the kidney reabsorbs water and osmolality decrease, restoring homeostasis

which which activity must the nurse carry out immediately before and after administering medication via intermitten IV access device

Flush the intermitten access device with saline before and after medication administration ensures that the medication is properly infused and does not interact with or remain in the access device.

precise control of a 100 mL IV medicaiton is necessasry. Which device will the nurse use to administer the medication

when administering small amounts of intravenous fluids to children such as medication requiring precise control, volume control devices can be used to reduce the risk of fluid and drug overdose.

what are the parts of the primary administration infusion set from top of infusion set to the part that inserts into the IV tubing

spike - puncture IV solution/medication drip chamber roller clamp (fast or slow drip) sliding clamp (stop flow of solution/meds until ready) protective cap (put on if not infusion)

types of vascular access

peripheral short site --short-term access for less than 1 week for IV drugs and fluids peripheral midline site--is used for access of 2-4 week central venous catheter and peripheral inserted central catheter--- used when longer terms and central access are needed. not used for short-term use unless the situation calls for it. has greater complications.

which will the nurse gather when preparing to administer a prescribed blood transfusion to a patient

y-set tubing normal saline infusion pump