Alterations in Fluids and Electrolytes Flashcards
What are the functions of body fluids?
transport gases
generate electrical activity needed to power body functions
take part in the transformation of food into energy
maintain overall function of the body
What is the normal range of K+ within a cell?
3.5-5 .0mL
What is the normal range of Na within a cell?
135-145
What does the intracellular compartment (ICF) have a high concentration of?
K+
What does the extracellular compartment (ECF) have a high concentration of?
Na
What is insensible fluid loss?
Water loss that you cant measure // i.e. sweating and exhaling
What organ is the main regulator of sodium?
The kidney is the main regulator of sodium.
What happens when the body is deficient on fluid?
It will increase to maintain the cardiac out-put and constrict blood vessels.
What is another term for “disorders of ADH expression”?
Diabetes insipidus (DI)
What does the acronym BUN mean?
Blood Urea Nitrogen = measure of kidney function
What are the normal levels of Na (sodium)?
135-145 are the normal levels
What is the major protein in the body?
Albumin
What elements are essential for cardiac function?
Na / Mg / Ca
What are the names of the fluid compartments?
Intracellular compartment (ICF) and Extracellular compartment (ECF)
What is the relative amount of body fluid in the ICF?
The ICF is the larger of the two compartments and is composed of 2/3 of the body water in healthy adults.
What is the relative amount of body fluid in the ECF?
The ECF contains 1/3 of the remaining body water.
What are the mechanisms of fluid movement between fluid compartments?
Diffusion and osmosis
What is diffusion?
Movement of charged or uncharged particles along a concentration gradient (movement from high concentration to low concentration)
What is osmosis?
Movement of water across a semipermeable membrane(from the side of the membrane with a low particles and high concentration of water to the side of the membrane with high particles and low concentration of water.)
What is the goal of both diffusion and osmosis?
to equal out the balance or Solution concentrations equalized
Identify the routes of water intake and output to and from the body:
Water intake routes:
water, Na, and oral intake
metabolism of nutrients
Water output routes: kidneys, skin, lungs, GI tract.
What is the regulator for water INtake?
Thirst
What is the regulator for water OUTput?
ADH
How do the kidneys regulate sodium?
The kidneys monitor arterial pressure. They retain sodium when arterial pressure is decreased and eliminates sodium when arterial pressure is increased.
How does the body react to fluid deficit?
Hypovolemia and thirst.
What is a fluid deficit mean?
Fluid imbalance.
What are the blood electrolytes?
Na // Cl// HCO3
What do the blood electrolytes do?
Regulate nerve/ muscle function
Maintain acid-base balance and H2O
What is part of the brain is ADH released by?
Posterior pituitary (synthesized by hypothalamus)
What part of the brain is aldosterone secreted by?
Adrenal cortex
What does aldosterone do?
- Regulates Na levels
2. Promotes Na and H2O uptake
What does ADH do?
- Makes you hold on to water
2. Prevents fluid loss and conserves water. (promotes reabsorption of Na and H2O)
What does ANP do?
Promote H2O and Na loss by the kidneys
What is a cause of hypoCALcemia ?
Abnormal losses of calcium from the kidney
What are the signs and symptoms of hypoCALcemia?
face tingling/ fatigue/ muscle cramps/ diarrhea / increased neuromuscular excitability
What is HYPERmagnesium?
Its caused by renal failure and excessive intake of magnesium containing antacids (magnesium containing medications)
What is the normal range of potassium?
3.5 - 5.0 mL
What is HYPERkalemia?
Increase in plasma levels of Potassium above 5.0 mEq/L
What is HYPOkalemia?
Decrease in plasma potassium levels below 3.5 mEq/L
What are the causes of hyperphosphatemia?
excessive intake in phosphate//
kidney failure to excrete excess phosphate//
rapid redistribution of intracellular phosphate to the ECF compartment
What is a S/S of hypernatremia?
Body swelling (retention)
What occurs during dehydration (hypovolemia)?
Decreased fluid loss
What are the causes of dehydration (hypovolemia)?
Diarrhea / vomiting / poly urea ( peeing a lot ) / diabetes insipidus (DI)
What are the causes of insensible fluid loss in dehydration (hypovolemia)?
Sweating and respiration
What are the signs and symptoms of dehydration (hypovolemia)
Thirst / tachycardia / low blood pressure / dry mucus membranes (cotton mouth)
What are the causes of edema?
increased capillary permeability leaky capillaries
What are the 2 functions of the kidneys?
Filtration and sodium regulation
What are the HYPERvolemia signs and symptoms?
Respiratory crackles / edema / increased blood pressure / SOB / increased heart rate (bounding pulse) [you can see and hear it due to heart compensation]
What is an effect of hyperventilation?
Excess CO2 exudation / decrease in PaCO2 // blowing off too much
What does atrial natriuretic peptide (ANP) cause?
A reduction of ECF volume by increasing renal sodium excretion
What are the causes of increased carbonic acid in the lungs?
“Brachycardia” Slow breathing / CO2 being excreted by respiration
What does hypofusion effect?
Effects the kidney// increases ADH// reabsorba H2O and NA
What does syndromes of inappropriate anti diuretic hormone (SIDAH) effect?
ADH Effects and signs - decreased NA / DI excessive thirst and poly urea (I.e: causes body to retain water and sodium levels to fall)
How does the body assess that there is a fluid imbalance?
Thirst and hypovolemia
What are the blood electrolytes?
Na, Cl, HCO3, K
What do the blood electrolytes do?
- Regulate nerve and muscle function
2. Help maintain acid-base balance and water balance in the body
What are the 3 hormones that have a key role in regulating fluid and electrolyte balance?
- ADH
- Aldosterone
- ANP
ADH is released from the ____________.
Posterior pituitary
What does ADH do in the body?
Prevent fluid loss and promote the body’s conservation of water (holds and retains water)
Aldosterone is secreted from the _________.
Adrenal cortex
What does aldosterone do in the body?
Regulates sodium levels
Where is ANP (atrial natueric peptide) produced?
The heart
What does ANP do in the body?
Promotes both fluid and sodium loss by the kidneys and stimulated when the blood volume or pressure is elevated
What is HYPOkalcemia?
Low calcium levels
What are signs and symptoms of HYPOkalcemia?
Increased neuromuscular excitability (diarrheas/tingling and numbness in the face/ fatigue/ muscle cramps)
Na, K, Cl help regulate ________.
Nerve and muscle function
What is hypermagnesium?
High levels of magnesium
When a patient has hypermagnesium, what are the different teaching considerations are you going to make when approaching this patient?
Do NOT take antacids because they are high in magnesium
What is the normal potassium range?
3.5 - 5.0
Potassium levels below 3.5 is:
HYPOkalemia
Potassium levels above 5.0 is:
HYPERkalemia
Define Hyperphosphatemia:
High phosphate levels in the blood
List the signs and symptoms of hyperphosphatemia:
- Failure of the kidneys
- Rapid reabsorption of the intracellular phosphate to the extracellular compartment
- Excessive intake of phosphate
What is dehydration?
Low fluid volumes
List the signs and symptoms of dehydration:
- Dry mucous membrane
- Thirst
- Tachycardia
- Low BP
Hypovolemia is also known as:
Dehydration
Define hypERvolemia:
High volume of fluid// fluid excess
List the signs and symptoms of hypervolemia:
- Respiratory crackles
- Shortness of breath
- Elevated or bounding pulse
- Edema
List the causes of fluid loss:
Diarrhea
Vomiting
Polyuria (excessive urination)
DI (diabetes insipidus)
What is the cause of edema?
Increased capillary permeability (leaky capillaries)
What are the major functions of the kidneys?
- Filtration / sodium regulation
- Removes wastes from the body
- Balances the bodies fluids
- Activate vitamin D
What is SIADH:
Frequent urination
What are the expected lab values of DI?
Low Na levels because Na is secreted when we urinate
List the symptoms of DI:
Polyuria
Excessive thirst
Low Na levels
Define Hyperfusion:
Low blood levels in the kidneys
If you have low blood flow to the kidneys , what happens to ADH levels?
ADH will be increased in the body to retain water and sodium. If there is low perfusion, the kidneys will nee to retain water and sodium to promote circulation.
If fluid volumes are low ______.
Circulation will be poor