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Nurs 186 > Body Fluids > Flashcards

Body Fluids Flashcards

1
Q

Adult female

A

50% body fluid, less due to adipose tissue

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2
Q

Intracellular compartment

A

-holds 2/3 of body fluids

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3
Q

Extra cellular compartment

A
  • interstitial fluid(fluid around the cells)

- intravascular fluid(fluid in bloodstream 5 liters)

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4
Q

Age considerations in fluid distributions

A
  • as we age we lose muscle mass=less water/fluids
  • elderly increase in fat=decrease fluids
  • infants hold more fluid in interstitial spaces than adults
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5
Q

Osmosis

A

Movement of water from areas of high concentration of water to lower concentrations of water

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6
Q

Capillary filtration and reabsorption

A

-Movement of fluid through capillary membranes(via hydrostatic pressure) in order to carry water and nutrition into cells, water outside is reabsorption through blood stream

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7
Q

Normal serum osmolarity

A

270-300 mOs/L

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8
Q

Obligatory urine output

A

Minimal amount of urine needing to be excreted per 24 hours to avoid accumulation of waste products and possibly causing lethal electrolyte imbalances

400-600ml/24hours

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9
Q

ADH

A
  • released from hypothalamus, and pituitary gland
  • ADH is released and causes kidneys to hold water
  • released when brain doesn’t sense enough volume in body
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10
Q

Renin angiotensin aldosterone

A
  • aldosterone causes the kidneys to retain sodium(retention in water)
  • responds to volume not osmolarity
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11
Q

Atrial natriuretic peptide

A
  • responds to volume

- released when there is too much volume!(stops ADH and aldosterone release)

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12
Q

Thirst

A
  • major driver for controlling osmolarity

- depends on the brain to function

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13
Q

Insensible water loss

A

Water loss from skin,lungs, and stool

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14
Q

Fluid volume deficit hypovolemia

A

Hypovolemia is an extra cellular problem caused by decrease of fluid in extra cellular space

-your concentration of electrolytes stays the same just a loss of volume

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15
Q

Third spacing

A

When fluid moves from the intravascular space to interstitial space.

  • response to injury
  • ex:bowels, pleural cavity, pericardium
  • may occur as a result of increased permeability of the capillary membrane, that allows fluid into interstitial spaces
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16
Q

May lead to hypovolemia shock

A

Third spacing or Hemorrhage

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17
Q

Ascites

A

Accumulation of fluid in the peritoneal cavity

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18
Q

Finding with hypovolemia

A
  • changes in LOC
  • increased HR,decreased BP
  • oliguria(less than 30ml/Hr)
19
Q

Fluid volume deficit dehydration

A
  • fluid leaving the cells by osmosis to high concentrated areas
  • Intracellular problem
20
Q

Dehydration may be caused by

A

-npo,tube feeding, inability to obtain water,prolonged diarrhea,prolonged fever, hyperglycemia

21
Q

Diabetes insipidis

A

Patient does not make enough ADH, may have output up to 30 liters

22
Q

S/S of dehydration

A
  • weight loss
  • increased HR,decreased BP
  • weak thready pulse
  • poor skin turgor
  • decreased LOC
  • dry mucous membranes
  • elevated labs (osmolarity>300)(BUN>25)(USG>1.030)(elevated sodium>145)
23
Q

Palpation BP

A
  • feel for artery
  • systolic only
  • chart as 80/P
24
Q

Doppler BP

A
  • only systolic reading

- chart as 80/D

25
Q

Crystalloids

A

Solutions that have small particles that pass into the cells quite easily

26
Q

Isotonic solution

A
  • same as plasma(most friendly solution with osmolarity of 240-340)
  • EX: 0.9 NaCL: only solution that can be used in blood transfusion
  • ringers solution: largely NaCL but does have same Ca added
  • elaborated ringers: isotonic solution with majority of NaCL, has lactate in it for the body to create bicarbonate(good for patients with acidosis)
27
Q

Dextrose 5% in water… Special case

A
  • considered isotonic while in bag
  • when infused in body, the body uses the sugar leaving you with just water and a little glucose(not much of a replacement)
28
Q

Fluid bolus

A
  • large amount of IV fluid in a short period of time
  • purpose: stabilize BP, restore blood volume, maintain kidney function by dumping water into vascular system forcing excretion
29
Q

Nursing considerations while giving a bolus

A
  • monitor vitals every 15-30 minutes

- monitor IV Site

30
Q

After we deliver a bolus

A
  • monitor output

- assess heart and lungs for fluid volume excess

31
Q

Colloids

A
  • aka plasma expanded
  • have large molecules that cannot get to interstitial fluid space
  • good for hypovolemia
32
Q

Colloid examples

A
  • Albumin:fluid magnet

- albumin comes in different strengths

33
Q

Hypotonic crystalloids

A
  • solution contains less than 240 mOs/L

- quickly move through vascular system

34
Q

Fluid volume excess hypervolemia

A

An excess of isotonic fluid(water and sodium) in the extra cellular compartment

35
Q

Causes of hypervolemia

A
  • excessive fluid intake via po/IV
  • heart failire(poor cardiac function)
  • limited output
  • increased sodium intake
36
Q

Finding present in hypervolemia

A
  • dependent edema(sacrum,butt,legs,feet)
  • pulmonary edema
  • tachycardia with bounding pulse
  • distended hand and neck veins
  • BUN & hematocrit below normal
37
Q

What to do for hypervolemia

A
  • restrict fluids as ordered
  • restrict NA
  • give diuretics
  • give cardio tonics(Digoxin,betablockers)
  • digoxin strengthens cardiac contractions and slows the HR
  • monitor lungs sounds
  • daily weight
  • O2 saturation
  • fatigue
38
Q

Fluid volume excess: water intoxication

A
  • a hypotonic extra cellular problem

- too much fluid shifting into cells

39
Q

Water intoxications causes

A
  • overuse of hypotonic IV solutions
  • too may tap water enemas
  • too much tap water NG irrigation
  • overly dilute baby formula
40
Q

Syndrome of increased and dangerous hydration

SIADH

A
  • opposite of diabetes insipides
  • pituitary gland is releasing too much ADH
  • cancer releases a substance in blood stream that mimics ADH
41
Q

Findings with water intoxication

A
  • ICF more hypertonic than ECF
  • pronounced neurological changes with increased ICP
  • increased BP,decreased HR
  • lab results(osmolarity
42
Q

How can we help with water intoxication

A
  • restrict water intake
  • monitor neurological status
  • monitor labs
  • daily weights
  • provide safe environment
43
Q

Hypertonic crystalloids

A
  • greater osmolarity than plasma
  • greater than 340

-D5/lactated ringers 3-5%NaCL draws fluid from cells

44
Q

Adult male

A

60 % body fluid(40 liters)

Nurs 186 (12 decks)

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