Ch. 10 Fluids & Electrolytes Flashcards
The three spaces in the body where fluid is found
1 – intracellular
2 – extracellular
3 - trans cellular - “3rd space”
Where is MOST water in the body found (which space)
Intracellular space
Outcome of too much intracellular water
+ Pulmonary edema
+ heart failure
Outcome of too little water in the intracellular space
+ Low blood pressure
+ shock / hypovolemic shock
Where is extracellular water/body fluid located – two spaces
+ Intravascular
+ interstitial
Examples of trans cellular “third space syndrome”
+ Lymphatic edema
+ pleural effusion
+ ascites (peritoneal area)
+ synovial effusion - swelling, bleeding
+ pericarditis
+ hydrocephalus
+ glaucoma
+ hematuria
+ SBO, IBS
Area where least amount of body fluid/water is found
Transcellular space.
Normal range for sodium - Na
135-145mEq/L
Normal range for K - potassium
3.5-5
Normal range for chloride - Cl
95-105
Normal range for calcium - Ca
9-11
Types of IV fluids (crystalloid)
+ Normal saline – isotonic
+ lactated ringer – isotonic
+ D5W - 5% dextrose
Purpose of giving normal saline - IV
+ Hydration
+ electrolyte imbalance
Purpose for giving lactated ringers
+ pts. w/low blood volume & low blood pressure
+ replace water and electrolytes
Purpose for D5W IV
+ Replace water
+ replace carbohydrates
What determines amount of IV fluids (3 things)
+ Rate of metabolism
+ weight
+ body surface area
Two types of fluid loss in the body
+ Normal loss — urine, respiration, sweat, feces, normal electrolyte losses,
+ pathological loss — vomiting, diarrhea, third-spacing
Isotonic vs. hypotonic vs. hypertonic
+ ISOTONIC: has equal fluid/salts (solutes) as blood ➡️ cell stays same size
+ HYPOTONIC: has LOWER salt (solutes) to fluid ratio than blood ➡️ cell SWELLS
+ HYPERTONIC: has HIGHER salts (solutes) to fluid ratio than blood ➡️ cell SHRINKS
Difference between acidosis and alkalosis
+ Acidosis is low pH in body
+ alkalosis is high pH in body
Difference between metabolic and respiratory acidosis/alkalosis
+ MEtabolic acidosis/alkalosis: both pH & CO2 are in saME direction - high or low - ⬆️⬆️, ⬇️⬇️
+ REspiratory acidosis/alkalosis: pH & CO2 are in REverse directions ⬆️⬇️
What is hypovolemia?
Volume depletion of liquid portion of blood – plasma
What causes hypovolemia?
Loss of body fluids & electrolytes occurs more rapidly than fluid intake = Fluid Volume Deficit (FVD)
+ Vomiting
+ diarrhea
+ blood loss
+ third-space shifts
+ gastric suctioning
+ excessive sweating
+ burns, ascities
Physical assessment for hypovolemia
+ Orthostatic hypotension
+ tachycardia
+ organ dysfunction
+ thirst, dry oral mucosa
+ skin turgor
+ cold extremities
+ change in LOC
+ palor
+ GERI PT: altered mental status, poor perfusion of hands/feet veins, *skin turgor not good assessment for them
Labs to test for hypovolemia
+ Urinary output
+ urine specific gravity
+ oliguria (< 300ml/daily urine) — should be ~30ml/kg/hr
+ lactic acid
+ Na & K levels can be HYPO or HYPER!!
+ BUN/Cr > 20:1 — SHOULD be 10:1 — ***BUN alone NOT optimal gauge of kidney fnct! (TEST QUEST!!)
+ hematocrit
+ ⬇️ central venous pressure
