Chaper 5 Fludis & Electrolytes Flashcards
1
Q
Total body water accounts for how much % of body weight in adults
A
60%
2
Q
Total body water is composed of what two fluids?
A
- Intracellular fluid
- Extracellular fluid
3
Q
What are components of extracellular fluid? (3)
A
- Intersitial fluid
- Intravascular fluid
- Transcellular fluid
4
Q
How does aging impact the amount of total body water?
A
It decreases it
5
Q
What is edema?
A
Accumulation of fluid within the intersitial spaces
6
Q
Causes of edema (4)
A
Increase in capillary hydrostatic pressure
- Decrease in plasma oncotic pressure
- Incraeses in capillary permeability
- Lymph channel obstruction
7
Q
Symptoms of edema (5)
A
- Swelling
- Increase in body weight
- Functional impairment
- Pain
- Impairment of arterial circulation
8
Q
Water loss does what to HR?
A
Increase
9
Q
Water loss does what to BP and CO?
A
Decrease
10
Q
Water loss does what to urine output?
A
Decrease
11
Q
Functions of the Renin-angiotensin-aldosterone system
A
-Maintains sodium/water balance in body
12
Q
How the renin-angiotensin-aldosterone system operates when waer is lost
A
- Kidneys secrete renin
- Renin produces angiotensin I
- Vasoconstriction
- Angiotensin I converts to angiotensin II
- More vasoconstriction
- Aldosterone production
- Aldosterone leads to sodium and water reapsorbstion (RETAINING FLUID)
- Natriuretic peptides (BNP) cause sodium and water excretion
13
Q
Anti-diuretic Hormone function in water balance
A
Increases water reabsorption into the plasma
14
Q
Thirst stimulation function in water balance (3)
A
- Osmoreceptors
- Volume receptors
- Baroreceptors
15
Q
Conditions effecting water loss (8)
A
- Hemorrhage
- Burns
- Diarrhea
- DM
- Vommiting
- Sweating
- Laxative use
- Diruetic abuse
16
Q
Condtions effecting water gain (3)
A
- Heart disease
- Renal failure
- Sodium increase
17
Q
Assessment of water gain or loss (7)
A
- Skin tugor
- Urine output
- Specfic gravity
- I/O every 8 hours
- Capillary refil
- Labs: BUN, Creat, serum osmolarity
- Daily weights
- Aseess for neck vein distention
18
Q
Isotonic
A
Solute equal concentration to that of cells
19
Q
Hypotonic (3)
A
- Solute has a leser concentration of sodium to that of cells
- Water moves into the cells
- Cells swell
20
Q
Hypertonic (3)
A
- Solute has greater concentration sodium that cell
- Draws fluid out of the cell
- Cells crenate
21
Q
Isotonic alterations
A
- Total body water change with proportional electrolyte and water change
- No change in concentraion
22
Q
Isotonic fluid loss is known as…
A
Hypovolemia
23
Q
Isotonic fluid excess is known as…
A
Hypervolemia
24
Q
Causes of hypovolemia (3)
A
- Mild vommiting
- Mild diarrhea
- Mild sweating
25
Findings of hypovolmia (7)
- Weight loss
- Dryness of the skin
- Decreased skin tugor
- Decreased urine output
- increased HR
- Flattened neck veins
- Decreased BP
26
Causes of hypervolemia (3)
- Excessive administration of IV fluids
- Hypersecretion of aldosterone
- Drugs (cortisone)
27
Findings of hypervolemia (5)
- Weight gain
- Decreased hematocrit
- Distended neck veins
- Increase in BP
- Edema
28
Hypertonic alterations (3)
- Increased osmolarity
- Hypernatremia
- Water deficit in ECF (dehydration)
29
Hypernatremia sodium level
>145mEq/L
| Sodium gain or water loss
30
Hypernatremia manifestations (3)
- Brain cell shrinkage
- Altered membrane potentials
- Increased BP
31
Hypernatremia Isovolemic
Deficit of free water and normal sodium
32
Hypernatremia Hypovolemic
Loss of sodium and greater loss of body water
33
Hypernatremia Hypervolemic
Increase of body water with greater increases in sodium
34
What often occurs with hypernatremia?
Hypercloremia
35
Causes of hypernatremic volume depletion (6)
- Water deprivation
- Loss of thirst
- Inability to swallow
- Diabetes inspidus
- Excessive urination
- Excessive sweating
36
Findings of Hypernatremic volume delpletion (5)
- Weight loss
- Weak pulses
- Increased HR
- Postural hypotension
- Excessive urination
37
Caues of hypernatremic volume excess
Excessive intake of sodium
38
Findings of hypernatremic volume excess (6)
- Weakness
- Agitation
- Firm subcutaneous tissue
- Increased thirst
- Edema
- Elevated BP
39
Hypotonic alterations (3)
- Decreased osmolality
- Hyponatremia
- Water excess in ECF
40
Hyponatremia sodium level
<135mEq/L
41
Normal sodium level
135-145mEq/L
42
Manifestations of Hyponatremia (4)
- Cell swelling
- Altered action potentials
- Cerebral edema
- Increased intracranial pressure
43
Normal Value for calcium
8.8-10.5mg/dl
44
Normal value for phosphate
2.5-5.0mg/dl
45
High levels of potassium
Hyperkalemia
46
Mild attack of hyperkalemia cause (2)
- Increased neuromuscular iritability
| - Restlessness, intestinal cramping, and diarrhea
47
Severe attacks of hyperkalemia cause (2)
- Decreases the resting membrane potential
| - Muscle weakness, loss of muscle tone, paralysis
48
EKG with hypokalemia
ST Depression
49
EKG changes with hyperkalemia
Peaked T-waves
50
Hyperkalemia potassium level
>5.5mEq/L
51
Treatment of hyperkalemia
Kayexalate or insulin combined with glucose
52
Hypokalemia potassium level
<3.5mEq/L
53
Hypokalemia treatment
-Take in more potassium
54
Isovolemic Hyponatermia
Loss of sodium with normal water
55
Hypervolemic Hyponatremia
-Increased body sodium causes increased body water
56
Hypovolemic Hyponatremia
-Loos of body water with greated loss in sodium
57
Dillutional Hyponatremia
-Intake of large amounts of free water which dilutes sodium
58
What often occurs with hyponatremia?
Hypocloremia
59
Normal pH level
7.35-7.45
60
Normal PaC02 Level
35-45
61
Normal HC03 Level
22-26
62
Normal Pa02 Level
80-100
63
Acidosis occurs at what pH?
Less than 7.35
64
Alkalosis occrs at what pH
Over 7.45
65
If the abnormality of the ABG causes a pH that is low, is it acidosis or alkalosis
Acidosis
66
If the pH is high, is it acidosis or alkalosis
Alkalosis
67
If the abnormality of an ABG is with PaC02, is it respiratory or metabolic
Respiratory
68
If the abnormality with an ABG is with HC03, is it respiratory or metabolic?
Metabolic
