Chaper 5 Fludis & Electrolytes Flashcards
Total body water accounts for how much % of body weight in adults
60%
Total body water is composed of what two fluids?
- Intracellular fluid
- Extracellular fluid
What are components of extracellular fluid? (3)
- Intersitial fluid
- Intravascular fluid
- Transcellular fluid
How does aging impact the amount of total body water?
It decreases it
What is edema?
Accumulation of fluid within the intersitial spaces
Causes of edema (4)
Increase in capillary hydrostatic pressure
- Decrease in plasma oncotic pressure
- Incraeses in capillary permeability
- Lymph channel obstruction
Symptoms of edema (5)
- Swelling
- Increase in body weight
- Functional impairment
- Pain
- Impairment of arterial circulation
Water loss does what to HR?
Increase
Water loss does what to BP and CO?
Decrease
Water loss does what to urine output?
Decrease
Functions of the Renin-angiotensin-aldosterone system
-Maintains sodium/water balance in body
How the renin-angiotensin-aldosterone system operates when waer is lost
- 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
Anti-diuretic Hormone function in water balance
Increases water reabsorption into the plasma
Thirst stimulation function in water balance (3)
- Osmoreceptors
- Volume receptors
- Baroreceptors
Conditions effecting water loss (8)
- Hemorrhage
- Burns
- Diarrhea
- DM
- Vommiting
- Sweating
- Laxative use
- Diruetic abuse
Condtions effecting water gain (3)
- Heart disease
- Renal failure
- Sodium increase
Assessment of water gain or loss (7)
- 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
Isotonic
Solute equal concentration to that of cells
Hypotonic (3)
- Solute has a leser concentration of sodium to that of cells
- Water moves into the cells
- Cells swell
Hypertonic (3)
- Solute has greater concentration sodium that cell
- Draws fluid out of the cell
- Cells crenate
Isotonic alterations
- Total body water change with proportional electrolyte and water change
- No change in concentraion
Isotonic fluid loss is known as…
Hypovolemia
Isotonic fluid excess is known as…
Hypervolemia
Causes of hypovolemia (3)
- Mild vommiting
- Mild diarrhea
- Mild sweating
Findings of hypovolmia (7)
- Weight loss
- Dryness of the skin
- Decreased skin tugor
- Decreased urine output
- increased HR
- Flattened neck veins
- Decreased BP
Causes of hypervolemia (3)
- Excessive administration of IV fluids
- Hypersecretion of aldosterone
- Drugs (cortisone)
Findings of hypervolemia (5)
- Weight gain
- Decreased hematocrit
- Distended neck veins
- Increase in BP
- Edema
Hypertonic alterations (3)
- Increased osmolarity
- Hypernatremia
- Water deficit in ECF (dehydration)
Hypernatremia sodium level
> 145mEq/L
Sodium gain or water loss
Hypernatremia manifestations (3)
- Brain cell shrinkage
- Altered membrane potentials
- Increased BP
Hypernatremia Isovolemic
Deficit of free water and normal sodium
Hypernatremia Hypovolemic
Loss of sodium and greater loss of body water
Hypernatremia Hypervolemic
Increase of body water with greater increases in sodium
What often occurs with hypernatremia?
Hypercloremia
Causes of hypernatremic volume depletion (6)
- Water deprivation
- Loss of thirst
- Inability to swallow
- Diabetes inspidus
- Excessive urination
- Excessive sweating
Findings of Hypernatremic volume delpletion (5)
- Weight loss
- Weak pulses
- Increased HR
- Postural hypotension
- Excessive urination
Caues of hypernatremic volume excess
Excessive intake of sodium
Findings of hypernatremic volume excess (6)
- Weakness
- Agitation
- Firm subcutaneous tissue
- Increased thirst
- Edema
- Elevated BP
Hypotonic alterations (3)
- Decreased osmolality
- Hyponatremia
- Water excess in ECF
Hyponatremia sodium level
<135mEq/L
Normal sodium level
135-145mEq/L
Manifestations of Hyponatremia (4)
- Cell swelling
- Altered action potentials
- Cerebral edema
- Increased intracranial pressure
Normal Value for calcium
8.8-10.5mg/dl
Normal value for phosphate
2.5-5.0mg/dl
High levels of potassium
Hyperkalemia
Mild attack of hyperkalemia cause (2)
- Increased neuromuscular iritability
- Restlessness, intestinal cramping, and diarrhea
Severe attacks of hyperkalemia cause (2)
- Decreases the resting membrane potential
- Muscle weakness, loss of muscle tone, paralysis
EKG with hypokalemia
ST Depression
EKG changes with hyperkalemia
Peaked T-waves
Hyperkalemia potassium level
> 5.5mEq/L
Treatment of hyperkalemia
Kayexalate or insulin combined with glucose
Hypokalemia potassium level
<3.5mEq/L
Hypokalemia treatment
-Take in more potassium
Isovolemic Hyponatermia
Loss of sodium with normal water
Hypervolemic Hyponatremia
-Increased body sodium causes increased body water
Hypovolemic Hyponatremia
-Loos of body water with greated loss in sodium
Dillutional Hyponatremia
-Intake of large amounts of free water which dilutes sodium
What often occurs with hyponatremia?
Hypocloremia
Normal pH level
7.35-7.45
Normal PaC02 Level
35-45
Normal HC03 Level
22-26
Normal Pa02 Level
80-100
Acidosis occurs at what pH?
Less than 7.35
Alkalosis occrs at what pH
Over 7.45
If the abnormality of the ABG causes a pH that is low, is it acidosis or alkalosis
Acidosis
If the pH is high, is it acidosis or alkalosis
Alkalosis
If the abnormality of an ABG is with PaC02, is it respiratory or metabolic
Respiratory
If the abnormality with an ABG is with HC03, is it respiratory or metabolic?
Metabolic
