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Chapter 13 Flashcards

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1
Q

What is the balance of fluid and electrolytes called?

A

Homeostasis

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2
Q

What is the most common substance in the body?

A

Water, making up 50%-55% of total body weight.

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3
Q

What is the fluid outside of the cells called?

A

Extracellular fluid (plasma).

1/3 of total body water

Includes interstitial fluid (third space), blood, lymph, bone, and connective tissue water and transcellular fluids (CSF, synovial fluid, peritoneal fluid, pleural fluid.

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4
Q

What is the fluid inside of the cells called?

A

Intracellular fluid

2/3 of total body water

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5
Q

What is a solvent?

A

the WATER portion of fluids

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6
Q

What is a solute?

A

Particles dissolved or suspended in the water

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7
Q

Solutes that express an overall electrical charge?

A

Electrolytes

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8
Q

What is filtration?

A

Movement of fluid through a cell or blood vessel membrane because of hydrostatic pressure differences on both sides of membrane (water volume pressing against confining walls)

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9
Q

What is equilibrium?

A

Hydrostatic pressure that is the same in both ECF and ICF.

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10
Q

Example of a hydrostatic filtering force.

A

Blood pressure.

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11
Q

What is diffusion?

A

Movement of solute from an area of higher concentration to lower concentration (down a concentration gradient)

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12
Q

What is a concentration gradient?

A

When two fluid spaces have different amounts of the same type of particle.

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13
Q

When is diffusion more rapid?

A

When the gradient is steeper (when way more particles need to move from higher to lower side)

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14
Q

When can particles NOT move across a cell membrane?

A

When the membrane is impermeable to the particle.

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15
Q

____cannot cross most cell membranes without the help of insulin. This is due to ________.

A

Glucose

selective membrane permeability.

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16
Q

Diffusion that requires assistance of membrane-altering system is called

A

facilitated diffusion or facilitated transport

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17
Q

Movement of water through semipermeable membrane.

A

Osmosis

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18
Q

Number of mmol/L in a LITER of solution

A

OsmolaRity (liteR)

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19
Q

number of mmol/L in a KILOGRAM of solution

A

OsmolaLity (kiLo…also L for little-r amount)

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20
Q

Normal osmolarity value for plasma and other body fluids

A

270-300 mOsm/L

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21
Q

Fluid with osmolarity >300

A

Hypertonic or hyperosmotic

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22
Q

Fluid with osmolarity <270

A

Hypotonic or hypo-osmotic

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23
Q

This mechanism is an example of how osmosis helps maintain homeostasis

A

Thirst mechanism

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24
Q

Minimum amount of urine to excrete toxic waste products

A

400-600 mL

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25
Amount of insensible water loss
500-1000mL
26
Three hormones that help control F&E balance
AldosTYRONE, ADH, and natriuretic peptide
27
___ is a hormone secreted by the _____ when ___ levels in ECF are decreased
Aldosterone Adrenal cortex Sodium
28
___ or vasopressin, is produced in the brain and stored in the ___. Controlled by the _____ in response to changes in blood osmolarity.
ADH Posterior pituitary gland. hypothalamus
29
___ are hormones secreted by special cells that line the atria of the heart. Are secreted in response to stretching of the heart tissue. Has opposite effect of _____
ANP aldosterone
30
___ is secreted by kidneys in response to bring blood pressure back up to normal. Does not allow release of sodium and water.
Renin
31
A powerful vasoconstrictor that helps elevate blood pressure without adding more blood volume. Also decreases urine output to help elevate blood pressure.
Angiotensin II
32
Hormone that causes kidneys to reabsorb water and sodium, allowing return to blood, increasing blood pressure and volume
Aldosterone
33
Best indicator of perfusion adequacy after surgery
Urine output
34
Most common type of fluid loss problem
Isotonic dehydration
35
1 L of water weighs
2.2 pounds (1kg)
36
A weight change of 1 pound corresponds to a fluid volume change of about
500 mL
37
___is a good indicator of hydration status.
Cardiovascular changes
38
For every degree (Celsius) increase in body temp, a mimimum of an additional ____ of body fluid is lost.
500mL
39
Weight loss over ___ is fluid loss
a half pound
40
Mild to moderate dehydration is corrected with __ and given in a dose of ___ every hour
oral fluid replacement 2-4 ounces
41
Two most important areas to monitor during rehydration
pulse rate/quality and urine output
42
Most common type of fluid overload
hypervolemia
43
Indicators of fluid overload
``` bounding pulse increasing neck vein distention crackles in lungs increasing peripheral edema reduced urine output Monitor these every 2 hours ```
44
Each pound of weight equates to __ of retained water weight.
500mL (1 kg = 1000mL)
45
Call healthcare provider for weight gain ..
> 3 lbs in a week or 1-2 lbs in 24hr period
46
Low Na+ inhibits secretion of
ADH and NP, and triggers aldosterone secretion
47
High Na+ inhibits secretion of
aldosterone, and secretes ADH and NP
48
Hyponatremia, the osmolarity of ECF is ___ than ICF
lower
49
Hyponatremia mnemonic
S tupor/coma A bdominal cramping, N&V L ethargy T endon reflexes decreased L imp muscles (weakness) O rthostatic hypotension (weak, thready pulse) S eizures/headache S tools frequent and watery
50
Hypernatremia mnemonic
``` F - Fever (low), flushed skin R - Restless (irritable) I - Increased fluid retention & increased BP E - Edema (peripheral and pitting) D - Decreased urinary output, dry mouth ``` S - Skin flushed A - Agitation L - Low-grade fever T - Twitching ``` CAUSE: MODEL Medications, meals Osmotic diuretics Diabetes insipidus Excessive water loss Low water intake ```
51
Hyponatremia interventions
D iuretics I sotonic IV E at more salt D rink less
52
Potassium's role
``` MOVIE RATINGS: E, G, PG Excitable tissue depolarization Generates action potential Protein synthesis Glucose use/storage is regulated ```
53
What is the main controller of ECF K+ levels?
Sodium-potassium pump
54
What organ also controls potassium?
Kidney. | Excretion is enhanced by aldosterone
55
Hypokalemia mnemonic
``` 6 L's (kallllllllemia) Lethargy, aLoc Leg cramps Limp muscles Low, shallow respirations Lethal cardiac dysrhythmias Lots of urine (polyuria) paraLytic iLeus (severe hypokalemia) ```
56
Causes of hypokalemia
``` Drugs (dig, diuretic, corticosteroids) Aldosterone (increased secretion) Cushings Diarrhea Vomiting ```
57
Hypokalemia interventions
Drug therapy: K+ replacements IV is 1 mEq K to 10mL solution. Max infusion rate 5-10 mEq/hr, NEVER exceed 20 mEq!!! Never give IV push. Will cause cardiac arrest.
58
Hyperkalemia mnemonic
``` MURDER M - Motility increased U - Urine, oliguria, anuria R - Respiratory distress D - Decreased cardiac contractility E - ECG changes R - Reflexes, (early: hyperreflexia (twitching), late: areflexia (flaccid)) Causes MACHINE M - Medications - ACE inhibitors, NSAIDS A - Acidosis - Metabolic and respiratory C - Cellular destruction - Burns, traumatic injury H - Hypoaldosteronism/ hemolysis I - Intake - Excessive N - Nephrons, renal failure E - Excretion - Impaired ```
59
Hyperkalemia interventions
K- Kayexalate (orally/ enema) I- Insulin N- Na HCO3 D- Diuretics (Furosemide & Thiazides)
60
Potassium movement into the cells is enhanced by __
Insulin
61
How many charges does Calcium have?
2. Divalent cation
62
How does calcium exist in the body?
bound and ionized (unbound or free form)
63
What does bound calcium attach to?
serum protein
64
Where is ionized calcium found?
ECF
65
What is calcium's purpose?
``` Maintaining bone strength and density Activating enzymes Allowing skeletal and cardiac muscle contraction, Controlling nerve impulse transmission Allowing blood clotting ```
66
Where is calcium absorbed?
intestinal tract and requires vitamin D for absorbtion
67
Where is calcium stored?
Bones.
68
Where is calcium excreted?
Urine
69
If body needs Calcium, where is serum levels increased?
PTH
70
What does PTH do to increase Ca++ levels?
Release free Ca++ from bone storage (bone resorption) Stimulate vitamin D to increase intestinal absorption of Ca++ Inhibit kidney Ca++ excretion Stimulate kidney Ca++ reabsorption
71
Hypocalcemia mnemonic
C - Convulsions A - Arrhythmias T - Tetany S - Spasms (charley horses) and stridor G - Gut (hyperactive bowel sounds) O -osteoporosis NUMB (paresthesias) Baja California diarrhea (don't drink water) dancing (tetany, seizures, Chvostek, Trousseau) relaxed (decreased HR)
72
Hypocalcemia interventions
Drug: Ca++ replacement (oral and IV) Environment: keep room quiet, no overstimulation Seizure precautions
73
Hypercalcemia mnemonic
Northern California Groans: constipation Moans: pain - joint aches Bones: loss of calcium from bones, bone metastasis Stones: kidney stones Overtones: psychiatric overtones - depression, confusion Cardiac dysrhythmias
74
Tissue most affected by hypercalcemia
Heart skeletal muscles nerves intestinal smooth muscle
75
Hypercalcemia causes faster _____ times
clotting Clots occur in vessels with slow blood flow
76
Hypercalcemia intervention
``` Normal saline IV Lasix Ca++ chelators (binders) Dialysis in severe cases ECG for T-wave changes ```
77
Phosphorus in body (P-)
Needed to activate vitamins and enzymes Forms ATP for energy Assists in cell growth and metabolism
78
Phosphorus balance and ____ balance are intertwined
calcium Meaning change in P- results in equal and opposite change in Ca++
79
Phosphorus mnemonic
Rhabdo (muscle breakdown) Cardiac depression Oddly shaped bones
80
Hypophosphatemia interventions
D/C antacids, osmotic diuretics, Ca++ supplements Vitamin D with P- replacement Increase P- rich foods, decrease Ca++ rich foods
81
Causes of hyperphosphatemia
kidney disease certain cancer treatments increased p- intake hypoparathyroidism
82
What is magnesium for?
``` skeletal muscle contraction carbohydrate metabolism ATP formation vitamin activation cell growth ```
83
Daily mg requirement for adults
300mg
84
Where is Mg++ excreted?
kidneys
85
Hypomagnesemia effects
``` Hyperactive deep tendon reflexes parathesias painful muscle contraction Weak muscles Tetany Seizures Depression/confusion/psychosis Abdominal distention ```
86
Hypomagnesemia intervention
MgSO4 | Assess deep tendon reflex every hour
87
Hypermagnesmia effects
bradycardia hypotension prolonged PR interval with wide QRS complex absent deep tendon reflex
88
Chloride is important in formation of
HCl in stomach
89
___ is anion most commonly exchanged for Cl-
HCO3-

Chapter 13 (1 decks)

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