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Chapter 13 > Chapter 13 > Flashcards

Chapter 13 Flashcards

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
Q

Amount of insensible water loss

A

500-1000mL

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26
Q

Three hormones that help control F&E balance

A

AldosTYRONE, ADH, and natriuretic peptide

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27
Q

___ is a hormone secreted by the _____ when ___ levels in ECF are decreased

A

Aldosterone
Adrenal cortex
Sodium

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28
Q

___ or vasopressin, is produced in the brain and stored in the ___. Controlled by the _____ in response to changes in blood osmolarity.

A

ADH
Posterior pituitary gland.
hypothalamus

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29
Q

___ 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 _____

A

ANP

aldosterone

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30
Q

___ is secreted by kidneys in response to bring blood pressure back up to normal. Does not allow release of sodium and water.

A

Renin

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31
Q

A powerful vasoconstrictor that helps elevate blood pressure without adding more blood volume. Also decreases urine output to help elevate blood pressure.

A

Angiotensin II

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32
Q

Hormone that causes kidneys to reabsorb water and sodium, allowing return to blood, increasing blood pressure and volume

A

Aldosterone

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33
Q

Best indicator of perfusion adequacy after surgery

A

Urine output

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34
Q

Most common type of fluid loss problem

A

Isotonic dehydration

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35
Q

1 L of water weighs

A

2.2 pounds (1kg)

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36
Q

A weight change of 1 pound corresponds to a fluid volume change of about

A

500 mL

37
Q

___is a good indicator of hydration status.

A

Cardiovascular changes

38
Q

For every degree (Celsius) increase in body temp, a mimimum of an additional ____ of body fluid is lost.

A

500mL

39
Q

Weight loss over ___ is fluid loss

A

a half pound

40
Q

Mild to moderate dehydration is corrected with __ and given in a dose of ___ every hour

A

oral fluid replacement

2-4 ounces

41
Q

Two most important areas to monitor during rehydration

A

pulse rate/quality and urine output

42
Q

Most common type of fluid overload

A

hypervolemia

43
Q

Indicators of fluid overload

A 
bounding pulse
increasing neck vein distention
crackles in lungs
increasing peripheral edema
reduced urine output
Monitor these every 2 hours
44
Q

Each pound of weight equates to __ of retained water weight.

A

500mL (1 kg = 1000mL)

45
Q

Call healthcare provider for weight gain ..

A

> 3 lbs in a week or 1-2 lbs in 24hr period

46
Q

Low Na+ inhibits secretion of

A

ADH and NP, and triggers aldosterone secretion

47
Q

High Na+ inhibits secretion of

A

aldosterone, and secretes ADH and NP

48
Q

Hyponatremia, the osmolarity of ECF is ___ than ICF

A

lower

49
Q

Hyponatremia mnemonic

A

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
Q

Hypernatremia mnemonic

A 
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
Q

Hyponatremia interventions

A

D iuretics
I sotonic IV
E at more salt
D rink less

52
Q

Potassium’s role

A 
MOVIE RATINGS:   E, G, PG
Excitable tissue depolarization
Generates action potential
Protein synthesis
Glucose use/storage is regulated
53
Q

What is the main controller of ECF K+ levels?

A

Sodium-potassium pump

54
Q

What organ also controls potassium?

A

Kidney.

Excretion is enhanced by aldosterone

55
Q

Hypokalemia mnemonic

A 
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
Q

Causes of hypokalemia

A 
Drugs (dig, diuretic, corticosteroids)
Aldosterone (increased secretion)
Cushings
Diarrhea
Vomiting
57
Q

Hypokalemia interventions

A

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
Q

Hyperkalemia mnemonic

A 
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
Q

Hyperkalemia interventions

A

K- Kayexalate (orally/ enema)
I- Insulin
N- Na HCO3
D- Diuretics (Furosemide & Thiazides)

60
Q

Potassium movement into the cells is enhanced by __

A

Insulin

61
Q

How many charges does Calcium have?

A
  1. Divalent cation
62
Q

How does calcium exist in the body?

A

bound and ionized (unbound or free form)

63
Q

What does bound calcium attach to?

A

serum protein

64
Q

Where is ionized calcium found?

A

ECF

65
Q

What is calcium’s purpose?

A 
Maintaining bone strength and density
Activating enzymes
Allowing skeletal and cardiac muscle contraction, 
Controlling nerve impulse transmission
Allowing blood clotting
66
Q

Where is calcium absorbed?

A

intestinal tract and requires vitamin D for absorbtion

67
Q

Where is calcium stored?

A

Bones.

68
Q

Where is calcium excreted?

A

Urine

69
Q

If body needs Calcium, where is serum levels increased?

A

PTH

70
Q

What does PTH do to increase Ca++ levels?

A

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
Q

Hypocalcemia mnemonic

A

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
Q

Hypocalcemia interventions

A

Drug: Ca++ replacement (oral and IV)
Environment: keep room quiet, no overstimulation
Seizure precautions

73
Q

Hypercalcemia mnemonic

A

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
Q

Tissue most affected by hypercalcemia

A

Heart
skeletal muscles
nerves
intestinal smooth muscle

75
Q

Hypercalcemia causes faster _____ times

A

clotting

Clots occur in vessels with slow blood flow

76
Q

Hypercalcemia intervention

A 
Normal saline IV
Lasix 
Ca++ chelators (binders)
Dialysis in severe cases
ECG for T-wave changes
77
Q

Phosphorus in body (P-)

A

Needed to activate vitamins and enzymes
Forms ATP for energy
Assists in cell growth and metabolism

78
Q

Phosphorus balance and ____ balance are intertwined

A

calcium

Meaning change in P- results in equal and opposite change in Ca++

79
Q

Phosphorus mnemonic

A

Rhabdo (muscle breakdown)
Cardiac depression
Oddly shaped bones

80
Q

Hypophosphatemia interventions

A

D/C antacids, osmotic diuretics, Ca++ supplements
Vitamin D with P- replacement
Increase P- rich foods, decrease Ca++ rich foods

81
Q

Causes of hyperphosphatemia

A

kidney disease
certain cancer treatments
increased p- intake
hypoparathyroidism

82
Q

What is magnesium for?

A 
skeletal muscle contraction
carbohydrate metabolism
ATP formation
vitamin activation
cell growth
83
Q

Daily mg requirement for adults

A

300mg

84
Q

Where is Mg++ excreted?

A

kidneys

85
Q

Hypomagnesemia effects

A 
Hyperactive deep tendon reflexes
parathesias
painful muscle contraction
Weak muscles
Tetany
Seizures
Depression/confusion/psychosis
Abdominal distention
86
Q

Hypomagnesemia intervention

A

MgSO4

Assess deep tendon reflex every hour

87
Q

Hypermagnesmia effects

A

bradycardia
hypotension
prolonged PR interval with wide QRS complex
absent deep tendon reflex

88
Q

Chloride is important in formation of

A

HCl in stomach

89
Q

___ is anion most commonly exchanged for Cl-

A

HCO3-

Chapter 13 (1 decks)

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