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LCCC Nursing > Chapter 17 Fluids: Med Surg > Flashcards

Chapter 17 Fluids: Med Surg Flashcards

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1
Q

what does water content vary with?

A

gender, age, body mass

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2
Q

percentage of body weight of water greater in men or women?

A

men

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3
Q

who would have more water content as compared to body weight?

A

infants 70%-80%

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4
Q

intracellular fluid

A

2/3 of body water and 40% of body weight

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5
Q

extracellular fluid

A

1/3 of body water, consisits of intravascular, interstitial and transcellular spaces

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6
Q

intravascular space

A

1/3 of ECF located here as plasma

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7
Q

interstitial space

A

2/3 of ECF

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8
Q

transcellular space

A

1 L of ECF; CSF, fluid in GI, pleural, synovial, peritoneal fluid

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9
Q

why is body water needed?

A

fluids are in constant motion and transport nutrients, electrolyes, oxygen, regulate temperatures, lubricate joints and membranes, and aids digestion

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10
Q

how much does 1 L of fluid weigh?

A

2.2 kg

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11
Q

electrolytes

A

molecules dissociate (split into ions) when placed in water

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12
Q

ions

A

electrically charged particles

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13
Q

cations

A

positive charged ions

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14
Q

anions

A

negative charged ions

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15
Q

valence

A

electrical charge of an ion

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16
Q

ECF cation

A

sodium

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17
Q

ECF anion

A

chloride

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18
Q

ICF cation

A

potassium

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19
Q

ICF anion

A

phosphate

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20
Q

diffusion

A

movement of molecules from an area of high concentration to one of low concentration; membrane must be permeable; no energy

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21
Q

facilitated diffusion

A

same as diffusion, but some molecules diffuse slowly into the cell and need some help so a carrier molecule accelerates the rate; no energy

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22
Q

active transport

A

molecules move against the concentration gradient, external energy is required; e.g. sodium potassium pump: potassium in and sodium out

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23
Q

osmosis

A

water movement through a semipermeable (favors water not solutes) membrance from an area of low solute concentration to an area of high solute concentration; no external energy, stops when equal

24
Q

osmolality

A

describes fluids (water balance) inside the body, typically performed to evaluate the concentration of plasma in urine

25
Q

normal plasma osmolality

A

275-295

26
Q

increased plasma osmolality

A

concentration is too high or water is too low aka water deficit -> dehydrated

27
Q

decreased plasma osmolality

A

concentration is too low or water is too high aka water excess

28
Q

major determinant of plasma osmolality

A

sodium and glucose

29
Q

ECF and ICF are:

A

isotonic to each other, hence no movement of water occurs and no gain or loss of water occurs although ECF expands e.g. lactated ringers, 0.5% saline

30
Q

if the cell is surrounded by hypotonic fluid:

A

water moves into the cell and causes it to swell and possibly burst ECF -> ICF e.g. 0.45% saline

31
Q

if the cell is surrounded by hypertonic fluid:

A

water leaves the cell to dilute the ECF and the cell shrinks and may eventually die ICF -> ECF e.g. 3% saline

32
Q

hydrostatic pressure

A

force within the fluid compartment, blood pressure generated by the contaction of the heart and pushes water out of the vascular system

33
Q

oncotic pressure

A

osmotic pressure exerted by colloids in solution, pulls fluid from the tissue space to the vascular space

34
Q

major colloid

A

protein, which does not dissolve completely since they are too large of molecules

35
Q

what two pressures move water into the capillaries?

A

plasma oncotic pressure and interstitial hydrostatic pressure

36
Q

what two pressures move water out of the capillaries?

A

capillary hydrostatic pressure and interstitial oncotic pressure

37
Q

first spacing

A

normal distribution of fluid in ECF and ICF

38
Q

second spacing

A

abdnormal accumulation of interstitial fluid (edema)

39
Q

third spacing

A

fluid accumulates in a portion of the body (transcellular fluid) from which it is not easily exchanged with the rest of the ECF, not functional e.g. ascites, edema with burn, trauma

40
Q

how does the hypothalamus, pituitary, and adrenal cortex respond in water regulation?

A

the hypothalamus recognizes a fluid deficit and increases plasma osmolality sending osmoreceptors to the posterior pituitary and releasing ADH, which acts in the distal tubules to cause water reabsorption

41
Q

decreased ADH

A

diabetes insipidus

42
Q

increased ADH

A

SIADH

43
Q

dextrose solutions

A

osmolarity changes once dextrose is metabolized

44
Q

at the arterial end of the capillary:

A

capillary hydrostatic pressures exceeds plasma oncotic pressure, which draws fluid into interstitium (EDEMA)

45
Q

at the venous end of the capillary:

A

capillary hydrostatic pressure is lower than plasma oncotic pressure and fluid is drawn back into the capillary

46
Q

glucorticoids

A

cortisol, which has an antiinflammatory effect and increases glucose levels

47
Q

mineralocorticoids

A

aldosterone, which enhances sodium retention and potassium excretion

48
Q

primary organ that controls f&e balance

A

kidneys

49
Q

insensible water loss

A

600-900 mL lost a day, ONLY water, sweating is sensible perspiration and causes f&e loss

50
Q

how do you calculate fluid requirement for a pediatric patient?

A

convert weight to kg, 100 mL/kg for first 10 kg, 50 mL/kg for second 10 kg, and 20 mL/kg for the remainder of weight. IF ASKED FOR IN ML/HR SIMPLY DIVIDE ANSWER BY 24

51
Q

fluid volume deficit

A

restless, drowsy, thirst, decreased skin turgot and capilarry refill, increased pulse, decreased urine, increased respirations, weight loss

52
Q

fluid volume excess

A

headache, edema, venous distention, bounding pulse, increased blood pressure, dyspnea, crackles, muscle spasms, weight gain

53
Q

assess neurologic fx

A

LOC, pupillary response to light and equality of size, voluntary movement of extremities, degree of muscle strength, reflexes

54
Q

assess skin turgor where?

A

clavicle!

55
Q

first signs of deficit:

A

tachycardia, decreased blood pressure, increased respirations

56
Q

late signs of deficit:

A

hypotension and decreased capillary refill

LCCC Nursing (15 decks)

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