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Week 5 - Chapters 18, 26, 27 > Chapter 18 > Flashcards

Chapter 18 Flashcards

1
Q

What are the major types of Fluid Imbalances?

A

Extracellular fluid volume deficit (dehydration)
Extracellular fluid volume excess
Interstitial fluid volume excess (edema)

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2
Q

In all persons, what are the ways fluid can leave the body?

A

Skin
Feces
Urine
Respiration

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3
Q

What is body fluid?

A

Body fluid is body water that has solutes dissolved in it.

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4
Q

What are electrolytes?

A

Electrolytes are particles (ions) dissolved in body fluid.

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5
Q

What electrolytes found in body fluid are necessary for normal cellular function?

A 
Sodium (NA+) 
Potassium (K+)
Calcium (Ca2+)
Magnesium (Mg2+)
Chloride (Cl-)
Phosphorus (Pi)
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6
Q

What are the two major fluid compartments of the body?

A

Intracellular

Extracellular

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7
Q

What is “Intracellular fluid”?

A

Intracellular fluid is fluid found “inside” the cell.

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8
Q

What is “extracellular” fluid?

A

Extracellular fluid is fluid located outside the cell separated into two separate areas
Intravascular fluid
Interstitial fluid

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9
Q

What is “intravascular” fluid?

A

Intravascular fluid is fluid located inside the blood and lymphatic vessels.

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10
Q

What is “interstitial” fluid?

A

Interstitial fluid is fluid located between the vessels and the cell wall.

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11
Q

What are the HIGH concentrations of electrolytes in intravascular fluid?

A

The high concentrations of electrolytes found in intravascular fluid are:

Sodium (Na+)
Chloride (Cl+)
Proteins

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12
Q

What are the HIGH concentration of electrolytes in interstitial fluid?

A

The high concentrations of electrolytes found in interstitial fluid are:

Sodium (Na+)
Chloride (Cl+)

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13
Q

What are the HIGH concentration of electrolytes in intercellular fluid?

A

The high concentration of electrolytes found in intercellular fluid are:

Potassium (K+)
Magnesium (Mg2+)
Phosphorus (Pi)
Protein

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14
Q

How are the hydrogen ions maintained at normal levels within the body?

A

Buffers are the main component in helping the body maintain normal hydrogen ion levels within the body.

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15
Q

How do buffers help to maintain normal hydrogen ion levels?

A

Buffers help to maintain normal hydrogen ion levels by binding hydrogen ions together when levels are high, and by releasing them when levels fall.

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16
Q

What are the important buffers located in body fluid?

A

The important buffers located in body fluid are:

Bicarbonate
Protein
Hemoglobin
Phosphate

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17
Q

Where is the buffer “Bicarbonate” found in bodily fluid?

A

The buffer “Bicarbonate” can be found in
Plasma
Interstitial fluid

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18
Q

Where can the buffer “Protein” be found in bodily fluid?

A

The buffer “Protein” can be found in
Plasma
Intracellular fluid

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19
Q

Where can the buffer “Hemoglobin” be found in bodily fluid?

A

The buffer “Hemoglobin” can be found on in the red blood cells.

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20
Q

Where can the buffer “Phosphate” be found in bodily fluid?

A

The buffer “Phosphate” can be found
Intracellular fluid
Urine

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21
Q

How does fluid move between intravascular and interstitial fluid?

A

Fluid moves between intravascular and interstitial fluid through filtration.

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22
Q

How do electrolytes cross over cell membranes?

A

Electrolytes cross over cell membranes either through diffusion or active cell transport.

23
Q

True or False?

The LOWER the pH, the more ACIDIC the solution.

A

True.

The LOWER the pH, the more ACIDIC the solution.

24
Q

True of False?

The HIGHER the pH, the more BASIC (alkaline) the solution.

A

True.

The HIGHER the pH, the more BASIC (alkaline) the solution.

25
Q

What is the range of pH values?

A

pH values can range from 1 - 14, with 1 being the most acidic, and 14 the most base. 7 is neutral.

26
Q

True or False?

The pH of blood influences the pH of the cells.

A

True.

The pH of the blood influences the pH of the cells.

27
Q

What is “Acidemia”?

A

Acidemia refers to blood BELOW its normal pH.

28
Q

What “Alkalemia”?

A

“Alkalemia” refers to blood ABOVE its normal pH.

29
Q

What are the arterial blood pH ranges for an infant?

A

The arterial blood pH ranges for an infant are 7.36 to 7.42.

30
Q

What are the arterial blood pH ranges for a child?

A

The arterial blood pH ranges for a child are 7.37 to 7.43

31
Q

What are the arterial blood pH ranges for an adolescent?

A

The arterial blood pH ranges for an adolescent are 7.35 to 7.41

32
Q

What happens when intracellular pH becomes out of balance?

A

If the pH inside the cell becomes out of balance (too low or too high), then the speed of chemical reactions becomes inappropriate for proper cell function.

33
Q

During normal cell function, What types of acids do cells produce?

A

During normal cell function, cell produce Carbonic and Metabolic acid.

34
Q

When unable to neutralize it, how does the body excrete Carbonic acid?

A

In instances where the body is unable to neutralize it by using buffers in bodily fluid, the body excretes Carbonic acid through the lungs in the form of carbon dioxide and water.

35
Q

When unable to neutralize it, how does the body excrete Metabolic acid?

A

In instances where the body is unable to neutralize it by using buffers in bodily fluid, the body excretes Metabolic acid through the Kidneys.

36
Q

What monitors the Pco2 and pH in the blood?

A

Chemoreceptors in the hypothalamus and the aorta and carotid arteries monitor Pco2 and pH in the blood.

37
Q

What diagnostic and/or laboratory test are used for fluid and electrolyte status?

A

The diagnostic and laboratory test used for fluid and electrolyte status are
Arterial Blood Gas
Serum Electrolyte Panel
Urinary specific gravity

38
Q

What areas should a nurse look at when performing a focused assessment on fluid and electrolyte status.

A

When performing a focused assessment for fluid and electrolyte status, a nurse should look at

1) Recent changes in Body Weight
2) Skin turgor and mucous membranes
3) Pulse and blood pressure
4) Capillary refill and small-vein filling times
5) Respiratory rate
6) Presence of nausea vomiting and/or diarrhea
7) Oral intake
8) urinary output
9) muscle tone and symmetry
10) State of alertness
11) Level of consciousness
12) condition of the anterior fontanelle

39
Q

What is Isotonic dehydration?

A

Isotonic dehydration occurs when fluid loss is not balanced by fluid intake and the loss of water and sodium is in equal proportion.

40
Q

What is Extracellular Fluid Volume Deficit? (Dehydration)

A

Extracellular fluid volume deficit occurs when there is not enough fluid in the extracellular compartment (interstitial and vascular)

41
Q

What is Hypotonic dehydration?

A

Hypotonic dehydration occurs when there is a greater loss of sodium than water in the extracellular fluid. This causes fluid to shift from the extracellular fluid to intracellular fluid compartments. Cell swelling and eventually cell rupture.

42
Q

What is Hypertonic dehydration?

A

Hypertonic dehydration occurs when there is a greater loss of water than sodium in extracellular fluid. This causes a fluid shift from the cell to extracellular fluid. Cell shrinking

43
Q

What can cause hypotonic dehydration?

A

Hypotonic dehydration can occur in instances of prolonged vomiting and diarrhea, burns, renal disease,as well as administration of of IV fluids without electrolytes.

44
Q

What can cause hypertonic dehydration?

A

Hypertonic dehydration can occur in instances of diabetes insipidus or administration of IV fluids or tube feedings with high electrolyte contact.

45
Q

What is the treatment of choice for dehydration?

A

The treatment of choice for dehydration is oral rehydration.

46
Q

In severe cases of dehydration in which IV fluids are used in addition to Oral Rehydration Fluids, Which IV fluids are used?

A

In severe cases of dehydration in which IV fluids are used in addition to Oral Rehydration Fluids, lactated ringer and 0.9% diluted Saline solution.

47
Q

In mild to moderate dehydration, what is the recommend guidelines for the initiating administration of Oral Hydration Fluids?

A

In mild to moderate dehydration, it is recommended to begin administration of oral hydration fluids at 5 to 15 ml every 10 - 15 min as tolerated, even if the child continues to vomit, because some absorption can occur. For the first 2 to 4 hours 50mL/kg should be the targeted intake.

48
Q

For the dehydrated child, what type of diet is recommended in addition the the rehydration guidelines?

A 
For the dehydrated child, In addition to oral rehydration therapy prescribed, the parent should include
Cereal
Starches
Soup 
Fruits 
Vegetables
49
Q

For the dehydrated child, what type of foods should the parent avoid because they can worsen diarrhea?

A

For the dehydrated child, parents should avoid foods that contain simple sugars (such as soda, juice, jell-o and sweetened cereals) because the osmotic effects can worsen diarrhea.
(if juices are used, they should be diluted with water)

50
Q

Why is soda, juice, and many sports drinks bad for oral rehydration therapy for children?

A

Soda, juice and many sports drinks are bad of oral rehydration therapy for children because they can be concentrated which can worsen diarrhea. If these are given they should be diluted equal parts water.

51
Q

Based on level of the child’s dehydration, what is the the usual protocol for IV replacement therapy?

A

Based on the level of the child’s dehydration level the typical protocol for IV replacement therapy is as follows:

1) Initially, 50% (1/2) of the total 24 hour total maintenance and replacement fluid is given in the first 6 to 8 hours.
2) Then the rate is slowed for the remainder of the 24 hours.

52
Q

What is the calculation for IV fluid replacement therapy?

A

the calculation for IV fluid replacement therapy is:

% of body weight loss x 10 x normal weight = mL/kg/24 hour requirement.

53
Q

What is extracellular fluid volume excess?

A

Extracellular fluid volume excess occurs when there is too much fluid in the vascular and interstitial space.

Week 5 - Chapters 18, 26, 27 (1 decks)

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