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CRNI > Chapter 3 Fluids & Electrolytes > Flashcards

Chapter 3 Fluids & Electrolytes Flashcards

1
Q

Total body fluid of an infant

A

70-80%

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2
Q

Total body fluid of a one year old

A

64%

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3
Q

Total body fluid from puberty to 39 years old

A

M:60%
F: 54%

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4
Q

Total body fluid from 40-60 years old

A

M: 55%
F: 47%

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5
Q

Total body fluid over 60 years old

A

M: 52%
F: 46%

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6
Q

Intracellular fluid compartment

A

Fluid within the cell
Amounts to 2/3 of body fluid or 40% of body weight

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7
Q

Extracellular fluid compartment

A

Fluid outside the cell
Amounts to 1/3 of body fluid or 20% of body weight
Located in two spaces (5% plasma & 15% interstitial)

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8
Q

Transcellular fluid compartment

A

All secretions / cerebral spinal fluid
No % given
Total of approximately 1 liter

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9
Q

Composition of body fluid

A

Water
Non-electrolytes
Electrolytes
Calcium & magnesium

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10
Q

Non-electrolytes

A

Urea
Dextrose
Creatinine
Albumin

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11
Q

Electrolytes

A

Intracellular (2 p’s in a pod) - potassium and phosphate
Extracellular - sodium and chloride (like a saline flush)

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12
Q

What are chemotherapy pt’s and crush injury pt’s at risk of

A

Hyperkalemia and hyperphosphatemia due to damaged cells leaking K+ and phos

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13
Q

Percentage breakdown of calcium and magnesium in the body

A

Calcium = 99% bone and 1% Extracellular
Magnesium = 60% bone, 39% Intracellular, 1% Extracellular

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14
Q

Osmotic pressure

A

Drawing power of water
Dependent on number of molecules in a solution
Water is mobilized from an area of lesser concentration to an area of higher concentration

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15
Q

Oncotic pressure

A

Drawing power of colloids (albumin)
Water mobilized from the interstitial area to the venous system

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16
Q

Diffusion

A

Random movement of molecules from regions where concentration is high to regions where concentration is low
Ex: change of CO2 and O2 in the lungs

17
Q

Active transport

A

Ions move from areas of lesser concentration to areas of higher concentration via release of ATP (energy)
Ex: pushing your way from the back of a crowded concert to the front towards the stage requires a lot of energy

18
Q

Filtration

A

Transfer of H2O and a dissolved substance from regions of high pressure (arterials) to low pressure (interstitial)

19
Q

What are the regulators of homeostasis

A

Kidneys
Circulatory system
Lungs
Pituitary gland
Adrenal gland
Thyroid/parathyroid

20
Q

How do the kidneys regulate homeostasis

A

Filter 170L of plasma per day
Regulate blood pH via excretion or retention of hydrogen ions
Regulate the Extracellular fluid (ECF) volume and osmolality by retention or exertion of H2O
Regulate ECF electrolytes

21
Q

Renal output

A

Normal: 1000-1500ml/24hr or 40-80ml/hr on average
Oliguria: below 400ml/24hr
Anuria: below 50-100ml/24hr
Total anuria: no urine
Polyuria: above 1500-2000ml/24hr

Urine output of 200ml/hr or more is too much

22
Q

How does the circulatory system regulate homeostasis

A

Blood flow to kidneys
Circulate all hormones including: aldosterone, antidiuretic hormone (ADH), parathyroid hormone (PTH) and calcitonin

23
Q

How do the lungs regulate homeostasis

A

Effect blood pH by the regulation of hydrogen ions via CO2 retention and exhalation

24
Q

How does the pituitary gland regulate homeostasis

A

Releases ADH which stimulates the kidneys to retain H2O

ADH is manufactured in the hypothalamus and released by the pituitary gland

25
Q

How do the adrenal glands regulate homeostasis

A

Produces aldosterone which regulates sodium/potassium
Increased aldosterone leads to Na retention (plus H2O) and K+ loss (liver disease pts - because the liver plays a role in inactivating aldosterone, if this mechanism is affected then there will be an increase in aldosterone and thus an increase in Na and H2O retention leading fluid imbalance)
Decreased aldosterone leads to Na loss (plus H2O) and K+ retention (addison’s disease)

26
Q

How does the thyroid/parathyroid regulate homeostasis

A

Regulates calcium
Thyroid - calcitonin (reduces plasma Ca+) [ calciTONIN - tone down]
Parathyroid - parathyroid hormone (PTH) - elevates plasma Ca+ [PARAlegals increase the work lawyers can produce - PARAthyroid hormone increases the calcium produced]

27
Q

Water required per M2

A

1500ml of H2O per M2 is required to maintain fluid for 24hrs

28
Q

Signs and symptoms of fluid volume excess

A

Weight gain
Shortness of breath / respiratory distress
Peripheral edema
Distended neck veins
Bounding pulse and elevated blood pressure
Increase ventral venous pressure

29
Q

Causes of fluid volume excess

A

altered renal function - reduced excretion of Na & H2O / excess saving of Na or H2O (SIADH)

30
Q

Symptoms of fluid volume deficit

A

Dry, sticky mucus membrane
Thirst
Weight loss
Weak, rapid pulse and decreased blood pressure
Decreased central venous pressure
Increase in urine output (over 200ml/hr)

31
Q

Main cause of fluid volume deficit (FVD) / hypovolema

A

Third spacing phenomenon

CRNI (2 decks)

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