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Fundamentals 1 > !! Chapter 40 Principles of Fluid, Electrolytes, and Acid-Base Balance > Flashcards

!! Chapter 40 Principles of Fluid, Electrolytes, and Acid-Base Balance Flashcards

1
Q

Water in the body functions primarily to:

A
  • Transport nutrients to cells and wastes from cells
  • Transport hormones, enzymes, blood platelets, and red and white blood cells
  • Facilitate cellular metabolism and proper cellular chemical functioning
  • Act as a solvent for electrolytes and nonelectrolytes
  • Help maintain normal body temperature
  • Facilitate digestion and promote elimination
  • Act as a tissue lubricant
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2
Q

What is the total body water/fluid in a healthy person?

A

Approximately 50% to 60% of body weight in a healthy person.

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3
Q

Body fluid is located in what 2 fluid compartments?

A
  • intracellular fluid

- extracellular fluid

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4
Q

The fluid constituting about 70% of the total body water or 40% of the adult’s body weight.

A

Intracellular fluid

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5
Q

The fluid accounting for about 30% of the total body water or 20% of the adult’s body weight.

A

Extracellular fluid

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6
Q

The extracellular fluid includes two major areas:

A
  • the intravascular and interstitial compartments

- and third minor compartment is the transcellular fluid

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7
Q

The liquid component of the blood that surrounds tissue cells and includes lymph (i.e., fluid found within the vascular system)

A

Intravascular fluid/plasma

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8
Q

What 2 things separate the intracellular and extracellular compartments?

A

The capillary walls and cell membranes

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9
Q

What 3 factors cause variations in fluid content?

A
  • person’s age
  • body fat
  • biological sex
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10
Q

__ cells contain little water, whereas __ tissue is rich in water.

A

Fat

Lean

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11
Q

Similarly, the decreasing percentage of body fluid in older people is related to an increase in ___.

A

Fat cells

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12
Q

How does the human body obtain fluids?

A
  • 1st: Ingestion of liquids (provides the largest amount of water)
  • 2nd: Food
  • a by product of metabolism
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13
Q

___ has considerably more body fluid and ECF than an ___; more prone to fluid volume deficits

A

An infant

Adults

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14
Q

Liquids that hold a substance in solution (water)

A

Solvents

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15
Q

Substances dissolved in a solution (electrolytes and nonelectrolytes)

A

Solutes

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16
Q

Fluctuations in fluid intake and output can:

A

destabilize the balance between fluids and electrolytes.

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17
Q

The equilibrium between the acidity and alkalinity of body fluids is

A

acid–base balance.

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18
Q

Water passes from an area of lesser solute concentration to greater concentration until equilibrium is established

A

Osmosis

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19
Q

Tendency of solutes to move freely throughout a solvent (“downhill”)

A

Diffusion

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20
Q

Requires energy for movement of substances through the cell membrane from the lesser solute concentration to the higher solute concentration

A

Active transport

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21
Q

Passage of fluid through a permeable membrane from the area of higher to lower pressure

A

Capillary Filtration

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22
Q

What process is this:

  • Solvent and solute particles move to equalize concentrations.
  • No semipermeable membrane is involved.
A

Diffusion

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23
Q

What process is this:

  • Only solvent particles move. Solute particles do not move.
  • The movement is through a semipermeable membrane.
A

Osmosis

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24
Q

Osmolarity of a Solution:

same concentration of particles as plasma.

A

Isotonic

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25
Q

Osmolarity of a Solution:

greater concentration of particles than plasma

A

Hypertonic

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26
Q

Osmolarity of a Solution:

lesser concentration of particles than plasma

A

Hypotonic

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27
Q

A ___ solution has a greater osmolarity, causing water to move out of the cells and to be drawn into the intravascular compartment, causing the cell to shrink.

A

Hypertonic

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28
Q

What are the 4 Fluid Losses?

A

Kidneys: urine
Intestinal tract: feces
Skin: perspiration
Insensible water loss (fever)

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29
Q

What are the 9 primary organs of homeostasis?

A
  • kidneys
  • cardiovascular system
  • lungs
  • adrenal glands
  • pituitary gland
  • thyroid gland
  • nervous system
  • parathyroid glands
  • GI tract
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30
Q

What increases the blood flow in the body and increases renal circulation?

A

The thyroid gland

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31
Q

What inhibits and stimulates mechanisms influencing fluid balance?

A

The nervous system

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32
Q

What regulates the level of calcium in ECF?

A

Parathyroid glands

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33
Q

What absorbs water and nutrients that enter the body through this route?

A

GI tract

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34
Q

What stores and releases ADH?

A

Pituitary gland

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35
Q

What helps the body conserve sodium, save chloride and water, and excrete potassium?

A

Adrenal glands

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36
Q

What regulates oxygen and carbon dioxide levels of the blood?

A

Lungs

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37
Q

What pumps and carries nutrients and water in body?

A

Cardiovascular system

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38
Q

What filters 170 L of plasma and excrete 1.5 L of urine?

A

Kidneys

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39
Q

Substance containing hydrogen ions that can be liberated or released.

A

Acid

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40
Q

Substance that can trap hydrogen ions.

A

Base

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41
Q

What are the 3 Major Homeostatic Regulators of Hydrogen Ions?

A

Buffer systems
Respiratory mechanisms
Renal mechanisms

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42
Q

What are 3 types of buffer systems?

A
  • carbonic acid- NA bicarbonate
  • phosphate
  • protein
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43
Q

Which of the chemical buffer systems is the most important buffer system of the body in that it buffers as much as 90% of the hydrogen of ECF?

A

Carbonic acid- sodium bicarbonate buffer system.

44
Q

For normal cellular functioning to occur, the pH of body fluids must remain between:

A

7.35 - 7.45

45
Q

What two compensatory mechanisms are designed to help maintain homeostasis?

A
  • respiratory (changes RR to balance CO2 and Oxygen)

- renal (metabolic) (can keep Hydrogen or release them into urinary tract depending on what they need)

46
Q

What are the Four acid–base imbalances that can occur?

A

Respiratory acidosis and alkalosis and metabolic acidosis and alkalosis

47
Q

Occur when carbonic acid or bicarbonate levels become disproportionate.

A

Acid-Base imbalances

48
Q

Deficiency in amount of water and electrolytes in ECF with near-normal water/electrolyte proportions.
(Fluid is outside the cells
Decrease in circulation volume)

A

Hypovolemia

49
Q

Decreased volume of water and electrolyte change

A

Dehydration

50
Q

Distributional shift of body fluids into potential body spaces

A

Third-space fluid shift

51
Q

Excessive retention/loss of water and sodium at the same time in the ECF

A

Hypovolemia

52
Q

Above-normal amounts of water in extracellular spaces

A

Overhydration

53
Q

Excessive ECF accumulates in tissue spaces, causing swelling.

54
Q

Movement of fluid from space surrounding cells to blood

A

Interstitial-to-plasma shift

55
Q

Fluid imbalances involve:

A

either volume or distribution of water or electrolytes

56
Q

occurs with excessive loss or inadequate intake of fluid. (FVD)

A

Fluid volume deficit

57
Q

occurs when water and sodium are lost at the same rate.

A

Isotonic fluid deficit or hypovolemia

58
Q

occurs when water is lost in excess of sodium.

A

Hypertonic fluid volume deficit or dehydration

59
Q

A change of 1 kg (2.2 lb) is equivalent to __ of fluid.

A

1 L (1000 mL)

60
Q

A significant and visible indication of fluid volume excess

61
Q

Characterized by a lasting indentation in the skin when pressure is applied.

A

pitting edema

62
Q

Occurs when there is obvious swelling. The tissue is too firm and hard to be indented.

A

Brawny edema

63
Q

How do you grade an edema?

A

1+ : slight indentation (2mm), returns back to normal quick
2+ : deeper indentation (4mm), indentation lasts longer
3+ : Obvious indentation (6mm), indentation lasts several seconds
4+ : deep indentation (8mm), indentation remains several minutes

64
Q

When fluid volume deficit is present, the skin __

A

remains pinched, or tented, after release.

65
Q

In severe fluid volume deficit:

A

Mucous membranes are dry and sticky, with furrows in the tongue. Cracked lips.

66
Q

Skin turgor can provide an indicator of ___.

A

fluid volume imbalance.

67
Q

What are the 4 Parameters of Assessment?

A

Nursing history and physical assessment
Fluid intake and output
Daily weights
Laboratory studies

68
Q

What are 4 Lab Studies to Assess for Imbalances?

A

Complete blood count
Serum electrolytes, blood urea nitrogen, and creatinine levels
Urine pH and specific gravity
Arterial blood gases

69
Q

What are 6 Risk Factors for Imbalances?

A

Pathophysiology underlying acute and chronic illnesses
Abnormal losses of body fluids
Burns
Trauma
Surgery
Therapies that disrupt fluid and electrolyte balance

70
Q

What are 3 Nursing Diagnoses Related to Imbalances?

A

Excess fluid volume
Deficient fluid volume
Risk for deficient fluid volume

71
Q

What 2 tests show kidney function?

A

BUN and Creatinine

72
Q

What do diffusion and osmosis both do?

A

Equalizes the concentration of two solutions

73
Q

What are the 4 types of Isotonic solutions?

A
  • D5W
  • 0.9% NaCl (NS)
  • D5 0.225% NaCl (NS)
  • Lactated Ringers
74
Q

What are the pH ranges for acid-base balances?

A
  • Death: 6.80 and below
  • Acidosis: 6.80 - 7.35
  • Normal: 7.35 - 7.45
  • Alkalosis: 7.45 - 7.80
  • Death: 7.80 and above
75
Q

What is a third-space fluid shift?

A

When fluid shifts to a different part of the body. ex; ascites (fluid in their stomach)

76
Q

What is an example of fluid volume deficit?

A
  • could be blood loss due got trauma
  • vomiting
  • not enough intake
77
Q

Specific gravity range?

A

(dilute) 1.010 - 1.025 (concentrated)

78
Q

What are diuretics?

A

water pills that decrease salt amount and increase water amount in the body. Pulls fluid from the system, and is eliminated through renal.

79
Q

What are the 2 types of ions?

A
  • Cations: pos charge

- Anions: neg charge

80
Q

What are the major electrolytes?

A
  • NA
  • Potassium
  • Calcium
  • Magnesium
  • Chloride
  • Bicarbonate
  • Phosphate
81
Q

What electrolyte controls and regulates volume of body fluids?

82
Q

What electrolyte is the chief regulator of cellular enzyme activity and water content?

83
Q

What electrolyte involves nerve impulse, blood clotting, muscle contraction, and B12 absorption?

84
Q

What electrolyte involves the metabolism of carbohydrates and proteins, and the vital actions involving enzymes?

85
Q

What electrolyte maintains osmotic pressure in blood, produces hydrochloric acid?

86
Q

What is the body’s primary buffer system?

A

Bicarbonate

87
Q

What electrolyte is involved in important chemical reactions in the body, cell division, and hereditary traits?

88
Q

What are the electrolyte levels?

magnesium, phosphorus, potassium, calcium, chloride, sodium.

A

magnesium: 1.3-2.1 mEq/L
phosphorus: 2.5-4.5 mEq/L
potassium: 3.5-50 mEq/L
calcium: 8.5-10.5 mg/dL
chloride: 95-105 mEq/L
sodium: 135-145 mEq/L

89
Q

SODIUM IMBALANCES

A

Hyponatremia/Hypernatremia

90
Q

POTASSIUM IMBALANCES

A

Hypokalemia (levels lower than 3.5 mEq/L)

Hyperkalemia (levels higher than 5.0 mEq/L)

91
Q

CALCIUM IMBALANCES

A

Hypocalcemia (levels below 8.5 mg/dL)

Hypercalcemia (10.5 mg/dL)

92
Q

MAGNESIUM IMBALANCES

A

Hypomagnesemia (levels less than 1.3 mEq/L)

Hypermagnesemia (levels more than 2.1 mEq/L)

93
Q

PHOSPHORUS IMBALANCES

A

Hypophosphatemia (levels below 1.7 mEq/L)

Hyperphosphatemia (levels above 2.6 mEq/L)

94
Q

Humans are made up of:

A

60% water and 40% solid

95
Q

How much water is intracellular vs extracellular?

A

66% or 2/3 intracellular and 33% or 1/3 extracellular

96
Q

ECF (extracellular fluid) is made up of:

A

Interstitial fluid: 80%

Plasma: 20%

97
Q

Inside the cell is __, the outside of the cell is ___.

A
  • negative

- positive

98
Q

What condition is someone experiencing when they have fever and chills during a transfusion?

A

Febrile reaction

99
Q

A decrease in arterial blood pressure will result in the release of:

100
Q

Symptoms of hypocalcemia:

A
  • blood clotting
  • seizure activity
  • report of numbness/tingling
  • muscle cramps
101
Q

What is the standard drop factor of microdrip tubing?

102
Q

The primary extracellular electrolytes are:

A

sodium, chloride, bicarbonate

103
Q

How do you calculate flow rate?

A

ml per hours x drop factor (gtt/mL) divided by minutes.

104
Q

What are substances that are capable of breaking into particles called ions?

A

Electrolytes

105
Q

Major electrolytes in the __ include sodium, chloride, calcium, and bicarbonate.

106
Q

Major electrolytes in the __ include potassium, phosphorus, and magnesium

Fundamentals 1 (24 decks)

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