!! 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
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.
3
Q
Body fluid is located in what 2 fluid compartments?
A
- intracellular fluid
- extracellular fluid
4
Q
The fluid constituting about 70% of the total body water or 40% of the adult’s body weight.
A
Intracellular fluid
5
Q
The fluid accounting for about 30% of the total body water or 20% of the adult’s body weight.
A
Extracellular fluid
6
Q
The extracellular fluid includes two major areas:
A
- the intravascular and interstitial compartments
- and third minor compartment is the transcellular fluid
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
8
Q
What 2 things separate the intracellular and extracellular compartments?
A
The capillary walls and cell membranes
9
Q
What 3 factors cause variations in fluid content?
A
- person’s age
- body fat
- biological sex
10
Q
__ cells contain little water, whereas __ tissue is rich in water.
A
Fat
Lean
11
Q
Similarly, the decreasing percentage of body fluid in older people is related to an increase in ___.
A
Fat cells
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
13
Q
___ has considerably more body fluid and ECF than an ___; more prone to fluid volume deficits
A
An infant
Adults
14
Q
Liquids that hold a substance in solution (water)
A
Solvents
15
Q
Substances dissolved in a solution (electrolytes and nonelectrolytes)
A
Solutes
16
Q
Fluctuations in fluid intake and output can:
A
destabilize the balance between fluids and electrolytes.
17
Q
The equilibrium between the acidity and alkalinity of body fluids is
A
acid–base balance.
18
Q
Water passes from an area of lesser solute concentration to greater concentration until equilibrium is established
A
Osmosis
19
Q
Tendency of solutes to move freely throughout a solvent (“downhill”)
A
Diffusion
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
21
Q
Passage of fluid through a permeable membrane from the area of higher to lower pressure
A
Capillary Filtration
22
Q
What process is this:
- Solvent and solute particles move to equalize concentrations.
- No semipermeable membrane is involved.
A
Diffusion
23
Q
What process is this:
- Only solvent particles move. Solute particles do not move.
- The movement is through a semipermeable membrane.
A
Osmosis
24
Q
Osmolarity of a Solution:
same concentration of particles as plasma.
A
Isotonic
25
Osmolarity of a Solution:
| greater concentration of particles than plasma
Hypertonic
26
Osmolarity of a Solution:
| lesser concentration of particles than plasma
Hypotonic
27
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.
Hypertonic
28
What are the 4 Fluid Losses?
Kidneys: urine
Intestinal tract: feces
Skin: perspiration
Insensible water loss (fever)
29
What are the 9 primary organs of homeostasis?
- kidneys
- cardiovascular system
- lungs
- adrenal glands
- pituitary gland
- thyroid gland
- nervous system
- parathyroid glands
- GI tract
30
What increases the blood flow in the body and increases renal circulation?
The thyroid gland
31
What inhibits and stimulates mechanisms influencing fluid balance?
The nervous system
32
What regulates the level of calcium in ECF?
Parathyroid glands
33
What absorbs water and nutrients that enter the body through this route?
GI tract
34
What stores and releases ADH?
Pituitary gland
35
What helps the body conserve sodium, save chloride and water, and excrete potassium?
Adrenal glands
36
What regulates oxygen and carbon dioxide levels of the blood?
Lungs
37
What pumps and carries nutrients and water in body?
Cardiovascular system
38
What filters 170 L of plasma and excrete 1.5 L of urine?
Kidneys
39
Substance containing hydrogen ions that can be liberated or released.
Acid
40
Substance that can trap hydrogen ions.
Base
41
What are the 3 Major Homeostatic Regulators of Hydrogen Ions?
Buffer systems
Respiratory mechanisms
Renal mechanisms
42
What are 3 types of buffer systems?
- carbonic acid- NA bicarbonate
- phosphate
- protein
43
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?
Carbonic acid- sodium bicarbonate buffer system.
44
For normal cellular functioning to occur, the pH of body fluids must remain between:
7.35 - 7.45
45
What two compensatory mechanisms are designed to help maintain homeostasis?
- 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
What are the Four acid–base imbalances that can occur?
Respiratory acidosis and alkalosis and metabolic acidosis and alkalosis
47
Occur when carbonic acid or bicarbonate levels become disproportionate.
Acid-Base imbalances
48
Deficiency in amount of water and electrolytes in ECF with near-normal water/electrolyte proportions.
(Fluid is outside the cells
Decrease in circulation volume)
Hypovolemia
49
Decreased volume of water and electrolyte change
Dehydration
50
Distributional shift of body fluids into potential body spaces
Third-space fluid shift
51
Excessive retention/loss of water and sodium at the same time in the ECF
Hypovolemia
52
Above-normal amounts of water in extracellular spaces
Overhydration
53
Excessive ECF accumulates in tissue spaces, causing swelling.
Edema
54
Movement of fluid from space surrounding cells to blood
Interstitial-to-plasma shift
55
Fluid imbalances involve:
either volume or distribution of water or electrolytes
56
occurs with excessive loss or inadequate intake of fluid. (FVD)
Fluid volume deficit
57
occurs when water and sodium are lost at the same rate.
Isotonic fluid deficit or hypovolemia
58
occurs when water is lost in excess of sodium.
Hypertonic fluid volume deficit or dehydration
59
A change of 1 kg (2.2 lb) is equivalent to __ of fluid.
1 L (1000 mL)
60
A significant and visible indication of fluid volume excess
edema
61
Characterized by a lasting indentation in the skin when pressure is applied.
pitting edema
62
Occurs when there is obvious swelling. The tissue is too firm and hard to be indented.
Brawny edema
63
How do you grade an edema?
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
When fluid volume deficit is present, the skin __
remains pinched, or tented, after release.
65
In severe fluid volume deficit:
Mucous membranes are dry and sticky, with furrows in the tongue. Cracked lips.
66
Skin turgor can provide an indicator of ___.
fluid volume imbalance.
67
What are the 4 Parameters of Assessment?
Nursing history and physical assessment
Fluid intake and output
Daily weights
Laboratory studies
68
What are 4 Lab Studies to Assess for Imbalances?
Complete blood count
Serum electrolytes, blood urea nitrogen, and creatinine levels
Urine pH and specific gravity
Arterial blood gases
69
What are 6 Risk Factors for Imbalances?
Pathophysiology underlying acute and chronic illnesses
Abnormal losses of body fluids
Burns
Trauma
Surgery
Therapies that disrupt fluid and electrolyte balance
70
What are 3 Nursing Diagnoses Related to Imbalances?
Excess fluid volume
Deficient fluid volume
Risk for deficient fluid volume
71
What 2 tests show kidney function?
BUN and Creatinine
72
What do diffusion and osmosis both do?
Equalizes the concentration of two solutions
73
What are the 4 types of Isotonic solutions?
- D5W
- 0.9% NaCl (NS)
- D5 0.225% NaCl (NS)
- Lactated Ringers
74
What are the pH ranges for acid-base balances?
- 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
What is a third-space fluid shift?
When fluid shifts to a different part of the body. ex; ascites (fluid in their stomach)
76
What is an example of fluid volume deficit?
- could be blood loss due got trauma
- vomiting
- not enough intake
77
Specific gravity range?
(dilute) 1.010 - 1.025 (concentrated)
78
What are diuretics?
water pills that decrease salt amount and increase water amount in the body. Pulls fluid from the system, and is eliminated through renal.
79
What are the 2 types of ions?
- Cations: pos charge
| - Anions: neg charge
80
What are the major electrolytes?
- NA
- Potassium
- Calcium
- Magnesium
- Chloride
- Bicarbonate
- Phosphate
81
What electrolyte controls and regulates volume of body fluids?
Sodium
82
What electrolyte is the chief regulator of cellular enzyme activity and water content?
Potassium
83
What electrolyte involves nerve impulse, blood clotting, muscle contraction, and B12 absorption?
Calcium
84
What electrolyte involves the metabolism of carbohydrates and proteins, and the vital actions involving enzymes?
Magnesium
85
What electrolyte maintains osmotic pressure in blood, produces hydrochloric acid?
Chloride
86
What is the body’s primary buffer system?
Bicarbonate
87
What electrolyte is involved in important chemical reactions in the body, cell division, and hereditary traits?
Phosphate
88
What are the electrolyte levels?
| magnesium, phosphorus, potassium, calcium, chloride, sodium.
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
SODIUM IMBALANCES
Hyponatremia/Hypernatremia
90
POTASSIUM IMBALANCES
Hypokalemia (levels lower than 3.5 mEq/L)
| Hyperkalemia (levels higher than 5.0 mEq/L)
91
CALCIUM IMBALANCES
Hypocalcemia (levels below 8.5 mg/dL)
| Hypercalcemia (10.5 mg/dL)
92
MAGNESIUM IMBALANCES
Hypomagnesemia (levels less than 1.3 mEq/L)
| Hypermagnesemia (levels more than 2.1 mEq/L)
93
PHOSPHORUS IMBALANCES
Hypophosphatemia (levels below 1.7 mEq/L)
| Hyperphosphatemia (levels above 2.6 mEq/L)
94
Humans are made up of:
60% water and 40% solid
95
How much water is intracellular vs extracellular?
66% or 2/3 intracellular and 33% or 1/3 extracellular
96
ECF (extracellular fluid) is made up of:
Interstitial fluid: 80%
| Plasma: 20%
97
Inside the cell is __, the outside of the cell is ___.
- negative
| - positive
98
What condition is someone experiencing when they have fever and chills during a transfusion?
Febrile reaction
99
A decrease in arterial blood pressure will result in the release of:
renin
100
Symptoms of hypocalcemia:
- blood clotting
- seizure activity
- report of numbness/tingling
- muscle cramps
101
What is the standard drop factor of microdrip tubing?
60 gtt/mL
102
The primary extracellular electrolytes are:
sodium, chloride, bicarbonate
103
How do you calculate flow rate?
ml per hours x drop factor (gtt/mL) divided by minutes.
104
What are substances that are capable of breaking into particles called ions?
Electrolytes
105
Major electrolytes in the __ include sodium, chloride, calcium, and bicarbonate.
ECF
106
Major electrolytes in the __ include potassium, phosphorus, and magnesium
ICF
