Chapter 42: Fluid, Electrolyte, and Acid-base Balance Flashcards
intracellular fluids are basic or acidic?
acidic
What percentage of body weight is water?
60% norm, 50% old, women less than men, less in obese people. 70-80% infant
Difference between ECF and ICF
Extracellular is intravascular/interstitial. Intracellular is cytosol w/ in cell.
Define transcellular fluid
cerebrospinal, pleural, synovial, parietal
What makes up the 42L of fluid inside us?
28L intracellular fluid, 11L interstitial fluid, 3L intravascular fluid
Name some cations in bodily fluids
Na, K, Ca, Mg
Name some anions in bodily fluids
Cl, bicarbonate (HCO3)
What is a salt?
Cations and anions combined
What is mEq/L?
Milliequivalents per liter
What is mmol/L?
Millimoles per liter
Define osmailty
of particles/kg of water
Define tonicity
Particle concentration in ECF that is not cell membrane permeable
Define isotonic
Particle concentration in ECF that is cell membrane permeable b/c it is the same as the inside of cell
Difference between diffusion, osmosis, and filtration?
Diffusion: water and particles move. Osmosis: water moves. Filtration: flows between vascular/interstitial w/ hydrostatic pressure
Define colloids
Albumin/other proteins. Larger than glucose, electrolytes, other molecules that dissolve easily. Too large to leave capillaries, stays in blood
What pushes colloids back into capillaries?
Colloid osmotic pressure/Oncotic pressure
Fluid leaves capillary because
Hydrostatic pressure is strong
Fluid enters venous entrance at cap bed because
Hydrostatic pressure is weaker and osmotic pressure is stronger
What is a healthy adults average daily fluid intake?
2300ml
What happens when plasma osmolality increases?
Osmoreceptors are triggered and hypothalamus makes you thirsty
How much fluid is lost with stool passage?
100ml
What is ADH?
Antidiuretic hormone regulates osmolarity. Made is posterior pituitary gland. Tells renal cells to take water from renal tubular and put back in blood.
What is RAAS?
Renin-angiotensin-aldosterone. Kidneys release renin, which is turned into angiotensin one y liver, which is turned into angiotensin 2 by lungs, which is turned into aldosterone by adrenal cortex. This makes pt reabsorb sodium/water.
What is ANP?
Atrial Naturetic Peptides. Heart realizes there is too much volume for it to push out so it releases ANP which increases sodium/water loss.
Difference between hyper/hypocalcemia
Hypo: Ion isn’t bound to something (citrate). Associated w/ pancreatitis. Hyperactive reflexesHyper: Lung/breast cancers affect thyroid which makes hormone that decalcifies bones. Decreases neuromuscular excitability.
Difference between acids and bases
Acid: release H+ Base: takes up H+. PH 1 acid, PH 14 basic.
What is the PH of adult blood?
7.35-7.45
What does ABG track?
acid base balance of blood
What are the two types of acid?
Metabolic (kidneys) and carbonic acid (lungs).
Name the biggest ECF buffer system
Bicarbonate buffer system: HCO3. Bicarb + H=carb acid. The more this reaction happens the less acidic, more basic. Ratio 20 bicarb to 1 carbonic acid.
Difference between metabolic Alk/Acid
Acid: Sudden increase of metabolic acid/decrease in bicarb. confusion, excitement. Alk: increase in bicarb, decrease metabolic acid. From vomiting/gastric suction. causes hypo ventilation to increase acidity. No severe neuro symptoms.
Difference between Resp Acid/Alk
Acid: Sympt start after 24 hrs. CSF/neuro affect after 3-5 days = decreased LOC. Alk: hyper vent, short lived so not comp from kidneys. Excitement, confusion w/ short episodes. CNS depression is long episode.
Difference between crystalloids and colloids
Crystal: electrolytes, NaCl fluids. Colloids: blood/blood component
What is PN?
Parenteral nutrition. IV admin complex, highly concern solution containing nutrients/electrolytes. CVC from higher osmo. Peripheral lower osmo.
Define extravasation
Tissue damage from infiltration
Define phlebitis
inflammation of vein from chemical, mechanical, infectious
Describe blood types
A: RBC A antig anti-B antibodies plasma
B: RBC B antig anti-A antibodies plasma
AB: RBC A/B antig NO antibodies plasma
O: RBC NO antibodiers, anti-B/A antibodies plasma
O- EVERYONE
What is Rh?
Another blood antigen. If a pt is Rh negative they can only receive Rh negative blood products
Define autologous transfusion
Collection/reinfusion of pts own blood. Lasts up to 6 weeks.
How long should blood transfusion take?
2-4 hours. After 4 risk fro infection increases.
Bolus infusion of citrated blood can lead to
Hyperkalemia, hypocalcemia, hypomagnesmia, metabolic alkalosis.
How do you use weight to determine amount of fluid in a patient?
1 kg = 1 liter of fluid
How much ice is equivalent to how much fluid intake?
100 mL of ice = 50 mL volume
Name different ways to assess for nutrition
Diet hx
I&O
BMI (skin folds, waist-hip ratio)
Lab tests
Physical exam
Dysphagia
Define Cachexia
wasting away from malnutrition
Define Kwashiorkor
distended bellies (usually in children due to lack of protein)
Some signs of malnutrition
- Depigmentation of the hair (specifically hair that is unpigmented due to malnutrition)
- Beefy red tongue
- Spoon-shaped nail
- Beading of the ribs (they stick out in bumps)
Define Kylosis
thickening of the skin (specifically around the mouth)
Define Conjunctival injection
edness of the sclera
Define Ricketts
Bowing of legs
Aspiration precautions
Positioning- 90 degrees with a chin tuck (not the cosmetic version)
s/s
Assess: mental status and medications
Provide thick liquids as needed
Adjust pace of eating
Suspected aspiration -> suction upper lungs or heimlich maneuver
