Chapter 42: Fluid, Electrolyte, and Acid-base Balance

Question 1

intracellular fluids are basic or acidic?

Answer 1

acidic

Question 2

What percentage of body weight is water?

Answer 2

60% norm, 50% old, women less than men, less in obese people. 70-80% infant

Question 3

Difference between ECF and ICF

Answer 3

Extracellular is intravascular/interstitial. Intracellular is cytosol w/ in cell.

Question 4

Define transcellular fluid

Answer 4

cerebrospinal, pleural, synovial, parietal

Question 5

What makes up the 42L of fluid inside us?

Answer 5

28L intracellular fluid, 11L interstitial fluid, 3L intravascular fluid

Question 6

Name some cations in bodily fluids

Answer 6

Na, K, Ca, Mg

Question 7

Name some anions in bodily fluids

Answer 7

Cl, bicarbonate (HCO3)

Question 8

What is a salt?

Answer 8

Cations and anions combined

Question 9

What is mEq/L?

Answer 9

Milliequivalents per liter

Question 10

What is mmol/L?

Answer 10

Millimoles per liter

Question 11

Define osmailty

Answer 11

of particles/kg of water

Question 12

Define tonicity

Answer 12

Particle concentration in ECF that is not cell membrane permeable

Question 13

Define isotonic

Answer 13

Particle concentration in ECF that is cell membrane permeable b/c it is the same as the inside of cell

Question 14

Difference between diffusion, osmosis, and filtration?

Answer 14

Diffusion: water and particles move. Osmosis: water moves. Filtration: flows between vascular/interstitial w/ hydrostatic pressure

Question 15

Define colloids

Answer 15

Albumin/other proteins. Larger than glucose, electrolytes, other molecules that dissolve easily. Too large to leave capillaries, stays in blood

Question 16

What pushes colloids back into capillaries?

Answer 16

Colloid osmotic pressure/Oncotic pressure

Question 17

Fluid leaves capillary because

Answer 17

Hydrostatic pressure is strong

Question 18

Fluid enters venous entrance at cap bed because

Answer 18

Hydrostatic pressure is weaker and osmotic pressure is stronger

Question 19

What is a healthy adults average daily fluid intake?

Answer 19

2300ml

Question 20

What happens when plasma osmolality increases?

Answer 20

Osmoreceptors are triggered and hypothalamus makes you thirsty

Question 21

How much fluid is lost with stool passage?

Answer 21

100ml

Question 22

What is ADH?

Answer 22

Antidiuretic hormone regulates osmolarity. Made is posterior pituitary gland. Tells renal cells to take water from renal tubular and put back in blood.

Question 23

What is RAAS?

Answer 23

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.

Question 24

What is ANP?

Answer 24

Atrial Naturetic Peptides. Heart realizes there is too much volume for it to push out so it releases ANP which increases sodium/water loss.

Question 25

Difference between hyper/hypocalcemia

Answer 25

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.

Question 26

Difference between acids and bases

Answer 26

Acid: release H+ Base: takes up H+. PH 1 acid, PH 14 basic.

Question 27

What is the PH of adult blood?

Answer 27

7.35-7.45

Question 28

What does ABG track?

Answer 28

acid base balance of blood

Question 29

What are the two types of acid?

Answer 29

Metabolic (kidneys) and carbonic acid (lungs).

Question 30

Name the biggest ECF buffer system

Answer 30

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.

Question 31

Difference between metabolic Alk/Acid

Answer 31

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.

Question 32

Difference between Resp Acid/Alk

Answer 32

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.

Question 33

Difference between crystalloids and colloids

Answer 33

Crystal: electrolytes, NaCl fluids. Colloids: blood/blood component

Question 34

What is PN?

Answer 34

Parenteral nutrition. IV admin complex, highly concern solution containing nutrients/electrolytes. CVC from higher osmo. Peripheral lower osmo.

Question 35

Define extravasation

Answer 35

Tissue damage from infiltration

Question 36

Define phlebitis

Answer 36

inflammation of vein from chemical, mechanical, infectious

Question 37

Describe blood types

Answer 37

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

Question 38

What is Rh?

Answer 38

Another blood antigen. If a pt is Rh negative they can only receive Rh negative blood products

Question 39

Define autologous transfusion

Answer 39

Collection/reinfusion of pts own blood. Lasts up to 6 weeks.

Question 40

How long should blood transfusion take?

Answer 40

2-4 hours. After 4 risk fro infection increases.

Question 41

Bolus infusion of citrated blood can lead to

Answer 41

Hyperkalemia, hypocalcemia, hypomagnesmia, metabolic alkalosis.

Question 42

How do you use weight to determine amount of fluid in a patient?

Answer 42

1 kg = 1 liter of fluid

Question 43

How much ice is equivalent to how much fluid intake?

Answer 43

100 mL of ice = 50 mL volume

Question 44

Name different ways to assess for nutrition

Answer 44

Diet hx I&O BMI (skin folds, waist-hip ratio) Lab tests Physical exam Dysphagia

Question 45

Define Cachexia

Answer 45

wasting away from malnutrition

Question 46

Define Kwashiorkor

Answer 46

distended bellies (usually in children due to lack of protein)

Question 47

Some signs of malnutrition

Answer 47

- 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)

Question 48

Define Kylosis

Answer 48

thickening of the skin (specifically around the mouth)

Question 49

Define Conjunctival injection

Answer 49

edness of the sclera

Question 50

Define Ricketts

Answer 50

Bowing of legs

Question 51

Aspiration precautions

Answer 51

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