Chapter 52 Fluid Electrolyte And Acid Base

Question 1

Intravascular Fluids
Interstitial Fluids
Transcellular Fluids

Answer 1

Intravascular accounts for approximately 20% of ECF and is found within the vascular system
Interstitial accounting for approximately 75% of ECF surrounds cells
Transcellular ex cerebrospinal pericardial pancreatic pleural intracular biliary

Question 2

Intracellular vs Extracellular Fluids

Answer 2

ICF is found within the cells of the body it constitutes approximately two thirds of the total body fluid in adults
ECF is found outside the cells and accounts for about one third of total body fluid

Question 3

Composition of Body Fluids 
Ions 
Electrolytes 
Cation 
Anions

Answer 3

Ions dissolved nutrients from the GI tract excretory products of metabolism such as carbon dioxide and charged particles
Electrolytes sodium and chloride are capable of conducting electricity
Cations positive charge
Anions negative charge

Question 4

Hypertonic vs Hypotonic solutions

Answer 4

Hypertonic such as 3% sodium chloride have a higher osmolality than ECF
Hypotonic 0.45% sodium chloride have s lower osmolality than ECF

Question 5

Fluids I&O

Answer 5

Fluid intake normal activity at moderate temperature the average adult drinks 2,500 mL per day for normal functioning
Fluid output fluid losses the body counterbalance the intake of fluid
pg 1453 - 1454

Question 6

Maintaining Homeostasis

Answer 6

The volume and composition of the body fluids are regulated through several homeostatic mechanisms
Hormones such as antidiuretic hormone ADH known as arginine vasopressin AVP

Question 7

Fluid Imbalances what are the difference between fluid volume deficit vs fluid volume excess?

Answer 7

Fluid volume Deficit not enough fluid intake ex dehydration or third space syndrome (spacing)
Fluid volume Excess to much fluid intake ex Edema over dehydration and hypervolemia

Question 8

Metabolic Acidosis vs Metabolic Alkalosis

Answer 8

Metabolic Acidosis prefer to as prolonged diaherra and cardiac arrest
Metabolic Alkalosis prefer to as vomiting excessive antacid use and GI suctioning

Question 9

Respirations PH balance of Alkalosis vs Acidosis

Answer 9

Alkalosis > 7.45 hyperventilating

Acidosis

Question 10

What are the factors that effects body fluids?

Answer 10

Age Sex Body size Environmental Temp and Lifestyle

Question 11

Define solutes crystalloids osmolality

Answer 11

Solutes are substances dissolved in a liquid
Crystalloids salts that dissolve readily into true solutions
Osmolality total solute concentration within a fluid compartment and is measured as parts of solute per kilogram of water

Question 12

Define isotonic hypertonic n hypotonic

Answer 12

Isotonic solution has the same osmolality as ECF normal saline 0.9%
Hypotonic solution such as 0.45% sodium chloride have a lower osmolality than ECF
Hypertonic solutions such as 3% sodium chloride have a higher osmolality than ECF

Question 13

Define osmotic pressure n osmosis

Answer 13

Osmotic pressure is the power of solution to pull water across a semipermeable membrane
Colloid pressure exert by plasma proteins
Oncotic pressure holding water plasma
Osmosis specific kind of diffusion in which water moves across cell membranes from less concentrated solutions
Normal levels for osmolality 285-295 mOsm / kg H20

Question 14

Define filtration hydrostatic pressure n active transport

Answer 14

Filtration is a process whereby fluid and solutes move together across a membrane from an area of higher pressure
Hydrostatic pressure is the pressure exerted by a fluid within closed system on the walls of the container in which it contained
Active transport is the movement of solutes across cell membrane from a less concentrated solution to a more concentrated

Question 15

Sodium
Cation or Anion?
Normal Levels?
Terms for high and low?
S/S of Hyper?
S/S of Hypo?
Treatment

Answer 15

Cation Na + is the most abundant cation in ECF major contributor to serum osmolality
Normal serum levels are 135 to 145 mEq/L same as adults
Sodium is found high in many foods like bacon ham processed cheese
S/S Hyponatremia loss of sodium ex gastrointestinal fluid loss sweating gain of water ex hypotonic tube feelings S/S Hypernatremia loss of water ex insensible water loss hyperventilation or fever gain of sodium ex parenteral administration of saline solutions
Treatments

Question 16

•Potassium
Cation or Anion?
Normal Levels?
Terms for high and low?
S/S of Hyper?
S/S of Hypo?
Treatment

Answer 16

Cation K + the major cation in ICF with only a small amount found in the ECF
ICF levels 125 to 140 mEq/L normal serum potassium levels are 3.5 to 5.0 mEq/L both sex children 3.4 to 4.7 mEq/L
Potassium is a vital electrolyte for skeletal cardiac and smooth muscle
S/S Hyperkalemia is potassium excess defined as a serum potassium level greater than 5.0 mEq/L
Hypokalemia is a potassium deficit as serum levels of less than 3.5 mEq/l

Question 17

•Calcium
Cation or Anion?
Normal Levels?
Terms for high and low?
S/S of Hyper?
Treatment

Answer 17

Cation Calcium Ca 2+ in the body stored in the skeletal system with relatively small amounts in ECF
Normal range of serum calcium level 9 to 10.5 mg/dL both sex children 8.8 to 10.8 mg/dL
S/S Hypocalcemia is s calcium deficit as a total serum calcium level of less than 8.5 mg/dL
Hypercalcemia is a calcium excess as a total serum calcium level greater than 5.5 mEq/ L
Treatments

Treatments

Question 18

•Magnesium
Cation or Anion?
Normal Levels?
Terms for high and low?
S/S of Hyper?
S/S of Hypo?
Treatment?

Answer 18

Cation Mg 2+ found in the skeleton and ICF where it is the second most abundant ICF
Normal serum level 1.5 to 2.5 mEq/ L both sex 1.8-3 mg/dL Therapeutic (on Mg therapy) 4-8 mg/dL
S/S Hypomagnesemia deficiency defined as serum magnesium level of less than 1.5 mEq/L
Hypermagnesemia above level 2.5 mEq/L due to increase or decrease excretion
Treatments

Question 19

Isotonic
Identify which ones
When do you use them?

Answer 19

0.9% NaCl Lactated ringers a balanced electrolytes solution 5% dextrose in water D5W
Isotonic solutions such as NS and Lactated ringers initially remain in the vascular compartment expending vascular volume

Question 20

Hypotonic
Identify which ones
When do you use them?

Answer 20

0.45% NaCl half normal saline 0.33% NaCl one third normal saline
Hypotonic solutions are used to provide free water and treat cellular dehydration. These solutions promotes waste elimination by the kidneys

Question 21

•Hypertonic
Identify which one
When do you use them?

Answer 21

5% dextrose in normal saline D5NS 5% dextrose in 0.5% NaCl D3 1/2 NS 5% dextrose in Lactated ringers D5 L R
Hypertonic solutions draw fluid out of the ICF n interstitial compartments into vascular compartment expanding vascular volume

Question 22

Parenteral Fluids and Electrolyte Replacement
•When do you use IV fluids?
•Which are the best Venipuncture Sites?
•What is the difference between Central and Peripheral Sites?
•NPSG for Central Line Catheters (pg 1484)
•How to calculate IV fluids ml/hr
–Total mL’s of fluids ordered divided by hours to run

Answer 22

IV fluids is essential when clients are unable to take sufficient food and fluids orally
Vein puncture sites are chosen varies with clients age length n time an infusion is to run the type of solution ex adult arms are best in the arms
Central are inserted into the subclavian or jugular vein with the distal tip of the Cather resting
Peripheral inserted in the basic or cephalic vein just above or below the ante cubical