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Patho > Chapter 7: Fluid & Electrolyte Imbalances > Flashcards

Chapter 7: Fluid & Electrolyte Imbalances Flashcards

1
Q

What percentage is the human body made up of water?

A

60%

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2
Q

Functions of electrolytes and protein solutes

A

deliver nutrients and electrolytes to cells and carry away waste products from cellular metabolism

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3
Q

Intracellular Fluid Compartment

A

water in the cells; 40% of body weight, diffuse out of ICF= Cell shrinkage or cell dehydration; water entering=cell swelling or cell edema

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4
Q

Extracellular Fluid

A

within the bloodstream; 20% of body weight, contains electrolytes, oxygen, glucose and other nutrients and waste products for excretion

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5
Q

Interstitial Fluid

A

btwn cells and capillaries; lacks proteins b/c too large to diffuse, during inflammation, capillary membrane become extrapermable, pores enlarge, allowing proteins(WBC) out of tissues

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6
Q

hydrostatic pressure

A

pushing force exerted by water in the bloodstream into the cell

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7
Q

osmotic pressure

A

pressure exerted by solutes in solution; exerted by electrolytes, mainly sodium and plasma proteins, forces that pulls water into bloodstream from ICF and ISF, opposes hydrostatic pressure

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8
Q

A solution with greater number of particles has ____ _________ pressure?

A

higher osmotic

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9
Q

When Osmotic pressure is decreased, what happens?

A

fluid moves out of bloodstream and into ISF and ICF

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10
Q

oncotic pressure

A

colloidal osmotic pressure; a type of OP exerted specifically by albumin in bloodstream, albumin attracts water, helps keep it inside blood vessel

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11
Q

normal serum albumin level

A

3.1-4.3 g/dL

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12
Q

osmolality

A

measurement of the concentration of solutes per kg of solvent; used to evaluate hydration status

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13
Q

normal plasma osmolality

A

282 to 295 milliosmoles per kg of the h20

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14
Q

well hydrated osmolality number?

A

282

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15
Q

low hydration osmolality number?

A

295

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16
Q

osmolarity

A

of osmoles of solute per liter of solution

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17
Q

albumin

A

major protein within the bloodstream, exerts most osmotic pressure

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18
Q

sodium

A

main determinant of osmolarity, cation; assists in maintenance of fluid balance and osmotic pressure

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19
Q

Potassium

A

main intracellular cation; assists in maintenance of neuromuscular excitability and acid base balance

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20
Q

phosphate

A

intracellular negative ion=anion

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21
Q

magnesium

A

role in enzymatic systems within a body

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22
Q

Bicarbonate

A

role in neuromuscular irritability, blood clotting and bone structure

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23
Q

Tonicity

A

concentration of solutes in solution compared with bloodstream

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24
Q

isotonic solution

A

same tonicity as blood

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25
Q

When isotonic solution is infused as IV solution what happens?

A

doesn’t cause fluid shift or alter blood body cell size

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26
Q

Common isotonic solutions and what is it used for?

A

0.9% NaCl solution, Normal saline(NS); used to keep open connection to the IV route

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27
Q

Hypotonic solution

A

more water than blood

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28
Q

When hypotonic solution is infused what happens?

A

causes shift from ECF to ICF, makes the cell swell

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29
Q

Common hypotonic solutions and what is it used for?

A

0.45% Nacl or 1/2 NS; used for dehydration treatment

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30
Q

Hypertonic solution

A

more particles and less water than blood

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31
Q

when hypertonic solution is infused what happens?

A

solutes added to the bloodstream, causing fluid shift from ICF to ECF, body cells shrink

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32
Q

Common hypertonic solutions and what is it used for?

A

3% Nacl or mannitol; used to diminish cell swelling in edema

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33
Q

What is 5% dextrose water (D5W) used for?

A

delivers glucose to prevent hypoglycemia

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34
Q

What is the temporary replacement for blood?

A

Ringers Lactate

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35
Q

What does an increased plasma osmolarity do?

A

stimulates osmoreceptors in hypothalamus; stim thirst

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36
Q

thirst

A

conscious desire to drink fluids; triggered by response

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37
Q

where is the thirst center located?

A

anterior hypothalamus

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38
Q

When is RAAS activated?

A

decrease circulation or decrease in BP

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39
Q

steps of RAAS

A

1: kidneys sense decrease in circulation or BP and secrete renin
2: renin stimulates the liver— angiotensinogen
3; lungs convert to angiotensin I
4; amgiotension II stimulates peripheral arterial vasoconstriction with raises BP
5: stimulates adrenal gland to release aldosterone
6:aldosterone increases sodium and H2O reabsorption into bloodstream and causes potassium secretion into urine

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40
Q

RAAS net effect

A

increased blood volume and increased BP

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41
Q

Physiological effects of parathyroid hormone

A

increases reabsorption of bone; stimulates renal reabsorption of calcium; inhibits renal reabsorption of phosphate

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42
Q

physiological effects of antidiuretic hormone

A

increases renal water reabsorption, vasoconstriction

43
Q

physiological effects of calcitonin

A

inhibits osteoclasts in bone

44
Q

physiological effects of aldosterone

A

increased renal sodium and water reabsorption; increases renal excretion of potassium and hydrogen ions

45
Q

physiological effects of atrial natiruretic peptide

A

increase renal sodium and water excretion

46
Q

What increases the secretion of Aldosterone?

A

angiotension II, increased plasma potassium

47
Q

What increases the secretion of Parathyroid hormone?

A

low plasma calcium

48
Q

what increases the secretion of antidiuretic hormone?

A

increased osmolaity, substance decreased arterial blood pressure

49
Q

what increases the secretion of artial natriuretic peptide?

A

increased volume in the cardiac atria

50
Q

Calcitonin

A

high plasma calcium

51
Q

Natriuresis

A

excretion of a large amount of both sodium and water by the kidneys in response to excess ECF volume

52
Q

Atrial natriuretic peptide(ANP)

A

produced by hearts atria and is secreted in response to excess ECF volume

53
Q

C-type natriuretic peptide(CNP)

A

produced by endothelial cells of arteries and ventricular cells of heart

54
Q

B-type natriuretic peptide(BNP)

A

produced in hearts ventricles and in brain. Excreted in response to fluid volume overload stretching hearts ventricles.

55
Q

edema

A

occurs when excess of fluid in ISF and ICF or inflammation

56
Q

Third-spacing

A

when parts of the body that usually doesn’t have fluids, has sequestered fluids

57
Q

effusion

A

fluid that accumulates in these cavities

58
Q

transudate

A

serous filtrate of blood

59
Q

hypovolemia

A

diminished level of circulating blood volume, decreased osmolarity of the blood

60
Q

fluid necessary

A

1500 mL/m2= 2 liters per day

61
Q

dehydrated patient vital signs

A

tachycardia and hypotension

62
Q

Sodium normal levels

A

135-145mEq/L

63
Q

Where is sodium located?

A

ECF

64
Q

Sodiums does what?

A

controls distribution of H2O, maintains normal fluid balance, and maintains electrical gradient of neural membrane

65
Q

Hyponatremia

A

serum level less than 135mEq/L

66
Q

Causes of Hyponatremia

A

Hypergylcemia, dirrahea, burns, diuretic therapy, renal disease

67
Q

Hypernatermia

A

sodium level greater than 145 meq/L

68
Q

causes of hypernatremia

A

Cushings, diabetes insipidus, diarrhea, hypercalcemia, tube feedings, water deprivation

69
Q

severe hyponatermia can cause what?

A

seizures, coma and irreversible neurological damage

70
Q

manifestations of hypernatremia

A

weight gain, hypertension, tachycardia, thirst, dehydrated

71
Q

Where is potassium located?

A

ICF

72
Q

how much potassium do we require per day?

A

40-60

73
Q

Hypokalemia

A

potassium below 3.5 meq/L

74
Q

causes of hypokalemia

A

diuretic therapy, alkalosis, laxative abuse, nasogastric suction

75
Q

Treatment of hypokalemia?

A

replace with foods such as OJ, bananas, meat, fruits

76
Q

effects of hypokalemia on a ECG

A

flattened T wave, prominent U wave, prolonged PR interval

77
Q

Early symptoms of hypokalemia

A

anorexia, nausea, vomiting, sluggish bowel, cardiac arthymias, postural hypotension, muscle fatigue

78
Q

Hyperkalemia

A

blood level greater than 5.2 mEq/L

79
Q

Causes of hyperkalemia

A

addisons disease, burns, extreme exercise, renal failure

80
Q

Presentation of hyperkalemia

A

numbness or tingling, cramping, diarrhea,apathy and mental confusion

81
Q

Calcium functions

A

formation and function of bones, teeth, clotting and regulation of neuromuscular irritability

82
Q

hypocalcemia

A

blood calcium levels less than 8.5mg/dL or 4 meq/L

83
Q

Causes of hypocalcemia

A

lack of sufficient Ca in diet, vitamin D deficiency, renal disease or hypoparathyroidism,

84
Q

signs of hypocalcemia

A

paresthesias(numbness and tingling) around mouth, hands and feet; chvosteks sign and trousseaus sign; spasms, seizures and death; hypotension

85
Q

What does calcium have a synergetic relationship with?

A

phosphorus

86
Q

What does calcium have a inverse relationship with?

A

magnesium

87
Q

Hypercalcemia

A

calcium level greater than the 10mg/dL or 5 meq/L

88
Q

causes of hypercalcemia

A

hyperparathyroidism and cancer; BONE MEDS FROM CANCER!!!

89
Q

signs of hypercalcemia

A

muscle weakness, muscle flaccidity, renal stones, ECG changes, confusion, tiredness

90
Q

treat hypercalcemia

A

phosphate, increase mobility, calcitonin, diuretics, IV fluids

91
Q

Phosphorus functions

A

intracellular anion, components of bone, RBS and formation of ATP

92
Q

Hypophosphatemia

A

blood level phosphate lower than 2.5 mg/dL

93
Q

causes of hypophosphatemia

A

decreased absorption, increase excretion=alkalosis, deficient intake=malabsorption, vitamin d deficiency

94
Q

hyperphosphatemia

A

PO4- level of 4.5 mg/dL or greater

95
Q

causes of hyperphosphatemia

A

kidney failure, acidosis, hypocalcemia

96
Q

Magnesium stored where?

A

stored in bone

97
Q

Hypomagnesemia

A

less than 1.8mEq/L

98
Q

causes of hypomagnesemia

A

laxative abuse, burns, sepsis, alcoholism, stress

99
Q

symptoms of hypomagnesemia

A

tetany, spasms, tremors, cardiac arrhythmias, paralysis, heart block, coma, hypertension

100
Q

Hypermagnesemia

A

greater than 2.5

101
Q

diabetic keto acidosis

A

affects people with diabetes. It occurs when the body starts breaking down fat at a rate that is much too fast.

102
Q

causes of hypermagnesemia

A

renal disease, excessive laxative and antacid use

103
Q

symptoms of hypermagnesemia

A

hypotension, arrhythmias, cardiac arrest, not good reflexes

Patho (8 decks)

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