Class Two

Question 1

Total body water

Answer 1

Sum of fluids within all body compartments

60% of body weight

Question 2

ICF

Answer 2

Most body fluids are inside the cell

40% of body weight - 28 L

Question 3

ECF

Answer 3

All fluids outside of the cells - blood, lymph, bone, connective tissue, water, and transcellular fluid

20% of body weight - 14 L

Question 4

ECF divided into two parts

Answer 4

Interstitial: the fluid between cells
15%

Intravascular: refers to fluid inside the blood vessel
5%

Question 5

Isotonic fluid loss

Signs and symptoms

Answer 5

Dehydration and hypovolemia

Weight loss, increased thirst, dry skin

Question 6

Symptoms of hypovolemia

Answer 6

Increased hr 
Decreased urine output
Decreased bp
Increased hct 
Decreased (flat) neck veins

Question 7

Isotonic fluid excess

Causes

Symptoms

Answer 7

Hypervolemia

Excessive IV, Increases in aldosterone, drugs like cortisone (prednisone)

Weight gain, decreased albumin, increased bp, JVD, crackles in lungs, edema - pulmonary edema

Question 8

Hypertonic dehydration

Causes

Answer 8

Water loss exceeds electrolyte loss

Results from alterations in concentrations of specific plasma electrolytes

Fluid moves from ICF to plasma to interstitial spaces

Causes cell shrinkage

Question 9

Conditions that increase hypertonic dehydration

Answer 9

Excessive perspiration
Hyperventilation 
Ketoacidosis
Prolonged fevers 
Diarrhea
Early stage kidney disease
Diabetes insipidus

Question 10

Hypotonic dehydration

Causes

Answer 10

Electrolyte loss exceeds water loss

Results from fluid shifts between compartments, causing decrease in plasma volume

Fluid moves from plasma and interstitial spaces into the cells

Cells swell

Question 11

Conditions that increase hypotonic dehydration

Answer 11

Chronic illness
Excessive fluid replacement
Kidney disease
Chronic malnutrition

Question 12

Hypertonic overhydration

Causes

Answer 12

Very rare - caused by excessive sodium intake

Fluid drawn from ICF - ECF expands and ICF contracts

Caused by rapid infusion of hypertonic saline or excessive sodium bicarbonate therapy

Question 13

Hypotonic overhydration

Causes

Answer 13

Water intoxication - excess fluid moves in ICF a and all body fluid compartments expand

Electrolyte imbalances occur

Caused by early kidney disease, heart failure, inappropriate ADH secretion, inadequate IV therapy, irrigation of wounds with hypotonic fluids, replacement of isotonic fluids with hypertonic

Question 14

Osmotic pressure

Answer 14

Determined by the concentration of solutes in a solution

Force that pulls water into the bloodstream

Amount of hydrostatic pressure required to oppose osmotic movement of water

Question 15

Oncotic pressure

Answer 15

Colloids

Force exerted by albumin in the bloodstream

Overall osmotic effect of colloids, such as plasma proteins

Question 16

Dehydration

Causes

Symptoms

Answer 16

Both sodium and water loss

Isotonic, isoosmolar

Increase serum sodium concentrate
Thirst, headache, weight loss, decreased skin turgor
Confusion, hypovolemic shock, low bp, weak pulse

Question 17

Edema

Causes

Answer 17

Accumulation of fluid within interstitial spaces

Increase in capillary hydrostatic pressure
Decrease in plasma oncotic pressure
Increase in capillary permeability
Lymph obstruction (lymphedema)

Question 18

Edema Types

Answer 18

Localized
Generalized
Dependent (due to gravity)
Pitting

Question 19

Effects of iv guide on electrolytes and fluid balance

Answer 19

IV solutions and medications may be used to restore/replace lost fluids and electrolytes

Question 20

Importance of maintaining ph

Answer 20

It’s a narrow range 7.35-7.45

Acid base balances must be carefully regulated
Acids are produced by the metabolism of protein, fat, and carbs
Acid byproducts are excreted through lung and kidney
Balance is maintained by respiratory and renal systems

Question 21

What is ph?

Answer 21

The negative log of the H+ concentration
H+ high in number: ph is low - acidic
H+ low in number: ph is high - basic