exam 2 Flashcards
osmosis
water moves through a semipermeable membrane from a area of lower concentration to an area of higher concentration.
osmolality
concentration of solute per kg of water (norm 275-295)
osmolarity
concentration of solute per liter of solution
hypotonic solution
lower osmolality. 1/2 ns makes plasma less osmolal
solute concentration greater inside cells, so water flows in with an hypotonic solution.
hypertonic solution
pull water out of the cells into the vascular space (D5 1/2 NS)
diffusion
particles move from areas of higher concentration to lower concentration. (until equalized)
how much fluid in body?
total body fluid=60% of body weight
what are the fluids called surround the cells?
interstitial fluid and plasma (part of blood)
starling’s law of capillaries?
net filtration: consist of colloid pressure and hydrostatic pressure: fluid movement into and out of capillaries
and oncotic pressure
name the 2 types of fluid losses?
- kidneys
2. insensible loss: skin, perspirations, lungs, feces.
what are ways to balance water in the body:
- antidiuretic hormone: synthesized by hypothalamus: retains water
- aldosterone: (produce by adrenal gland): cause kidneys to secrete Na but excret K which makes h20 follow Na =water retention
- glucocororticoid: cortisol: (adrenal gland): promotes renal retention of sodium, which also leads to water retention.
which cardiac hormone is released when atria is stretched by High BP and high blood volume?
ANP (Atrial natriuretic peptide)
what can ANP cause?
vasodilation, suppresses renin-angiotensin aldosterone system, decrease ADH release and increase GFR = fluid excretion.
what can isotonic solution treat?
isotonic (equal loss of electrolytes and fluid)
hemorrhage, vomiting, burns, diuretics, sweating, fever.
what can hypertonic fluids treat?
- people with inadequate fluid intake
- diabetes insipidus,
- prolonged vomiting
- increase solute intake without increase in fluid as well.
what can hypotonic treat?
electroyles are loss, therefore fluid shift to ICF TO COmpensate’
- chronic illness
- malnutrion
- excess hypertonic fluid replacement
third spacing
fluid is deposited in extracellular body spaces that don’t normally hole large amounts of fluids.
ex: crush injuries, trauma, sepsis, cancer, intestinal obstruction, starvation, cirrhosis, ascites, heart failure, renal failure, vascular fluid overload
s/s fluid overload:
peripheral edema, venous engorgement, s3 heart sounds, spleenomegaly, cyanosis, decrease 02, bounding pulse, pulmonary edema, tachypnea, dyspnea, cough, sob, wet lungs, third spacing, pleura effusion, pericardial effusion, rapid wght gain, hct+bun decreased
s/s of hypokalemia
irregular pulse, weak shallow resp, dyspnea, polyuria, anxiety, lethargy, ecg changes, ST segment depression, confusion, leg cramps, decrease peristalisis
what are somethings you would check with some with hypokalemia?
bmp/ i&o/ ecg/ fall risk
what are some foods high in potassium?
bananas/ cantaloupe/ apricots/ oranges/ rasins/ milk/ legumes/ grains/ vegetables
s/s hyperkalemia?
irregular slow HR/ decreased bp/ narrowed peak T waves/ wide QRS complex/ Prolonged PR/ muscle weakness/ twitching cramps
what is the tx for hyperkalemia?
kayexalate
what are reasons for hypocalcemia?
hypoparathyroidism/ hypomagnesemia/ alkalotic state/ multiple blood transfusion/ pancreatitis/ hyperphosphatemia/ vit d def/ alcholism / gram neg sepsis/ burns/ post menopausal/ thryroidectomy/ crohn’s/ fractures/ osteoposis/ immobility/ diet/ lactose intolerance
s/s hypocalcemia
low bp, ecg changes, prolonged qt interval, , laryngeospasm, airway failure, renal failure, tingling, Chvostek sign: twitching of the cheek, trousseaus: spasms of arm when the BP cuff is inflated, hyperactive reflexes, apprehension, convulisoin, hallucinations, diarrhea, crampos, bone fractures, cataracts, dry hair, bleeding bruising,
what type of diuretics can decrease the excretion of calcium?
thiazides
name some food high in phosphate?
bran/ seeds/ cheese/ nuts/ bacon
s/s hypercalcemia?
hypertension, decreased st segment, HA, confusion, dysrhytmias, heart bloc, psychosis, fatigue, DTR decreased, lethargy coma, N/V, polyuria, polydipsia, bone fractures
how to treat hypercalcemia?
Medications Administer intravenous normal saline solution Administer diuretics: loop Administer biphosphonates, calcitonin, intravenous plicamycin, glucocorticoids Decrease ca intake Maintain hydration Prednisone will decrease Ca absorption i/o, ecg Dialysis
why should one take phosphate as prescribed?
risk for kidney stones.
s/s hypomagnesemia?
Medications Administer intravenous normal saline solution Administer diuretics: loop Administer biphosphonates, calcitonin, intravenous plicamycin, glucocorticoids Decrease ca intake Maintain hydration Prednisone will decrease Ca absorption i/o, ecg Dialysis
foods that contain high magnesium?
legumes/ whole grains/ nuts/ dark vegetables/ seafood/ bananas/ oranges/ chocolate
