Exam 2 Flashcards
Intracellular fluid
Within cells
70% of water total body water (TBW)
Extracellular fluid
Outside of cells
30% of TBW
Intravascular
Liquid component in blood
Interstitial
Fluid that surrounds tissue cells and includes lymph
Transcellular
Cerebrospinal, pericardial, synovial, intraocular, pleural
Variations of fluid in body
- Age
-Infants have more total body fluid and ECF
-Older people:
+Decreasing percentage of
body fluid bc of increase in fat
cells
+Lose muscle mass
+Reduced total body water - Sex
- Women = more fat => less body fluid
- Amount of fat cells in body
- Little water compared to lean tissue
Fluid Volume Deficit (FVD) definition
Loss of water and solutes of same proportion in ECF
Hypovolemia
Interstitial fluid is moved into intravascular space
Cellular fluid drawn into interstitial space
Cells without adequate water
Causes of FVD
Loss of body fluids
Decreased intake
Third space fluid shift Definition
Distributional shift of body fluids into transcellular compartments, joint cavities, bowel, or excess accumulation in interstitial space
Fluid moves out of intravascular space into these spaces
Deficit in ECF volume
Fluid NOT lost but trapped
So, no body weight loss so immeasurable
Causes of third space fluid shift
Disrupted colloid osmotic pressure, increase fluid volume (renal failure, excess IV), increased capillary hydrostatic pressure (heart failure), hyponatremia, increased in capillary membrane permeability (gross tissue trauma), severe burn, bowel obstruction, surgical procedures, pancreatitis, ascites, sepsis
Fluid Volume Excess (FVE) Definition
Excessive fluid retention of water and sodium in ECF in near equal proportions
Causes of FVE
Malfunction of kidneys
Failure of heart to work as pump
Effects of FVE
Fluid pulled from cells to equalize tonicity
By time ECF and ICF are equal, excess of water and sodium is in ECF, so cells are depleted
Accumulates in either intravascular compartments (Hypervolemia) or interstitial space (edema)
Edema is graded based on pit
Normal levels of Sodium
135-145 meq/L
Hyponatremia
Definition
Sodium deficit in ECF
Loss of sodium or gain of water
Hyponatremia causes
Vomiting, diarrhea, fistulas, sweating, diuretics
Fluid moves from ECF to ICF bc it is less concentrated
Hyponatremia Signs
Swelling cells
Confusion, hypotension, edema, muscle cramps, weakness, dry skin
Severe
Increasing intracranial pressure
Lethargy, muscle twitching, focal weakness, hemiparesis, seizures, death
Hypernatremia definition
Surplus of sodium in ECF
Excess water loss or excess sodium intake
Hypernatremia Causes
Fluid deprivation, lack of fluid consumption (diarrhea, unable to feel thirst, hyperventilation, burns)
Fluid moves from cells
CNS symptoms of Hyperatremia
Restlessness, weakness, disorientation, delusion, hallucinations
Potassium
Normal levels
3.5-5.0 meq/L
Hypokalemia Definition
Potassium deficit in ECF
Hypokalemia causes
Vomiting, gastric suction, alkalosis, diarrhea
ECF K+ lost
K+ moves from cells to ECF
Intracellular K+ deficit
Sodium and hydrogen retained by cells to maintain isotonic fluids
Skeletal muscles first demonstrate deficiency
Hypokalemia signs
Muscle weakness, leg cramps, fatigue, paresthesias, dysrhythmias
Hyperkalemia definition
Excess of K+ in ECF
Hyperkalemia Causes
Renal failure, hypoaldosteronism, medications
More dangerous than hypokalemia
Signs of hyperkalemia
Nerve conduction and muscle contractility affected
Skeletal muscle weakness and paralysis
Cardiac irregularities
Cardiac arrest
Calcium
Normal levels
Ionized: 4.5-5.1 Mg/dL
Serum: 8.6-10.2 Mg/dL
Hypocalcemia definition
Calcium deficit in ECF
Hypocalcemia causes
Inadequate calcium intake, impaired calcium absorption, excessive calcium loss
Hypocalcemia signs
Numbness and tingling of fingers, mouth or feet
Tetany
Muscle cramps
Seizures
Hypercalcemia definition
Excess of calcium in ECF
hypercalcemia causes
Cancer
Hyperparathyroidism
Signs of hypercalcemia
Nausea, vomiting, constipation, bone pain, excessive urination, thirst, confusion, lethargy, slurred speech
Severe= cardiac arrest
Magnesium Normal levels
1.3-2.3 meq/L
Hypomagnesemia definition
Magnesium deficit in ECF
Hypomagnesemia causes
NG suctioning, diarrhea, withdrawal from alcohol, administration of tube feedings or parenteral nutrition, sepsis, burns
Hypomagnesemia signs
Muscle weakness, tremors, tetany, hyperactive deep tendon reflexes, respiratory paralysis
Hypermagnesemia definition
Magnesium excess in ECF
causes of Hypermagnesemia
Renal failure, excessive magnesium intake
Signs of Hypermagnesemia
Nausea, vomiting, weakness, flushing, lethargy, loss of DTRs, respiratory depression, coma, cardiac arrest
Phosphorus
Normal levels
2.5-4.5 mg/dL
Hypophosphatemia
Below normal concentration of phosphorus in ECF
causes of Hypophosphatemia
Deficiency, administration of calories to malnourished patients, alcohol withdrawal, diabtic ketoacidosis, hyperventilation, insulin release, absorption problems, diuretic use
signs of Hypophosphatemia
Weakness, irritability, fatigue, paresthesias, confusion, seizures, coma
Hyperphosphatemia definition
Above normal concentration of phosphorus in ECF
causes of Hyperphosphatemia
Imparied kidney excretion
Hypoparathyroidism
Signs of Hyperphosphatemia
Tetany, anorexia, nausea, muscle weakness, tachycardia
Chloride
Normal levels
97-107 meq/L
Hypochloremia
below normal levels of chloride
Hypochloremia causes
Severe vomiting, diarrhea, drainage of gastric fluid, metabolic alkalosis, diuretic therapy, burns
Hypochloremia signs
Hyperexcitability of muscles, tetany, hyperactive DTRs, weakness, muscle cramps
Hyperchloremia definition
Above-normal level of chloride in ECF
causes of Hyperchloremia
Metabolic acidosis, head trauma, increased perspiration, excess adrenocortical hormone production, decreased glomerular filtration
signs of Hyperchloremia
Tachypnea, weakness, lethargy, diminished cognitive ability, hypertension, decreased cardiac output, dysrhythmias, coma
Metabolic acidosis
Definition
Proportionate deficit of bicarbonate ECF
Metabolic acidosis causes
Increase in acid components
Excessive loss bicarbonate
Metabolic acidosis results
Increase in rate and depth respirations to excrete CO2
Kidneys retain bicarbonate and excrete H+
Low pH
Metabolic alkalosis definition
Excess of HCO3 or decrease in H+ ions in ECF
Metabolic alkalosis causes
Excessive acid loss
Increased base ingestion or retention
Metabolic alkalosis results
Retain CO2 Respirations slow and shallow Periods of no breathing Kidneys Excrete excess H2O and Na+ ions with excess bicarbonate ions Retain H+
Respiratory acidosis definition
Excess of carbonic acid in ECF
Respiratory acidosis causes
Inadequate excretion of CO2 with inadequate ventilation
Elevated CO2 levels
Increased carbonic acid levels
Respiratory acidosis results
Increased respiratory rate
Kidneys eliminate H+ ions
Conserve bicarbonate and sodium ions
Respiratory alkalosis definition
Deficit of carbonic acid in the ECF
causes of respiratory alkalosis
Alveolar hyperventilation
Faster and deeper breathing
Loss of CO2
Decrease carbonic acid levels in plasma, increase pH
results of respiratory alkalosis
Breathe slower and less deep
Kidneys alleviate imbalance by increasing bicarbonate excretion and retaining more H+ ions
