F/E Flashcards
A low arterial pH due to reduces bicarbonate concentration is called
Metabolic Acidosis
A low arterial pH due to increased PCO2 is called
Respiratory Acidosis
This refers to an acid-base imbalance characterized by an increased in H+ concentration which in return has decrease blood pH
Acidosis
Makes up 60% of our body weight and is classified to be a weak electrolyte in addition to acetic acid
water
most abundant anion in the ECF
chloride (Cl-)
most abundant cation in the ECF
Sodium (Na+)
anion electrolytes found in the ECF
Chloride and Bicarbonate
cation electrolytes found in the ECF
Sodium, Calcium and Magnesium
cation electrolytes found in the ICF
Potassium and Magnesium
anion electrolytes found in the ICF
Phosphates, Sulfates and Proteins
Most abundant anion electrolyte in the ICF
Phosphates
Most abundant cation electrolyte found in the ICF
Potassium
The ECF is subdivided into what following fluid space
Intravascular, interstitial and transcellular
a shift of fluid from the vascular space (ECF) into an area where it is not available to support normal physiologic processes
Third space fluid shift/third spacing
Major cations in the body fluid are:
sodium, potassium, calcium, magnesium and hydrogen ions
Major anions in the body fluid are:
chloride, bicarbonate, phosphate, sulfate and proteinate ions
Refers to the pressure exerted by the fluid in the walls of the blood vessels.
hydrostatic pressure
True of False: Obese clients has more fluid volume because fat contains more water
FALSE
What is the average fluid input and output in a 24 hour period?
2500 ml
True or False: To maintain normal balance input and output should approximately be equal thus an intake of 2500 ml should have an output of 2600 ml
FALSE
the process by which water moves across a selectively permeable membrane from an area of lower solute concentration to an area of higher solute concentration.
Osmosis
True or False: Osmosis continues until the solute concentration on both sides of the membrane is equal.
TRUE - osmosis is into equilibrium of concentration
ability of all solutes to cause an osmotic driving force that promotes water movement from one compartment to another
Tonicity - also determines the normal state of cellular hydration and cell size
the amount of hydrostatic pressure needed to stop the flow of water by osmosis. It is primarily determined by the concentration of solutes
Osmotic pressure
the osmotic pressure exerted by proteins e.g. albumin
Oncotic pressure
The increase in urine output caused by the excretion of substances, such as glucose, mannitol or contrast agents in the urine
Osmotic diuresis
why does proteins in the bloodstream exert oncotic pressure
to pull fluid out of the interstitial space into the intravascular space to maintain fluid balance and osmolality.
average COP is 28 mmHg, a pressure that remains constant across the capillary
the process by which solute molecules move from an area of high solute concentration to an area of low solute concentration to become evenly distributed.
Diffusion
Two types of diffusion
Simple and Facilitated
occurs by the random movement of particles through a solution. Water, carbon dioxide, oxygen, and solutes move between plasma and the interstitial space
Simple Diffusion
also called carrier-mediated diffusion
allows large water-soluble molecules, such as glucose and amino acids, to diffuse across cell membranes. Proteins embedded in the cell membrane function as carriers, helping large molecules cross the membrane.
Facilitated Diffusion
What type of energy transport does the glucose use
Facilitated Diffusion
is the process by which water and dissolved substances (solutes) move from an area of high hydrostatic pressure to an area of low hydrostatic pressure. This usually occurs across capillary membranes.
and is influenced by hydrostatic pressure
Filtration
osmolality is measured in
mOsm/kg
osmolarity is measured in
mOsm/L
normal range of urine specific gravity - done by sending a 20 ml urine sample to the lab and test through a dip stick. The larger the urine volume the lower the specific gravity.
1.010 - 1.025
What will the lungs do if there is increased carbon dioxide in order to reduce the acid low
The lungs will increase rate and depth of respiration - Hyperventilation
Causes of Third Spacing
■ intestinal obstruction
■ pancreatitis
■ crushing traumatic injuries
■ bleeding (trauma or
dissected aortic aneurysm)
■ peritonitis
■ major venous obstruction
FVD/Intravascular fluid volume
Deficit s/sx:
■ Increase HR
■ decreased BP
■ decreased CVP
■ edema
■ increased Body weight
■ imbalances in the input and
output of the patient.
Four Major Causes of edematous state
- Decreased colloid osmotic pressure in the
capillary (e.g., Burns, Liver Failure) - Increased capillary hydrostatic pressure
(e.g., Congestive Heart Failure) - Increased capillary permeability (e.g.,
Burns, Allergic Reactions) - Lymphatic obstruction or increased
interstitial colloid osmotic pressure (e.g.,
Surgical removal of lymph structures)
Management of Edema
● Diuretic Therapy
● Elevating the affected extremity
● Elevating Support stockings in the morning
● Albumin IV
Manifestations of sever FVD
oliguria
Possible coma
Falling systolic/diastolic pressure
Indication for what fluid condition if patient experience decrease body temperature
Isotonic FVD
Indication for what fluid condition if patient experience increase body temperature
dehydration
Weight loss for Mild dehydration
2% (2-5%)
Weight loss for Moderate dehydration
5% (6-9%)
Weight loss for Severe Dehydration
8% (>10%)
Normal CVP
2-6mm Hg
Weight loss for Mild dehydration
Hypovolemic shock from
hemorrhage, fluid shift, dehydration
Manifestations of extracellular fluid overload
edema, bounding pulse, jugular vein distention, moist crackles - pulmonary edema, tachycardia, hypertension
also known as water intoxication – sobrang
pag inom ng water
Intracellular overload
Diuretic drug used to inhibit sodium and chloride reabsorption in the ascending loop of henle
Loop Diuretics: furosemide, ethacrynic acid, Bumetanide, torsemide
Type of diuretics that promote the excretion of sodium chloride, potassium and water by decreasing absorption in the distal tubule
Thiazide
○ Bendroflumethiazide
○ Chlorothiazide
○ Hydrochlorothiazide
○ Metolazone
○ Polythiazide
○ Chlorthalidone
○ Trichlormethiazide
○ Indamide
○ Xipamide
Promote excretion of sodium and water by inhibiting
sodium-potassium exchange in the distal tubule.
POTASSIUM-SPARING DIURETICS
○ Spironolactone–famous
○ Amioride
○ Triamterene
Both sodium and water levels
decrease in the extracellular area,
but sodium loss is greater than
water loss
Hypovolemic
Both water and sodium levels
increase in the extracellular area,
but the water gain is more
impressive. Serum sodium levels
are diluted and edema also occurs.
Hypervolemic
Both water and sodium levels
increase in the extracellular area,
but the water gain is more
impressive. Serum sodium levels
are diluted and edema also occurs.
Hypervolemic
surgical procedure wherein they
are going to remove the eschar or the dead
cells/tissue in order facilitate blood flow and to
promote wound healing
Debridement
Surgical incision through the eschar
into the subcutaneous tissues to allow the
extremity to continue to swell without compressing
the underlying blood vessels
Escharotomy
Surgical procedure where the
fascia is cut to relieve tension or pressure
commonly to treat the resulting loss of
circulation to an area of tissue or muscle.
Fasciotomy
Is a limb-saving procedure when
used to treat acute compartment
syndrome
Fasciotomy
○ Soften the scar and increases joint
mobility
○ Side effects: associated with
hypersensitivity reaction, decrease
in the WBC
● Silver Sulfadiazine cream
Painful upon application;
hypersensitivity, acid base
imbalance
Mafenide Acetate cream
