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@Nur180 Exam1 > F/E balance > Flashcards

F/E balance Flashcards

1
Q

constant stability; body fluids are in constant motion transporting nutrients, electrolytes and oxygen to cells while carrying away waste products

A

Homeostasis

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2
Q

Primary fluid in the body; most important nutrient
-carries nutrients and waste products
-participates in metabolic reactions, food digestion
-solvent for minerals, vitamins, glucose
-lubricant and cushion for the joints, eyes, spinal cord
-aids in regulation of body temp
-maintains blood volume
60% of an adult’s body weight

A

Water; H2O

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3
Q

problem before the kidneys

A

pre-renal

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4
Q

30-60 ml/hr

A

normal urine output

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5
Q

found in food
-daily need 2000-3000 ml
-1 L of H2o weighs 1 kg
Sudden change in body weight is a great indicator of fluid volume

A

Fluids (H2O) needed

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6
Q

liquids (1500 ml/day)
solid foods (800 ml/day)
Metabolism (300 ml/day)

A

Intake Sources of fluids

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7
Q 
Kidney (1200-1500 ml/day)
Skin (500-600 ml/day)
Lungs (400 ml/day)
GI tract (100-200 ml/day)
Drainage from Fistulas/drains, GI suction, salivation
A

Fluid Loss routes

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8
Q

oral fluid, tube feedings
parenteral fluid
enemas
retained irrigation fluid

A

Measurable fluid Intake

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9
Q

urine
emesis
feces
drainage from body cavities

A

Measurable fluid output

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10
Q

Solid foods

Metabolism

A

Non-measurable intake

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11
Q

sweating

vaporization through lungs

A

sensible loss

not measurable

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12
Q

chemicals dissolved in the body fluid, distribution affects fluid balance.
Regulates by intake, output, acid-base balance, hormones, and cell integrity

A

Electrolytes

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13
Q

Major extracellular electrolyte

controls and regulates water balance

A

Sodium

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14
Q

Major intracellular electrolyte
Helps maintain intracellular H20 balance
Transmit nerve impulses to muscles and contracts skeletal and smooth muscles

A

Potassium

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15
Q

mostly found from food;

kidneys excrete

A

electrolytes

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16
Q

135-145 mEq/L
determines whether water is retained, excreted or moved.
imbalance cause neuro problems

A

Sodium Na

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17
Q

3.5-5.5
increased with poor kidney function
decreased with excessive urination, diarrhea, vomitting
-imbalances cause cardiac problems

A

Potassium K

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18
Q

95-105; important in acid-base balance
-works with sodium to maintain osmotic pressure
increased with poor kidney function
decreased with excessive vomitting/ or diarrhea

A

Chloride Cl

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19
Q

9-11 ionized or serum 4.25-5.25
transmission of nerve impulses
heart and muscle contractions, blood clotting, formation of teeth and bone
Requires Vit D for absorption

A

Calcium Ca

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20
Q

balance is interwinded with Ca
Major anion of ICF. but found in ECF too.
Bone, skeletal muscle, and nerve tissue.
2.5-4.5 mg/dL
Functioning of muscles, nerves, & RBC’s.
Involved in metabolism of protein, fat and Carbohydrates
absorbed in intestine. all animal products, milk products, legumes, bread,

A

Phosphate PO4

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21
Q

6-20

A

BUN

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22
Q

0.6-1.3

A

Creatinine

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23
Q

42-52% Males

37-47% Females

A

Hematocrit

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24
Q

7.35-7.45

A

pH

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25
Q

35-45 mmHg

A

PaCO2

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26
Q

75-100% mmHg

A

PO2

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27
Q

24-28mEq/L

A

HCO3; bicarbonate

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28
Q

hematocrit normal is 3x the hemoglobin (10-14 normal)

A

H, H

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29
Q

indicates the H2O balance of the body
-serum osmo is 285-295 mOsm/kg
high is H2O deficit (concentrated)
low is H2O excess (dilute)

A

Serum Osmolarity

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30
Q

500-1200 mOsm/kg

avg 500-800 mOsm/kg

A

Urine Osmolarity

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31
Q

Together are used to determine what is causing a sodium imbalance.

  • solute to h2o ration
  • how well the kidneys are working
A

Serum and Urine Osmolarity

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32
Q

K, PO4; intracellular 2/3 body fluids
Na, Cl; extracellular 1/3 body fluids; interstitial (lymph) and transcellular (cerebrospinal, pleural, peritoneal, synovial fluids) and intravascular (blood plasma)

A

Distribution of body fluids & electrolytes

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33
Q

extracellular (33%)
-interstitial 25%
-intravascular (blood plasma) 8%
Intracellular (66%)

A

body water distribution

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34
Q

JG cells

  • sense low Na, low volume
  • release of renin
  • converts angiotensinogen to angiotensin I which converts to angiotensin II
  • stimulates release of aldosterone (RAAS)
A

Kidneys JG cells

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35
Q

adrenal cortex

  • senses low serum osmo or low Na
  • releases aldosterone
  • reabsorbs Na into the blood, increases K excretion in the urine
  • increases serum osmo
A

Kidneys Adrenal Cortex

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36
Q

senses high serum osmo or high Na

  • stimulates thirst
  • triggers release of ADH (vasopressin) from posterior pituitary
  • retains h2o in the blood
  • concentrates urine
  • mildly constricts blood vessels
  • decreases serum osmo
A

Hypothalamus

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37
Q

senses high volume through stretch receptors in the right atrium

  • secretes ANP, BNP
  • inhibits ADH
  • stops the RAAS
  • increases Na excretion through the urine
  • dilates blood vessels
  • decreases serum osmo
A

Heart

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38
Q

concentrates urine
raises Bp
H2O level down
ADH up

A

Antidiuretic hormone ADH

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39
Q

1st spacing normal
2nd spacing; edema, dehydration
3rd spacing; ascities, burn edema
capillary, interstital pressure changes, fluids shifts from 1 space to another. decreased protein causes 3rd spacing

A

Fluid spacing

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40
Q

fluid trapped and can’t be easily exchanged to other spacing.

A

3rd spacing

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41
Q

a solution that has the same osmo as body fluids.

-normal saline solution, 0.9% sodium chloride, D5W, LR

A

isotonic

42
Q

keep fluids in the intravascular without causing any fluid compartment shift

A

crystalloids

43
Q

refers to solutions that have a lower osmo than body fluids.

0.045%. 1/2 normal saline; hydrates cells

A

hypotonic

44
Q

refers to solutions that have a higher osmo than body fluids
3%
D5 1/2 NS
D10W

A

hypertonic

45
Q

colliods
plasmanate; replace body protein
lipids; IV therapy longer than 5 days

A

plasma expanders

46
Q

percent of body weight of h2o is decreased

  • structure changes in the kidney and decreased renal blood flow
  • decreased GFR
  • decreased creatinine clearance
  • loss of ability to concentrate urine and thus conserve h2o
  • decrease in renin and aldosterone
  • increase in ADH & ANP
  • Loss of subcutaneous tissue
  • decrease in thirst mechanism
  • musculoskeletal changes
  • mental status changes
  • incontinence; aging, body changes
  • instead of skin turgor, use I & O’s and daily weights, mucous membranes
A

Gerontologic considerations

47
Q

nurtrition, I & O’s, insensible losses, use of diuretics/laxatives, weight changes, kidney or endocrine disorders, LOC, mental status, depression, eating disorders, alcohol intake?

A

History; assessment considerations

48
Q

hydration status, skin turgor, muscous membranes, I & O’s

A

physical assessment considerations

49
Q

electrolyte levels, BUN, glucose, creatinine, pH, HCO3, osmolality, Hgb, Hct, urine dipstick, urine pH, urine specific gravity

A

Dx tests

50
Q

substances such as lg protein molecules that do not readily dissolve into true solutions

A

colloids

51
Q

concentrations of solutes in the body fluids is usually expressed in

A

osmolality

52
Q

the power of a solution to draw h2o across a semipermeable membrane.

A

osmotic pressure

53
Q

plasma proteins exert an osmotic draw, pulling h2o from the interstitial space into the vascular compartment
*important in maintaining vascular volume.

A

Colloid Osmotic Pressure or oncotic pressure

54
Q

the continual intermingling of molecules in liquids, gases or solids brought about by the random movement of the molecules.

A

Diffusion

55
Q

process whereby fluid and solutes move together across a membrane from one compartment to another.; movement from higher pressure to one of lower pressure

A

filtration

56
Q

the pressure a fluid exerts within a closed system on the walls of its container.

A

hydrostatic pressure

57
Q

When the hydrostatic pressure is greater than the osmotic pressure, the fluid filters out of the blood vessels; which can lead to swelling of the body tissues (excess fluid trapped)

A

Edema

58
Q

substances can move cell membranes from a less concentrated solution to a more concentrated one.

  • a substance combines with a carrier on the outside surface of the cell membrane, and together they move to the inside surface of the cell membrane.
  • requires enzymes and energy is expended.
  • Important in maintaining the differences in Na & K ion concentrations of ECF & ICF.
  • Sodium Potassium pump; activated, moving sodium from the cells and K into the cells
A

Active transport

59
Q

primary regulatro of fluid intake; located in the hypothalmus
Stimulating contributors:
-osmotic pressure of body fluids
-vascular volume
-angiotensin (hormone released in response to decreased blood flow to the kidneys)

A

Thirst mechanism

60
Q

certain fluid losses are required to maintain normal body function. 500 ml must be excreted through kidneys ea. day to eliminate metabolic waste products from the body

  • though skin
  • respirations
  • feces
A

obligatory losses necessary for temp regulation and elimination of waste products. total 1300 ml/day

61
Q

as kidneys regulate and filter waste, they return electrolytes, ie, K, and Na to blood for use.
-The Cardiovascular and Respiratory systems ensure the body has an adequate O2 to function and use fluids and electrolytes appropriately.

A

maintaining homeostasis

62
Q

ADH; antidiuretic hormone
RAAS; Renin-angiotension-adosterone system
ANF; atrial natriuretic factor

A

hormones involved in maintaing homeostasis

63
Q

primary regulator of body fluids and electrolyte balance
-regulate the volume and osmolality of extracellular fluids by regulating water and electrolyte excretion.
135-180 L of plasma/day, 1.5 L of urine excreted
-balance maintained by selective retention and excretion
*play significant role in acid-base balance regulation; excreting hydrogen and retaining HCO3

A

Kidneys

64
Q

regulates H20 excretion from the kidney, synthesized in the anterior portion of the hypothalamus and acts on the collecting ducts of the nephrons.
-increased serum osmolality rises, hormone produced (collecting ducts become more permeable to h20)

A

ADH

65
Q 
blood volume
temp
pain 
stress
drugs, ie. opiates, barbiturates, and nicotine
A

Factors that affect ADH production

66
Q

specialized receptors in the juxtaglomerular cells of the kidney nephrons respond to changes in renal perfusion.
;blood flow or pressure of kidney decreases, renin is released.
-promoting Na & h20 retention
-restore blood volume (renal perfusion) though Na and h20 retention

A

Renin-Angiotensin-Aldosterone System RAAS

67
Q

peptide hormone released from cells in the atrium of the heart in response to excess blood volume and stretching of the atrial walls.

  • ANF promotes Na wasting and acts as a potent diuretic; reducing vascular volume.
  • Inhibits thirst, reducing fluid intake
A

Atrial Natriuretic Factor

68
Q
  • maintaining fluid balance
  • contributing to acid-base regulation
  • facilitating enzyme reactions
  • transmitting neuromuscular reactions
  • must be consumed daily
  • K & Ca stored in the cells and bones; if serum levels drop, ions shift out of “storage”.
A

Electrolytes

69
Q

promotes enzyme reactions during carbohydrate digestion

A

Mg

70
Q

present in both ICF & ECF. primary function is regulating acid-base balance, as an essential component of the carbonic acid bicarbonate buffering system.
Extracellular bicarbonate levels regulated by the kidneys.
*produced through metabolic processes in adequate amounts

A

HCO3

71
Q

fluids constantly being shifted from one compartment to another to compensate a fluid imbalance.

A

Compensation

72
Q

rapid gains or losses (4-8%) of total body weight indicate moderate to severe fluid volume deficits or excesses

A

FVD

73
Q

tachycardia

A

early sign of hypovolemia

74
Q

elevated body temp

A

dehydration or FVD

75
Q

pulse volume low;

A

FVD

76
Q

high pulse volume

A

FVE

77
Q

irregular pulse rate may occur

A

electrolyte imbalances

78
Q

280-300 mOsm/kg

A

serum osmolality

79
Q

CBC; H & H
hematocrit measures the volume of whole blood (RBC)
-measure of volume of cells in relation to plasma, it is affected by changes in plasma volume.
increase in Hct; severe dehydration
decrease in Hct severe overload
normal values; 40-54% men and 36-46% women

A

HCT/ CBC

80
Q

doubling the serum Na and assoc Cl ions are the major determinants of serum osmolality
-measure of the solute concentration of the blood.

A

Osmolality

81
Q

indicator of urine concentration

1.005-1.030

A

Urine Specific Gravity

82
Q
  • sodium chloride

- potassium chloride

A

Electrolyte supplement

83
Q
  • serum albumin

- dextran 40

A

Colloids

84
Q
  • furosemide
  • hydrochlorothiazide
  • spironolactone (Aldactone)
A

diuretics

85
Q
  • 5% dextrose and H20
  • normal saline solution
  • lactated ringers
  • 5% dextrose and 1/2 normal saline
A

Crystalloids

86
Q

when water and electrolytes are lost or gained in equal proportions so that osmolality of body fluids remain constant.

A

isotonic imbalance

87
Q

involve the loss/gain of only water, so that the osmolality of the serum is altered

A

osmolar imbalance

88
Q

FVD
dehydration (hyperosmolar imbalance)
FVE
overhydration (hypoosmolar imbalance)

A

4 types of imbalances

89
Q

a decrease in intravascular, interstitial, and/or intracellular fluid in the body.
-common, can exist alone or in combo with other electrolyte or acid-base balance issues

A

FVD; fluid volume deficit

90
Q

refers to loss of fluid alone, often interchangable with FVD

A

dehydration

91
Q

decrease in circulating blood volume

A

hypovolemia

92
Q

K lost, Na same, fluid drawn into the vascular compartments from the interstitial spaces as the body attempts to maintain tissue perfusion.
-severe fluid loss can lead to cardiovascular collapse.

A

isotonic fluid volume deficit

93
Q

hyponatremic dehydration; greater loss of Na than H20. Serum Na below normal levels. Shifts for ECF and ICF to compensate leads to greater ECF dehydration.

A

Hypotonic dehydration

94
Q

F/E balance
A shift of fluid from the vascular space into an area where it is not available to support normal physiological processes
-Trapped fluid represents a volume loss; unavailable for normal physiological processes.
In abdomen or bowel, or other areas, ie pleural or peritoneal space. or with in soft tissue; burn, trauma

A

Third spacing

95
Q

Most common cause is excessive loss of GI fluids;
vomitting, diarrhea, or intestinal drainage, intestinal fistulas
-diuretics
renal disorders
endocrine disorders
H20 and Na loss; sweating excessive exercise
hemorrhage
chronic abuse of lax. and enemas

A

FVD

96
Q

most common type seen in initial period after a burn. fluid leaks into interstitial spaces, causing edema and further FVD; lower urine output

A

Hypotonic dehydration

97
Q 
darkend urine
decrease urine output
confusion
lethargy
headache
light headedness
sunken eyes
dry mucous membranes
dry axillae
long tongue furrows
postural changes in pulse and blood pressure
A

symptoms of dehydration

98
Q 
hypertension
tachycardia
weak pulse
tachypnea
reduced urine output/concentrated urine with increased sp. gravity
A

Decreased cardiac output

99
Q 
dry, cracked skin
dry mucous membranes
increased hematocrit
poor skin turgor
weightloss
A

inadequate fluid supply to tissues

100
Q

edema
symptoms of FVD
no weight loss

A

Third spacing

101
Q 
Bp down
HR up
pulse down
resp normal
jug vein flat
edema rare
skin turgor loose, poor
output low, concentrated
urine sp. gravity high
weight loss
A

FVD

102
Q 
BP up
HR up
pulse up
Resp crackles, wheezes
jug vein distended
skin turgor taut
output low to normal
urine sp grav. low
weight gain
A

FVE

@Nur180 Exam1 (6 decks)

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