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NUR 325 PATHO > F&E (Exam 3) > Flashcards

F&E (Exam 3) Flashcards

1
Q

How much of body weight is water?

A

-50-60%

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2
Q

Fluid Compartments:

A

-Intracellular = 70%

-Extracellular = 30%

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3
Q

Extracellular space areas

A

-Interstitial fluid - between cells

-Intravascular fluid - plasma (liquid part of the blood)

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4
Q

4 Processes that facilitate the movement of fluid and electrolytes

A

-Diffusion
-Facilitated Diffusion
-Active Transport
-Osmosis

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5
Q

Osmosis

A

-Movement of water down a concentration gradient

-Water movement from low to high solute concentation

-From a region of low solute concentration to one of high solute concentration across a semipermeable membrane

(Maintain homostasis)

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6
Q

When does osmosis stop

A

-When concentration differences disappear or when hydrostatic pressure builds and opposes further movement

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7
Q

Diffusion

A

-Movement of molecules from an area of high concentration to a lower concentration

-Movement stops when the concentration is equal in both areas

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8
Q

Fluid and Electrolyte Balance

A

-Water follows electrolytes

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9
Q

What electrolytes are primarily outside of the cell?

A

Sodium and Chloride

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9
Q

What electrolytes are primarily inside the cell

A

-Potassium, magnesium, phosphate

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10
Q

Osmosis is

A

The movement of water across the cell membrane toward the more concentrated solutes

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11
Q

Osmotic pressure is

A

The amount of pressure needed to prevent the movement of water across a cell membrane

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12
Q

Colloids

A

-Substances that increase colloid osmotic pressure (oncotic pressure)

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13
Q

What do colloids do?

A

-Move fluid from interstitial compartment to plasma compartment

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14
Q

3 Primary colloids:

A

-Albumin

-Globulin

-Fibrinogen

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15
Q

How do we measure colloids?

A

Total Protein level

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16
Q

Colloid oncotic pressure __________ with age and overall __________

A

Decreases and Malnutrition

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17
Q

Hydrostatic Pressure

A

-Force of fluid in compartment pushing against a cell membrane or vessel wall

-Generated by blood pressure

-At capillary level, major force that pushes water out of the vascular system into interstitial space

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18
Q

Changes in hydrostatic presssure equates to

A

Changes in blood pressure

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19
Q

Oncotic Pressures

A

-Also called osmotic pressure

-Caused by plasma colloids (large molecules) in solution

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20
Q

Plasma has LOTS of colloids, interstitial space has little

A

-Plasma proteins attract water, pulling fluid from tissue space into vascular space

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21
Q

Hydrostatic pressure is dictated by?

A

Blood pressure

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22
Q

Oncotic pressure is dictated by

A

colloids

23
Q

Watch the video in the power points

A
24
Q

What do electrolytes influence?

A

-Fluid balance, acid base balance, never impulses, muscle contraction, heart rhythm, and many other cell functions

25
Q

Because electrolytes function ______________, changes in one electrolyte can affect the ____________ of other electrolytes

A

collaboratively

balance

26
Q

What are electrolytes?

A

-Substances that are electrically charged when in a solution

27
Q

Concentrations of electrolytes depend on

A

-Electrolyte intake

-Electrolyte absorption (small intestines)

  • Electrolyte distribution (Postive vs negative charges)

-Electrolyte excretion (kidney function)

28
Q

Intracellular electrolytes

A

-Potassium

-Magnesium

-Phosphorous

29
Q

Extracellular electrolytes

A

-Sodium

-Calcium

30
Q

Positively charge electrolytes

A

-Cations

-Potassium, Sodium, Magnesium, Calcium

31
Q

Negatively charge electrolytes

A

-Anions

-Phosphorus, chloride, bicarbonate

32
Q

Sodium Imbalances

A
  • <136 = Hyponatremia
  • > 145 = Hypernatremia
33
Q

Key point with sodium

A

-Primary driver of fluid balance. (water follows sodium)

34
Q

Sodium

A

Main ECF cation

Governs osmolality

influences water distribution

Activates muscle and nerve cells

interstitial and intravascular spaces

35
Q

Hyponatremia: Causes

A

GI losses: Diarrhea, vomiting, fistulas, NG suction

Renal losses: Diuretics, adrenal insufficiency

Skin losses: Burns, wound damage

Fasting diest, polydipsia

-Excess hypotonic fluid

36
Q

Sodium is high associated with symptoms related to what?

A

Our brain

37
Q

Hyponatremia: Signs and Symptoms

A

-Confusion and Altered LOC (not enough sodium in cells cause water in go into cells and cause the cells to swell)

-Anorexia and muscle weakness

-Seizures and coma

(Cellular swelling)

38
Q

Dilution Hyponatremia

A

-Taking in to much water

-Hypervolemia

  • Increase BP

-Increase weight gain

-Bounding rapid pulse

-Increase urine Sp. gravity

39
Q

Depletional hyponatremia

A

-Hypovolemia

-Decrease BP and Tach pulse

-Weight loss

  • Decrease urine sp. gravity
40
Q

Hyponatremia

A

Too much fluid volume (Dilutional)

or

Too little sodium (Depletional)

41
Q

Hyponatremia Treatment

A

-Sodium Replacement (SLOWLY)

-PO/IV

-IV normal saline (Depletional)

-Fluid Restriction (Dilutional)

-Treat underlying problem

42
Q

What happens if we treat hyponatremia too quickly

A

-Irreversible neurological or brain damage

-Osmotic demylenation syndrome

43
Q

Dilutional Hyponatremia Treatment

A

-Restrict fluid causing fluid levels in the body to decrease and sodium concentation will be corrected

44
Q

Depletional Hyponatremia

A

IV normal saline

45
Q

Sodium Bicrobonate

A

-Used for long term hyponatremia (Acid base issues)

46
Q

Sodium Bicarbonate: MOA

A

Dissociates to provide bicrabonate ion which neutralizes ion concentration and raises blood and urinary pH

47
Q

Sodium Bicarbonate: Indication

A

Metabolic acidosis

48
Q

Sodium Bicarbonate: Adverse effects

A

-Edema, cerebral hemorrhage, hypernatremia, lots of electrolyte abnormalities, metabolic alkalosis, flatulence with PO, tetany, pulmonary edema, heart failure exacerbation

49
Q

Sodium Bicarbonate: Nursing consideration

A

-Monitor cardiac , ABG’s and electrolytes

-If IV, monitor patency thoroughly

-Lots of drug interaction if the drug mixing with is diluted with sodium solutions

-PO-give 1-3 after or before meals

50
Q

Sodium Bicarbonate at high concentations

A

Is a vesicant

-Can cause tissue damage

-Give via central lines and things to help decrease vesicant

51
Q

Hypernatremia Causes

A

-IV fluids, tube feeds, near drowning in salt water

-Not enough water intake or to much water loss (Cognitively impaired, diarrhea, high fever, heat stroke)

52
Q

Hypernatremia: Signs and Symptoms

A

-Alter LOC/Confusion, seizure, coma

-Extreme thirst (hyperosmolatity)

-Dry sticky mucous membranes

(Water shifting out of cells into extracellular space) (Shrinking brain cells)

53
Q

Hypernatremia: Treatment

A

-If H2O is cause then add water

-If sodium excess is cause remove sodium

54
Q

Gradually achieve normal sodium level over a 48 hour period to avoid edema of cerebral cells

A

-Too quick removal can damage brain cells and be lethal

-Physicians order: Infuse NSS @ 50cc/hr x 2hr then @ 75 cc/hr x 4h, then 100cc/hr

NUR 325 PATHO (44 decks)

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