Final - Fluid Mgmt Flashcards
What percentage of total body weight is water?
- 60%
Elderly and Obese patients will have lower percent of water in the body.
Pediatrics will have HIGHER percent of water in the body (Table 47.1)
What are the two main compartments fluid compartments?
How much does each compartment make up of TBW?
- Intracellular Fluid (ICF) makes up two-thirds of total body water
- Extracellular Fluid (ECF) makes up one-third of total body water
What are the 3 different compartments of the ECF?
A. intracellular
B. interstitial
C. extravascular
D. intravascular
E. transcellular
F. intrastitial
B. Interstitial: lymphatics and protein-poor fluid around the cell.
D. Intravascular: plasma volume
E. Transcellular: GI Tract, Urin, CSF, Joint fluid, aqueous humor.
Diffusion involves solute particles filling the solvent by moving from ___ to ___ concentrations.
A. low to high
B. high to low
C. different to same
B.. High to Low concentration
* occur across permeable membranes
* relate to electrical gradients
What are type of solutes found in our body? Select 2.
A. norepinephrine
B. glucose
C. proteins
D. ADH
B. Glucose
C. Proteins (Albumin, globulins, fibrinogen)
and Electrolytes!
What is the primary extracellular cation?
primary intracellular cation?
extra: Sodium (Na+)
intra: Potassium (K+)
Osmosis is the movement of water through a semipermeable membrane from ___ solute concentration.
A. low to high
B. high to low
C. similar
movement of WATER which diffuses from low to high solute concentration
Semipermeable membrane is what separates pure water from water with solute!
What is osmotic pressure?
A. pressure that has less pull on water
B. pressure that proteins place on walls of container
C. pressure that resists the movement of water thru osmosis
D. pressure that allows water to move freely thru membranes
C. Pressure that resists the movement of water through osmosis
more oncotic pressure = more pull
What is osmolarity?
A. number of osmotically active particles per L of solvent
B. number of osmotically inactive particles per L of solvent
C. number of osmotically active particles per kg of solvent
D. number of osmotically inactive particles per kg of solvent
A. Number of osmotically active particles per L of solvent
Higher osmolarity, higher “pulling power”
Patient A has serum glucose of 600mg/dl
Patient B has serum glucose of 250mg/dl
Who has higher osmolarity?
Patient A
What is osmolality?
A. number of osmotically active particles per L of solvent
B. number of osmotically inactive particles per L of solvent
C. number of osmotically active particles per kg of solvent
D. number of osmotically inactive particles per kg of solvent
C. Number of osmotically active particles per Kg of solvent
unit is usually mOsm
What is normal osmolality?
A. 200-210 mOsm
B. 250-260 mOsm
C. 280-290 mOsm
D. 300-310 mOsm
C. 280-290 mOsm
Oncotic pressure is the component of total osmotic pressure due to ___?
A. electrolytes
B. colloids
C. crystalloids
D. glucose
B. component of total osmotic pressure due to colloids
aka albumin, globulins, fibrinogen
What percentage of oncotic pressure is due to albumin?
65-75%
What makes up our daily average intake?
Solids:
Metabolism:
Liquids:
Solids - 750 mL
Metabolism - 350 mL
Liquids - 1400 mL
What makes up our daily output?
Insensible loss:
GI loss:
UOP:
Insensible Loss - 1000 mL
GI loss - 100 mL
Urine output - 0.5-1 mL/kg/hr
Urine secretion accounts for ____-% of daily water loss.
- 60%
What 3 hormones regulate urine output?
- ADH
- ANP
- Aldosterone
How does ADH regulate urine output?
Renal H2O excretion/retention in response to plasma tonicity
How does ANP regulate urine output?
- ANP is activated by ↑ fluid volume
- ↑ Atrial Stretch = ↑ Renal Excretion
How does Aldosterone regulate urine output?
- Regulates sodium and potassium levels
- Aldosterone is released if sodium and fluid volume decreases, causing sodium and water conservation.
What are the sensors for fluid balance?
- Hypothalamic osmoreceptors
- Low-pressure baroreceptors (large veins and RA)
- High-pressure baroreceptors (carotid sinus and aortic arch)
What is the trigger for fluid balance?
- Increased thirst or increase ADH
What are the compensatory mechanisms for acute disturbances in circulating volume?
- Venoconstriction
- Mobilization of venous reservoir
- Autotransfusion from ISF to plasma
- Reduced urine production
- Maintenance of CO…tachycardia, increased inotropy