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pathophysiology > Fluid > Flashcards

Fluid Flashcards

1
Q

Intracellular

A

2/3

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2
Q

Extracellular fluid

A

1/3

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3
Q

Distribution of body fluid: age differences

A
  • Paediatric: at birth 75% to 80% of body weight

- geriatric: decreased percent of total body water (renal decline and diminished thirst perception)

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4
Q

Children and the elderly are more at risk for fluid imbalance due to…

A

Differences in total body water (TBW) and regulatory mechanisms

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5
Q

Major factors influencing body fluid balances

A
  • water shifts due to hydrostatic, oncotic and osmotic gradients
  • where sodium goes, water follows
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6
Q

Major factors influencing body fluid balances is controlled by

A

ADH, renin-angiotensin- aldosterone, natriuretic peptides, renal function

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7
Q

Normal fluid movement as blood flows from arterioles to capillaries

A
  • “Pressure” forces water into interstitial space

- capillary hydrostatic pressure

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8
Q

Normal fluid movement as blood flow gets closer to veins

A
  • water is pulled back in

- capillary oncotic pressure

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9
Q

Interstitial forces

A
  • interstitial hydrostatic pressure

- interstitial oncotic pressure

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10
Q

Types of fluid imbalances:

A
  • Changes in intravascular volume
  • accumulation of fluid in interstitial space
  • alteration in fluid movement in and out of cell
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11
Q

Changes in intravascular volume

A
  • fluid volume deficit

- fluid volume overload

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12
Q

Accumulation of fluid in interstitial fluid

A

Edema

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13
Q

Alteration in fluid movement in and out of cell

A

Osmosis

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14
Q

Fluid volume deficit

A

Dehydration

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15
Q

Dehydration

A

Isotonic loss

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16
Q

Isotonic loss

A
  • water and sodium are lost in proportion

- intravascular space

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17
Q

Dehydration - causes

A

Bleeding, wound drainage, excess sweating, burn injuries

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18
Q

Dehydration - sign and symptoms

A

Weight loss, dry skin/mucous membranes, decreased urine output, low bp

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19
Q

Dehydration - treatment

A

Replace water and solutes/sodium

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20
Q

Fluid volume excess

A

Volume overload

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21
Q

Volume gain

A

Isotonic gain

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22
Q

Isotonic gain

A
  • water and sodium are gained in proportion

- intravascular space

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23
Q

Volume overload - cause

A

Too much IV solution, renal failure, liver failure and heart failure

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24
Q

Volume overload - sign and symptoms

A

Weight gain, development of edema, veins dilate, strong pulse strength

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25
Q

Volume overload - treatment

A

Optimize renal, kidney, cardiac function

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26
Q

Edema

A
  • movement of water from capillary (intravascular space) into interstitial space
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27
Q

Edema: causes

A
  • increase in capillary hydrostatic pressure
  • decrease in plasma oncotic pressure
  • increases in capillary permeability
  • lymph obstruction
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28
Q

Manifestations of Edema

A
  • localized Edema
  • pitting Edema
  • generalized
29
Q

Alterations in fluid movement in and out of cell because of

A
  • due to changes in osmosis

- strongly linked to sodium imbalances

30
Q

The most intracellular ion

A

Potassium

31
Q

Most extra cellular ion

A

Sodium

32
Q

Distribution of body fluid (2)

A 
Interstitial fluid (ICF) 
Extra cellular fluid (ECF)
33
Q

an imbalance in one electrolyte often produces an..

A

imbalance in another electrolyte

34
Q

hyponatremic (hypotonic) imbalances

A

concentration of sodium is decreased below normal levels

35
Q

hyponatremic imbalance - causes

A
  • imbalance in water, not enough sodium or too much water (
36
Q

hyponatremic and plasma

A
  • plasma will be hypotonic

- cellular edema

37
Q

hyponatremic imbalances - clinical manifestations

A
  • primarily related to cell swelling
  • neurological aches
  • muscle cramps, weakness
38
Q

Hypernatremic (hypertonic) imbalances

A

concentration of sodium is increased above normal levels

39
Q

hypernatremic imbalances - causes

A

too much sodium and not enough water, inability to retain water, excess intake of sodium tablets

40
Q

hypernatremic and plasma

A
  • plasma will be hypertonic

- cellular dehydration

41
Q

hypernatremic imbalances - clinical manifestations

A
  • primarily related to cell dehydration
  • neurological irritations
  • thirst, dry skin
42
Q

hypernatremic imbalances - intravascular volume

A

increase (hypertension and bounding pulse)

43
Q

potassium

A
  • the major systems that show signs and symptoms include CVS and CNS
  • a lot of overlap in symptoms with sodium and potassium
  • they both interact with acid-base status
44
Q

hypokalemia - causes

A
  • increased excretion
  • diarrhea, vomitting, NG suction, draining wounds
  • loop diuretics
  • hyperaldosteronism
    • decreased replacement
45
Q

hypokalemia - manifestation

A
  • mostly cardiac (dysrhythmias and cardiac arrest)
  • CNS: decreased reflects, lethargy
  • GI: decreased peristalsis
46
Q

hypokalemia - treatment

A

correct the cause and replace the potassium (either by IV or foods)

47
Q

hyperkalemia - causes

A
  • decreased excretion (renal disease and hypoaldosteronism)
  • burns and crush injuries
  • excess replacement
  • salt substitutes with K+
48
Q

hyperkalemia - manifestations

A
  • mostly cardiac (dysrhythmias, cardiac arrest)
  • CNS: increased reflects and anxieties
  • GI: diarrhea
49
Q

hyperkalemia - treatment

A

dialysis and kayexalate (treating the cause)

50
Q

calcium

A
  • hypocalcemia

- hypercalcemia

51
Q

hypocalcemia

A
  • chvostek’s sign

- trousseau’s sign

52
Q

hypercalcemia

A

weakness, loss of muscle tone and hypertension

53
Q

H+

A
  • needed to maintain membrane potential
  • regulates speed of nerve implies conductions and muscle finer contraction
  • maintains speed of enzyme reactions
54
Q

normal body pH

A

7.35-7.45

55
Q

To maintain the body’s normal pH

A

the H+ must be neutralized by buffers or excreted via the lungs or kidneys

56
Q

excretion of acids

A
  • Volatile

- nonvolatile

57
Q

Volatile

A
  • carbonic acid

- eliminated by lungs as CO2

58
Q

nonvolatile

A
  • sulfuric, phosphoric and other organic acids

- eliminated by the renal tables

59
Q

renal system controls pH by

A
  • excreting or conserving acid: H+

- conserving or excreting base: bicarbonate (HCO3-)

60
Q

acid-base imbalances

A
  • caused by respiratory or “metabolic” problems
  • categorized as either acidosis or alkalosis
  • if one is dysfunctional the other will try to compensate
61
Q

Respiratory alkalosis

A
  • too little CO2
62
Q

Respiratory alkalosis - causes

A
  • rapid/deep breathing
63
Q

Respiration acidosis - causes

A
  • slow/shallow breaking
64
Q

Respiration acidosis

A

too much CO2

65
Q

metabolic acidosis

A
  • not enough bicarbonate ion

- too much acid

66
Q

metabolic acidosis - causes

A
  • excess production of non-volatile acids
67
Q

metabolic alkalosis

A
  • too much bicarbonate ion HCO3-

- not enough acid

68
Q

full compensation

A

pH will become fully within normal range

69
Q

partial compensation

A

pH will move towards normal but not within normal range

pathophysiology (16 decks)

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