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MEDSURG > FLUID AND ELECTROLYTE > Flashcards

FLUID AND ELECTROLYTE Flashcards

1
Q

Approx. ____ of body weight consists of fluid

A

60%

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2
Q

FACTORS - body fluids

A

AGE
GENDER
BODY FAT

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3
Q

Fluid Compartments:

A

Extracellular Fluid
Intracellular Fluid

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4
Q

Under Extracellular Fluid

A

Intravascular
Interstitial Fluid
Transcellular Space

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5
Q

ECF total body fluid

A

1/3

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6
Q

ICF total body fluid

A

2/3

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7
Q

Fluid that surrounds the cell

Contains 11 L to 12 L in adults

Lymph fluid

A

Interstitial Fluid

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8
Q

Smallest division of ECF

Contains approx. 1 L

A

Transcellular space

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9
Q

Plasma, effective circulating volume

3L of the 6L of blood volume in adults made up the plasma

Found within the blood vessel

A

Intravascular

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10
Q

MAJOR CATIONS (body fluid):

A

Sodium (Na+), Potassium (K+) ✓ Calcium (Ca+), Magnesium
(Mg+) ✓ Hydrogen ions (H+)

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11
Q

Loss of ECF into a space that does not contribute to the equilibrium between the ICF and ECF is referred to as

A

third-space fluid shift or third spacing.

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12
Q

MAJOR ANIONS

A

✓ Chloride (CI-), Bicarbonate (HCO3-)

✓ Phosphate (PO4-), Sulfate
(SO4-)
✓ Proteinate ions

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13
Q
  • dominates the ECF. It is important in regulating the volume fluid of the body.
A

Sodium ions

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14
Q

-dominates the ICF.

A

Potassium

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15
Q

-the diffusion of water caused by a fluid concentration gradient.

A

Osmosis

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16
Q
  • is the ability of all solutes to cause an osmotic force that promotes water movement from one compartment to another.
A

Tonicity

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17
Q
  • the pressure exerted by the fluid on the walls of the blood vessel.
A

Hydrostatic pressure

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18
Q
  • is the amount of hydrostatic pressure needed to step the flow of water by osmosis.
A

Osmotic pressure

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19
Q
  • is the osmotic pressure exerted by proteins.
A

Oncotic pressure

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20
Q
  • is the increase in urine output caused by excretion of substances such as glucose, mannitol, or contrast agents in the urine
A

Osmotic diuresis

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21
Q
  • to move from an area of higher concentration to one of lower concentration
A

DIFFUSION

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22
Q

-movement of water and solutes occurs from an area of high hydrostatic pressure to an area of low hydrostatic pressure

A

FILTRATION

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23
Q

cell membrane, actively moves the sodium from I the cell into the ECF

A

Na-K pump (sodium potassium pump)

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24
Q
  • implies that energy must be expended for the movement to occur against a concentration gradient
A

Active transport

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25
Q

Systemic routes of gains and losses

A

KIDNEYS
SKIN
LUNGS
GI

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26
Q

KIDNEYS-daily urine output in the adult is

A

1L to 2L approx.

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27
Q

sensible perspiration refers to visible water and electrolyte loss through skin

A

sweating

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28
Q

Fluid losses from the skin and lungs are referred to as _____ because they can’t be measured or seen.

A

insensible losses

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29
Q

Fluid losses from urination, defecation, wounds, and other means are referred to as ___ because they can be measured.

A

sensible losses

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30
Q

NORMAL VALUE
k
mg
na
ca
Inorganic phosphorus
phosphate
chloride
HCO3

A

3.5-5 mEq/L (ABG)
1.5-2 mEq/L
135-145 mEq/L
8.5-10.5 mEq/L
1-1.5 mmol/L (acid base value)
0.8-1.5 mmol/L
95-106 mmol/L
18.22 mmol/L
22-28 mEq/L

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31
Q

Osmolality measures in
Osmolarity

A

milliosmoles per kg of water
milliosmoles per liter

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32
Q

occurs when the loss of ECF volume exceeds the intake of fluid.

It occurs when water and electrolytes are lost in the same proportion as they exist in normal body fluids;

A

hypovolemia

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33
Q

results from loss of body fluids and occurs more rapidly when coupled with decreased fluid intake.

can also develop with a prolonged period of inadequate intake.

A

FVD (FLUID VOLUME DISTURBANCE)

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34
Q

first line choice for hypotensive patient with FVD

A

Isotonic solution

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35
Q

Fluid volume excess

An isotonic expansion of the ECF caused by an abnormal retention of water and sodium

A

HYPERVOLEMIA

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36
Q

Most abundant electrolyte in the ECF.

Primarily determinant of ECF volume and osmolality

Major role in controlling water distribution throughout the body

A

sodium

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37
Q

Serum sodium level that is less than 135 mEq/L (135 mmol/L)

A

Hyponatremia

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38
Q
  • Na+ loss is greater than water loss.
A

HYPOVOLEMIC HYPONATREMIA

39
Q
  • total body water is moderately increased and Na+ levels are normal.
A

EUVOLEMIC HYPONATREMIA

40
Q

there is greater increase in total body water than in total body Na+.

A

HYPERVOLEMIC HYPONATREMIA

41
Q

no change in total body water or Na+ but instead a shifting between ICF and ECF.

A

REDISTRIBUTE HYPOVOLEMIA

42
Q

Serum sodium level higher than 145 mEq/L (145 mmol/L)

It can be caused by a gain of sodium in

excess of water or by a loss of water in excess of sodium.

Occurs in patients with normal fluid volume, FVD, FVE

Most affected are very old, very young, and cognitively impaired.

A

HYPERNATREMIA

43
Q
  • total body water is greatly decreased relative to Na+ loss.
A

HYPOVOLEMIC HYPERNATREMIA

44
Q
  • TBW is decreased relative to the normal total body Na+.
A

EUVOLEMIC HYPERNATREMIA

45
Q

TBW is increased but Na+ gain exceeds water gain.

A

HYPERVOLEMIC HYPERNATREMIA-

46
Q

Below-normal serum potassium

<3.5 mEq/L

May occur with normal potassium levels:

when alkalosis is present a temporary shift of serum potassium into cells occurs.

A

POTASSIUM DEFICIT (HYPOKALEMIA)

47
Q

98% is inside the cells. 2% is in the ECF

Important in neuromuscular function

Influences both skeletal and cardiac muscle activity.

A

Potassium

48
Q

99% of the body’s calcium (Ca++) is located in the skeletal system

Plays a major role in transmitting nerve impulses

Helps regulate muscle contraction and relaxation, including cardiac muscle.

A

Calcium

49
Q

Serum calcium value lower than 8.6 mg/dL [2.15 mmol/L]

A

Hypocalcemia

50
Q
  • most characteristic manifestation of hypocalcemia and hypomagnesemia
A

TETANY

51
Q

-inflate BP cuff on the upper arm, (+) carpal spasms within 2-5 minutes.

A

Trousseau sign

52
Q
  • consists of twitching of muscles enervated by the facial nerve.
A

Chvostek sign

53
Q

Serum calcium value greater than 10.2 mg/dL [2.6 mmol/L]

A

CALCIUM EXCESS (HYPERCALCEMIA)

54
Q

is abundant intracellular cation.

A

Magnesium

55
Q

It acts as an activator for many intracellular enzyme systems.

Plays a role in both carbohydrate and protein metabolism

is important in neuromuscular function

A

Magnesium

56
Q

Below-normal serum magnesium concentration (1.3 md/dL [0.62 mmol/L)

A

MAGNESIUM DEFICIT (HYPOMAGNESEMIA)

57
Q

Frequently associated with hypokalemia and hypocalcemia.

Causes: alcoholism, GI losses, enteral or parenteral feeding deficient in magnesium, medications, rapid administration of citrated blood.

A

Hypomagnesemia

58
Q

Serum magnesium level higher than 3.0 mg/dL [1.25 mmol/L]

Rare electrolyte abnormality, because the kidneys efficiently excrete magnesium

A

Hypermagnesemia

59
Q

a primary anion in IFC

A

PHOSPHORUS

60
Q

Essential to the function of muscle and red blood cells, and nervous system.

It is deposited with calcium for bone and tooth structure. I

VOLUMN

Involve in acid-base buffering system, energy production of ATP.

Cellular uptake and use of glucose.

A

Phosphorus

61
Q

serum level below 2.5 mg/dl

A

Hypophosphatemia

62
Q

Serum phosphorus level that exceeds 4.5 mg/dL (1.45 mmol/L).

Causes: kidney injury, excess phosphorus, excess vitamin D, hypoparathyroidism, chemotherapy

A

Hyperphosphatemia

63
Q

The major anion of the ECF, is found more in interstitial and lymph fluid compartments than in blood.

Also contained in gastric and pancreatic juices, sweat, bile, and saliva

A

Chloride

64
Q

A serum chloride level below 97 mEq/L (97 mmol/L).

NT

Causes: Addison disease, reduced chloride

intake, Gl loss, diabetic ketoacidosis, excessive sweating, fever, medications, metabolic alkalosis bums, medications, metabolic alkalosis

A

Hypochloremia

65
Q

Serum level of chloride exceeds 107 mEq/L (107 mmol/L)

A

Hyperchloremia

66
Q

These are located in the left atrium and the carotid and aortic arches.

These receptors respond to changes in the circulating blood volume and regulate the sympathetic and parasympathetic neural activity as well as endocrine activities.

A

Baroreceptors

67
Q

-is an enzyme that converts angiotensinogen, a substance formed by the liver into angiotensinogen I.

A

RENIN

68
Q
  • converts angiotensinogen I to angiotensin II.
A

ANGIOTENSIN CONVERTING ENZYME (ACE)

69
Q
  • vasoconstrictor properties, INCREASE ARTERIAL PERFUSION PRESSURE and stimulates thirst
A

ANGIOTENSIN II

70
Q

is number 1 indicator for fluid balance, only applicable to conscious people.

A

Thirst mechanism

71
Q
  • produced by the atrial myocardium with tissue distribution in the cardiac atria and ventricles
A

Atrial natriuretic peptide (ANP)

72
Q
  • produced by the ventricular myocardium with tissue distribution in the brain and cardiac ventricles
A

Brain Natriuretic Peptide (BNP)

73
Q

is the rapid loss of more than 3% of body weight owing to the loss of either water or sodium.

A

Dehydration

74
Q

intravascular contains how many L of blood volume in adults

A

3L of 6L

75
Q

interstitial fluid contains

A

11L to 12L

76
Q

Transcellular fluid contains

A

1L

77
Q

Continues water loss by evaporation approximately

A

500 ml/day

78
Q

The lungs normally eliminate water vapor at rare approximately

A

300

79
Q

the usual loss through GI Track is

A

100 to 200ml daily

80
Q

clinical manifestations of hypovolemia

A

mababa ang timbang, bp, urine output
flattened neck vein

opposite sa laboratory findings (matataas)

81
Q

Medical management of hypovolemia if not severe

A

Oral replacement

82
Q

Medical management for severe cases of hypovolemia

A

IV replacement

83
Q

First line choice for hypotensive patient with fluid volume disturbance

A

Isotonic solution

84
Q

Nursing management for hypovolemia

A

Pinakaimportante - Monitor input and output at least every 8 hours

Vital signs closely monitored
- bp drop
- rr increases
- pr increases (report, might have hypovolemic shock)

85
Q

caause of fluid volume excess (hypervolemia)

A

Heart failure
kidney failure/injury
cirrhosis of liver

86
Q

clinical manifestation of HYPERVOLEMIA

A

edema
distended neck veins
crackles

87
Q

medical management for hypervolemia

A

Diuretics - mild to moderate THIAZIDE
Loop Diuretic - severe FUROSEMIDE

88
Q

Due of effects of some diuretics, what medication (under hypervolemia)

A

K supplements

89
Q

If patient have severe hypervolemia and diuretics is not possible what is the next option

A

Temporary Dialysis (HEMO/PERITONEAL DIALYSIS)

90
Q

Nutritional therapy for hypervolemia

A

dietary restrictions of NA
Low sodium diet - 250 mg

91
Q

nursing management hypervolemia

A

I&O Input
daily weights (1kg = 1L water retain)

92
Q

inverse relationship between electrolyte

A

Na & K
Ca & Ph
Cl & Bicarbonate
Mg & Ph

93
Q

same relationship between electrolyte

A

Ca & Mg
Mg & K
Na & Cl

MEDSURG (6 decks)

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