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BCIT Module 4 > Fluid and Electrolyte > Flashcards

Fluid and Electrolyte Flashcards

1
Q

What are the 3 fluid compartments

A

extracellular
Intravascular(part of the extracellular)
intracellular

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2
Q

Relative fluid distribution between extracellular and intracellular

A

Extracellular 1/3

Intracellular 2/3

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3
Q

Major Extracellular Ion

A

Na+

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4
Q

Minor Extracellular Ions

A

HCO3-
Cl-
Ca++

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5
Q

Major Intracellular Ion

A

K+

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6
Q

Minor Intracellular Ions

A

Mg++
HPO4-
Proteins-

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7
Q

Avg. Fluid Concentration in body compartments

A

285-295 mOsm

Good estimate of mOsm is to find the sodium concentration and double it.

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8
Q

Define Osmosis

A

movement of liquid (water) to equalize concentrations across a membrane.

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9
Q

Define Hydrostatic Pressure

A

force of water/liquid across the membrane
(ie. blood pressure in peripheral circulation)
pressure gradient from aorta -> venacava

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10
Q

Oncotic Pressure

A

Water movement/being drawn towards large solutes.

plasma proteins/albumin

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11
Q

Diffusion

A

Movement of molecules (eg. Na+, Ca++) down their concentration gradient (chemical or electrical) Passive Process!

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12
Q

Pressures at the arterial end

A

Hydrostatic Pressure > Oncotic Pressure

Net movement of fluid into the interstitial space

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13
Q

Pressures at the venous end

A

Oncotic Pressure > Hydrostatic Pressure

Net movement of fluid into the vasculature

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14
Q

Osmolality vs Osmolarity

A

Osmolality (mOsm/kg)
Osmolarity (mOsm/L)

since 1 L of water = 1kg relatively interchangeable for our applications.

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15
Q

Serum Osmolality

A

= (2 x {Na + K}) + (BUN/2.8) + (glucose/18)

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16
Q

Isotonic Overhydration (Hypervolemia)

A
  • Gain of isotonic fluid (eg. 0.9 NS)
  • Osmolality unchanged
  • ICF volume (no change)
  • ECF volume (high)
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17
Q

What is RAAS

A

Renin-Angiotensin-Aldosterone_System

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18
Q

Function of Renin

A

Angiotensinogen -> Angiotensin I coversion

19
Q

Function of ACE

A

Angiotensin I -> Angiotensin II conversion

20
Q

What does Angiotensin II do

A 
Direct Vasoconstriction 
Aldosterone release (Na+ and H2O retention)
Sympathetic activity 
ADH release (H2O retention)
21
Q

What does Aldosterone do

A

Distal Tubule/Collecting Duct (Na+ absorption and K+ excretion)
H2O absorption follows Na+

22
Q

Isotonic Dehydration (Hypovolemia)

A
  • Loss of Isotonic fluid (hemorrhage)
  • Osmolality unchanged
  • ICF volume (no change)
  • ECF volume (low)
23
Q

Hypernatremia (Water Deficit)

A
  • poor fluid/water intake (imobility)
  • loss of hypotonic solutes (dilute urine, diabetes insipidus)
  • Increased ECF osmolarity with subsequent fluid shift into the extra cellular space.
24
Q

Hypernatremia (overhydration)

A 
Hypertonic IV solutions/Hyperaldosteronism
Increased ECF osmolarity with subsequent fluid shift into the extra cellular space.
ECF volume (high)
25
Q

Hyponatremia (Water Excess)

A 
Excess water intake/water intoxication 
Hypotonic IV fluids (D5W, 1/2 NS)
SIADH
Decreased ECF osmolarity with subsequent fluid shift into the ICF
Cells swell
26
Q

Hyponatremia (Dehydration)

A

Inadequate sodium intake/ excessive Na+ loss
Decreased ECF osmolarity with subsequent fluid shift into the ICF
cells swell

27
Q

What is a Cation

A

positive charged ion

Na+, K+, Ca++, H+

28
Q

What is an Anions

A

negative charged ions

Cl-, HCO3-

29
Q

Normal Serum Sodium (Na+)

A

135 - 145 mEq/L

30
Q

Physiological roles of Na+

A
  • 90% of all ECF cations
  • water/osmotic balance regulation
  • nerve conduction/neuromuscular function
  • acid base balance
  • concentration gradient for membrane transport
31
Q

Hyponatremia Symptoms

A

Neuro: lethargy, headache, confussion, seizure, coma.
Muscles: Cramps, weakness, fatigue
Gastro: Nausea, vomiting

32
Q

Hypernatremia Symptoms

A

Neuro: Confusion, irritability, restlessness.
Seizures (if severe Na+ increase)
Thirst
Fever/Flushed Skin

33
Q

Normal Serum Chlorine (Cl-)

A

97 - 105 mEq/L

34
Q

Physiological roles of Cl-

A

Provides electroneutrality, pairs with Na+

Moves with Na+, also important in Acid-base balance.

35
Q

Hypochloremia Symptoms

A

(usuallu goes along with hyponatremia)

signs of alkalosis, Low Na+ or Low K+

36
Q

Hyperchloremia Symptoms

A

(usuallu goes along with hypernatremia)
fluid retention
tachypnea / tachycardia
weakness, lethargy

+++ most symptoms in hyperchloremic patients are due to associated accidosis++++

37
Q

Normal Serum Potassium K+

A

3.5 - 4.5 mEq/L

ICF 156 mEq/L

38
Q

Physiological roles of K+

A

cell membrane re-polirization
intracellular fluid and ion balance
neuromuscular transmission
acid base balance (H+/K+ exchange)

39
Q

Fluctuation of serum K+

A

Insulin (K+ moves intracellulary, serum K+ decreases)
Catecholomines, B agonists ( lowers serum K+)
Acidosis (serum K+ increases)

40
Q

Hypokalemia Symptoms

A

Weakness/Flaccid Paralysis
Postural Hypotention
Arrhythmia (U wave), flat/absent P wave, PVC’s

41
Q

Hyperkalemia Symptoms

A

> 5.5 mEq/L
Peaked T’s, wide QRS, sinusoidal wave
Bradycardia, heart block, cardiac arrest
Cramps, Nausea, vomiting

42
Q

Normal serum Calcium (Ca++)

A

4.5 - 5.5 mEq/L or (9-10.5 mg/dl)

99% of calcium stored in bone

43
Q

Normal serum Phosphate (HPO4-)

A

2.5 - 4.5 mg/dl

inverse relationship with Ca++ 9 if one decreases the other increases.

44
Q

Normal serum Magnesium (Mg++)

A

1.8-2.4 mEq/L

BCIT Module 4 (3 decks)

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