Fluid and Electrolyte / Acid-Base Balance Flashcards
Normal fluid intake is..?
1100-1400 mL
Homeostasis
The bodies ability to keep its internal environment balanced; and is ability to correct itself when balance is not met.
Normal sodium (Na+) levels
136-145 mEq/L (mmol/L)
Normal potassium (K+) levels
3.5-5.0 mEq/L (mmol/L)
Normal calcium (Ca++) levels
8.4-10.5 mg/dL
Normal magnesium (Mg++) levels
1.5-2.5 mEq/L
Diffusion
Molecules move from higher concentration>lower concentration until equilibrium is met.
Filtration
Distributes ECF between interstitial and vascular spaces through a membrane via hydrostatic pressure
Osmosis
Distributes H2O between ECF and cells through a semi-permiable membrane.
Hydrostatic pressure
Pressure that pushes fluid out of its compartment or capillaries.
Output>input (>greater than)
Not enough H2O consumption Using diuretics Sweating too much vomiting/diarrhea Hemorrhage Burns Adrenal insufficiency (addisons) Tube feed with out fluids Diabetes
Output
Renal insufficiency/kidney disease Too much IV fluids Excess aldosterone Cirrhosis (liver damage) Corticosteroid use Cushing's disease (^cortisol levels) Too much H2O intake Tap-water enemas Too much salty foods/fluids
Altered distribution
- Acute ascites (liver failure)
- Intestinal obstruction
- Distribution into 3rd space (peritoneal cavity)
What do we asses for in Flui. and Elec. imbalance?
Health history
Diagnostic and lab tests
Psychical assessment ( daily weight, VS, I and O, thirst, skin, oral cavity, eyes, jugular and hand veins, neuromuscular systems)
ECV deficit
Too little volume: Weight loss Skin tenting Dry mucous membranes Rapid thready pulse BP drop Lightheadedness Flat neck veins Oligurea Syncope/ shock
ECV excess
Too much volume: Weight gain Edema Bounding pulse Distended neck veins Dyspnea
Hypronatremia
Na+ less than (
Hypernatremia
Na+ greater than (>) 145 mEq/L: Impaired cerebral function Thirst Decreases LOC Seizures
Hypokalemia
K+
Hyperkalemia
K+ >5.0 mEq/L:
Bilateral muscle weakness
Cardiac dysrythmias
Cardiac arrest
Hypocalcemia
Ca++
Hypercalcemia
Ca++ >11 mg/dL: Decreased neuromuscular excitability Anorexia Nausea Constipation Muscle weakness Diminished reflexes Decreased LOC Cardiac dysrythmias
Hypomagnesemia
Mg++
Hypermagnesemia
Mg++ >2.5 mEq/L: Decreased neuromuscular excitability Flushing Diaphoresis (sweating) Diminished reflexes Decreased LOC Muscle weakness Respiratory depression Bradycardia Cardiac dysrythmias
Interrelated concepts of Flui. and Elec. Balance
Nutrition Mobility Cognition Perfusion Gas exchange Acid-base balance Elimination
Acid-Base Balance is..?
Process of regulating pH, bicarbonate concentration and partial pressure of of CO2 on body fluids.
Normal pH range
- 35-7.45
7. 45= alkalotic
How is acid removed from the body?
Via respiratory and renal processes
What changes in flui. and elec. cause change in pH?
Diarrhea
Vomiting
What changes in pH cause change in flui. and elec.?
Hyperventilation
Respiratory acidosis
Hypoventilation ( ^ CO2)
Respiratory alkalosis
Hyperventilation ( decreased CO2)
Metabolic acidosis
Chronic diarrhea
Intoxication
Pancreatic fistula
Metabolic alkalosis
Excess bicarbonate use
Excess diuretic use
What is a DEFINITIVE test for acid-base imbalance?
ABGs (arterial blood gas)
Normal PaCO2 level
35-45 mm Hg
Normal PaO2 level
80-100 mm Hg
