Fluid and Electrolyte Balance Flashcards
what is fluid and electrolyte balance
process of regulating the extracellular fluid volume, body fluid osmolality, and plasma concentrations of electrolytes
where is fluid found
ecf
icf
bvs
lymphatics
how does fluid move
intake
absorptn (except iv)
distribution
ouput
what is extracellular fluid volume
fluid (h20 plus substances dissolved in it) outside of cells
what is body fluid osmolality
degree of concentration of substances in the fluid
what is plasma concentrations of electrolytes
vary for diff parts of the body to maintain optimal fxn, common electrolytes are potassium, sodium, mag, calcium
decreased intake and normal output
ECV deficit
high osmolality
plasma electrolyte deficits
normal intake and increased output
ecv deficit
high osmolality
plasma electroltye deficits
what can cause normal intake but increased output
diuretics
v/d
excessive or too rapid intake and normal output
ecv excess
low osmolality
plasma electrolye excesses
what can cause excessive or too rapid intake and normal output
iv fluids
normal intake decreased output
ecv excess
low osmolality
plasma electrolye excesses
what can cause normal intake and decreased output
renal failure
infant risk factors
high metabolic rate
immature kideys
more rapid resp rate (breathing off more water vapor)
proportionally greater body surface area
risk factors elderly
thrist sensation blunted
kidneys less able to respond to ADH
impaired ability to conserve eater
less lean body mass
how does fluid imbalance affect perfusion
optimal bp…optimal perfusion
optimal perfusion…transport of 02 to tissues
what is the effect of excess ecv on o2
distance of o2 to diffuse (blood capillary to alveoli)
fluid in alveoli
Effect of ecv deficit on oxygenation
imapired delivery of o2
effect of osmolality on brain
sodium increased or decreased can shrivel or shrink cells and cause loc change
how should osmolalty/ sodium imbalances be managed
dont want rapid changes in sodium/osmolality d/t risk of seizures
neuromusciular fxn on hyper/hypokalemia
affects resting membrane potential
muscle fxn
cardiac dysrhythmias
neurimuscular fxn on hypocalcemia/hypomagnesemia
increased neuromsucluar exictability
neuromuscular fxn on hypercalcemia/hypermagnesemia
decreased neuromuscular excitabilty
cause of ecv deficit
output normal, intake of na+, and h20 too low
fluid shift from ecv to 3rd space (not vascular or interstitial) (ex abd cavity….acscites)
output increased, not balanced by intake of na+ and h20
cause of ecv excess
output less than excessive or too rapid intake of na+ and h20
output decreased not balanced by decreased intake of na+ and h20
what is edema
NOT 3RD SPACING
shift into interstitial space
what can also cause fluid shift
low albumin- keeps fluid in intravascular space
causes of hypernatremia
body fluids too concentrated, osmolality too high
output normal, but intake of h20 too low
increased output not balanced by intake of h20
causes of hyponatremia
body fluids too dilute, osmality too low
output less than excessive pr too rapid intake of h20
decreased output not balanced by decreased intake of h20
what is the difference btwn osmolality and fluid balance
changes of intake and output are associated with too much/ little water….not sodium
causes of hypokalemia
output normal but intake of K+ too low
increased output not balanced by increased k+
rapid shift of k+ from ecf into cells
causes of hyperkalemia
output less than excessive or too rapid k+
decreased output no balanced by decreased k+ intake
rapid shift of k+ from cell into ecf
causes of hypocalcemia
output normal, but ca2+ intake/absorption too low
increased output not balanced by increased ca2+ intake/absorption
ca2+ shift from ecf into bone or physiological unavailable form
hypoparathyroidism
causes of hypercalcemia
output less than excessive ca2+ intake/absorption
decreased output not balanced by decreased ca2+ intake
ca2+ shift from bone into ecf
hyperparathyroidism
causes of hypomagnesemia
output normal, but intake/absorption of mg2+ too low
increased output not balanced by increased mg2+ intake/absorption
mg2+ shift into physiologically unavailable form
causes of hypermagnesemia
output less than excessive mg2+ intake/absorption
decreased output not balanced by decreased mg2+ intake
what lab tests ordered to monitor fluid/electrolyte imbalances
bmp
urinalysis
concentrated urine means what for the body
body is less concentrated
too dilute
low output
dilute urine means what for the body
body is more concentrated
losing fluid
high output
assessment findings for fluid/electroltye imbalance
ckd
heart failure
v/d
organ fxn
headache
cramping
weakness
fatigue
dizzy
sob
sudden wt change
i/o
meds/supplements
assessment findings with ecv deficit
suddent wt loss
skin tenting
vascular underload: rapid thready pulse, postural bp drop w/ concurrent hr increase, lightheadedness, flat neck veins supine, oliguria, syncope, circulatory shock
findings with ecv excess
suddent wt gain
dependent edema
vascular overload: bounding pulse, distended neck veins upright, dyspnea, pul edema
findings with hyponatremia
impaired cerebral fxn: decreased loc, nausea, seizures if severe, serum na+ <130
findings with hypernatremia
impaired cerebral fxn: decreased loc, thirst, seizures if severe; na+ >145
what does potassium imabalnces usually affect
muscle fxn and cardia dysrhythmias
what do calcium imbalances usually affect
heart fxn
is hypocalcemia usually increased effects or decreased effects
increased
is hypercalcemia usually increased effects or decreased
decreased
is hypomagnesemia usually increased effects or decreased effects
increased
is hypermagnesemia usually increased effects or decreased effects
decreased
what does imabalnce of magnesium typically cause
dysrhythmias
what is vasopressin
adh
retain water
