Fluid and Electrolyte imbalances Flashcards
Fluid balance at the level of the capillary relies on…
a balance between opposing forces: the pushing force of hydrostatic pressure, and the pulling force of oncotic pressure.
at the arterial end of the capillary _____ pressure is higher than ___ pressure.
hydrostatic; oncotic
toward the venous end of the capillary, much of the fluid has moved to the …
interstitial space
excess interstitial fluid is …
taken up by the lymphatics and returned to the central circulation
increased capillary hydrostatic pressure can cause ….
higher amounts of fluid to leave the capillary
if hydrostatic pressure continues to be high at the end of the venous end of the capillary, net fluid movement will be ____ of the capillary.
OUT
increased capillary hydrostatic pressure can result from…
hypertension or from an increase in fluid volume (sodium and water retention)
any clinical situation that results in deceased albumin can result in …
a decrease of capillary oncotic pressure.
leaky capillaries can lead to
increased interstitial colloidal osmotic pressure
what causes increased tissue hydrostatic pressure?
obstruction of lymph flow (lymphedema)
interstitial fluid accumulation
edema
transcellular fluid accumulation
third-spacing
fluid that collects in the peritoneal cavity
ascites
edema that is related to salt retention is usually ___
pitting edema
_____ in the hypothalamus keep track of osmolality or the concentration of the blood
osmoreceptors
____ are sensors located in the blood vessel walls and in the kidneys. These receptors measure the stretch in the vessel walls that is produced by blood volume and blood pressure.
baroreceptors
the body uses these mechanisms in response to messages from osmo- and baroreceptors …
- thirst
- ADH
- SNS
- RAAS
- Natriuretic peptides
___ regulates GFR, tubular reabsorption and renin release
sympathetic NS
who is at risk for fluid imbalances?
infants, elderly, obese, and ill.
infants have a ___ % of body water than adults, and more than half of their total body water is in the ______
higher; extracellular compartment
a reliable indicator of fluid volume
pulse and BP
an indicator of alterations in body fluid and electrolyte balance.
thirst, mucous membranes, turgor, tearing.
normal urine output in adults
1000-2000 ml/day
- thirst (maybe)
- decrease in body weight (maybe)
- decreased urine output
- sunken eyes
- loss of skin turgor
- infants: tearing
- changes in BP
- changes in pulse
- Hct, BUN
manifestations of isotonic fluid volume deficit
inadequate intake and excessive output
causes of isotonic fluid volume deficit
inadequate elimination and excessive intake.
isotonic fluid volume excess
weight gain, edema, distended neck veins, bounding pulse, respiratory symptoms, decrease in BUN and hematocrit
isotonic fluid volume excess manifestations
stop increasing the volume, start decreasing the volume, treat the cause
isotonic fluid volume excess treatment
too little ECF sodium, too much ECF water
hyponatremia
variable symptoms, brain swelling, neuromuscular effects, low serum osmolality
hyponatremia manifestations
determine and treat the cause, decrease the fluid excess, maybe replace some sodium, monitor carefully
hyponatremia treatment
too much ECF sodium, too little ECF water
hypernatremia
shrunken cells, volume depletion, thirst
hypernatremia manifestations
decrease the salt, increase the fluid, correct slowly.
hypernatremia treatment
too little potassium intake, too much potassium output
hypokalemia
major intracellular cation
potassium
thirst, anorexia, N/V, constipation, fatigue, weakness, muscle cramping, postural hypotension, and cardiac arrhythmias
hypokalemia manifestations
prevention, replacement, correct slowly
hypokalemia treatment
too rapid administration, too little output
hyperkalemia
N/V, cramping, diarrhea, abnormal sensation or paresthesia, dizziness, muscle cramps, decreased HR, ventricular fibrillation, and cardiac arrest
hyperkalemia manifestations
restrict intake and promote excretion
hyperkalemia treatment
