Fluid and Electrolyte Imbalances Flashcards
Capillary _ pressure pushes fluid out into the interstitial space
hydrostatic
Capillary _ pressure pulls the fluid into the capillary
colloidal osmotic
Excess interstitial fluid is taken up by _ and returned back to normal circulation
lymphatics
High Osmolarity causes :
_ thirst
_ ADH release
increased thirst and increase ADH
Low Osmolarity causes:
_ thirst
_ ADH release
decreased
Normal movement of fluid depends on the _ of the capillary membrane
integrity
DVT will result from increased capillary _ pressure
Hydrostatic
Burns, liver disease, malnutrition and excessive wound drainage can all contribute to _ levels in decreased capillary osmotic pressure
serum albumin
” leaky capillaries” is a result of_
increased interstitial osmotic pressure
Obstruction of _ flow occurs in increased tissue hydrostatic pressure
lymph flow, because excess fluid is not removed
What is the term that describes an accumulation of fluid in the interstitial space?
edema
What is the term used to describe fluid accumulating in transcellular spaces such as pericardium, joint spaces, and the peritoneum?
third-spacing
What does it mean when fluid is non-functional?
it means that the fluid does not return back to circulation such as in the case of third-spacing
What are causes and manifestations of edema in the brain?
- causes: infection, trauma
- increases intracranial pressure, patient will have headache, altered lvl of con, abnormal pupils, changes in breathing and muscle tone.
What are some common manifestations of edema in the lungs?
- decrease in gas exchange, dyspnea, anxiety or restlessness, crackling, diminished breath sounds
What is ascites?
third spacing of the peritoneal, causes loss inside the lumen and wall if there is obstruction
What would you expect to see in a patient with abdominal edema?
- increase in abdominal girth
- protruding umbilicus
- SOB (diaphragm impeded)
What are the two different types of peripheral edema?
pitting and dependent
What type of peripheral edema is caused by obstruction of venous blood flow?
dependent
What type of peripheral edema is caused by salt retention?
pitting
_ and _ are receptors that monitor fluid levels
chemoreceptors and baroreceptors
_ receptors are located in the hypothalamus and monitor blood concentration
chemoreceptors
_ receptors are located in blood vessels and kidneys, stretch receptors
baroreceptors
In what case what ADH be released?
The chemoreceptors in the hypothalamus sense low blood volume for increased osmolarity
How does GFR contribute to maintenance of blood volume?
constriction and relaxation of afferent and efferent arterioles
What cells in the baroreceptors sense the change in stretch?
juxtaglomerular cells
Where does aldosterone exert its effects?
In the distal tubules promoting the exchange of sodium and potassium because sodium brings water back into the cell promoting increase in blood volume
_ peptides counter balance the activity of baroreceptors, ADH and RAA system
natriuretic
What is one of the earliest signs of fluid imbalance?
Tachycardia
Fluids unavailable or withheld or impaired thirst mechanism are causes of _
isotonic fluid volume deficit
In severe volume depletion the body experiences _ shock with vascular _
hypovolemic, collapse
Treatment of isotonic fluid volume deficit include…
replace fluid and treat underlying cause
Inadequate elimination and excessive intake are causes of _
isotonic fluid volume excess
As healthcare providers when correcting a fluid loss we can sometimes cause _ because the body does not have enough time to adjust
hypovolemia
Restricting fluids, using diuretics and treating the underlying cause are treatment options for …
isotonic fluid volume excess
What fluid imbalance is characterized as a plasma concentration of sodium less than 135 mmol/L
hyponatremia
T/F: too much water in the ECF can lead to hyponatremia due to osmotic pull and water retention
True
T/F: a patient with hyponatremia will experience confusion and altered levels of consciousness due to swelling of brain cells
True
T/F: would you expect to see these lab values in a patient with hyponatremia?
- increase serum osmolality
- decreased HCT
- decreased BUN
False; serum osmolarity would be decreased
What fluid imbalance is characterized by an increase in serum sodium concentration of more than 245 mmol/L?
hypernatremia
T/F: the most common cause of hypernatremia is too much sodium in the ECF
False; the most common cause of hypernatremia is too little ECF water
Untreated _ will lead to stupor, seizures and coma
hypernatremia
Look for signs of neuromuscular excitability such as twitching in _
hypernatremia
Decreasing salt and increasing fluid slowly with a fluid such as ORS can be used as treatment for which fluid imbalance?
hypernatremia
The normal concentration of _ in the cells is 140 to 150 mmol/L
potassium
Hypokalemia is characterized as potassium levels below _
3.5 mmol/L
An inadequate amount of potassium intake can be seen in people on _
fad diets
_ promotes the movement of K+ into the cell as do medications such as _ and _
insulin
bronchodilators
decongestants
This fluid imbalance can be seen manifested in the kidneys, GI tract, skeletal muscles and cardiovascular system
hypokalemia
_ is not a common potassium imbalance
hyperkalemia
What is the most common cause of hyperkalemia
decreased renal function (too little output)
In times of acidosis, renal function _ further the retention of K+
decreasing
An increase of K+ > 5.0 mmol/L is diagnosed as…
hyperkalemia
_ is manifested in the GI tract, Neuromuscular, cardiovascular
hyperkalemia
In what case would you want to restrict fluids causing retention and promote excretion (exchanging K+ for Na+ in the intestines)?
hyperkalemia
Ca=, phosphorus and Mg imbalances are regulated by vitamin _, PTH, and _
D, calcitonin
