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fluid and electrolytes Flashcards

1
Q

a delicate balance of fluids, electrolytes, and acids and bases maintained in the body

A

HOMEOSTASIS

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2
Q

approximately 60% of average healthy adult’s weight (70% to 80% in infants and 50% to people older than 50)

A

Water

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3
Q

Water is the primary

A

body fluid

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3
Q

TWO COMPARTMENTS OF BODY’S FLUID

A

INTRACELLULAR FLUID (ICF)
EXTRACELLULAR FLUID (ECF)

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4
Q

found within the cells of the body; 2/3 of the total body fluid in adults

A

INTRACELLULAR FLUID (ICF)

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5
Q

found outside the cells; 1/3 of the total body fluid

A

EXTRACELLULAR FLUID (ECF)

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6
Q

20% of the ECF; found within the vascular system

A

INTRAVASCULAR FLUID (PLASMA)

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7
Q

75% of the ECF; surrounds the cells

A

INTERSTITIAL FLUID

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8
Q

charged particles

A

ions

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9
Q

ions that carry a positive charge

A

cations

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10
Q

ions that carry a negative charge

A

anions

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11
Q

minerals in the body that have electrical charge; chemicals from which ions are made

A

Electrolytes

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12
Q

are generally measured in milliequivalents per Liter of water (mEq/L) or milligrams per 100 milliliters (mg/100mL)

A

electrolytes

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13
Q

Sodium (Na+)

Potassium (K+)

Calcium (Ca++)

Magnesium (Mg++)

A

cations

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14
Q

Chloride (Cl-)

Bicarbonate (HCO3-)

Phosphate (HPO4–)

Sulfate (SO4–)

A

anions

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15
Q

selectively permeable/semi-permeable to solutes

A

membranes

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16
Q

MOVEMENT OF BODY FLUIDS AND ELECTROLYTES

A

Osmosis
Diffusion
Filtration
Active Transport

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17
Q

Movement of water across cell membranes, from the less concentrated solution to the more concentrated solution

A

osmosis

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18
Q

substances
dissolved in a liquid

A

solute

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19
Q

component that
can dissolve a solute

A

solvent

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20
Q

the concentration of solutes in body fluids; solute per kilogram of water

A

OSMOLALITY

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21
Q

power of a solution to draw water across a semipermeable membrane

A

OSMOTIC PRESSURE

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22
Q

pulls water from the interstitial space into the vascular compartment

A

COLLOID OSMOTIC PRESSURE (ONCOTIC PRESSURE)

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23
Q

solute and solvent are equal

A

Isotonic solution

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24
Q

higher osmolality than body fluids; cells shrink

A

Hypertonic solution

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25
Q

lower osmolality than body fluids; cells swell

A

Hypotonic solution

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26
Q

Movement of molecules through a semipermeable membrane from an area of higher concentration to an area of lower concentration

A

diffusion

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27
Q

Fluid and solutes move together across a membranes from an area of higher pressure to one of lower pressure.

A

filtration

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28
Q

pressure in the compartment that results in the movement.

A

Filtration pressure

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29
Q

pressure
exerted by a fluid within a
closed system on the walls
of the container in which it is
contained.

A

Hydrostatic pressure

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30
Q

Substances can move across cell membranes from a less concentrated solution to a more concentrated one

A

ACTIVE TRANSPORT

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31
Q

It differs from diffusion and osmosis
in that metabolic energy is expended

A

ACTIVE TRANSPORT

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32
Q

A substance combines with a carrier on the outside surface of the cell membrane.

A

ACTIVE TRANSPORT

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33
Q

Fluid Intake
Fluid Output
Maintaining Homeostasis

A

REGULATING BODY FLUIDS

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34
Q

An average adult needs 2,500 mL per day.

A

fluid intake

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34
Q

amount in oral fluids

A

1,200 to 1,500 mL

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35
Q

amount in Water in foods

A

1,000 mL

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35
Q

amount Water as by-product of food metabolism

A

200 mL

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36
Q

total amount intake

A

2,400 to 2,700 mL

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37
Q

it takes 30 minutes to 1 hour for the fluid to be absorbed and distributed throughout the body

A

Thirst mechanism

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37
Q

primary regulator of fluid intake

- thirst center is located in the hypothalamus of the 	brain.
A

Thirst mechanism

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37
Q

Fluid losses that counterbalance the adult’s 2,500-mL average fluid intake.

A

fluid output

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38
Q

amount in urine

A

1,400 to 1,500 mL

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39
Q

amount in Insensible Losses
Lungs (water vapor in the expired air)
Skin

A

350 mL to 400 mL

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39
Q

amount in Sweat

A

100 mL

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40
Q

amount in Feces

A

100 mL to 200 mL

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41
Q

total amount output

A

2,300-2,600 mL

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42
Q

Homeostatic regulators/mechanisms:

A
  1. Kidneys
    1. Antidiuretic Hormone
    2. Renin-Angiotensin-Aldosterone System
    3. Atrial Natriuretic Factor
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43
Q

Primary regulator of body fluids and electrolyte balance.

A

kidneys

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44
Q

Regulates water and electrolyte secretion

A

kidneys

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44
Q

Plays a significant role in acid-base regulation, excreting hydrogen ion (H+) and retaining bicarbonate.

A

kidneys

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45
Q

Regulates water excretion from the kidney

A

Antidiuretic Hormone (ADH)

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46
Q

Produced when serum osmolality rises; conversely, ADH is suppressed when serum osmolality decreases

A

Antidiuretic Hormone (ADH)

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47
Q

Synthesized in the anterior portion of the hypothalamus

A

Antidiuretic Hormone (ADH)

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48
Q

Restore blood volume (and renal perfusion) through sodium and water retention

A

Renin-Angiotensin-Aldosterone System

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49
Q
  1. When blood flow or pressure to kidneys decreases, renin is released.
  2. Renin causes the conversion of angiotensin to angiotensin I, which is converted to angiotensin II by angiotensin-converting enzyme.
    3.Angiotensin II acts directly on the nephrons to promote Sodium and water retention.
    4.Stimulates the release of Aldosterone from the adrenal cortex. It promotes sodium retention.
A

Renin-Angiotensin-Aldosterone System

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50
Q

Released from cells in the atrium of the heart in response to excess blood volume and stretching the atrial walls.

A

Atrial Natriuretic Factor (ANF)

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51
Q

Promotes sodium wasting and acts as a potent diuretic, thus reducing vascular volume.

A

Atrial Natriuretic Factor (ANF)

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51
Q

Reduces thirst, reducing fluid intake

A

Atrial Natriuretic Factor (ANF)

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52
Q

Importance of electrolytes:

A

Maintaining fluid balance
Contributing to acid-base regulation
Facilitating enzyme reactions
Transmitting neuromuscular reactions

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53
Q

Electrolytes

A

Sodium (Na+)
Potassium (K+)
Calcium (Ca++)
Magnesium (Mg++)
Chloride (Cl-)
Phosphate (PO4-)
Bicarbonate (HCO3-)

54
Q

Most abundant cation in the ECF and a major contribution to serum osmolality.

A

Sodium (Na+)

55
Q

Normal value: 135-145 mEq/L

A

Sodium (Na+)

56
Q

Aids in transmitting nerve impulses and contracting muscles

A

Sodium (Na+)

57
Q

Major cation in ICF, with only small amount found in ECF.

A

Potassium (K+)

58
Q

Normal serum levels: 3.5 to 5.0 mEq/L

A

Potassium (K+)

59
Q

Vital electrolyte for skeletal, cardiac, and smooth muscle activity.

A

Potassium (K+)

60
Q

Must be consumed everyday because the body cannot conserve it.

A

Potassium (K+)

61
Q

Sources: avocado, raw carrot, spinach, dried fruits, banana, apricot, orange, beef, pork, milk

A

Potassium (K+)

62
Q

found in the skeletal system, with a relatively small amount in the ECF.

A

Calcium (Ca++)

63
Q

Vital in regulating muscle contraction and relaxation, neuromuscular function, and cardiac function

A

Calcium (Ca++)

64
Q

Normal total serum levels: 8.5-10.5 mg/dL

A

Calcium (Ca++)

65
Q

Normal ionized serum levels: 4-5 mg/dL

A

Calcium (Ca++)

66
Q

decreases serum levels

A

calcitonin

66
Q

Parathyroid hormone and calcitriol increase serum

A

Calcium (Ca++)

67
Q

Daily intake should be 1,000-1,500 mg

A

Calcium (Ca++)

68
Q

Primarily found in the skeleton and in ICF

A

Magnesium (Mg++)

69
Q

Second most abundant ICF cation

A

Magnesium (Mg++)

69
Q

Sources: cereal grains, nuts, dried fruits, legumes, green, leafy vegetables, dairy products, meat, fish

A

Magnesium (Mg++)

70
Q

Normal serum levels: 1.5 to 2.5 mEq/L

A

Magnesium (Mg++)

71
Q

Aids in relaxing muscle contractions, transmitting nerve impulses, regulating cardiac function, and intracellular metabolism.

A

Magnesium (Mg++)

72
Q

Major anion of the ECF

A

Chloride (Cl-)

73
Q

Normal serum levels: 95 to 108 mg/dL

A

Chloride (Cl-)

74
Q

When sodium is reabsorbed in the kidney, chloride usually follows.

A

Chloride (Cl-)

75
Q

Major component of gastric juice (HCl), and is involved in regulating acid-base balance.

A

Chloride (Cl-)

76
Q

Found in the same foods as Sodium

A

Chloride (Cl-)

77
Q

Major anion of ICF

A

Phosphate (PO4-)

77
Q

Also found in the ECF, bone, skeletal muscle, and nerve tissue

A

Phosphate (PO4-)

78
Q

Normal serum levels: 2.5 to 4.5 mg/dL

A

Phosphate (PO4-)

79
Q

Aids in metabolizing Carbohydrate, Protein, and Fat; it is absorbed in the intestines

A

Phosphate (PO4-)

80
Q

Sources: meat, fish, poultry, milk products, legumes

A

Phosphate (PO4-)

81
Q

Present in both ICF and ECF

A

Bicarbonate (HCO3-)

82
Q

Primary function is to regulate acid-base balance (major body buffer)

A

Bicarbonate (HCO3-)

83
Q

Regenerated by the kidneys

A

Bicarbonate (HCO3-)

84
Q

ECF bicarbonate levels are regulated by the kidney

A

Bicarbonate (HCO3-)

85
Q

Produced through metabolic processes

A

Bicarbonate (HCO3-)

86
Q

substance that releases hydrogen ions (H+)

87
Q

have a low hydrogen ion
concentration and can accept hydrogen ions in
solution.

A

Bases (Alkalis)

87
Q

the relative acidity or alkalinity of a solution
- reflects the hydrogen ion concentration of the solution (inversely proportional)

88
Q

normal pH:

89
Q

REGULATION OF ACID-BASE BALANCE

A

Buffers
Respiratory Regulation
Renal Regulation

89
Q

prevent excessive changes in pH by removing or releasing hydrogen ions.

90
Q

Major buffer systems in the ECF:

A

Bicarbonate (HCO3-)
Carbonic acid (H2CO3)

91
Q

weak acid

A

Carbonic acid (H2CO3)

92
Q

acid buffer; opponent of acids

A

Bicarbonate (HCO3-)

93
Q

TO ACHIEVE NORMAL pH

A

1 part Carbonic Acid (1.2 mEq/L) : 20 parts bicarbonate (24 mEq/L)

94
Q

adding a strong acid in the ECF, depleting the bicarbonate and lowering the pH levels.

95
Q

adding a strong base to the ECF, depleting carbonic acid as it combines with the base, increasing the pH levels.

96
Q

The lungs help regulate acid-base balance by eliminating or retaining Carbon Dioxide (CO2), a potential acid.

A

RESPIRATORY REGULATION

97
Q

Carbon Dioxide (CO2) + Water (H2O) =

A

Carbonic acid (H2CO3)

98
Q

High Carbonic acid (H2CO3) and CO2 levels =

A

respiration rate and depth increases, exhaling CO2 and decreasing carbonic acid levels

99
Q

High Bicarbonate (HCO3-) levels =

A

the respiration rate and dept are reduced, retaining CO2 and increasing carbonic acid levels

100
Q

are the ultimate long-term regulator of acid-base balance, although slower to respond to changes.

101
Q

regulate pH by reabsorbing and regenerating bicarbonate and hydrogen ions

102
Q

Carbonic acid (H2CO3) =

A

Hydrogen ion (H+) + Bicarbonate (HCO3-)

103
Q

kidneys reabsorb and regenerate bicarbonate and excrete hydrogen ions

H2CO3&raquo_space; H+ (excreted) and HCO3- (retained)

A

High H+ ions (acidic)

104
Q

FACTORS AFFECTING BODY FLUID, ELECTROLYTES, AND ACID-BASE BALANCE:

A

Age
Gender and Body Size
Environmental Temperature
Lifestyle

105
Q

two types of Fluid Imbalances

A

isotonic
osmolar

106
Q

excess bicarbonate is excreted and H+ ion is retained

H2CO3&raquo_space; H+ (retained) and HCO3- (excreted)

A

Low H+ ions (alkalosis)

107
Q

water and electrolytes are lost or gained in equal proportions

108
Q

loss or gain of only water, so that the osmolality of the serum is altered (electrolytes are concentrated)

108
Q

Four Categories of Fluid Imbalances

A

Fluid Volume Deficit
Fluid Volume Excess
Dehydration (hyperosmolar imbalance)
Overhydration (hypo-osmolar imbalance)

109
Q

The body loses both water and electrolytes from the ECF (intravascular compartment) in similar proportions, so it often is called

A

hypovolemia

110
Q

Causes of hypovolemia

A

Abnormal losses through the skin, GI tract, kidney
Movement of fluid in a third space (area that deems the fluid unavailable for us)

111
Q

The body retains both water and sodium in similar proportions to normal ECF, often called

A

hypervolemia

112
Q

Increased intake of NaCl (sodium level is still normal, since both water and sodium are equally retained)
Infusion of sodium-containing fluids rapidly
Disease processes (heart failure, kidney failure, liver cirrhosis)

A

causes of hypervolemia

113
Q

excess interstitial fluid

114
Q

leaves a small depression or pit after finger pressure is applied

A

pitting edema

115
Q

Water is lost from the body, leaving the client with excess sodium
Sodium levels are increased
Cells are dehydrated/shrunk

A

Dehydration (Hyperosmolar imbalance)

116
Q

causes of Dehydration (Hyperosmolar imbalance)

A

Diabetic Ketoacidosis (DKA)
Osmotic diuresis
Administration of hypertonic solutions

116
Q

Water is gained in excess of electrolytes, resulting in low serum osmolality and low serum Na+ levels
Cells are swollen
Can lead to cerebral edema and impaired neurologic function

A

Overhydration (hypo-osmolar imbalance)

117
Q

causes of Overhydration (hypo-osmolar imbalance)

A

Syndrome of Inappropriate Anti-Diuretic Hormone (SIADH)
Head Injury

118
Q

Less than 135 mEq/L
Severe cases: <110 mEq/L
Can lead to neurological damage (cerebral edema) due to low serum osmolality
Causes: burns, GI losses, diuretics, head injury

A

Hyponatremia

119
Q

Higher than 145 mEq/L
Cells are dehydrated
Primary manifestations are neurological in nature
Causes: water deprivation, diabetes insipidus, excessive use of NaCl

A

Hypernatremia

120
Q

Less than 3.5 mEq/L

Causes:
GI losses (vomiting, diarrhea)
Potassium-wasting diuretics
Poor intake of Potassium
- S/Sx: muscle weakness, lethargy, cardiac dysrhythmias

A

Hypokalemia

121
Q

More than 4.5 mEq/L
More dangerous than hypokalemia – can lead to cardiac arrest
Causes:
1. Renal Failure
2. High Potassium Intake
3. Burns
- S/Sx: confusion, muscle weakness, bradycardia, irregular pulse, numbness in extremities

A

hyperkalemia

122
Q

Total calcium: <8.5 mg/dL

Ionized calcium: <4 mg/dL
SEVERE HYPOCALCEMIA CAN CAUSE TETANY WITH MUSCLE SPASMS AND PARESTHESIAS AND CAN LEAD TO CONVULSIONS. Other manifestations include: decreased cardiac output, hyperactive DTR

Two signs:
Chvostek’s sign
Trousseau’s sign
Causes: total thyroidectomy, hypomagnesemia, chronic alcoholism

A

hypocalcemia

123
Q

Total calcium: >10.5 mg/dL

Ionized calcium: >5 mg/dL
Calcium is mobilized from the skeleton due to malignancy or prolonged immobilization
S/Sx: depressed DTR, cardiac dysrhythmias, hypercalciuria, flank pain secondary to urinary calculi

A

hypercalcemia

124
Q

when a carpopedal spasm of the hand and wrist occurs after an individual wears a blood pressure cuff inflated over their systolic blood pressure for 2 to 3 minutes

A

Trousseau’s sign

124
Q

increased irritability of the facial nerve, manifested by twitching of the ipsilateral facial muscles on percussion over the branches of the facial nerve,

A

Chvostek’s sign

124
Q

Less than 1.5 mEq/L
Common cause: chronic alcoholism
Other causes: GI losses, burns, pancreatitis
S/Sx: Chvostek’s and Trousseau, increased reflexes, respiratory difficulties, cardiac dysrhythmias

A

hypomagnesemia

125
Q

More than 2.5 mEq/L
Often iatrogenic (result of overzealous magnesium therapy)
S/Sx: depressed DTR, bradycardia, lethargy, respiratory depression, cardiac arres

A

hypermagnesemia

126
Q

Below 95 mEq/L
Causes: GI/kidney losses, sweating
S/Sx: muscle twitching, tremors, tetany

A

Hypochloremia

127
Q

Above 108 mEq/L
Causes: excess replacement of NaCl or KCl
S/Sx: acidosis, weakness, lethargy, dysrhythmias, coma

A

Hyperchloremia

128
Q

Below 2.5 mg/dL
Causes: GI losses, use of phosphate-binding antacids, alcohol withdrawal
S/Sx: paresthesias, muscle weakness and pain, metal changes, and possible seizures

A

Hypophosphatemia

129
Q

Above 4.5 mg/dL

Causes: tissue trauma, chemotherapy, renal failure, increased ingestion/administration of phosphate

  • S/Sx: numbness, tingling around the mouth and fingertips, muscle spasms, tetany
A

Hyperphosphatemia

130
Q

Acid-base imbalances classified as

A

respiratory or metabolic

131
Q

normally regulated by the lungs through the retention/excretion of CO2 (respiratory acidosis or alkalosis)

A

carbonic acid levels

132
Q

are regulated by the kidneys (metabolic acidosis or alkalosis)

A

Bicarbonate and Hydrogen ion levels

MUSCULAR (8 decks)

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