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Fluids and Electrolytes > Fluid and Electrolytes > Flashcards

Fluid and Electrolytes Flashcards

1
Q

what are isotonic fluids

A

same concentration as plasma
cause no fluid shifts
osmotic pressure is the same in and out of cells
cells do not shrink or swell with movement
intravascular dehydration
stays in intravascular compartment
expands intravascular compartment

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2
Q

what is hypotonic fluids

A

has less concentration of particles than plama
water moves out of intravascular compartment into the cells (osmotic pressure)
RBC swell
cellular dehydration

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3
Q

what is hypertonic solutions

A

greater concentration than plasma
osmotic pressure shifts fluid from the cells
RBC shrink
intravascular dehydration

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4
Q

what does fluid balance consist of

A

fluid intake and absorption
fluid distribution
fluid output

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5
Q

examples of fluid intake

A

drinking
eating foods
thirst and habit

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6
Q

movement of fluid among its various compartments equal

A

fluid distribution

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7
Q

what regulates fluid intake

A

thirst- 2300ml/day

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8
Q

what are hormonal influences for fluid intake

A

antidiuretic hormone
renin-angiotensin-aldosterone mechanism
atrial natiuretic peptides

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9
Q

what is insensible loss

A

water loss through the skin and lungs, which is not measurable

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10
Q

what is sensible loss

A

water loss through feces, urine, wound drainage, which is measurable

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11
Q

where do fluid output happen

A

kidney, skin, lungs and GI tract

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12
Q

abnormal fluid output

A

vomiting, wound draining, hemorrhage

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13
Q

fluid output influenced by

A

antidiuretic hormone
renin-angiotensin-aldosteron system
atrial natriuretic peptides

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14
Q

what is adrenal cortical regulation

A

hormones released by the adrenal cortex help regulate both water and electrolyte

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15
Q

what is renal regulation

A

kidney regulate water balance through adjustment in water volume

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16
Q

the hypothalmic are

A

thirst receptors

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17
Q

what is pituitary regulation

A

posterior pituitary release ADH which regulates water retention by kidneys

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18
Q

what are the functions of electrolytes

A 
regulate water distribution
muscle contraction
nerve impulse transmission
blood clotting 
regulate enzyme reactions
regulate acid-base balance
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19
Q

what are electrolytes

A

most enter body from ingested food
substances that when in solution separate into electronically charged particles called ions
can be negatively charged anions
can be positively charged cations

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20
Q

cations include

A

sodium
potassium
calcium
magnesium

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21
Q

anions

A

chloride
bicarbonate
phosphorus

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22
Q

sodium

A 
major catio
abundant in ecf
control water balance
condution of nerve impulses
135-145 mEq/L
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23
Q

hyponatremia

A

less than 135mEq/L

results from excess water or loss of Na

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24
Q

signs and symptoms of hyponatremia

A 
muscle weakness
vomiting
lethargy
confusion
seizures
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25
Q

treatments of hyponatremia

A

foods high in Na
diuretics
0.9Z%NaCi

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26
Q

hypernatremia

A

greater than 145 mEq/L
results from Na excess or water loss
water moves out of cells into vascular space-cellular dehydration

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27
Q

signs and symptoms of hypernatremia

A

thirst
dry mucous membranes
flushed skin

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28
Q

treatment of hypernatremia

A

fluids (hypotonic solution)
0.33% NaCi
low Na diet

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29
Q

additional signs and symptoms of hypernatremia

A 
increased fluid retention
restlessness and irritability
elevated BP
edema
decreased urinary output
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30
Q

potassium

A

3.5-5.0 mEq/L
most abundant in icf
major mineral in all body fluids
aids in muscle contraction, nerve impulse condution, regulates enzyme activity
fruit, banana, oranges, vegetable, and meats

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31
Q

hypokalemia

A

less than 3.5 mEq/L
results from loss via GI tract and potassium depleting diuretics
life threatening

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32
Q

signs and symptoms of hypokalemia

A 
muscle weakness
leg cramp
u wave
cramps 
constipation
cardiac dysrhythmias
thigoxin
irregular weak pulse
orthostatic hypotension
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33
Q

treatment for hypkalemia

A 
replace K
diet
meds
add KCL to IV
monitor EKG
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34
Q

hyperkalemia

A

greater than 5 mEq/L

result from renal failure, excessive intake, trauma, crush injuries, burns

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35
Q

sign and symptoms

A

muscle weakness
cardiac changes
parathesia of face/finger/tongue

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36
Q

treatment of hyperkalemia

A

insulin
IV
dialysis

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37
Q

what are some K+ deficits

A 
alkalosis
shallow respirations
irritability
confusion, drowsiness
weakness, fatigue
arrhythmias (irregular rate, tachy)
lethargy
thready pulse
drecreased intestinal motility
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38
Q

calcium

A 
8.5-10.5
99% in teeth and bones
needed for nerve transmission, muscle contraction, and blood clotting
inverse relationship with phosphate
vitamin D needed for Ca absorption
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39
Q

hypocalcemia

A

Ca less than 8.5 mEq/L

loops diuretics, parathyroid disorders, renal failures, hypoparathyroidism

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40
Q

signs and symptoms of hypocalcemia

A 
osteoporesis
cardiac dysrhythmias
tetany
fractures
tingling
chovstek sign (+)
trousseau sign (+)
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41
Q

hypercalcemia

A

Ca greater than 10.5 mEq/L

causes multiple fractures, hyperthyroidism, some cancers, TUMS, immobiliztion

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42
Q

signs and symptoms of hypercalcemia

A

muscle weakness, renal calculi, decreased GI motility, cardiac changes, CNS changes

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43
Q

chloride

A

98-106 mEq/L
combine with Na to form slats maintains water balance
most abundant anion in ECF

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44
Q

hypochloremia

A

less than 98 mEq/L

results from prolonged vomitting and suctioning

45
Q

signs and symptoms of hypochloremia

A

metabolic alkalosis, nerve excitability, muscle cramps, twitching

46
Q

hyperchloremia

A

greater than 106 mEq/L

results from excessive intake or loss via kidneys and dehydration

47
Q

signs and symptoms of hyperchloremia

A

arrhythmias, decreased cardiac output, LOC changes, kussmals respiration

48
Q

phosphate

A

2.7-4.5 mg/dl

needed for acid-base balance, neuroligical and muscle function, energy transfer and metabolism of carbs/proteins/lipids

49
Q

hypophosphatemia

A

less than 2.7 mg/dl

results from decreased intestinal absorption and increased excretion

50
Q

signs and symptoms of hypophosphatemia

A

bone and muscle, pain, mental changes, chest pain, respiration failure

51
Q

hyperphosphatemia

A

greater than 4.5 mg/dl

results from renal failure, large intake of calcium

52
Q

signs and symptoms of hyperphosphatemia

A

neuromusculare changes (tetany), EKG changes, parathesia finger tips/mouth

53
Q

what is electrolyte homeostasis

A

to maintain balance to control by balancing the dietary intake of elctrolytes with the renal excretion and reabsorption of electrolytes

54
Q

daily weights

A

is the most accurate indicator of water balance

55
Q

hematocrit

A

increases with dehydration, and decreases with overhydration

56
Q

hematocrit

A

percentage of cells in 100 ml blood
males 42-52%
females 37-47%

57
Q

osmolarity

A

serum and urine osmolarity both increase with dehydration

58
Q

urine specific gravity

A

1.010-1.025

increases with dehydration

59
Q

urine PH

A

4.6-8.0

60
Q

serum sodium

A

increases with excessive fluid losses

decreases with excessive fluid intake

61
Q

serum albumin

A

3.5-5.0g/dl
helps maintain osmotic pressure
cannot pass thru cell membranes

62
Q

peripheral edema

A

smooth, shiny, pale, cool skin
swelling especially in legs
weight gain

63
Q

pulmonary edema

A

constant cough
dyspnea
moist rales in lungs
bounding pulse

64
Q

infiltration

A

fluid leaked out of vein to surrounding tissue

swellin, coolness, discomfort, pallor, slowed rate, pain , pale to color(blanching skin)

65
Q

phlebitis

A

swelling, warmth, redess, tenderness, red streak

66
Q

fluid overload

A

SOB, distended neck veins, elevated BP, crackles in lungs, tachycardia

67
Q

fludi volume deficit

A

aka hypovolemia
dehydration
elevated hemaocrit
major cause is fluid shift of vascular space
hemorrhage, vomiting, diarrhea, burns, crushing injuries

68
Q

signs and symptoms of hypovolemia

A 
increased HR, decreased BP, 
thirst, decreased motility
decreased CNS activity
decreased output
dry mouth, poor turgor
69
Q

fluid volume excess

A

aka hypervolemia
intercellular tissue
loss of ecf from vacular to other body compartments

70
Q

fluid volum excess causes

A 
increased Na/H2O retention
excessive intake of Na/H2O
fluid shifting from icf to ecf
renal failure
congestive heart failure
71
Q

signs and symptoms of fluid volume excess

A 
anxiety
dyspnea
crackes
tachypnea
increased BP
distended jugular veins
edema
third spacing
weight gain
72
Q

what is the primary body fluid

A

water

73
Q

what is fluid balance

A

fluids gained each day= fluids lossed each day

2.5L/day

74
Q

what maintain proper fluid balance

A

skin, kidney and lungs

75
Q

what is fluid

A

water that contains dissilved or suspended substances such as glucose, mineral, salts, and proteins

76
Q

fluid concentration equals

A

osmolality

77
Q

degree of acidity equal

A

Ph

78
Q

elderly people

A

lower percentage of total body fluid than young adults due to higher body fat

79
Q

women

A

lower percentage total body fluid than men due to higher body fat

80
Q

fat cells

A

contain less water than muscle cells

81
Q

risk factors for older adults

A

decreased thirst sensation
affects oral intake of fluids
increased risk of dehydration
decreased in gfr and number of filtering nephrons
decrease the ability to maintain normal electrolyte level
decreased excretion of meds

82
Q

what is intracellular fluid

A

fluid insid the cell

2/3 of total body water

83
Q

what is extracellular fluid

A

fluid outside the cell

1/3 ot total body water

84
Q

what is interstitial fluid

A

around and between cells

85
Q

what is intravascular

A

plasma fluid in blood vessels

86
Q

what is the total body water volume

A

40L, 60% body weight

87
Q

what is the fluid volume for intracellular

A

25L, 40% body weight

88
Q

what is the fluid volume for extracellular

A

15L, 20% body weight

89
Q

what is the fluid volume for interstitial

A

12L. 80% of ECF

90
Q

what is the total plasma volume

A

3L, 20% of ECF

91
Q

what is osmolarlity

A

the number of particles

92
Q

what is solvent

A

liquid with a substance in solution

93
Q

what is solute

A

the substance in the solution

94
Q

what is active transport

A

movement of ions against osmotic pressure to an area of higher pressure ; requires energy

95
Q

what is diffusion

A

passive movement of electrolytes or other particles down the concentration gradient from higher to lower concentration

96
Q

what is osmosis

A

movement of water or other solute from an area of lesser to one of greater concentration

97
Q

what is filtration

A

movement across a membrane under pressure from higher to lower pressure

98
Q

types of isotonic solutions

A

dextrise 5% in water
0.9 normal saline
lactated ringers

99
Q

types of hypotonic solutions

A
  1. 45% NS

0. 33% NS

100
Q

types of hypertonic solution

A

0.45% NS
0.9% NS
D 10 W

101
Q

what is body fluids

A

water and electrolytes

102
Q

what type of client should be monitiored closely

A

patients that are not eating, drinking or NPO

103
Q

who are high risk population for fluid and electrolytes

A

infants
older adults
patient with cardiac and renal problems

104
Q

older adults has less body fluid as there is an

A

increase in fat cells with aging (muscle cells turn into fat cells)

105
Q

for osmosis to occur a

A

membrane must separate two fluid compartments- at least one compartment must contain a solute that cannot move thru the membrane- this creates a concentration gradient of the solute

106
Q

because of osmosis

A

water will move from the compartment with less solute to the are with more soute until an equilbrium exists and pressure is equal on both sides of the membrane

107
Q

what is osmotic pressure

A

the pull of particles

108
Q

the osmotic pressure and number of particles is what

A

makes up different types of IV solutions

109
Q

what happens when a patient takes a diuretic

A

patient loses fluid and electrolytes

Fluids and Electrolytes (1 decks)

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