Fluid and Electrolytes Flashcards
(109 cards)
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
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
3
Q
what is hypertonic solutions
A
greater concentration than plasma
osmotic pressure shifts fluid from the cells
RBC shrink
intravascular dehydration
4
Q
what does fluid balance consist of
A
fluid intake and absorption
fluid distribution
fluid output
5
Q
examples of fluid intake
A
drinking
eating foods
thirst and habit
6
Q
movement of fluid among its various compartments equal
A
fluid distribution
7
Q
what regulates fluid intake
A
thirst- 2300ml/day
8
Q
what are hormonal influences for fluid intake
A
antidiuretic hormone
renin-angiotensin-aldosterone mechanism
atrial natiuretic peptides
9
Q
what is insensible loss
A
water loss through the skin and lungs, which is not measurable
10
Q
what is sensible loss
A
water loss through feces, urine, wound drainage, which is measurable
11
Q
where do fluid output happen
A
kidney, skin, lungs and GI tract
12
Q
abnormal fluid output
A
vomiting, wound draining, hemorrhage
13
Q
fluid output influenced by
A
antidiuretic hormone
renin-angiotensin-aldosteron system
atrial natriuretic peptides
14
Q
what is adrenal cortical regulation
A
hormones released by the adrenal cortex help regulate both water and electrolyte
15
Q
what is renal regulation
A
kidney regulate water balance through adjustment in water volume
16
Q
the hypothalmic are
A
thirst receptors
17
Q
what is pituitary regulation
A
posterior pituitary release ADH which regulates water retention by kidneys
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
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
20
Q
cations include
A
sodium
potassium
calcium
magnesium
21
Q
anions
A
chloride
bicarbonate
phosphorus
22
Q
sodium
A
major catio abundant in ecf control water balance condution of nerve impulses 135-145 mEq/L
23
Q
hyponatremia
A
less than 135mEq/L
results from excess water or loss of Na
24
Q
signs and symptoms of hyponatremia
A
muscle weakness vomiting lethargy confusion seizures
25
treatments of hyponatremia
foods high in Na
diuretics
0.9Z%NaCi
26
hypernatremia
greater than 145 mEq/L
results from Na excess or water loss
water moves out of cells into vascular space-cellular dehydration
27
signs and symptoms of hypernatremia
thirst
dry mucous membranes
flushed skin
28
treatment of hypernatremia
fluids (hypotonic solution)
0.33% NaCi
low Na diet
29
additional signs and symptoms of hypernatremia
```
increased fluid retention
restlessness and irritability
elevated BP
edema
decreased urinary output
```
30
potassium
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
31
hypokalemia
less than 3.5 mEq/L
results from loss via GI tract and potassium depleting diuretics
life threatening
32
signs and symptoms of hypokalemia
```
muscle weakness
leg cramp
u wave
cramps
constipation
cardiac dysrhythmias
thigoxin
irregular weak pulse
orthostatic hypotension
```
33
treatment for hypkalemia
```
replace K
diet
meds
add KCL to IV
monitor EKG
```
34
hyperkalemia
greater than 5 mEq/L
| result from renal failure, excessive intake, trauma, crush injuries, burns
35
sign and symptoms
muscle weakness
cardiac changes
parathesia of face/finger/tongue
36
treatment of hyperkalemia
insulin
IV
dialysis
37
what are some K+ deficits
```
alkalosis
shallow respirations
irritability
confusion, drowsiness
weakness, fatigue
arrhythmias (irregular rate, tachy)
lethargy
thready pulse
drecreased intestinal motility
```
38
calcium
```
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
```
39
hypocalcemia
Ca less than 8.5 mEq/L
| loops diuretics, parathyroid disorders, renal failures, hypoparathyroidism
40
signs and symptoms of hypocalcemia
```
osteoporesis
cardiac dysrhythmias
tetany
fractures
tingling
chovstek sign (+)
trousseau sign (+)
```
41
hypercalcemia
Ca greater than 10.5 mEq/L
| causes multiple fractures, hyperthyroidism, some cancers, TUMS, immobiliztion
42
signs and symptoms of hypercalcemia
muscle weakness, renal calculi, decreased GI motility, cardiac changes, CNS changes
43
chloride
98-106 mEq/L
combine with Na to form slats maintains water balance
most abundant anion in ECF
44
hypochloremia
less than 98 mEq/L
| results from prolonged vomitting and suctioning
45
signs and symptoms of hypochloremia
metabolic alkalosis, nerve excitability, muscle cramps, twitching
46
hyperchloremia
greater than 106 mEq/L
| results from excessive intake or loss via kidneys and dehydration
47
signs and symptoms of hyperchloremia
arrhythmias, decreased cardiac output, LOC changes, kussmals respiration
48
phosphate
2.7-4.5 mg/dl
| needed for acid-base balance, neuroligical and muscle function, energy transfer and metabolism of carbs/proteins/lipids
49
hypophosphatemia
less than 2.7 mg/dl
| results from decreased intestinal absorption and increased excretion
50
signs and symptoms of hypophosphatemia
bone and muscle, pain, mental changes, chest pain, respiration failure
51
hyperphosphatemia
greater than 4.5 mg/dl
| results from renal failure, large intake of calcium
52
signs and symptoms of hyperphosphatemia
neuromusculare changes (tetany), EKG changes, parathesia finger tips/mouth
53
what is electrolyte homeostasis
to maintain balance to control by balancing the dietary intake of elctrolytes with the renal excretion and reabsorption of electrolytes
54
daily weights
is the most accurate indicator of water balance
55
hematocrit
increases with dehydration, and decreases with overhydration
56
hematocrit
percentage of cells in 100 ml blood
males 42-52%
females 37-47%
57
osmolarity
serum and urine osmolarity both increase with dehydration
58
urine specific gravity
1.010-1.025
| increases with dehydration
59
urine PH
4.6-8.0
60
serum sodium
increases with excessive fluid losses
| decreases with excessive fluid intake
61
serum albumin
3.5-5.0g/dl
helps maintain osmotic pressure
cannot pass thru cell membranes
62
peripheral edema
smooth, shiny, pale, cool skin
swelling especially in legs
weight gain
63
pulmonary edema
constant cough
dyspnea
moist rales in lungs
bounding pulse
64
infiltration
fluid leaked out of vein to surrounding tissue
| swellin, coolness, discomfort, pallor, slowed rate, pain , pale to color(blanching skin)
65
phlebitis
swelling, warmth, redess, tenderness, red streak
66
fluid overload
SOB, distended neck veins, elevated BP, crackles in lungs, tachycardia
67
fludi volume deficit
aka hypovolemia
dehydration
elevated hemaocrit
major cause is fluid shift of vascular space
hemorrhage, vomiting, diarrhea, burns, crushing injuries
68
signs and symptoms of hypovolemia
```
increased HR, decreased BP,
thirst, decreased motility
decreased CNS activity
decreased output
dry mouth, poor turgor
```
69
fluid volume excess
aka hypervolemia
intercellular tissue
loss of ecf from vacular to other body compartments
70
fluid volum excess causes
```
increased Na/H2O retention
excessive intake of Na/H2O
fluid shifting from icf to ecf
renal failure
congestive heart failure
```
71
signs and symptoms of fluid volume excess
```
anxiety
dyspnea
crackes
tachypnea
increased BP
distended jugular veins
edema
third spacing
weight gain
```
72
what is the primary body fluid
water
73
what is fluid balance
fluids gained each day= fluids lossed each day
| 2.5L/day
74
what maintain proper fluid balance
skin, kidney and lungs
75
what is fluid
water that contains dissilved or suspended substances such as glucose, mineral, salts, and proteins
76
fluid concentration equals
osmolality
77
degree of acidity equal
Ph
78
elderly people
lower percentage of total body fluid than young adults due to higher body fat
79
women
lower percentage total body fluid than men due to higher body fat
80
fat cells
contain less water than muscle cells
81
risk factors for older adults
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
what is intracellular fluid
fluid insid the cell
| 2/3 of total body water
83
what is extracellular fluid
fluid outside the cell
| 1/3 ot total body water
84
what is interstitial fluid
around and between cells
85
what is intravascular
plasma fluid in blood vessels
86
what is the total body water volume
40L, 60% body weight
87
what is the fluid volume for intracellular
25L, 40% body weight
88
what is the fluid volume for extracellular
15L, 20% body weight
89
what is the fluid volume for interstitial
12L. 80% of ECF
90
what is the total plasma volume
3L, 20% of ECF
91
what is osmolarlity
the number of particles
92
what is solvent
liquid with a substance in solution
93
what is solute
the substance in the solution
94
what is active transport
movement of ions against osmotic pressure to an area of higher pressure ; requires energy
95
what is diffusion
passive movement of electrolytes or other particles down the concentration gradient from higher to lower concentration
96
what is osmosis
movement of water or other solute from an area of lesser to one of greater concentration
97
what is filtration
movement across a membrane under pressure from higher to lower pressure
98
types of isotonic solutions
dextrise 5% in water
0.9 normal saline
lactated ringers
99
types of hypotonic solutions
0. 45% NS
| 0. 33% NS
100
types of hypertonic solution
0.45% NS
0.9% NS
D 10 W
101
what is body fluids
water and electrolytes
102
what type of client should be monitiored closely
patients that are not eating, drinking or NPO
103
who are high risk population for fluid and electrolytes
infants
older adults
patient with cardiac and renal problems
104
older adults has less body fluid as there is an
increase in fat cells with aging (muscle cells turn into fat cells)
105
for osmosis to occur 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
because of osmosis
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
what is osmotic pressure
the pull of particles
108
the osmotic pressure and number of particles is what
makes up different types of IV solutions
109
what happens when a patient takes a diuretic
patient loses fluid and electrolytes
