Fluid and electrolytes in acute settings

Question 1

Why is adequate circulation essential?

Answer 1

• Maintain oxygen and
nutrient delivery to organs
and tissues

• Remove waste products of
cellular respiration

Question 2

What are the 4 things which regulate fluid balance in the body?

Answer 2

The Kidney’s

ADH

Renin-Angiotensin-aldosterone system

Atrial Naturetic Peptide hormone

Question 3

In order for
adequate
circulation
to exist
what must
be
present?

Answer 3

• Good heart function
• Adequate blood volume
• Systemic vascular resistance
• Adequate Haemoglobin
• Oncotic pressure
• Hydrostatic pressure
• Adequate ventilation

Question 4

How many fluid Compartment are in the body?

Answer 4

3

Question 5

What are the three major fluid compartment which are functionally connected?

Answer 5

Intracellular fluid compartment

interstitial fluid

plasma

Question 6

Describe the first type of fluid spacing

Answer 6

Normal distribution within

ECF and ICF

Question 7

Describe the second type of fluid spacing

Answer 7

Accumulation within the
interstitial compartments.

This causes
oedema but fluid is still available for
exchange between compartments

Question 8

Describe the third type of fluid spacing

Answer 8

Accumulation in parts of
the body where it is not available for
exchange between different
compartments e.g. Ascites

Question 9

If there is normal distribution within

ECF and ICF what type of fluid spacing will be presented?

Answer 9

1st spacing

Question 10

If there is if a patient is presenting oedema and ther is an accumulation within the
interstitial compartments. but fluid is still available for
exchange between compartments, what type of fluid spacing is this?

Answer 10

2nd spacing

Question 11

if a patient present wth ascites, what type of fluid spacing is being presented?

Answer 11

3rd spacing

Question 12

What is the volume of each fluid compartment dependent on?

Answer 12

• Total body water amount
• Hydrostatic pressure
• Oncotic pressure
• Solute concentration

Question 13

What is Hydrostatic Pressure?

Answer 13

The pressure which a fluid exerts on the
wall of its container

The force of blood on the blood vessel
walls

Created by systole and intravascular
volume

Question 14

How is oncotic pressure created?

Answer 14

the pull of proteins in the plasma

Question 15

What is main protein responsiblein for creating oncotic into the vebous cavity?pressure

Answer 15

albumin

Question 16

What is albumin?

Answer 16

a protein produced by the liver which creates oncotic pressure in to the vessels

Question 17

How does fluid circulate/move between compartments?

Answer 17

osmosis

diffusion

Question 18

How man molecules of oxygen can haemoglobin hold?

Answer 18

4 oxygen molecules

Question 19

If a patient has a pulmonary oedema, what can the nurse do immediately to relieve symptoms?

Answer 19

sit them up with their legs dangling of the bed.

Question 20

What are some of the clinical manifestations of pulmonary oedema?

Answer 20

• Shortness of breath
• Use of accessory respiratory muscles
• Hypoxia
• Anxiety/Restlessness
• Coarse crackles on auscultation and
percussion
• Expectoration of pink frothy fluid

Question 21

A patient is presenting SOB, and using accessory muscle. They are also expectorating pink frothy fluid. What myight the patient have?

Answer 21

pulmonary oedema.

Question 22

What are the factors which case pulmonary oedema?

Answer 22

↑capillary permeability – cellulitis, sepsis

↑venous (capillary) pressure – heart
failure, venous insufficiency

↓oncotic capillary pressure - ↓albumin
–liver disease, malnutrition

Question 23

What is a pulmonary oedema?

Answer 23

Accumuation of fluid in the lungs around he air sacs.

Question 24

When choosing an IV fluid, what targets should be considered?

Answer 24

Maintenance fluid

Fluid resuscitation (Intravascular space)

Whole body hydration (intracellular compartent