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Nursing Block 2 > Fluid And Electrolytes Part 1 > Flashcards

Fluid And Electrolytes Part 1 Flashcards

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1
Q

The body is always trying to achieve:

A

Homeostasis

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2
Q

Water uses in the body:

A
  • Metabolic transport
  • Transport
  • Lubricant
  • Insulator
  • Body temperature
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3
Q

How are fluids lost?

A
  • Kidney: Urine output of 1 mL/kg/hr
  • Skin loss: sensible due to sweating and insensible due to fever, exercise, and burns.
  • Lungs: 300 mL everyday, greater with increased RR.
  • GI: Losses due to diarrhea or fistulas.
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3
Q

Factors affecting water balance:

A
  • Age
  • Sex/ Gender
  • Body habitus
  • Temperature
  • Disease state
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4
Q

Approximately 60% of typical adults are fluid, how is this dispersed?

A
  • Intracellular fluid (~40% of body weight/ 28 liters): ⅔ of body fluid, skeletal muscle mass.
  • Extracellular fluid (~20% of body weight/14.5 liters):
    - Intravascular (5% / 3.5 liters): Plasma, erythrocytes, leukocytes, thrombocytes.
    - Interstitial (14% / 10 liters): Lymph
    - Transcellular (1% / 1 liter): Cerebrospinal, pericardial, synovial.
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5
Q

Osmolarity:
Fewer particles =

A

Lower osmolarity

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6
Q

Osmolarity:
More particles =

A

Higher osmolarity

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7
Q

Normal serum osmolarity:

A

280-295 mOsm/kg

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8
Q

Osmolarity - Isotonic fluid:

A

Fluid with the same osmolarity.

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9
Q

Isotonic fluid examples:

A

0.9% NaCl and LR

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10
Q

Osmolarity - Hypotonic fluid:

A

Solutes are less concentrated than the cells.

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11
Q

Hypotonic fluid examples:

A

0.45% NaCl

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12
Q

Osmolarity- Hypertonic Fluid:

A

Solutes are more concentrated than the cells.

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13
Q

Hypertonic fluid examples:

A

3% NaCl

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14
Q

D5W is considered what kind of fluid?

A

Both Isotonic and hypotonic crystalloid fluid.

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15
Q

Osmosis definition:

A

Water moves from an area of low solute concentration to an area of high solute concentration.

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16
Q

During osmosis water moves across a ______ _______.

A

Semipermeable membrane.

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17
Q

Hydrostatic Pressure:

A

Exerted on walls of blood vessels.
Blood pressure generated by heart contractions.

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18
Q

Osmotic pressure:

A

Exerted by proteins in plasma.
Proteins (albumin) in plasma attract water, pulling from the tissue spaces into the vascular space.

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19
Q

The direction of fluid movement depends on differences in:

A

Hydrostatic and osmotic pressure.

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20
Q

Fluid shift is described as:
Fluid can shift from—

A

Fluid can shift from plasma spaces to interstitial spaces.

21
Q

First spacing results in:

A

Normal distribution.

22
Q

Second spacing results in:

A

Abnormal accumulation of interstitial fluid (edema).

23
Q

Third spacing results in:

A

Fluid is trapped where it is difficult or impossible to move back into cells or blood vessels (ascites).

24
Q

What is the primary organ for regulating fluid and electrolyte balance by adjusting urine volume?

A

Kidneys

25
Q

Renal tubules are sites of action for:

A

ADH (Antidiuretic hormone) and Aldosterone.

26
Q

Osmoreceptrs in the _______ sense changes in the body fluid.

A

Hypothalamus

27
Q

A fluid deficit causes:

A

Increased thirst and triggers the release of ADH.

28
Q

Fluid excess causes:

A

Suppression of the release of ADH.

29
Q

Adrenal Cortical regulation releases hormones to:

A

Regulate water and electrolytes.

30
Q

During adrenal cortical regulation, glucocorticoids may cause:

A

Cortisol may cause Na and fluid retention.

31
Q

During adrenal cortical regulation, mineralcorticoids may cause:

A

Aldosterone causes Na retention and K+ excretion.

  • Water retention with Na.
32
Q

Clinical application of RAAS:

A
  • Kidneys sense low perfusion and secrete renin.
  • Renin converts angiotensinogen into angiotensin I.
  • Angiotensin I then is converted into Angiotensin-converting enzyme (ACE) into angiotensin II.
  • Angiotensin II: Powerful vasoconstrictor, Stimulates adrenals to release aldosterone.
33
Q

ACE inhibitors disrupt:

A

The RAAS by reducing the amount of ACE produced.

34
Q

ACE inhibitors cause greater:

A

Excretion of water and Na in the urine.

35
Q

ACE inhibitors block ________ ________ and thus ______ blood pressure.

A

Angiotensin II receptors

Lowers

36
Q

Fluid imbalances occurs due to:

A

Disrupts or the normal homeostatic mechanisms.

37
Q

Dehydration is:

A

Not the same as FVD, loss of water alone, with increased serum sodium levels.

38
Q

Fluid volume deficit (FVD) - Hypovolemia:

A

May occur alone or in combination with other imbalances.

Extracellular fluid loss exceeds the intake ratio of water.

39
Q

Possible causes for FVD:

A
  • Abnormal fluid losses: Vomiting, diarrhea, sweating, and GI suctioning.
  • Decreased intake: Nausea or lack of access to fluids.
  • Third-space fluid shifts: due to burns or ascites.
  • Additional causes: Diabetes insipidus, adrenal insufficiency, hemorrhage, or trauma.
40
Q

Fluid volume excess (FVE) - Hypovolemia:

A

Isotonic expansion of the ECF is caused by the abnormal retention of water and sodium in approximately the same proportions in which they normally exist in the ECF.

41
Q

Possible causes for FVE:

A
  • Heart failure, renal injury or failure, liver failure (cirrhosis), Excessive intravenous solutions and/or blood transfusions.
  • Excessive Oral sodium intake, Abnormal retention of fluids and sodium, or Fluid shift increasing intravascular volume (interstitial-to-plasma fluid shift).
42
Q

Colloid fluids:

A

Stay in vascular space and increase osmotic pressure and pulls fluid into vascular space.

43
Q

Colloid fluid examples:

A

Human plasma products (albumin, fresh frozen plasma, blood), Semisynthetics (dextran and starches, Hespan).

44
Q

Crystalloid fluids:

A

A solution (e. Saline) with small molecules, which can move around easily when injected into the body.

45
Q

Colloid fluid examples:

A

NaCL (0.45%, 0.9%, 3%), LR, D5W.

46
Q

What does pure / sterile water do:

A

Lyse RBCs, never inject without additives.

47
Q

Hypotonic solutions move water from:

A

ECF to ICF by osmosis.

48
Q

Isotonic solutions expand:

A

ECF
No net loss or gain from ICF.

49
Q

Hypertonic solutions initially expand and raise:

A

The osmolarity of ECF.

50
Q

When administering Hypertonic fluids what needs to be monitored?

A

Frequent monitoring of BP, lung sounds, and serum sodium levels.

Nursing Block 2 (4 decks)

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