Fluid and electrolytes worksheet Flashcards
_______________ (fluid inside the cell) = 70% of total body water/40% of body weight
Intracellular fluid
_______________ (fluid outside the cell) = 30% of total body water/20% of body weight
Extra cellular fluid
___________ (is found around the cells) = 25% of total body fluid (excess = edema)
Interstitial fluid
___________ (in the blood vessels) = 8%
Intravascular fluid
8% of body weight
Transcellular
(cerebrospinal, pericardial, synovial, intraocular & pleural
fluids) = minor amounts.
What do GI fluids contain?
Contain electrolyres
Sources of Fluid Gain
Liquids 1500
solid foods 800
Water of oxidation 300- Water formed by the oxidation of foods
Sensible sources of fluid loss
Feces
Urine
Insensible sources of fluid loss
Skin
Lungs
Daily I&O is approximately ___________ ml/day.
2500
Osmosis is the passive movement of _________ across a membrane from an area of _______ solute
concentration to an area of _______ solute concentration.
water
Low solute concentration
High solute concentration
Osmosis is the passive movement of _________ across a membrane from an area of _______ solute
concentration to an area of _______ solute concentration.
water
Low solute concentration
High solute concentration
Osmolality/Tonicity is the
concentration of solutes providing pressure in body fluid
Isotonic is ______ tonicity as the blood
same
Hypertonic = ______ osmolality than blood = water enters vascular space
higher
Hypotonic = _______ osmolality than blood = water enters cells
lower
solutes that readily dissolve (i.e., electrolytes)
Crystalloids
larger molecules that do not readily dissolve (proteins)
Examples include
colloids
EXAMPLE ALBUMIN
low albumin level will lead to generalized pitting edema because there isn’t
enough protein in the blood to keep water within the bloodstream.
Diffusion: _______ move from an area of _______ concentration to an area of _______ concentration.
solutes
high
low
Filtration: _______ and _______ move together from an area of _______ pressure to an area of
_______ pressure.
water and solutes
high
low
Active Transport: requires ATP to move ___________ from an area of low concentration to an area of
higher concentration. Ex. Sodium-potassium pump.
molecules
Colloid osmotic pressure
pressure from proteins such as albumin that cause reabsorption of fluid and
solutes.
Functions of the kidneys
Nephrons form urine by filtering blood.
Retains or resorbs water and electrolytes when needed and excretes more fluids and
electrolytes when in excess.
Secretes renin, which activates the RAAS (renin-angiotensin-aldosterone system)
Aldosterone (secreted by the adrenal cortex) regulates sodium and water reabsorption by
kidneys.
ADH (vasopressin) – produced by the _, secreted by posterior pituitary.
hypothalamus
ADH Reduces
diuresis and _________ water retention if serum osmolality increases or blood volume
decreases.
increases
(Too much ADH = too much water in the interstitial space which causes
Edema
why are the elderly at risk for
F&E imbalance.
Loss of muscle mass to retain fluid
Loss of sense for thirst
confusion, loss of memory, l
RAAS – in response to decreased blood flow (↓ BP):
kidneys secrete ____
Liver secret _____ >
Lungs will secret ___
angiotensin II (liver) >
production of aldosterone by the _ = ______________ of water and sodium
Kidneys-Renin
Liver-Angiotensinogen
Lungs- ACE
Reabsorption
ANP (Atrial Natriuretic Peptide) – Produced and stored in the atrium of the heart. Stops the
action of RAAS – causes _ and _________ excretion of sodium and water.
Vasodilation
Increases
Thyroid hormone – ↑ TH = _ Cardiac output = _urine output
increase
increase
Thirst is regulated by the
Hypothalamus
Body fluid varies with
Age
Gender
Fat
Fat cell percentage
↑fat = ↓ water
Why are Infants/children at risk for fluid and electrolytes imbalance
high percentage of total body water.
Why are comatose, confused or bedridden patients at risk for f&e imbalance
High dependence to perform tasks.
______ is the primary measure of fluid loss/gain**
Daily weights
Measure daily weights with the same
Weight gain of ____ kg in ____ days generally indicates fluid retention
Clothes
Time
Scale
2 kg in 3 days
Intensity of fluid loss or gain
1 kg (2.2 lb) = 1 L of fluid
5% loss = clinically significant
8% loss = severe
15% loss = fatal
Causes of fluid volume deficit
- Excess water and/or electrolyte loss
- Inadequate water and/or sodium intake
- Fluid shifts from bloodstream to interstitial space
what is isotonic dehydration
The other name for Isotonic dehydearion is_______
What are the causes of hypovolemia
Loss of equal electrolytes and water
Hypovolemia
Causes: Decreased blood volume and inadequate tissue perfusion.
What are the causes of isotonic dehydration
- Diarrhea/vomiting/ sweat
- Hemorrhage
- Carbon Monoxide poisoning
- Third spacing (fluid shift from IV to IT) will cause EDEMA.
- Wound suction/drainage/blood loss
- Profuse sweating/heatstroke
- Severe burns
- Diuretic therapy
Inadequate intake and excessive loss of fluids and electrolytes
In isotonic dehydration, Circulating volume ______ but serum osmolarity _____
decreases
remiains constatnt
Hypotonic dehydration is Loss of more _____ than ______
In hypotonic dehydration fluids move from ______ to the _____
Elecrolytes than water
Move from Interstitial to the cell
Hypertonic dehydration is Loss of more _____ than ______
water
sodium
In hypertonic dehydration, Water is pulled out of the _______, into the ____.
Intracellular
Interstitial and blood plasma.
Causes of hypotonic dehydration
Prolonged fever, Hyperventilation
Inadequate sodium during rehydration
Adrenal insufficiency or failure
Excess hypotonic fluid replacement
Cuases of hypertonic dehydration
Inadequate water intake (can’t
obtain independently, NPO,
dysphagia, nausea, anorexia)
* Concentrated enteral feedings/infant
formula.
* Hyperventilation
* Diabetes insipidus
* Hypeglycemia
* Hyperventilation
Lab values for fluid volume deficit
___ HCT
____ Hgb (if blood loss)
____ Na+ level
____ Urine specific gravity
____ BUN
HCT- increased
Hgb (if blood loss) -
Na+ level - >145 INCREASED
Urine specific gravity> 1.30
BUN> 20
Causes of fluid volume excess
Excessive fluid intake
Abnormal fluid retention (disease, medications)
Adrenal gland disorders
Isotonic overhydration is caused by the excess administration of
Sodium and water
Isotonic overhydration is also called.
hypovolemia
Excess fluid stays in the extracellular space therefore causing edema
What is osmotic pressure
pressure that would be required to stop water from diffusing through a barrier by osmosis
What is hydrostatic pressure?
force of fluid in a compartment pushing against a cell membrane or vessel wall
What are the signs and symptoms of dehydration?
DEHYDRATED
D ry mucous membranes
E levated heart rate (early)
H ypotension (orthostatic) – decreased circulatory volume
Y oung babies: sunken fontanelles
D ecreased skin turgor
R efill sluggish (capillary refill)
A ttitude changes – neuro status changes, can lead to seizures
T hirsty – diminished in elderly
E xperience weight loss – weight is a good indicator of fluid status!
D iagnostics – labs can determine type of dehydration
Hypertonic overhydration is caused by_______
The fluid then moves from the _____space to the ______ space.
Excessive consumption of sodium.
Fluid moves from intracellular to extracellur
Hypotonic overhydration is known as
Excess fluid moves from the ______ space to the _____ space
Whst does it cause
Water intoxication
From extracellular to intracellular
Electrolyte imbalance due to dillution
