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NUR 324: Medsurg > Fluid Balance > Flashcards

Fluid Balance Flashcards

1
Q

Percentage of water in premature babies

A

83%

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2
Q

Percentage of water in infants

A

77%

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3
Q

Percentage of water in adults

A

60%

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4
Q

Percentage of water in elderly

A

50%

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5
Q

Do fat cells hold more water

A

No

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6
Q

How much TBW is in the intracellular fluid

A

2/3 of TBW or 28L

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7
Q

How much TBW is in the extracellular fluid

A

1/3 TBW or 14L

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8
Q

What is the ECF (extracellular fluid) composed of

A

ICF (interstitial fluid) and IVF (intravascular fluid)

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9
Q

Where is the interstitial space

A

Between tissues

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10
Q

Where is the intravascular space

A

Within blood vessels

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11
Q

Intra-

A

Within

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12
Q

Inter-

A

Between

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13
Q

Extra-

A

Outside

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14
Q

Cation

A

Positive charge

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15
Q

Anion

A

Negative charge

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16
Q

How much water is in the interstitial space

A

75% of extracellular water or ~15% of body weight

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17
Q

Pedal edema

A

Swollen ankles

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18
Q

How much water is in the intravascular space (blood)

A

25% of extracellular water or ~5% of body weight

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19
Q

What is the only fluid compartment that can be measured directly

A

Intravascular space or blood

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20
Q

What is blood made of

A

Water mixed with
- Molecules (glucose, creatinine, lipids, vitamins)
- Electrolytes (K+, Na+, Cl-)
- Blood cells (RBCs, WBCs)
- Platelets (not a cell but a piece/fragment of a cell)
- Proteins (albumin, globulin, fibrinogen)

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21
Q

Globulin

A

A blood protein responsible for immune functioning

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22
Q

Fibrinogen

A

A blood protein responsible for blood clotting

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23
Q

Albumin

A

A blood protein that maintains colloid osmotic pressure in the extracellular space

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24
Q

Colloid osmotic pressure

A

Osmotic (water) pressure from proteins (albumin) in a blood vessel that exerts a greater pull than smaller molecules
- Water will follow the protein

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25
Q

Where does the diffusion of oxygen in nutrients from the blood go into tissues occur

A

Capillaries

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26
Q

Where does the diffusion of waste products from metabolism from the tissues in the blood occcur

A

Capillaries

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27
Q

Plasma

A
  • Water
  • Molecules
  • Electrolytes
  • Proteins (minus RBC & WBCs)
  • Platelets
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28
Q

Serous

A

Clear fluid without blood, pus, or debris

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29
Q

Sanguinous

A

Bloody or red drainage

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30
Q

Serosanguinous

A

Watery pale red to pink fluid

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31
Q

Osmotic pull

A

Proteins exerting a pull of water back into the blood vessel and the small molecules

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32
Q

Hydrostatic pressure

A

Push from the heart and out through the capillary walls

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33
Q

Osmotic pressure

A

Push or pull of the large molecules (albumin) which pull water with them wherever they’re located

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34
Q

Cardiac output

A

The amount of blood pumped by the heart through the intravascular system (blood vessels) per minute

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35
Q

Cardiac output equation

A

CO = SV x HR

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36
Q

Stroke volume

A

The amount of blood pumped by the heart per beat

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37
Q

Anuria

A

No urine output

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38
Q

Oliguria

A

Limited urine output
- Less than 400 mL of urine in 24 hours

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39
Q

Normal osmolality (n)

A

270 - 295 mosm/kg +/- -5 of body weight

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40
Q

Osmolarity

A

Measures the amount of solutes to water using liters
- mOsm/L

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41
Q

Osmolality

A

Calculates the amount of solutes to water using weight or kilograms
- mOsm/kg

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42
Q

Clysis

A

Injection of fluid into the body when venipuncture is not possible
- Route chosen is the subcutaneous infusion (under the skin) which is also known as hypodermoclysis

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43
Q

Systolic pressure

A

Pressure exerted by circulating blood on the walls of blood vessels while the heart is pumping

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44
Q

Hydrostatic pressure

A

Pressure of water
- Blood pressure

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45
Q

Isotonic

A

Same concentration inside and outside the cell - cells in this solution do not lose or gain fluid
- 0.9% NS or 0.9% NaCl

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46
Q

Hypotonic

A

Less concentraiton outside the cell - water moves into the cell
- 0.5% NS or 0.45% NS

47
Q

Hypertonic

A

More concentration outside the cell - water from cells and interstitial spaces goes into the blood or intravascular space
- 3% NaCl

48
Q

Indentation of < 1/4 inch

A

1+ pitting edema

49
Q

Indentation between 1/4 and 1/2 inch

A

2+ pitting edema

50
Q

Indentation between 1/2 inch and 3/4 inch

A

3+ pitting edema

51
Q

Indentation between 3/4 and 1 inch

A

4+ pitting edema

52
Q

Eclampsia

A

Condition that causes convulsions and is assess early by checking for proteinuria (protein in urine)

53
Q

Nephrotic syndrome

A

Albumin is not filtered and all of it is allowed to pass right through the tubular system and is lost in the urine which causes low plasma proteins

54
Q

Osmosis

A

Movement of water across a semi-permeable membrane from an area of LESSER concentration of molecules to an area of GREATER concentration of molecules

55
Q

Diffusion

A

Movement of molecules from an area of HIGHER concentration of molecules to LOWER concentration of molecules

56
Q

Active transport

A

Pushing of substances across/against a concentration of electric gradients using energy
- Glucose
- Na/K pump

57
Q

Aldosterone

A

The major regulator of sodium balance (ECF) that causes resorption of Na+ and water - removes Na+ and water from renal tubules and returning it to blood increased ECF volume

58
Q

Antidiuretic hormone (ADH)

A

Controls excretion of water in urine by causing renal cells to reabsorb water, taking it from the renal tubular fluid and putting it back into blood - decreases urine volume

59
Q

Atrial natriuretic peptide (ANP)

A

In response to stress (cardiac), causes diuresis (increased excretion of urine) and decreases cardiac workload - weak hormone that increases the loss of Na+ and water in urine
- Opposite effect of aldosterone

60
Q

MAP

A

Mean arterial pressure which reflects the average perfusion pressure
- Normal: 70-105 mmHg
- Major organs require a MAP of 65 mmHg to maintain blood flow

61
Q

Brain natriuretic peptide (BNP)

A

Initiated from too much strain on the heart (ventricles) due to increased water so it blocks aldosterone
- Natriuretic hormone initially identified in the brain but released primarily from the heart, particularly in the ventricles
- More common than ANP
- Normal: 100
- Heart failure: 300

62
Q

Insensible loss

A

Fluid losses that are unnoticed
- Process of respiration causes water loss
- Simple evaporation off the skin (not only sweat)

63
Q

What is normal urinary output for 24 hours

A

~1500 mL/day

64
Q

What is calculated insensible loss (lung, sweat, solid stool) for 24 hours

A

1000 mL/day

65
Q

Crystalloid IVs

A

Solutions with fluids and electrolytes

66
Q

Colloid IVs

A

Solutions with proteins (albumin), dextran, or blood

67
Q

Total parenteral nutrition (TPN) & partial parenteral nutrition (PPN)

A
  • IV solutions that are high in glucose, amino acids, vitamins, and fats
  • Nutritious solutions that are ready for use → the gut doesn’t have to break it down → ready for cellular use
  • Contain carbohydrates in the form of sugar or glucose, protein in the useable form of amino acids, and fats in the form of lipids
  • Vitamins are added to the solution
68
Q

Central line

A

A catheter placed in a very large vein (subclavian or jugular) that is advanced to the superior vena cava (right side of the heart)

69
Q

Peripherally inserted central catheter (PICC)

A

An IV in the arm but ends in the superior vena cava because it’s a central line

70
Q

Air embolism

A

A blockage of blood supply caused by air bubbles in a blood vessel or the heart

71
Q

Ischemia

A

Inadequate blood supply to a local area due to blockage of blood vessels leading to that area
- Temporary

72
Q

Infarction

A

Death of tissue
- Permanent

73
Q

Enteral

A

To feed someone via their GI tract
- Anywhere from mouth, esophagus, stomach, or small intestine

74
Q

Parenteral

A

Any route of administration of a substance other than via the digestive tract
- Intravenous
- Subcutaneous

75
Q

Nasogastric (NG) tube

A

A tube that goes through the nares into the stomach

76
Q

Nasojejunal/intestinal (NJ) tube

A

A tube that goes through the nares into the jejunal or intestine

77
Q

Single lumen feeding tube

A

Are only used to put food/fluid/medication in and CANNOT be used to decompress (or take fluid/air out of the stomach)

78
Q

Double lumen feeding tube

A

Can decompress (take fluid/air out) the stomach
- One lumen is an air vent

79
Q

Euvolemic

A

Normal fluid balance

80
Q

Hypervolemic

A

High fluid balance

81
Q

Hypovolemic

A

Low fluid balance

82
Q

What is the Parkland formula and what is it used for

A

Used for burns
4 mL x %TBSA (total body surface area) x kg

83
Q

Jugular vein distention (JVD)

A

When the jugular vein is full which indicates FVE and right ventricular failure

84
Q

Dependent edema

A

Edema that’s specific to different parts of the body that are influenced by gravity
- Legs
- Feet
- Arms

85
Q

Symmetric edema

A

Symmetrical swelling
- Both legs
- Both feet
- Both arms

86
Q

Baroreceptors

A

Specialized sensory nerves that are sensitive to changes in blood pressure

87
Q

Pulse pressure

A

The difference between the systolic and the diastolic pressure (typically 60-80 mL/beat)
- BP = 120/70 = 50 mmHg pulse pressure

88
Q

How many mL in a pound

A

500 mL

89
Q

Hemoconcentration

A

Increased concentration of cells and solids in the blood usually resulting from loss of fluid in the tissues
- More molecules and less water

90
Q

Normal hemoglobin/hematocrit for a man

A

42-50%

91
Q

Normal hemoglobin/hematocrit for a woman

A

36-48%

92
Q

Hemodilution

A

Removing RBCs to lower the hematocrit

93
Q

Hematocrit

A

The proportion of RBCs present in the blood stream or intravascular space
- HCT of 45% = 45% of the whole blood is comprised of RBCs

94
Q

Hemoconcentration

A

Increase in hematocrit which means there’s less water in the blood stream = increase in RBCs in blood

95
Q

Blood urea nitrogen (BUN)

A

Reflects protein metabolism

96
Q

Creatinine (Cr)

A

Reflects muscle metabolism

97
Q

Normal BUN levels

A

7-18 mg/dL

98
Q

Normal Cr levels

A

0.6-1.2 mg/dL

99
Q

Normal BUN/Cr ratio

A

10-15:1

100
Q

Uremia

A

Excess urea in blood but also includes s/s associated with lab abnormalities
- Associated with kidney failure

101
Q

Central venous pressure (CVP) or right atrial pressure (RAP)

A

Measure of right ventricular preload (volume of blood returning to heart) and is measured via a catheter that sits in the superior vena cava or right atrium
- Measures pressure filling of right ventricle and is related to the interplay of blood volume, vessel tone, and right ventricular function (pump capability)

102
Q

Pulmonary Artery Wedge Pressure (PAWP)

A

Measure of the left ventricular preload or volume going to the left ventricle of a patient with a pulmonary catheter which sits in the pulmonary artery

103
Q

Periorbital edema

A

Edema around the eyes

104
Q

How to calculate urinary output per hour

A

.5 - 2 mL/kg/hr of urine

105
Q

Poor Man’s method to guesstimate serum osmolality

A

(2(Na+) + Glucose) / 18 + BUN / 2.8 = serum osmolality

106
Q

Diabetes insipidus

A

The body produces too much urine and people often feel thirsty

107
Q

Third spacing

A

Occurs when fluid moves from the IVS (blood vessels) into the interstitial or transcellular space (“third” space)

108
Q

Syncope

A

Temporary loss of consciousness due to fall in blood pressure

109
Q

What is normal pulse range

A

60 - 100 bpm

110
Q

What is normal blood pressure

A

120 / 80

111
Q

Diastolic pressure

A

Pressure exerted on the walls of the blood vessels when the heart is in filling/relaxed phase

112
Q

Diastolic pressure

A

Pressure exerted on the walls of the blood vessels when the heart is in filling/relaxed phase

113
Q

Diastolic pressure

A

Pressure exerted on the walls of the blood vessels when the heart is in filling/relaxed phase

NUR 324: Medsurg (3 decks)

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