fluid balance Flashcards
What is the focus of Medical/Surgical Nursing?
Protection, promotion & optimization of suffering through the diagnosis and treatment of human responses and advocacy in the care of individuals, families, communities, and populations.
Define Homeostasis.
Defining feature of physiology.
What is the most common fluid and electrolyte disorder in the U.S.?
Dehydration.
What are the two main fluid compartments in the body?
- Intracellular
- Extracellular
What is the difference between interstitial fluid and plasma?
Plasma contains higher concentrations of protein.
List the mechanisms of fluid and electrolyte movement.
- Simple diffusion
- Facilitated transport or diffusion
- Active transport
- Osmosis
- Hydrostatic pressure
- Oncotic or osmotic pressure
What is simple diffusion?
Molecules in constant random motion move from areas of high concentration to lower until net flux is equal.
What is facilitated diffusion?
A process of passive transport aided by membrane proteins.
What is active transport?
Uses energy to move molecules against a concentration gradient, from low to high concentrations.
What is the sodium-potassium pump?
An active transport system that moves sodium out of the cell and potassium into the cell.
What is hydrostatic pressure?
Pressure pushing fluid out of the cell.
What is oncotic pressure?
Pressure keeping fluid in the cell.
Define osmolality.
Measures the number of milliosmoles/kg of water.
What is the normal plasma osmolality range?
Between 275 and 295 mOsm/kg.
What is the role of the hypothalamus in fluid balance?
It acts as the thirst center.
What hormones are involved in fluid balance regulation?
- ADH (Pituitary)
- RAAS (Renal)
- ANP and BNP (Cardiac)
What are insensible losses?
Not visual or measurable losses, for example, through breathing and sweating.
Name three concerns when caring for an older adult experiencing a fluid and electrolyte disorder.
- Decreased body water
- Decreased thirst mechanism
- Increased moisture loss
What are the clinical manifestations of Extracellular Fluid Volume Deficit (ECFVD)?
- Fatigue
- Dizziness
- Dryness
- Weight loss
- Decreased urine output
- Low blood pressure
- Increased heart rate
- Weak and thready pulse
- Dry mucous membranes
- Tenting
What are lab indicators of ECFVD?
- Osmolality above 295 mOsm/kg
- Plasma sodium above 145 mEq/L
- Blood Urea Nitrogen above 25 mg/dl
- Hematocrit above 55%
- Urine specific gravity above 1.030
What is the goal for a patient with fluid volume deficit?
Client will urinate at least 30ml/hr.
What type of fluids are used for IV rehydration?
- Hypotonic
- Isotonic
- Hypertonic
What are isotonic fluids used for?
Fill vascular space.
What is the expected intervention for a client experiencing third spacing?
Identify and treat the cause.