Fluid balance

Question 1

Contains the fluid inside the billions of cells within the body. Largest of the two compartments. 2/3 of total body water.

Answer 1

Intracellular fluid

Question 2

Contains any fluid outside the cell. 1/3 of total body water. Divided into what three compartments?

Answer 2

Extracellular fluid
Interstitial and intravascular are the major
transcellular is the minor

Question 3

Produced in the brain and stored in and released by the posterior pituitary gland. Results in a decreased production of urine.

Answer 3

Antidiuretic hormone (ADH)

Question 4

Produced by the adrenal cortex through the renin-angiotensin-aldosterone system (RAAS). Regulates sodium and potassium balance but how?

Answer 4

Aldosterone
Circulates to the kidneys where it causes resorption of sodium and water in the distal renal tubules into the blood, causing increases in the volume of ECF.
Increases urinary excretion of potassium and hydrogen ions.

Question 5

Produced from specialized cells in the atrial muscle of the heart. Released in response to stretching of the atrial muscle during periods of circulatory overload

Answer 5

Atrial natriuretic peptide (ANP)

Inhibits ADH by increasing loss of sodium and water in the urine. Opposes the effect of aldosterone.

Question 6

What is the primary regulator of fluid intake?

Answer 6

Thirst. Hypothalamus is activated.

Question 7

Chemical compounds that do not dissociate in solution. Are the chemical end products of carbs, proteins, fats

Answer 7

Non-electrolytes

Question 8

Chemical compounds that dissociate in solution to form ions (charged particles)

Answer 8

Electrolytes

Positive are cations, negative are anions. They combine to make mineral salts/electrolytes.

Question 9

What is sensible and insensible fluid loss?

Answer 9

Sensbile is kidneys and GI tract

Insensible (not visible) is skin and respirations

Question 10

Expands fluid volume without causing a fluid shift. Expands the ECF. Have the same osmolality or tonicity as blood. Used for patients who are hypotensive due to hypovolemia.

Answer 10

Isotonic solutions
0.9% sodium chloride
Lactated Ringers

Question 11

Allows fluids to shift out of blood vessels to move into cells. Has a lower osmolality and is more dilute than blood. Used for patients who need cellular hydration (DKA or increased glucose levels)

Answer 11

Hypotonic solutions
0.45% sodium chloride (half normal saline)
5% dextrose

Question 12

Causes fluid to shift from the interstitial and intracellular space into the intravascular space. Has a higher osmolality and is more concentrated than blood. Used to decrease peripheral edema, stabilize BP, and adequate urinary output.

Answer 12

Hypertonic
D10W, D20W
3% NaCl

Question 13

What is the most common electrolyte to be added to IVs?

Answer 13

Potassium (K+). Can only be given IV or PO. Must be diluted. Cannot be given faster than 10 mEq/hr. Max that can be given is 40 mEq/hr.

Question 14

How much weight lost is equal to how much fluid?

Answer 14

1 kf og weight gained or lost Is equal to 1 liter of fluid gained or lost

Question 15

Dehydration

Fluid overload

Answer 15

Hypovolemia

Hypervolemia

Question 16

Decreased intake due to fluids being unavailable

Answer 16

Fluid deficit. Diuretic therapy, diarrhea, vomiting, gastric suctioning, anorexia, third spacing-fluid is not available or use, sweating

Question 17

What are the characteristics of body fluids?

Answer 17

Fluid amount/volume
Concentration/osmolality
Composition/electrolyte concentration
Degree of acidity/pH

Question 18

Fluid that’s between the cells and outside blood vessels

Answer 18

Interstitial fluid

Question 19

Fluids such as cerebrospinal, pleural, peritoneal, and synovial fluids that are secreted by epithelial cells

Answer 19

Transcellular fluids

Question 20

Examples of cations in body fluids?

Answer 20

Sodium, potassium, calcium, magnesium

Question 21

Examples of anions in body fluids?

Answer 21

Chloride and bicarbonate

Question 22

A measure of the number of particles per kg of water

Answer 22

Osmolality

Question 23

Concentrations of what are higher in the ECF?

Answer 23

Sodium, chloride, bicarbonate

Question 24

Concentrations of what are higher in the ICF?

Answer 24

Potassium, magnesium, and phosphate

Question 25

How do cells maintain their high intracellular electrolyte concentration?

Answer 25

Active transport. Requires energy in the form of ATP to move electrolytes across cell membranes against the concentration gradient, from areas of lower concentration to higher.

Question 26

The force of fluid pressing outward against a surface. Capillary vs interstitial fluid?

Answer 26

Hydrostatic pressure.
Capillary one moves fluid from capillaries to the interstitial fluid. IF is a weaker opposing force that tends to push fluid back into capillaries.

Question 27

An inward-pulling force caused by blood proteins that helps move fluid from the interstitial area back into capillaries

Answer 27

Colloid osmotic pressure, or oncotic pressure

Normally a very small opposing force

Question 28

What happens at the arterial end of a normal capillary?

Answer 28

Capillary hydrostatic pressure is strongest, and fluid moves from the capillary into the interstitial area, bringing nutrients into cells.

Question 29

What happens at the venous end of a normal capillary?

Answer 29

Capillary hydrostatic pressure is weaker and the colloid osmotic pressure of the blood is stronger. Fluid moves into the capillary, removing waste products from cellular metabolism.

Question 30

How does fluid distribution occur?

Answer 30

Between extra cellular and intracellular occurs by osmosis.

Between vascular and interstitial parts of the ECF by filtration.

Question 31

An infants proportion of total body water is greater than that of children or adults. How much? Risks?

Answer 31

70-80%. Have greater water needs and immature kidneys. Greater risk for ECV deficit and hypernatremia because body water loss is proportionately greater per kg of body weight.