Fluid balance and intravenous therapy - exam 2 Flashcards
movement of fluid ( water) across cell membrane due to hydrostatic pressure
filtration
movement of solutes (substances) from higher to lower concentration
diffusion
movement of fluid (Water) from areas of more fluid to areas of less fluid
osmosis
solutes (particles) move from an area of higher concentration to an area of lower concentration resulting equal distribution
diffusion
in diffusion, solutes
move
fluid ( water) moves from areas with lower solute concentration to areas with higher concentration
osmosis
in osmosis fluid
moves
is generated by the
cardiovascular system as blood is pumped
through the body’s blood vessels
hydrostatic pressure
DS
diffusion/solutes
OF
osmosis/fluid
a type of biological or synthetic, polymeric membrane that will allow certain molecules or ions to pass through it by osmosis.
Semipermeable membrane
osmotic balance
control of water and electrolyte balance in the body
the active regulation of the osmotic pressure of bodily fluids to maintain the homeostasis of the body’s water content; that is it keeps the body’s fluids from becoming too dilute or too concentrated
Osmoregulation
exerted by pumping of heart
hydrostatic= pushing force - pushes fluid out of capillaries
is the ‘pulling force’ pulling fluids from the surrounding tissue into the capillaries.
Oncotic pressure
what do we associate hydrostatic pressure with?
think heart - pushing fluid out
what do we associate oncotic pressure with?
think albumin - pulling fluid in
condition where fluid accumulates in a pocket that is not serving a purpose
third spacing
this happens when fluid accumulates and does not serve a purpose
third spacing
occurs as a result of increased permeability of the capillary membrane or decreased plasma colloid osmotic pressure
third spacing
common causes of edema ?
long periods of standing or sitting
chronic lung diseases
CHF
albumin level in lab value will be low
starvation
if the heart is not pumping well, not enough pushing fluid through capillary so get a build up of hydrostatic pressure can lead to
edema
an accumulation of interstitial fluid within tissues
edema
severe, generalized edema marked by profound swelling of subcutaneous tissues and accumulation of fluid in body cavities
anasarca
sodium and potassium use ATP to move in and out of cells in a form of
active transport called the sodium potassium pump
ICF
fluid inside the cells
ECF
fluids outside of the cells
fluid found inside the cells
intracellular 2/3 of fluid
fluid outside the cells
extracellular 1/3 of fluid
fluids outside of the cell must be balanced with
intracellular fluid
to maintain balance or homeostasis inside the cell must
be balanced with ectracellular fluid
found in the vascular system that consists of arteries, veins and capillary networks
intravascular
is whole blood volume and also includes red blood cells, white blood cells, plasma, and platelets
intravascular fluid
fluid between cells
interstitial
cerebral spinal fluid, synovial fluid, peritoneal and pleural fluid
transcellular
what small molecules move easily across the cell membrane
urea and water
what substances have a harder time getting across the membrane
protein
osmolality is measure by?
Kg
used to assess body state of water balance?
osmolality
water deficit
high osmolality
water excess
low osmolality
osmolarity is measure in
Liters
normal osmolarity would be
270-300
normal saline is
isotonic 0.9% NaCl
why is saline isotonic ?
same concentration of sodium in the blood
hypotonic causes the cells to
swell
hypertonic does what to the cells?
makes cells skinny; fluid pulled from cell so cells shrink
what are the three types of osmosis?
- hypertonic
- isotonic
- hypotonic
has the same solute concentration as another solution; no fluid shifts occur because the solutions are equally concentrated
isotonic
less concentrated than other solutions; fluid pulled or moved from the bloodstream (veins) into the cells =swell
hypotonic
more concentrated than other solutions; fluid pulled from the cell into the bloodstream = shrink
Hypertonic
things that maintain balance
- kidneys
- ADH
- RASS
-ANP - Thirst
regulate fluid and electrolyte balance by adjusting urine volume and the excretion of electrolytes
kidneys
remove excess wastes from the body
kidneys
7 functions of the kidneys
A- controlling ACID base balance
W- controlling WATER balance
E- maintaining ELECTROLYTE balance
T- removing TOXINS and waste products from the body
B- controlling BP
E- producing the hormone ERYTHROPIETIN
D- activating Vitamin D
produced by hypothalamus and stored in the pituitary
anti diuretic hormone
ADH restores blood volume by
- reducing diuresis
- increasing water retention
- vasoconstricts
what medication is the medication form of ADH
vasopressin- Desmopressin
renin acts to produce ?
angiotensinogen
angiotensin 1 produces?
converts to angiotensin 2
vasoconstriction causes the BP to
increase
A2 stimulates release of
Aldosterone
Aldosterone increases
BP
Water regulator
Aldosterone
Causes kidney to retain Na+ and H20
Alderstone
Causes kidney to retain Na+ and H20
Aldosterone
what is released when Na+ is low and K+ is high
Aldosterone
Stored in Kidneys
Aldosterone
produced and stored in the atria
atrial natriuretic peptide (ANP)
stops reaction of RAAS
ANP
decreases blood by vasodilation
ANP
reduces fluid volume by increasing secretion of Na+ and water
ANP
regulated by the hypothalamus
Thirst
stimulated by increase ECF and drying of mucous membranes
Thirst
causes a person to drink fluids
Thirst
What Depletes Electrolytes ?
- vomiting
- peeing
-pooping
-sweating
fluid deficit of isotonic fluid in extracellular space caused by abnormal ? (8)
- fluid loss
- fever
- sweating
- hemorrhaging
- vomiting
- diarrhea
- Gi Suction
- decrease fluid intake
fluid deficit of isotonic fluid in extracellular space
hypovolemia
fluid excess of isotonic fluid ( sodium & water ) in the extracellular space
Hypervolemia
abnormal retention of sodium and water
hypervolemia
-isotonic fluid overload
- excess sodium intake
- heart failure, renal failure, liver cirrhosis
hypervolemia
danger signs for fluid deficit
- restlessness, confusion
- cold clammy skin
- decreased tugor
- weak, rapid HR
- rapid respirations
- decreased urine output
danger signs of fluid excess
- headache, confusion
- peripheral edema
- jugular vein distension
- S3 heart sound
- bounding pulse
- dyspnea
- weight gain
How to treat hypovolemic shock
- fluid replacement ~ NS, LR, blood transfusion, vasopressor
- oxygen therapy
- monitor Vs and mental status
- monitor lung sounds
decrease in BP
hypovolemia
