fluid, electrolyte, acid-base balance

Question 1

what are the body fluid compartments

Answer 1

intracellular and extracellular

Question 2

what is the intracellular compartment

Answer 2

critical for maintaining cell size, 70% of total body fluid, about 40% of adult body weight is from ICF

Question 3

what is the extracellular compartment

Answer 3

30% of total body fluid, about 20% of body weight; contains intravascular fluid, interstitial fluid, trans cellular

Question 4

what is intravascular fluid

Answer 4

in the extracellular; plasma of the blood-> blood volume, impacts HR/BP

Question 5

what is interstitial fluid

Answer 5

in extracellular; surrounds cells

Question 6

what is trans cellular

Answer 6

in extracellular; cerebrospinal, pleural, peritoneal, synovial, digestive secretions, sweat

Question 7

what is osmolarity

Answer 7

the concentration of particles in a solution

Question 8

what is isotonic

Answer 8

when the osmolarity is equivalent to plasma

Question 9

where does isotonic fluid remain

Answer 9

in the intravascular space

Question 10

what is hypertonic

Answer 10

when the osmolarity is greater than plasma

Question 11

what do hypertonic fluids do

Answer 11

pull water from the cells and into intravascular spaces; cell shrinks

Question 12

what is hypotonic

Answer 12

when the osmolarity is less than plasma

Question 13

what do hypotonic fluids do

Answer 13

move from the intravascular space to the ICF; cell swells

Question 14

isotonic solutions treat?

Answer 14

hypovolemia, hypercalcemia, metabolic alkalosis

Question 15

hypertonic solutions replace?

Answer 15

electrolytes, provides calories, shifts fluid form cells to vascular space expanding vascular volume

Question 16

hypotonic solutions are used as?

Answer 16

a maintenance fluid, provides Na, Cl, and free water

Question 17

how is fluid balance achieved

Answer 17

with oral intake of fluid matching the output of the kidneys; match I & O

Question 18

how do kidneys manage fluid and electrolyte balance

Answer 18

filter 180 L of plasma/day while excreting 1.5 L/day; regulate electrolyte levels by retaining or eliminating

Question 19

how does the heart and vascular manage fluid and electrolyte balance

Answer 19

circulate fluid, adequate perfusion pressure in kidneys for filtration, stretch receptors respond to change in volume and stimulate fluid retention when hypovolemia is present

Question 20

how do the lungs manage fluid and electrolyte balance

Answer 20

water vapor excreted/lost per day, about 300mL/day

Question 21

how does the nervous system manage fluid and electrolyte balance

Answer 21

osmoreceptors sense changes in ECF concentration and stimulate the pituitary gland to release or inhibit release of ADH

Question 22

how does the GI track manage fluid and electrolyte balance

Answer 22

absorbs water and nutrients

Question 23

what glands have hormonal control of fluid and electrolyte balance

Answer 23

adrenal glands, thyroid gland, pituitary gland, parathyroid gland

Question 24

aldosterone secretion causes

Answer 24

sodium (and water) retention and potassium loss

Question 25

pituitary gland manages

Answer 25

antidiuretic hormone (ADH)

Question 26

what is ADH (antidiuretic hormone)

Answer 26

allows the body to retain water; in increased when osmotic pressure of ECF is greater than that of the cells, when blood volume is decreased; suppressed when osmotic pressure of ECF is less than that of cells or when blood volume is increased

Question 27

parathyroid gland regulates

Answer 27

calcium and phosphate balance through parathyroid hormone (PTH)

Question 28

parathyroid hormone influences

Answer 28

bone reabsorption, calcium absorption from the intestines and calcium reabsorption from the kidneys; increased levels causes increased blood calcium and decreased phosphate, visversa

Question 29

hypovolemia/ fluid volume deficit

Answer 29

loss of fluid and solutes from ECF

Question 30

dehydration

Answer 30

loss of total body water, results in increased serum sodium

Question 31

fluid volume excess

Answer 31

retaining sodium and water in EFC

Question 32

what is third spacing

Answer 32

when fluid moves into trans cellular compartments(pleural, peritoneal, pericardial, joints, bowel) or interstitial spaces; causes hypovolemia

Question 33

what are electrolytes

Answer 33

the basis for chemical interactions in the body necessary for metabolism and other functions; cations & anions

Question 34

examples of cations

Answer 34

sodium, magnesium, calcium, hydrogen, potassium

Question 35

examples of anions

Answer 35

chloride, bicarbonate, phosphate

Question 36

-natremia

Answer 36

sodium

Question 37

-kalemia

Answer 37

potassium

Question 38

-calcemia

Answer 38

calcium

Question 39

-magnesemia

Answer 39

magnesium

Question 40

-phosphatemia

Answer 40

phosphorus

Question 41

-chloremia

Answer 41

chloride

Question 42

chvosteks sign is what test

Answer 42

hypocalcemia test; tapping on facial nerve just anterior to the ear produces tetany (involuntary twitching on the same side of the patients face/upper lip)

Question 43

trousseau sign is what test

Answer 43

hypocalcemia test; inflate a BP cuff above NSBP range. positive response in a patient with hypocalcemia is a wrist, metacarpal and phalangeal/thumb flexion

Question 44

questions to ask about fluid and electrolyte balance assessment

Answer 44

illnesses(diabetes, HF), abnormal fluid loss(vomiting, diarrhea), medications, weight changes, lab studies

Question 45

normal pH

Answer 45

acid- 7.35-7.45- base

Question 46

normal PaCO2

Answer 46

base- 35-45- acid; respiratory

Question 47

normal HCO3

Answer 47

acid- 22-26- base; metabolic

Question 48

s/sx of metabolic acidosis

Answer 48

kussmaul breathing(rapid and vigorous), capillary dilation, dehydration, and pain, N/V

Question 49

causes of metabolic acidosis

Answer 49

severe infection, diabetic acidosis, tissue trauma, shock, renal failure, HF

Question 50

s/sx of metabolic alkalosis

Answer 50

shallow breathing, tetany-like sx, confusion, vomiting

Question 51

causes of metabolic alkalosis

Answer 51

hyperemesis, gastric suctioning, peptic ulcers

Question 52

s/sx of respiratory acidosis

Answer 52

dyspnea/ impaired gas exchange, warm skin, tachycardia, weakness

Question 53

causes of respiratory acidosis

Answer 53

pneumonia, COPD, chest injuries, opioids

Question 54

s/sx of respiratory alkalosis

Answer 54

rapid shallow breathing, tetany-like symptoms, palpitations, vertigo

Question 55

causes of respiratory alkalosis

Answer 55

fever, pain, brain tumor, anxiety, drug toxicity, excessive exercise

Question 56

cellular metabolism yields (H2CO3 ->)

Answer 56

carbonic acid (-> H2O + CO2)

Question 57

as CO2 increased in the blood, the respiratory rate does what

Answer 57

increases to reduce CO2 levels

Question 58

respiratory management of acid base is

Answer 58

rapid, but short term

Question 59

metabolism regulation of ions and bicarbonate is

Answer 59

slower, may take up to 3 days to correct pH

Question 60

when pH is low (acidosis), the kidneys

Answer 60

excrete H+ and retain HCO3-

Question 61

for acid base balance assessment assess

Answer 61

respiratory rate and depth, cognitive function, dizziness

Question 62

a nurse carefully assesses the acid-base balance of a patient whose carbonic acid (H2CO3) level is decreased. This is most likely a patient with damage to the

Answer 62

lungs

Question 63

a nurse is monitoring a patient who is diagnosed with hypokalemia. which nursing intervention would be appropriate for this patient

Answer 63

administer oral K supplements as ordered