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fundamentals exam 3 > fluid, electrolyte, acid-base balance > Flashcards

fluid, electrolyte, acid-base balance Flashcards

1
Q

what are the body fluid compartments

A

intracellular and extracellular

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2
Q

what is the intracellular compartment

A

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

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3
Q

what is the extracellular compartment

A

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

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4
Q

what is intravascular fluid

A

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

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5
Q

what is interstitial fluid

A

in extracellular; surrounds cells

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6
Q

what is trans cellular

A

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

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7
Q

what is osmolarity

A

the concentration of particles in a solution

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8
Q

what is isotonic

A

when the osmolarity is equivalent to plasma

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9
Q

where does isotonic fluid remain

A

in the intravascular space

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10
Q

what is hypertonic

A

when the osmolarity is greater than plasma

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11
Q

what do hypertonic fluids do

A

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

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12
Q

what is hypotonic

A

when the osmolarity is less than plasma

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13
Q

what do hypotonic fluids do

A

move from the intravascular space to the ICF; cell swells

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14
Q

isotonic solutions treat?

A

hypovolemia, hypercalcemia, metabolic alkalosis

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15
Q

hypertonic solutions replace?

A

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

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16
Q

hypotonic solutions are used as?

A

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

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17
Q

how is fluid balance achieved

A

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

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18
Q

how do kidneys manage fluid and electrolyte balance

A

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

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19
Q

how does the heart and vascular manage fluid and electrolyte balance

A

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

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20
Q

how do the lungs manage fluid and electrolyte balance

A

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

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21
Q

how does the nervous system manage fluid and electrolyte balance

A

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

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22
Q

how does the GI track manage fluid and electrolyte balance

A

absorbs water and nutrients

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23
Q

what glands have hormonal control of fluid and electrolyte balance

A

adrenal glands, thyroid gland, pituitary gland, parathyroid gland

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24
Q

aldosterone secretion causes

A

sodium (and water) retention and potassium loss

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25
Q

pituitary gland manages

A

antidiuretic hormone (ADH)

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26
Q

what is ADH (antidiuretic hormone)

A

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

27
Q

parathyroid gland regulates

A

calcium and phosphate balance through parathyroid hormone (PTH)

28
Q

parathyroid hormone influences

A

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

29
Q

hypovolemia/ fluid volume deficit

A

loss of fluid and solutes from ECF

30
Q

dehydration

A

loss of total body water, results in increased serum sodium

31
Q

fluid volume excess

A

retaining sodium and water in EFC

32
Q

what is third spacing

A

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

33
Q

what are electrolytes

A

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

34
Q

examples of cations

A

sodium, magnesium, calcium, hydrogen, potassium

35
Q

examples of anions

A

chloride, bicarbonate, phosphate

36
Q

-natremia

A

sodium

37
Q

-kalemia

A

potassium

38
Q

-calcemia

A

calcium

39
Q

-magnesemia

A

magnesium

40
Q

-phosphatemia

A

phosphorus

41
Q

-chloremia

A

chloride

42
Q

chvosteks sign is what test

A

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)

43
Q

trousseau sign is what test

A

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

44
Q

questions to ask about fluid and electrolyte balance assessment

A

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

45
Q

normal pH

A

acid- 7.35-7.45- base

46
Q

normal PaCO2

A

base- 35-45- acid; respiratory

47
Q

normal HCO3

A

acid- 22-26- base; metabolic

48
Q

s/sx of metabolic acidosis

A

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

49
Q

causes of metabolic acidosis

A

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

50
Q

s/sx of metabolic alkalosis

A

shallow breathing, tetany-like sx, confusion, vomiting

51
Q

causes of metabolic alkalosis

A

hyperemesis, gastric suctioning, peptic ulcers

52
Q

s/sx of respiratory acidosis

A

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

53
Q

causes of respiratory acidosis

A

pneumonia, COPD, chest injuries, opioids

54
Q

s/sx of respiratory alkalosis

A

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

55
Q

causes of respiratory alkalosis

A

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

56
Q

cellular metabolism yields (H2CO3 ->)

A

carbonic acid (-> H2O + CO2)

57
Q

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

A

increases to reduce CO2 levels

58
Q

respiratory management of acid base is

A

rapid, but short term

59
Q

metabolism regulation of ions and bicarbonate is

A

slower, may take up to 3 days to correct pH

60
Q

when pH is low (acidosis), the kidneys

A

excrete H+ and retain HCO3-

61
Q

for acid base balance assessment assess

A

respiratory rate and depth, cognitive function, dizziness

62
Q

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

A

lungs

63
Q

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

A

administer oral K supplements as ordered

fundamentals exam 3 (5 decks)

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