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Ruben's Nursing 50B > Fluid/Electrolyte/Acid-Base Balance > Flashcards

Fluid/Electrolyte/Acid-Base Balance Flashcards

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1
Q

What are the 4 characteristics of body fluids?

A

Amount (volume)-Concentration (osmolality)-Composition (electrolyte Concentration)-Acidity (pH)

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2
Q

What percent of the body weight of an adult man is water?

A

60%

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3
Q

What percent of the body weight of an older man’s weight is water?

A

50%

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4
Q

What is the term for water that contains dissolved or suspended substances such as glucose, mineral salts, and proteins?

A

fluid

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5
Q

What are the two distinct compartments where body fluids are located? What proportion of the total body water is in each compartment?

A

-Extracellular Fluid (ECF) (1/3)-Intracellular Fluid (ICF) (2/3)

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6
Q

Where does fluid output occur? (5)

A

Kidneys-Lungs-Feces-Sweat-Skin

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7
Q

Where is most of the body water located?

A

ECF

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8
Q

What are the two major divisions of ECF?

A

Intravascular Fluid-Interstitial Fluid

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9
Q

What is the minor division of ECF?

A

Transcellular fluid

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10
Q

What is an electrolyte?

A

mineral salts in the body compartments

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11
Q

What is a cation?

A

positively charged ions

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12
Q

What is an anion?

A

negatively charged ions

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13
Q

Give 4 examples of cations in body fluids:

A

-Sodium (Na+)-Potassium (K+)-Calcium (Ca++)-Magnesium (Mg++)

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14
Q

What are 2 common anions in body fluids?

A

-Chloride (Cl-)-Bicarbonate (HCO3-)

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15
Q

What are the two different units for measuring electrolyte concentration?

A

-milliequivalents per liter (mEq/L)-millimoles per liter (mmol/L)

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16
Q

How is mEq/L calculated?

A

millimoles per liter multiplied by electrolyte charge

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17
Q

How is mmol/L calculated?

A

milligrams of electrolyte divided by its molecular weight that are contained in a liter of fluid being measured

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18
Q

Why is mEq/L used?

A

A milliequivalent of one electrolyte can combine with a milliequivalent of another electrolyte

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19
Q

What is osmolality?

A

a measure of the number of particles per kilogram of water

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20
Q

What determines the tonicity of a fluid?

A

The number of particles that cannot cross cell membranes easily

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21
Q

What is an isotonic solution?

A

A fluid with the same concentration of nonpermeant particles as normal blood

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22
Q

What is a hypotonic solution?

A

A fluid with a lower concentration of nonpermeant particles as normal blood (diluted)

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23
Q

What is a hypertonic solution?

A

A fluid with a greater concentration of nonpermeant particles as normal blood (concentrated)

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24
Q

What are the 4 basic ways in which water and electrolytes move between body compartments?

A

Active transport-Diffusion-Osmosis-Filtration

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25
Q

Which electrolytes are higher in the ECF than in the ICF?

A

Na+C-HCO3-

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26
Q

Which electrolytes are higher in the ICF than in the ICF?

A

K+Mg++PO4—

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27
Q

How do cells maintain their high intracellular electrolyte concentration?

A

active transport

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28
Q

What is the energy source for active transport?

A

ATP

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29
Q

What is required for diffusion of electrolytes across the cell membrane?

A

proteins (ion channels)

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30
Q

How does water move across the cell membrane?

A

Osmosis

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31
Q

What does a hypotonic IV do to the interstitial fluid?

A

dilutes it which causes water to move into the cells

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32
Q

What does a hypertonic IV do to the interstitial fluid?

A

concentrates it which causes water to leave cells

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33
Q

What is hydrostatic pressure?

A

the force of the fluid pressing outward against a surface

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34
Q

What is colloid osmotic pressure (oncotic pressure)?

A

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

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35
Q

What are the three process that effect fluid homeostasis?

A

Fluid intake/absorption-Fluid distribution-Fluid output

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36
Q

Where is the thirst-control mechanism located in the brain?

A

hypothalamus

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37
Q

Who is at the highest risk of dehydration?

A

Infants-Patients w/ neurological/psychological disorders-older adults

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38
Q

How does fluid distribution between the extracellular and intracellular compartments occur?

A

osmosis

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39
Q

How does fluid distribution between the vascular and interstitial ports of the ECF occur?

A

filtration

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40
Q

Fluid output normally occurs through which 4 organs?

A

Skin-Lungs-GI tract-Kidneys

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41
Q

What are the 3 hormones that influence renal fluid excretion?

A

Antidiuretic hormone (ADH)-Adosterone-Atrial natriuretic peptide (ANP)

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42
Q

How does ADH regulate the osmolality of the body fluids?

A

influences how much water is excreted in the urine

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43
Q

How does the Renin-Angiotensin-Aldosterone System(RAAS) regulate ECF volume?

A

influences how much sodium and water are excreted in urine

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44
Q

How does atrial natriuretic peptide regulate ECV?

A

influences how much sodium and water are excreted in the urine

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45
Q

What are the 2 major types of fluid imbalanes?

A

Volume imbalances(extracelllar) and osmolality imbalances (concentration)

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46
Q

How does ECV deficit occur?

A

insufficient isotonic fluid in the extracellular compartment

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47
Q

Which condition is likely to occur during ECV deficit?

A

Hypovolemia

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48
Q

How does ECV excess occur?

A

too much isotonic fluid in the extracellular compartment

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49
Q

What are the 2 types of osmolality imbalances called?

A

hypernatremia and hyponatremia

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50
Q

What are the 2 general causes of hypernatremia?

A

loss of relatively more water than salt OR gain of relatively more salt than water

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51
Q

What are the 2 general causes of hyponatremia?

A

gain of relative more water than salt OR loss of relatively more salt than water

52
Q

What is term for when ECV deficit and hypernatremia occur at the same time?

A

clinical dehydration

53
Q

What are the usual causes of clinical dehydration?

A

gastroenteritis or other causes of severe vomiting and diarrhea when people are not able to replace their fluid output with enough intake of dilute sodium-containign fluids

54
Q

Which vitamin is best for calcium absorption?

A

Vitamin D

55
Q

How is potassium distributed?

A

low in ECF, high in ICF

56
Q

What is the important function of potassium?

A

maintains resting membrane potential of skeletal, smooth, and cardiac muscle, allowing for normal muscle function

57
Q

How is calcium distributed?

A

low in ECF, mostly in bones and intracellular

58
Q

What is the important function of calcium?

A

Influences excitability of nerve and muscle cells; necessary for muscle contraction

59
Q

How is magnesium distributed?

A

low in ECF, mostly in bones and intracellular

60
Q

What is the important function of magnesium?

A

influences function of neuromuscular junctions and is a cofactor for numerous enymes

61
Q

How is phosphate distrubuted?

A

low in ECF; higher in ICF and in bones

62
Q

What is the important function of phospate?

A

Necessary for production of ATP, the energy source for cellular metabolism

63
Q

What are the symptoms of hypokalemia?

A

muscle weakness, respiratory depression, cardiac dysrhythmias, abdonmial distention, decreased bowel sounds, constipation

64
Q

What are the symptoms of hyperkalemia?

A

muscle weakness, cardiac dysrhythmias, cardiac arrest, abdominal cramps, diarrhea

65
Q

What are the signs of hypocalcemia?

A

Positive Chvostek’s sign, Positive Trousseau’s sign, numbness and tingling of fingers and circumoral region, hyperactive relfexes, muscle twitching, tetany, seizures, dysrythmias

66
Q

What are the signs of hypercalcemia?

A

fatigue, diminished reflexes, lethargy, decreased LOC, confusion

67
Q

What are the signs of hypomagnesemia?

A

hyperactive deep tendon reflexes, insomnia, muscle cramps/twitching, grimacing, dysphagia, tachycardia

68
Q

What are the signs of hypermagnesemia?

A

lethargy, hypoactive deep tendon reflexes, bradycardia, flushing, flaccid muscle paralysis

69
Q

What are the 3 processes that control acid-base homeostasis?

A

Acid production, acid buffering, and acid excretion

70
Q

Which lab is drawn to monitor pH?

A

Arterial blood gases (ABGs)

71
Q

What are the 2 types of acid created through cellular metabolism?

A

carbonic acid and metabolic acids

72
Q

How does CO2 act like an acid in the body?

A

concerts to carbonic acid (H2CO3) which then dissociates into H+ and HCO3-(bicarbonate)

73
Q

What is the purpose of buffers in the blood?

A

Keep the blood from becoming to acid when acids that are produced by cells circulate to the lungs and kidneys for excretion

74
Q

What are the twoacid excretion systems of the body?

A

Lungs and Kidneys

75
Q

Which acids are excreted by the lungs?

A

carbonic acid

76
Q

Which acids are exreted by the kidneys?

A

metabolic acids

77
Q

What are the two types of acidosis?

A

Respiratory acidosis and metabolic acidosis

78
Q

What are the two types of alkalosis?

A

Respiratory alkalosis and metabolic alkalosis

79
Q

What is the anion gap?

A

difference between the concetrations of serum cations and anions

80
Q

How is the anion gap determined?

A

by measuring the concentrations of sodium cations and chloride & bicarbonate anions

81
Q

What is respiratory acidosis?

A

Excessive carbonic acid caused by alveolar hyporventilation

82
Q

What is respiratory alkalosis?

A

Deficient carbonic acid caused by alveolar hyperventilation

83
Q

What is metabolic acidosis?

A

Excessive metabolic acids

84
Q

What is metabolic alkalosis?

A

Deficient metabolic acids

85
Q

What are the risk factor categories that lead to imbalances?

A

Age. Environment. GI output. Chronic diseases. Trauma. Therapies/medications

86
Q

What is the % of total body water in an infant?

A

70-80%

87
Q

Why are infants at a greater risk for ECV deficit and hypernatremia?

A

body water loss is proportionately greater per kilogram of weight

88
Q

Which electrolyte imbalance does chronic alcohol abuse commonly cause?

A

hypomagnesemia

89
Q

What can occur if baking soda is used as an antiacid?

A

can cause ECV ecess because of its high sodium content that holds water in the extracellular compartments

90
Q

Which imbalance does is caused by ACE inhibitors?

A

hyperkalemia

91
Q

Which imbalance is caused by antidepressents/SSRIs?

A

hyponatremia

92
Q

Which imbalances are caused by calcium carbonate antiacids?

A

hypercalcemia, mild metabolic alkalosis

93
Q

Which imbalances are caused by corticosteroids?

A

hypokalemia, metabolic alkalosis

94
Q

Which imbalances are caused by potassium wasting diuretics?

A

ECV deficit, hyponatremia (thiazides), hypokalemia, hypomagnesemia, mild metabolic alkalosis

95
Q

Which imbalances are caused by potassium sparring diuretics?

A

hyperkalemia, mild metabolic acidosis

96
Q

Which imbalance is caused by effervescent antacids and cold medications (high Na+)?

A

ECV excess

97
Q

Which imbalance is caused by laxatives?

A

ECV deficit, hypokalemia, hypocalcemia, hypomagnesemia, metabolic acidosis

98
Q

Which imbalance is caused by magnesium hydroxide?

A

hpermagnesemia

99
Q

Which imbalance is caused by NSAIDS?

A

mild ECV excess, hyponatremia

100
Q

Which imbalanced is caused by high dose penicillins?

A

hypokemia, metabolic alkalosis; hyperkalemia with penecillin G

101
Q

Which acid/base imbalance can be caused by gastric suctioning?

A

metabolic alkalosis

102
Q

Why can diarrhea, intestinal suctioning, or a fistula cause metabolic acidosis?

A

the intestinal and pancreatic fluids are bicarbonate rich

103
Q

Which acid/base imbalance can be caused by burns?

A

metabolic acidosis because of greatly increased cellular metabolism

104
Q

Which electrolyte imbalance can be caused by crush injuries?

A

hyperkalemia because the trauma destroys the cellular structure, resulting in a massive release of intracelluar K+ into the blood

105
Q

How is ice chip intake documented in I&Os ?

A

50% of the volume of ice chips

106
Q

What are the 3 types of parenteral nutrition?

A

Parenteral nutrition (PN), IV fluid/electrolytes (crystalloids), Blood and Blood components (colloids)

107
Q

What is the osmolality of PN solutions administered through central IVs?

A

high

108
Q

What is the osmolality of PN solutions administered through peripheral IVs?

A

low

109
Q

What happens if incompatible blood is transfused?

A

potentially dangerous transfusion reaction

110
Q

What happens if an IV solution is infused too rapidly or in too great an amount?

A

circulatory overload

111
Q

Which blood type is the universal donor?

A

Type O

112
Q

Which blood type is the universal recipient?

A

Type AB

113
Q

What is the time frame for blood infusion?

A

2-4 hours

114
Q

What can happen with rapid administration of cold blood through a central venous catheter?

A

cardiac dysrhythmias

115
Q

What is the minimum amount of urine per day needed excrete toxic waste products? Volume?

A

obligatory urine output (400-600ml)

116
Q

What is insensible water loss? Volume?

A

Water loss from skin, lungs, and stool (500-1000mL/day)

117
Q

What is the most common type of fluid loss problem?

A

isotonic dehydration

118
Q

What are the two most important things to monitor during rehydration?

A

pulse rate/quality

urine output

119
Q

The problems caused by hyponatremia involve which two mechanisms?

A

reduced excitable membrane depolarization

cellular swelling

120
Q

What are the 3 types of drugs that cause hypokalemia?

A

Diuretics

Digitalis

Corticosteroids

121
Q

Which hormone regulates ECF phosphorus levels?

A

parathyroid hormone (PTH)

122
Q

How will a decreased level of phosphorus effect calcium levels?

A

increases calcium levels

123
Q

What are the 3 ways that the kidneys control pH?

A

movement of bicarbonate

formation of acids

formation of ammonium

124
Q

Which breathing pattern is seen with metabolic acidosis?

A

kussmaul respirations (deep, rapid and involuntary)

125
Q

Which breathing patter is seen with respiratory acidosis?

A

shallow and rapid (not ventilating enough oxygen)

Ruben's Nursing 50B (15 decks)

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