Fluid/Electrolyte/Acid-Base Balance Flashcards
1
Q
What are the 4 characteristics of body fluids?
A
Amount (volume)-Concentration (osmolality)-Composition (electrolyte Concentration)-Acidity (pH)
2
Q
What percent of the body weight of an adult man is water?
A
60%
3
Q
What percent of the body weight of an older man’s weight is water?
A
50%
4
Q
What is the term for water that contains dissolved or suspended substances such as glucose, mineral salts, and proteins?
A
fluid
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)
6
Q
Where does fluid output occur? (5)
A
Kidneys-Lungs-Feces-Sweat-Skin
7
Q
Where is most of the body water located?
A
ECF
8
Q
What are the two major divisions of ECF?
A
Intravascular Fluid-Interstitial Fluid
9
Q
What is the minor division of ECF?
A
Transcellular fluid
10
Q
What is an electrolyte?
A
mineral salts in the body compartments
11
Q
What is a cation?
A
positively charged ions
12
Q
What is an anion?
A
negatively charged ions
13
Q
Give 4 examples of cations in body fluids:
A
-Sodium (Na+)-Potassium (K+)-Calcium (Ca++)-Magnesium (Mg++)
14
Q
What are 2 common anions in body fluids?
A
-Chloride (Cl-)-Bicarbonate (HCO3-)
15
Q
What are the two different units for measuring electrolyte concentration?
A
-milliequivalents per liter (mEq/L)-millimoles per liter (mmol/L)
16
Q
How is mEq/L calculated?
A
millimoles per liter multiplied by electrolyte charge
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
18
Q
Why is mEq/L used?
A
A milliequivalent of one electrolyte can combine with a milliequivalent of another electrolyte
19
Q
What is osmolality?
A
a measure of the number of particles per kilogram of water
20
Q
What determines the tonicity of a fluid?
A
The number of particles that cannot cross cell membranes easily
21
Q
What is an isotonic solution?
A
A fluid with the same concentration of nonpermeant particles as normal blood
22
Q
What is a hypotonic solution?
A
A fluid with a lower concentration of nonpermeant particles as normal blood (diluted)
23
Q
What is a hypertonic solution?
A
A fluid with a greater concentration of nonpermeant particles as normal blood (concentrated)
24
Q
What are the 4 basic ways in which water and electrolytes move between body compartments?
A
Active transport-Diffusion-Osmosis-Filtration
25
Which electrolytes are higher in the ECF than in the ICF?
Na+C-HCO3-
26
Which electrolytes are higher in the ICF than in the ICF?
K+Mg++PO4---
27
How do cells maintain their high intracellular electrolyte concentration?
active transport
28
What is the energy source for active transport?
ATP
29
What is required for diffusion of electrolytes across the cell membrane?
proteins (ion channels)
30
How does water move across the cell membrane?
Osmosis
31
What does a hypotonic IV do to the interstitial fluid?
dilutes it which causes water to move into the cells
32
What does a hypertonic IV do to the interstitial fluid?
concentrates it which causes water to leave cells
33
What is hydrostatic pressure?
the force of the fluid pressing outward against a surface
34
What is colloid osmotic pressure (oncotic pressure)?
an inward-pulling force caused by blood protiens that helps move fluid from the interstitial area back into capillaries
35
What are the three process that effect fluid homeostasis?
Fluid intake/absorption-Fluid distribution-Fluid output
36
Where is the thirst-control mechanism located in the brain?
hypothalamus
37
Who is at the highest risk of dehydration?
Infants-Patients w/ neurological/psychological disorders-older adults
38
How does fluid distribution between the extracellular and intracellular compartments occur?
osmosis
39
How does fluid distribution between the vascular and interstitial ports of the ECF occur?
filtration
40
Fluid output normally occurs through which 4 organs?
Skin-Lungs-GI tract-Kidneys
41
What are the 3 hormones that influence renal fluid excretion?
Antidiuretic hormone (ADH)-Adosterone-Atrial natriuretic peptide (ANP)
42
How does ADH regulate the osmolality of the body fluids?
influences how much water is excreted in the urine
43
How does the Renin-Angiotensin-Aldosterone System(RAAS) regulate ECF volume?
influences how much sodium and water are excreted in urine
44
How does atrial natriuretic peptide regulate ECV?
influences how much sodium and water are excreted in the urine
45
What are the 2 major types of fluid imbalanes?
Volume imbalances(extracelllar) and osmolality imbalances (concentration)
46
How does ECV deficit occur?
insufficient isotonic fluid in the extracellular compartment
47
Which condition is likely to occur during ECV deficit?
Hypovolemia
48
How does ECV excess occur?
too much isotonic fluid in the extracellular compartment
49
What are the 2 types of osmolality imbalances called?
hypernatremia and hyponatremia
50
What are the 2 general causes of hypernatremia?
loss of relatively more water than salt OR gain of relatively more salt than water
51
What are the 2 general causes of hyponatremia?
gain of relative more water than salt OR loss of relatively more salt than water
52
What is term for when ECV deficit and hypernatremia occur at the same time?
clinical dehydration
53
What are the usual causes of clinical dehydration?
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
Which vitamin is best for calcium absorption?
Vitamin D
55
How is potassium distributed?
low in ECF, high in ICF
56
What is the important function of potassium?
maintains resting membrane potential of skeletal, smooth, and cardiac muscle, allowing for normal muscle function
57
How is calcium distributed?
low in ECF, mostly in bones and intracellular
58
What is the important function of calcium?
Influences excitability of nerve and muscle cells; necessary for muscle contraction
59
How is magnesium distributed?
low in ECF, mostly in bones and intracellular
60
What is the important function of magnesium?
influences function of neuromuscular junctions and is a cofactor for numerous enymes
61
How is phosphate distrubuted?
low in ECF; higher in ICF and in bones
62
What is the important function of phospate?
Necessary for production of ATP, the energy source for cellular metabolism
63
What are the symptoms of hypokalemia?
muscle weakness, respiratory depression, cardiac dysrhythmias, abdonmial distention, decreased bowel sounds, constipation
64
What are the symptoms of hyperkalemia?
muscle weakness, cardiac dysrhythmias, cardiac arrest, abdominal cramps, diarrhea
65
What are the signs of hypocalcemia?
Positive Chvostek's sign, Positive Trousseau's sign, numbness and tingling of fingers and circumoral region, hyperactive relfexes, muscle twitching, tetany, seizures, dysrythmias
66
What are the signs of hypercalcemia?
fatigue, diminished reflexes, lethargy, decreased LOC, confusion
67
What are the signs of hypomagnesemia?
hyperactive deep tendon reflexes, insomnia, muscle cramps/twitching, grimacing, dysphagia, tachycardia
68
What are the signs of hypermagnesemia?
lethargy, hypoactive deep tendon reflexes, bradycardia, flushing, flaccid muscle paralysis
69
What are the 3 processes that control acid-base homeostasis?
Acid production, acid buffering, and acid excretion
70
Which lab is drawn to monitor pH?
Arterial blood gases (ABGs)
71
What are the 2 types of acid created through cellular metabolism?
carbonic acid and metabolic acids
72
How does CO2 act like an acid in the body?
concerts to carbonic acid (H2CO3) which then dissociates into H+ and HCO3-(bicarbonate)
73
What is the purpose of buffers in the blood?
Keep the blood from becoming to acid when acids that are produced by cells circulate to the lungs and kidneys for excretion
74
What are the twoacid excretion systems of the body?
Lungs and Kidneys
75
Which acids are excreted by the lungs?
carbonic acid
76
Which acids are exreted by the kidneys?
metabolic acids
77
What are the two types of acidosis?
Respiratory acidosis and metabolic acidosis
78
What are the two types of alkalosis?
Respiratory alkalosis and metabolic alkalosis
79
What is the anion gap?
difference between the concetrations of serum cations and anions
80
How is the anion gap determined?
by measuring the concentrations of sodium cations and chloride & bicarbonate anions
81
What is respiratory acidosis?
Excessive carbonic acid caused by alveolar hyporventilation
82
What is respiratory alkalosis?
Deficient carbonic acid caused by alveolar hyperventilation
83
What is metabolic acidosis?
Excessive metabolic acids
84
What is metabolic alkalosis?
Deficient metabolic acids
85
What are the risk factor categories that lead to imbalances?
Age. Environment. GI output. Chronic diseases. Trauma. Therapies/medications
86
What is the % of total body water in an infant?
70-80%
87
Why are infants at a greater risk for ECV deficit and hypernatremia?
body water loss is proportionately greater per kilogram of weight
88
Which electrolyte imbalance does chronic alcohol abuse commonly cause?
hypomagnesemia
89
What can occur if baking soda is used as an antiacid?
can cause ECV ecess because of its high sodium content that holds water in the extracellular compartments
90
Which imbalance does is caused by ACE inhibitors?
hyperkalemia
91
Which imbalance is caused by antidepressents/SSRIs?
hyponatremia
92
Which imbalances are caused by calcium carbonate antiacids?
hypercalcemia, mild metabolic alkalosis
93
Which imbalances are caused by corticosteroids?
hypokalemia, metabolic alkalosis
94
Which imbalances are caused by potassium wasting diuretics?
ECV deficit, hyponatremia (thiazides), hypokalemia, hypomagnesemia, mild metabolic alkalosis
95
Which imbalances are caused by potassium sparring diuretics?
hyperkalemia, mild metabolic acidosis
96
Which imbalance is caused by effervescent antacids and cold medications (high Na+)?
ECV excess
97
Which imbalance is caused by laxatives?
ECV deficit, hypokalemia, hypocalcemia, hypomagnesemia, metabolic acidosis
98
Which imbalance is caused by magnesium hydroxide?
hpermagnesemia
99
Which imbalance is caused by NSAIDS?
mild ECV excess, hyponatremia
100
Which imbalanced is caused by high dose penicillins?
hypokemia, metabolic alkalosis; hyperkalemia with penecillin G
101
Which acid/base imbalance can be caused by gastric suctioning?
metabolic alkalosis
102
Why can diarrhea, intestinal suctioning, or a fistula cause metabolic acidosis?
the intestinal and pancreatic fluids are bicarbonate rich
103
Which acid/base imbalance can be caused by burns?
metabolic acidosis because of greatly increased cellular metabolism
104
Which electrolyte imbalance can be caused by crush injuries?
hyperkalemia because the trauma destroys the cellular structure, resulting in a massive release of intracelluar K+ into the blood
105
How is ice chip intake documented in I&Os ?
50% of the volume of ice chips
106
What are the 3 types of parenteral nutrition?
Parenteral nutrition (PN), IV fluid/electrolytes (crystalloids), Blood and Blood components (colloids)
107
What is the osmolality of PN solutions administered through central IVs?
high
108
What is the osmolality of PN solutions administered through peripheral IVs?
low
109
What happens if incompatible blood is transfused?
potentially dangerous transfusion reaction
110
What happens if an IV solution is infused too rapidly or in too great an amount?
circulatory overload
111
Which blood type is the universal donor?
Type O
112
Which blood type is the universal recipient?
Type AB
113
What is the time frame for blood infusion?
2-4 hours
114
What can happen with rapid administration of cold blood through a central venous catheter?
cardiac dysrhythmias
115
What is the minimum amount of urine per day needed excrete toxic waste products? Volume?
obligatory urine output (400-600ml)
116
What is insensible water loss? Volume?
Water loss from skin, lungs, and stool (500-1000mL/day)
117
What is the most common type of fluid loss problem?
isotonic dehydration
118
What are the two most important things to monitor during rehydration?
pulse rate/quality
urine output
119
The problems caused by hyponatremia involve which two mechanisms?
reduced excitable membrane depolarization
cellular swelling
120
What are the 3 types of drugs that cause hypokalemia?
Diuretics
Digitalis
Corticosteroids
121
Which hormone regulates ECF phosphorus levels?
parathyroid hormone (PTH)
122
How will a decreased level of phosphorus effect calcium levels?
increases calcium levels
123
What are the 3 ways that the kidneys control pH?
movement of bicarbonate
formation of acids
formation of ammonium
124
Which breathing pattern is seen with metabolic acidosis?
kussmaul respirations (deep, rapid and involuntary)
125
Which breathing patter is seen with respiratory acidosis?
shallow and rapid (not ventilating enough oxygen)
