Fluid, Electrolyte, and Acid-Base Balance PPT Flashcards
Fluid surrounds all the cells in the body and is also inside cells. Body fluids contain electrolytes such as sodium and ______; they also have a certain degree of acidity.
potassium
Fluid electrolyte and acid-base balances within the body maintain the health and _____ of all body systems.
function
______ is water that contains dissolved or suspended substances such as glucose, mineral salts, and proteins.
fluid
Fluid amount = _______
volume
Fluid concentration = ______
osmolality
Fluid composition = ________
electrolyte concentration
Degree of acidity = ________
pH
Characteristics of Body Fluids
Volume
Osmolality
Electrolyte concentration
pH
The _____ of body fluids influence body system function because of their effects on cell function.
characteristics
All the the characteristics of body fluids have _______, which keep them in balance for normal function.
regulatory mechanisms
Water is about ____% of body weight (and proportion decreases with age).
60%
Body fluids are located in 2 distinct compartments, ______ and ______.
extracellular and intracellular
Body fluids containing water, Na+, and other electrolytes are distributed between distinct compartments: _______ is outside the cells, and _______ is inside the cells.
extracellular fluid (ECF) intracellular fluid (ICF)
Extracellular fluid (ECF) make up ____ of total body water.
1/3
The three divisions of extracellular fluid (ECF) include interstitial, intravascular, and ______.
trasncellular
_______ are the fluids between cells and outside the blood vessels. These include lymph (fluid in the lymphatic channels)
interstitial fluid
______ is liquid part of blood (plasma) found in the vascular system.
intravascular fluid
_______ are secreted by epithelial cells and include cerebrospinal, pleural, peritoneal, and synovial fluids.
transcellular fluid
Body Fluid Compartments
p 935 figure 42-1
Fluid in body compartments contain _____ (mineral salts)
electrolytes
______ are compounds that separate into ions (charged particles) when they dissolve in water.
electrolytes
Ions are _____ particles.
charged
_____ are positively charged ions.
cations
_____ are negatively charged ions.
anions
Clinical laboratories usually report electrolytes in _____ or ______. (units of concentration)
mEq/L or mmol/L
Positively Charged Ions
sodium
potassium
calcium
magnesium
Negatively Charged Ions
chloride
bicarbonate
sulfate
Anions and cations combine to make _____.
salts
If you put table salt (NaCL) in water is separates into ____ and ____.
Na+ and Cl-
Fluid that contains a large number of dissolved particles is more _____ than the same amount of fluid that contains only a few particles.
concentrated
______ of fluid is a measure of the number of particles per kilogram of water.
osmolality
Electrolytes (____) are dissolved in plasma (_____).
solute
solvent
The liquid in which a solute is dissolved is called a ____.
solvent.
Table 43-1 Lab Normal Values for Adults
page 935
How are solutions classified?
hypertonic
isotonic
hypotonic
Particles that cannot cross cell membranes easily are called _____ particles that determine the tonicity of a fluid.
nonpermeant
A fluid with the same concentration of nonpermeant particles as normal blood is called _____.
isotonic
____ solutions have the same osmolarity as blood, similar to normal saline (0.9% sodium chloride).
isotonic
A ____ solution is more dilute than blood, and a hypertonic solution is more concentrated than normal blood.
hypotonic
A ____ solution such as 3% sodium chloride pulls fluid from cells, causing them to shrink.
hypertonic
A ____ solution such as 0.45% sodium chloride moves fluids into cells, causing them to enlarge.
hypotonic
Some particles such as _____ pass easily through cell membranes.
urea
Some particles such as ___ cannot cross cell membranes easily.
Na+
Fig 42-2 p 936
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A hypotonic solution is more dilute than blood, and a ______ solution is more concentrated than normal blood.
hypertonic
Slide 8-18
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_____ regulates fluid intake.
thirst
When a disease process disrupts the process of fluid intake and output, _____ will occur.
imbalances
What should your fluid intake be a day?
2300 mL/day
Fluid imbalance occurs with diarrhea. If there is a rapid increase in fluid output a fluid imbalance, ______, will occur if intake does not increase appropriately.
dehydration
ICF and ECF move via ____.
osmosis
Vascular to Interstitial fluid moves via ____.
filtration
Hormonal influences on fluid balance include what 3 hormones.
antidiuretic hormone
renin-angiotensis=aldosterone mechanism
atrial natriuretic peptides
Fluid output occurs through kidneys, skin, lungs, and the ______.
GI tract
Insensible loss
def
sensible loss
def
Extracellular fluid volume ______ occurs when there is a disturbances of the amount of fluid in the extracellular compartment.
deficit
______ means decreased vascular volume and often is used when discussing ECV deficit.
hypovolemia
Table 42-3
p940
ECV excess occurs when too much ___ fluid is found in the extracellular compartment.
isotonic
_____ imbalances are disturbances in the concentration of body fluids. Fluids become either hypertonic or hypotonic.
osmolality
_____ is a water deficit; hypertonic
hypernateremia
____ is water excess; hypotonic
hyponatremia
_______ is the combination of ECV deficit and hypernatremia.
clinical dehydration
Two major types of fluid imbalances
volume imbalances
osmolality imbalances
Volume and osmolality imbalances may occur separately or in _____.
combination
ECV deficit and excess are abnormal volumes of isotonic fluid, manifested as sudden changes in ____ and changes in markers of vascular and interstitial volume.
body weight
ECV deficit is present when isotonic fluid is insufficient in the ______ compartment. Remember that a lot of sodium is found in normal ECF. With ECV deficit, output of isotonic fluid exceeds intake of sodium-containing fluid. Because ECF is both vascular and interstitial, signs and symptoms arise from lack of volume in both of these compartments.
extracellular
ECV excess occurs when too much isotonic fluid is found in the extracellular compartment. Intake of sodium-containing isotonic fluid has _____ fluid output. For example, when you eat more salty foods than usual and drink water, you may notice that your ankles swell or rings on your fingers feel tight, and you gain 2 lbs (1 kg) or more overnight. These are manifestations of mild ECV excess.
exceeded
______ is called water excess or water intoxication, is a hypotonic condition. It arises from gain of relatively more salt than water. The excessively dilute condition of interstitial fluid causes water to enter cells by osmosis, causing the cells to swell. Signs and symptoms of cerebral dysfunction occur when brain cells swell.
hyponatremia
ECV deficit and hypernatremia often occur at the same time; this combination is called clinical dehydration. The ECV is ______, and the body fluids are too concentrated.
toolow
Clinical dehydration is common with _______ or other causes of severe vomiting and diarrhea when people are not able to replace their fluid output with enough intake of dilute sodium-containing fluids. Signs and symptoms of clinical dehydration are those of both ECV deficit and hypernatremia.
gastroenteritis
Treatment for ECV excess consists of _______ and fluid restriction, if severe; treatment for hyponatremia usually involves water restriction.
Na+ restriction
Hyponatremia < ____ meQ/L
135
Hyponatremia is the gain of more _____ than ____.
water than salt
Hyponatremia is the loss of more _____ than _____.
salt than water
With ______ cells swell.
hyponatremia
Hyponatremia signs and symptoms
decreased level of consciousness (confusion, lethargy, coma)
seizures, if develops rapidly or is severe
serum osmolality X280 mmol/kg
Hypernatremia >____ meQ/L
145
_______ is the loss of more water than salt. Also, it is the gain or more salt than water.
hypernatremia
With ______ cells shrivel.
hypernatremia
Hypernatremia of signs and symptoms
Decreased level of consciousness (confusion, lethargy, coma)
Thirst
Seizures, if develops rapidly or is severe
Serum Osmolality >300mmol/kg
Three processes to maintain homeostasis
- intake and absorption
- distribution
- output
What is included in output?
urine, feces, sweat, vomiting, drainage, fistulas?
You can best understand electrolyte balance by considering the three processes involved in electrolyte ______: electrolyte intake and absorption, electrolyte distribution, and electrolyte output.
homeostasis
Interplay of electrolyte intake and absorption, electrolyte distribution, and electrolyte output determines the balance of _________.
K+, Ca2+, Mg2+, and phosphate.
Although sodium is an electrolyte, it is not included here because ______ are the osmolality imbalances discussed previously.
serum sodium imbalances
Electrolyte distribution is an important issue. Note that the electrolyte values that you review from laboratory reports are measured in _____ and do not measure intracellular levels.
blood serum
_______ occurs through normal excretion in urine, feces, and sweat. Output also occurs through vomiting, drainage tubes, and fistulas.
Electrolyte output
When electrolyte output increases, electrolyte intake must ____ to maintain electrolyte balance.
increase
Similarly, if electrolyte output decreases, as with oliguria (abnormally small amounts of urine), electrolyte intake must also _______ to maintain balance.
decrease
-emia means
blood condition
hyper means
excessive
hypo means
deficient
kal relates to
potassium
calc relates to
calcium
Hypokalemia and Hyperkalemia are related to what electrolyte?
Potassium (K+)
Hypocalcemia and Hypercalcemia are related to what electrolyte?
Calcium (Ca2+)
Hypomagnesemia
Hypermagnesemia are related to what electrolyte?
Magnesium (Mg2+)
review page 942 box 42.-5
pp
patient hypertension what intake will be limited first by dr
pot, sod, pro, flu
cor: sod
when a nurse evaluating i&o the fluid intake documented should be
slightly more than fl o
lower than u o
higher than fl o
equal
cor: slightly more
a diuretic is give to a patient retaining fluid. what should you encourage the patient to ingest nutrients rich in
mag
pot
cal
sod
cor: potassium
a fluid and electrolyte imbalance is suspected in an older patient. which assessment best reflects fluid/elect bala in older adults.
intake and output results
serum lab val
condi of skin
prese of tent
cor: serum lab val
a patient with a fever has profuse sweating, dry sticky mucous membranes, wekaness, disor, decreasing LOC. what concon does the data supp?
hyperkalemia - has cardiac effects
hypercalcemia
hypernatremia
hypermagnesemia
cor: hypernatremia
inc bp and 2 lb weigh gain over 48 hours what is associated manifestation?
dec hr
inc turgor
inc pulse volume (CO)
dec pulse press
cor: inc pulse volume
assessing sev patients for f/e imbala. the common to excess fluid vol and defi flu vol?
inc pul ampli
dec bp
diff brea
muscl weak
cor: mus weak
your assessing a pat fl status. what asses indicates a deficient fluid volmue
neg balance in I%o
dec bod temp (not hypothermia)
inc bp
sob
corr: negative bala
know case study values
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client with fever and diaphoretic. monitoring i & O you expect
urine will be dilute
output decreased
urine production increased
the majority=(not right) of fluid will b excreted through the skin
corr: outpul decreased
a client taking k sparing diurectic about foods h in potassium. further education is needed if the client thinks this fruit is high in K
kiwi
celery
orang
dried fruit
corr: celery (not on quiz prop)
______ maintains resting potential of skeletal, smooth, and cardiac muscle allowing for normal muscle function and nerve impulse conduction.
potassium
_____ is abnormally low potassium concentration in the blood (below _____ mEq/L)
Hypokalemia
3.5mEq/L
Results from a decreased potassium intake and absorption, a shift of potassium from the extracellular fluid into the cells, and an increased potassium output describes _____.
hypokalemia
Risk Factors for Hypokalemia
Diarrhea
repeated vomiting
DKA (following correction)
use of potassium wasting diurectics.
Signs and Symptoms of Potassium K+
muscle weakness, which can become life threatening if it includes respiratory muscles, and potentially life threatening cardiac dysrhythmias.
depressed ST segment
Flattened T-wave
_________ is abnormally high potassium concentration in the blood (>_______mEq/L)
hyperkalemia
5.0
classification of surgeries on qquiz
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