Fluid & Electrolyte Imbalances

Question 1

Second spacing

Answer 1

Edema, fluid shifting from primary intravascular space to interstitial space

Question 2

Water content of an average adult

Answer 2

50-60%

Question 3

Water content of an average older adult

Answer 3

45-55%

Question 4

ICF (Intracellular)

Answer 4

2/3 of all fluid is inside the cell

inside the cell, makes up 42% of body weight
- 2/3 of fluid is inside cells
- High in K+ and PO43- (phosphate)
- low in Na+

Question 5

ECF (extracellular)

Answer 5

1/3 of all fluid is outside the cell

• primarily interstitial spaces and lymph between cells (2/3), intravascular space/plasma fluid (1/3)
• high in Na+ and Cl-
• low in K

Question 6

Lymph or transcellular fluid

Answer 6

1L of body fluid including CSF, joint fluid, pleural, peritoneal, synovial

Can become a “third space”

Question 7

What kind of transport is a Na-K pump?

Answer 7

Active transport - molecules move against [ ] gradient, ATP required

Question 8

What kind of transport is glucose moving into cells?

Answer 8

Facilitated diffusion

Question 9

What does high osmolality mean?

Answer 9

Highly concentrated (lots of solute)

Question 10

What is osmotic pressure?

Answer 10

Amount of pressure required to stop osmotic flow of water determined by concentration of solutes in solution.

Question 11

What is hydrostatic pressure?

Answer 11

Force within a fluid compartment (ex. BP generated by contraction of heart) Major force that pushes water out of vascular system at capillary level. Gradually decreases as blood moves through artery.

Question 12

What is oncotic pressure?

Answer 12

Osmotic pressure exerted by colloids (proteins) in solution (colloidal osmotic pressure). Measure albumin.

Question 13

role of albumin in the body

Answer 13

Keeps fluid from leaking out of your blood vessels into other tissues (pulls water back at the venous end) Carries hormones, vitamins, and enzymes throughout your body. Without enough albumin, fluid can leak out of your blood and build up in your lungs, abdomen (belly), or other parts of your body

Question 14

Decreased plasma albumin may result in

Answer 14

ECF excess, edema, colloid osmotic pressure inside capillary has decreased

Question 15

Two pressures causing movement into capillaries

Answer 15

Interstitial hydrostatic pressure and Plasma oncotic pressure

Question 16

Two pressures causing movement out of capillaries

Answer 16

Interstitial hydrostatic pressure, plasma oncotic pressure

Question 17

Push pressure

Answer 17

hydrostatic

Question 18

Pull pressure

Answer 18

oncotic

Question 19

Forces at the arterial end of the capillary

Answer 19

Capillary: hydrostatic 40 mm Hg, (plasma) oncotic 25 mm Hg

Interstitial: hydrostatic 1 mm Hg and oncotic 1 mm Hg

Question 20

Forces at the venous end of the capillary

Answer 20

Capillary: hydrostatic 10 mm Hg, (plasma) oncotic 25 mm Hg

Interstitial: hydrostatic 1 mm Hg and oncotic 1 mm Hg

Question 21

What causes edema

Answer 21

elevated capillary hydrostatic pressure
decreased plasma oncotic pressure
elevated interstitial oncotic pressure

Question 22

What pressure do compression stockings increase?

Answer 22

interstitial hydrostatic pressure

Question 23

Third Spacing puts the vascular system at risk of

Answer 23

Deficient Fluid Volume/Fluid Volume Deficit/FVD/hypovolemia
- state or condition where the fluid output exceeds the fluid intake

Question 24

In Phase II of Third spacing when the fluid moves back, it puts the vascular system at risk of

Answer 24

Fluid Volume Excess, could lead to HF

Question 25

Regulation of Water Balance

Answer 25

Hypothalamic, pituitary, adrenal, renal, cardiac, GI, insensible water loss

Question 26

Hypothalamic regulation

Answer 26

osmoreceptors sense fluid change and stimulate thirst and ADH from pituitary regulation

Question 27

Adrenal Cortical Regulation

Answer 27

releases hormones to regulate water and electrolytes
- glucocorticoids (ex. cortisol, anti-inflam)
- mineralocorticoids (ex. aldosterone, ↑ Na+ retention, ↑ K+ excretion)

Question 28

Insensible Water Loss

Answer 28

Invisible vaporization from lungs and skin to regulate body temperature
- ~900 mL/day is lost
- no electrolytes are lost