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Fundamentals of nursing > Fluid Electrolytes 1 > Flashcards

Fluid Electrolytes 1 Flashcards

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1
Q

Homeostasis:

A

Volume and composition of each space
remains constant.
These can impact homeostasis:
- vomiting
-diarrhea
-ace inhibitors
-diuritics

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2
Q

Composition of
Body Fluids Water:

A

Primary component of body
Accounts for approx 60% of body weight but it varies with age.
Adequate balance is necessary for
- maintenance of temp - elimination of
waste products - all transportation within
body

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3
Q

Factors That
Affect Body
Water

A

Age is a huge factor.
neonates are made of 80% water vs older adults which is 45%.
Other factors that influence body water are:
The more adipose tissue the less body water you have. The more muscle mass you have the more water you have.

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4
Q

Composition of
Body Fluids Solutes

A

Electrolytes: Chemical compounds that
develop an ionic charge when dissolved
in water
All body fluids contain electrolytes

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5
Q

Electrolytes

A

Regulation of electrolyte levels is critical
for:
maintenance of body fluid osmolality
acid balance
neuromuscular function
cell metabolism

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6
Q

Composition of
Body Fluids. Nonelectrolytes

A

Nonelectrolytes
Do not dissociate in solution
measured by wt
Glucose - Urea - Creatnine - Bilirubin
- Proteins

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7
Q

Amount of plasma in the body :

A

Plasma: 3L
Interstitial fluid (IF): 10L
Intracellular fluid (ICF): 28L

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8
Q

Body Fluid Compartments. Transcellular
Fluids. (not subject to significant
gains or losses)

A

They are available in very small amounts so their impact is small.
CSF (cerebrospinal fluid)
GI tract
Pleural (between layers of pleura)
Synovial (between joints)
Peritoneal (in peritoneum)

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9
Q

Fluid Spacing

A

First spacing
a) Normal distribution of fluid

Second spacing
a) Abnormal accumulation of interstitial fluid

Third spacing
a) Abnormal accumulation in areas that
have no or little amt of fluid
b) Fluid unavailable for use

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10
Q

Movement of
Body Fluids

A

1) Fluid constantly moves among intracellular,
interstitial and vascular spaces to maintain
body fluid balance
2) Moves through permeable membranes
- permits movement of water and some
solutes
3) Normally ICF and ECF are isotonic with
each other

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11
Q

Osmosis

A

Osmosis stops when equilibrium is reached
Major force in body fluid movement
Important to consider with IV therapy

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12
Q

Movement of
Body Fluids

A

Osmotic Pressure: It is specific to water and it means the movement of water from an area of low concentration of a solute to an area that has a higher consecration of solutes.

Refers to pulling power of a solution for
water
The higher the osmolality of a solution,
greater pulling power for water
Oncotic Pressure (it is a form of somotic pressure)
Refers to pulling force exerted by colloids

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13
Q

Diffusion

A

Diffusion is the movement of molecules from a region of higher concentration to a region of lower concentration (Sugar cube in coffee)

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13
Q

Facilitated Diffusion (glucose)

A

Facilitated diffusion is the diffusion of solutes through transport proteins in the plasma membrane. Facilitated diffusion is a type of passive transport. Even though facilitated diffusion involves transport proteins, it is still passive transport because the solute is moving down the concentration gradient.

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14
Q

Movement of
Body Fluids: Filtration

A

Movement of fluids and solutes from an area of
high hydrostatic pressure to an area of low
hydrostatic pressure into or out of the
capillary
Dependent on forces favoring filtration &
opposing it
Think of it as a tug of
war - pushing and pulling

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15
Q

Net Filtration

A

A) Forces favoring filtration
 Capillary hydrostatic pressure (blood pressure) Straw
 Interstitial oncotic pressure (water being pulled by the proteins in the interstitial fluid)
B) Forces favoring reabsorption
 Plasma oncotic pressure (water being pulled by albumin the BV)
 Interstitial hydrostatic pressure from interstitial space to BV

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16
Q

Fluid Shifts: Interstitial fluid to plasma

A

Interstitial fluid to plasma (meaning BV )

Fluid is drawn into plasma space whenever there is an increase in plasma osmotic or oncotic pressure

Wearing of compression stockings or hose is a therapeutic action on this effect

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17
Q

Movement of
Body Fluids. Active Transport

A

Movement of solute from an area of lower
solute concentration to an area of higher solute concentration
Depends on ATP so if you have inadequate phosphate then you run the risk of not having enough ATP which is requires for energy
Example is Sodium- Potassium pump.

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18
Q

Renin-
Angiotensin (From Lippincott, Williams & Wilkins,
Check slide 22

A

(From Lippincott, Williams & Wilkins,
F&E Made Incredibly Easy Retrieved
From: https://web-a-ebscohost-
com.ccsf.idm.oclc.org/ehost/ebookviewe
r/ebook/ZTAwMHhuYV9fMTQ4NDM4
NV9fQU41?sid=e7406067-860e-4038-
8c58-
1d22daac1f8f@sessionmgr4008&vid=0
&format=EK&lpid=navPoint-4&rid=0)

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19
Q

Aldosterone(From Lippincott, Williams &
Wilkins, F&E Made Incredibly
Easy) Check slide 23

A
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20
Q

Regulation of
Body Fluids. Antidiuretic
Hormone (ADH)

A

Hormone synthesized by hypothalamus stored and Secreted by the posterior pituitary

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21
Q

Regulation of Body Fluids

A

Thirst Mechanism:

1) Stimulated by thirst receptors in
hypothalamus
2) Primary protection against
hyperosmolality
3) Normally occurs with even
small fluid losses
4) Stimulates the release of ADH and
aldosterone
5) Depressed in older people: and this puts them at risk for hyper osmolarity and therefore hypernatrimia. It is important to monitor for I/O and have water stations.

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21
Q

Regulation of
Body Fluids check slide

A

Atrial Natriuretic Peptide (ANP)

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22
Q

Atrial Natriuretic Peptide (ANP). One liter of
water weighs:

A

2.2lbs/1kg

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23
Q

Fluid Losses: Kidneys: Primary regulators Primary regulators
of fluid and electrolyte of fluid and electrolyte
balance

A

pprox 1500ml urine
excreted/day

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23
Q

Fluid Losses. Skin

A

Ave of 500 - 600ml of
sensible & insensible fluid sensible & insensible fluid
lost via skin each day (Can lost via skin each day (Can
be as great as 2l/hr)

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24
Q

Fluid Losses. Lungs

A

Approx 400ml insensible
fluid

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25
Q

Fluid Losses. G.I. Tract

A

100-200ml

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26
Q

Fluid Losses. Abnormal Losses

A

varied

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27
Q

Fluid Losses. Third Space Losses

A

Unavailable

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28
Q

Fluid Volume Excess. Causes of FVE

A

1- Renal Disease
2- Too rapid infusion of IV fluids
3- Steroid Therapy
4- Production of ADH
5- Cardiac Disease

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29
Q

Brawny Edema

A

A change typical of chronic venous insufficiency, characterized by: thickening, induration, lipodermatosclerosis and non-pitting edema stopping above the ankle. the brawny color is due to hemosiderin from lysed red blood cells (RBCs) with chronic ischemia.

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30
Q

Fluid Volume Deficit. Causes of FVD

A

1- NPO
2- Drains
3- Surgery
4- Blood loss
5- Fluid loss from GI tract
6- Profuse sweating
7- polyuria
8- fever
9- third spacing
10- Decreased intake

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31
Q

What is crenation ?

A

When the cell shrinks

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32
Q

Most of the oxygen is inside the cell or outside the cell in the human body ?

A

Inside the cell

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33
Q

What is ascites ?

A

it is a condition in which fluid collects in spaces in your abdomen. Usually it accumulates in the peritoneal space. like the woman who runs the lake in oakland. She has a belly but she is not pregnant.

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34
Q

Second spacing example ?

A

If you have a pt who has an increased BP and have been standing for a long time they will get an edema due to fluid leaving the blood vessel and accumulating in the interstitial fluid due to high bp and fighting gravity.

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35
Q

Are the ICF and ECF isotonic with each other ?

A

Yes unless there is an issue

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36
Q

Oncotic pressure?

A

It is the same as osmotic pressure but it is stronger because proteins pull harder (this is because they are bigger) It draws more water towards it than other solutes. It is carried out by the protein albumin. This type of pressure helps put fluid back to the vasculature to maintain BP. Coz remember more water in the BV = more pressure and more perfusion

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37
Q

Facilitated diffusion ?

A

Some solutes can’t move into a cell without help due to the phospholipid bailayer membrane. They require a carrier protein to attach to it and bring it inside the cell then disassociate. A perfect example is glucose which requires insulin to help carry it into the cell.

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38
Q

Hydrostatic pressure

A

Straw analogy.

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39
Q

Oncotic osmotic pressure is the same as calloid osmotic pressure

A

oui

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40
Q

What is an example of active transport ?

A

The sodium potassium pump. coz atp is used

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41
Q

In renin/ agiotenesin what senses a drop in BP ?

A

The Glomerulus

42
Q

What cells secrete the enzyme renin after receiving a signal by the glomerulus?

A

The justaglumerular cells.

43
Q

Explain the Renin angiotenisin system.

A
44
Q

What do ACE inhibitos do ?

A

They prevent renin which is an enzyme from producing angiotensin 2 to (Ace inhibitor medications are used to lower BP)

45
Q

What does ACE mean ?

A

It is an acronym for angiotenesin converting enzyme which in this case rennin

46
Q

what is an example of an ACE inhibitor ?

A

Lisnopril: It helps block ACE (Rennin) which in turn helps the production of angiotenesin 2 which in turn blocks the production aldosterone. This causes the body not to hold on to NA and therefore water which causes a decrease in BP.

47
Q

What happens to K when aldosterone in released and H2O and NA are retained?

A

K levels go down due to excretion.
So more aldosterone means more NA and less K

48
Q

Is the thirst mechanism the primary protection against hyperosmolarity ?

A

Yes.

49
Q

What is another name for ADH?

A

Vasopressin

50
Q

What is ADH where is made, stored and what stimulates its secrition.

A

Antidiuritic hormone. made in the hypothalamus and stored and secreted by the posterior pituitary gland when it senses an increase in osmolality.

51
Q

Chemical compounds that
develop an ionic charge when dissolved
in water

A

Electrolytes

52
Q

All body fluids contain

A

Electrolytes

53
Q

Accounts for approx 60% of body weight

A

water

54
Q

Do not dissociate in solution

A

Nonelectrolytes

55
Q

Glucose - Urea - Creatnine - Bilirubin and Proteins are examples of ?

A

Nonelectrolytes

56
Q

They are available in very small amounts so their impact is small.

A

Transcellular
Fluids. (not subject to significant
gains or losses)

57
Q

Osmotic Pressure aka as osmosis?

A

It is specific to water and it means the movement of water from an area of low concentration of a solute to an area that has a higher consecration of solutes.

58
Q

facilitated diffusion requires a source of ATP.

A

no

59
Q

Simple diffusion does not require energy

A

yes

60
Q

Causes the kidneys to retain water but not sodium NA to decrease osmolality

A

ADH

61
Q

SIADH

A

syndrome of innapropriate secrition of the antidiuritic hormone (Too much release of ADH)

62
Q

Running a marathon can cause SIADH because ?

A

you keep drinking water but you are not replacing the sodium which leads to hyponatrimia

63
Q

Drugs that interfear with ADH secrition are

A

coffee or alcohol they act as a diuritic because they turn off our adh hormone. This makes us pee more diluted urine

64
Q

what conditions can trigger SIADH

A

pulmonary conditions, lung cancer, pneumonia which causes us to produce to much ADH

65
Q

In DI very little ADH is produces

A

true

66
Q

Dry inside caused by ?

A

DI diabetes insipidus

67
Q

Soaked inside caused by ?

A

SIADH

68
Q

Definition of DI ?

A

A state in which we pee a lot coz our body doesn’t produce enough ADH. so what happens is that we pee a lot of water and keep too much sodium which leads to hypernatremia

69
Q

SIADH causes hypo or hypernatrimia ?

A

hypo

70
Q

DI causes hypo or hypernatrimia ?

A

hyper

71
Q

causes higher bp, swealling in the brain due to excessive amounts of water in the brain. It causes headaches and it can also cause seizures

A

SIADH

72
Q

Stop urination sign of SIADH or DI?

A

SIADH

73
Q

Hypoosmolality/ hyponatremia with NA levels less than 135

A

SIADH

74
Q

Too much water in the head which means swelling

A

SIADH

75
Q

Severe high bp and edema build-up

A

SIADH

76
Q

To mitigate SIADH

A

Stop all fluids. This means no IV or drinking and the exception would be an IV saline with salt. We can also give diuretics to reduce H2O.

77
Q

decreased Bp

A

DI

78
Q

Desmopressin/vasopressin

A

used for DI

79
Q

brain damage such as brain surgery, ectopic tumors that secrete ADH (same as cushing syndrome) sepsis, or infections in the brain like meningitis and even pneumonia

A

DI

80
Q

Atrial natriuretic hormone ?ANP

A

A hormone secreted by the atria in the heart due to an increase in BP in the BV. ANP targets the kidneys and causes a decrease in NA reabsorption. + NA exits the body therefore h2o follows it by osmosis. ANP affects BV by causing vasodilation.

81
Q

ANP increases glomerular filtration by vasodilating the afferent artriole in the nephron which brings blood into the glomerulus therefor increasing the amount of filtrate produced by the kidneys.

A

yes

82
Q

other things are done by ANP

A
  • inhibits rennin angiotenesin system
    -reduces the secrition of aldosterone by the adrenal cortex in the kidneys
    -it releases free fatty acids from adipose tissue
83
Q

When do you usually see ANP

A

withh heart failure.

84
Q

ANP when does it kick in?

A

only kicks in when there is fluid overload and causes diurises

85
Q

hyponatremia is the most common chemical imbalance seen in hospital patients.

A

yes

86
Q

another thing besides the rennin angiotensin system that can stimulate the release of aldosterone is an increase in K

A

oui

87
Q

Major cation icf

A

k

88
Q

Major anion ecf

A

cl

89
Q

Major cation ecf

A

Na

90
Q

ACE inhibitors

A

they are diuretics

91
Q

Lisinopril is an ACE inhibitor

A

makes you pee

92
Q

Ca

A

Major ecf cation

93
Q

when you think of calcium you think?

A

muscle contractions and action potentials (so neuromuscular) and some heart arrhythmias

94
Q

85 % of phosphorus is in bones 14 in soft tissues and of the remaining 1% the majority is in the ICF

A

oui

95
Q

Most abundant extracellular anion

A

Cl

96
Q

Most abundant extracellular cat

A

NA

97
Q

makes up for two-thirds plasma anions

A

Cl

98
Q

Normal serum values 100-106 mEq/L

A

CL

99
Q

mainly in stomach as hydrochloric acid. HCl

A

Cl

100
Q

Major cation in ICF

A

k

101
Q

if we are going to hold on to NA

A

K will be excreted and viceversa

102
Q

it helps drive K into the cell

A

insulin

103
Q

furosemide/Lasix

A

loop diuretic (furosemide/Lasix it gets rid of K+)

104
Q

Primary anion found in intracellular fluid

A

PO 3− 4

105
Q

Activates enzymes involved in the metabolism of CHO & protein

A

mg

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