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BSNC 2000 > Fluid & Electrolytes > Flashcards

Fluid & Electrolytes Flashcards

1
Q

Extracellular fluid compatments

A

interstitial fluid
blood
lymph

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2
Q

Intracellular fluid compartment

A

cytosol

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3
Q

osmolality

A 
solute concentration of fluid
# of particles per kg of water
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4
Q

Fluid characteristics

A

volume

osmolality

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5
Q

Important electrolytes

A

sodium
potassium
magnesium
calcium

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6
Q

Primary site of calcium absorption

A

duodenum

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7
Q

Physiological processes regulating F/E

A

intake & absorption
distribution
output

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8
Q

Intake & absorption

A

process where fluids/electrolytes are physically brought into the body & enter the bloodstream

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9
Q

Distribution

A

process where fluid/electrolytes move between fluid comparments

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10
Q

Output

A

physical removal of F/E from the body

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11
Q

Na+ levels

A

135-145 meq/L

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12
Q

K+ levels

A
  1. 5-5.0 meq/L

* most K+ stored intracellularly

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13
Q

Factors stimulating thirst

A

Angiotensin II
Dry oral mucous membranes
Arterial baroreceptors (hypovolemia)
Fluid osmolality

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14
Q

Na+ fluid compartment

A

mainly located in the ECF

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15
Q

K+ fluid compartment

A

98% of total body potassium stored intracellularly

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16
Q

Ca++ compartment

A

bone

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17
Q

Mg++ compartment

A

cells & bones

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18
Q

Normal excretory routes

A

kidneys
lungs
skin
GI tract

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19
Q

Abnormal excretory routes

A

emesis
hemorrhage
drainage through tubes or fistulas
clinical interventions

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20
Q

3 Main causes of F/E imbalances

A

output > intake/absorption
intake/absorption > output
altered distribution

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21
Q

Major electrolytes in ECF

A

sodium
bicarbonate
chloride

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22
Q

Stimuli triggering thrist

A

osmoreceptors detecting change in serum osmolality
baroreceptors detecting change in effective circulating volume
ATII –> production of nonosmotic thirst

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23
Q

Factors decreasing GFR

A

SNS activation

Angiotensin II

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24
Q

Factors decreasing ADH rls

A

alcohol

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25
Q

Fluid compartments

A

ICF
ECF
Third space

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26
Q

Circulatory overload

A

caused by increase in blood volume

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27
Q

Causes of circulatory overlaod

A

increased Na+ retention
infusion of IV fluids
excessive blood transfusion

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28
Q

Effects of HF on F/E volume

A

decreased effective circulatory volume
decreased renal blood flow
compensatory Na+/H2O retention

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29
Q

Which organ metabolizes aldosterone

A

Liver

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30
Q

Liver Failure & F/E balance

A

decreased aldosterone metabolism
decreased effective circulating volume
decreased renal perfusion

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31
Q

Electrolyte definition

A

particles that dissociate into cations and anions in a solution

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32
Q

Cation

A

positive ion

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33
Q

Anion

A

negative ion

34
Q

Acute onset hyponatremia

A

<48 hours

35
Q

Osmotic demyelination syndrome

A

syndrome that occurs d/t rapid correction of hyponatremia in the brain
results in destruction of myelin of axons crossing the brainstem –> severe neurological injury & death

36
Q

Types of Hyponatremia

A

Hypertonic hyponatremia
Hypovolemic hypotonic hyponatremia
Euvolemic hyponatremia
Hypervolemic hypotonic hyponatremia

37
Q

3 types of dehydration

A

isotonic
hypertonic
hypotonic

38
Q

Hypertonic dehydration

A

water loss exceeds sodium loss –> hypernatremia

causes water to move from ICF –> ECF shrinking cells

39
Q

Hypotonic dehydration

A

sodium loss exceeds water loss –> hyponatremia

causes water to move from ECF –> ICF causing cells to swell

40
Q

At risk populations for dehydration

A 
older adults (diminished thirst response)
neonates
41
Q

Third space compartment

A

fluid compartment that is not considered ICF or ECF
non-functional (ex: joints, serous membranes)
increase in third space is considered abnormal and takes away fluid volume for normal physiologic processes

42
Q

S/S of dehydration

A 
early:
thirst response
decreased urine output , dark urine
decreased sweating 
headache, fatigue
dry mucous membranes 
decreased skin turgor 
late:
confusion
headache, dizziness, light-headedness
hypotension, tachycardia, tachypnea, fever
muscle cramps (ischemic injury)

rare:
hypovolemic shock
seizure
unconsciousness, death

43
Q

Causes of dehydration

A

medication (esp diuretics)
inadequate intake
excessive output (diarrhea, vomiting)
decreased blood colloid oncotic pressure (inadequate albumin production)
decreased blood osmolarity (hyponatremia)

44
Q

Older Adult Risk Factors

A

decreased muscle mass (muscle holds water)
diminished thirst response
dysphagia/swallowing difficulties
inadequate food intake
increased output d/t chronic conditions (diabetes)
cognitive deficits
fear of incontinence

45
Q

Dehydration treatment

A 
increased oral intake
IV fluids (rehydrate & replace lost electrolytes)
treat underlying condition
46
Q

Insensible water loss

A

water evaporation from skin (not consciously perceived)

increased with fever

47
Q

Primary sources of water loss

A

sweating
urination
excretion

abnormal: vomiting, diarrhea, hemorrhage

48
Q

Normal serum osmolality

A

285-295 mOsm/kg

49
Q

Crystalloid

A

a solution with particles small enough to pass through cell membranes
ex: NaCl infusion

50
Q

Colloids

A

a solution where the particles are too large to pass through the cell membrane
ex: albumin infusion

51
Q

Risk of output > intake

A 
increased osmolality (hypernatremia)
fluid volume deficit (dehydration
hypokalemia
52
Q

Risk of intake > output

A

edema (dependent, pulmonary)
increase in the third space compartment
decreased osmolality (hyponatremia)
hyperkalemia

53
Q

Osmotic Demyelination syndrome

A

rapid Na+ resuscitation can cause demyelination in the CNS
this is b/c neurons adapt to electrolyte imbalances by changing concentration of intracellular osmolytes to prevent fluid shift. this process takes time to correct which is why rapid infusion can damage neurons

54
Q

Hypernatremia

A

> 145 mEq/L

occurs when water loss > intake

55
Q

S/S of Hypernatremia

A 
thirst
neurologic symptoms d/t loss of water from brain cells
confusion
neuromuscular excitability
seizures
coma
56
Q

Normal daily urine output

A

1-2 L

57
Q

Osmotic pressure

A

amount of hydrostatic pressure needed to stop osmotic movement into an area. determined by solute concentration

58
Q

Oncotic pressure

A

osmotic pressure exerted by proteins (albumin)

59
Q

Osmotic diuresis

A

increase in urine output d/t increased excretion of solutes (draws water with it)

60
Q

Serum osmolality solutes

A

sodium, BUN, glucose

61
Q

Urine osmolality solutes

A

urea, creatinine, uric acid

62
Q

Normal serum osmolality

A

275-300 mmol/L

63
Q

Normal urine osmolality

A

250-900 mmol/L

64
Q

Normal urine specific gravity

A

1.010-1.025

65
Q

Urine Specific Gravity

A

a functional kidney test
measures kidney’s ability to reabsorb water –> concentrate water
decreased urine specific gravity –> decreased water reabsorption (increased risk of dehydration)

66
Q

Normal BUN levels

A

3.6-7.2 mmol/L

67
Q

Factors increasing BUN

A 
decreased renal function
GI bleeding
dehydration 
increased protein intake 
fever
sepsis
68
Q

Factors decreasing BUN

A

end-stage liver disease
low-protein diet
starvation
fluid excess

69
Q

Normal serum creatinine

A

60-130 mmol/L

used to indirectly measure GFR

70
Q

Hematocrit

A

total volume percentage of RBC in whole blood

71
Q

Normal hematocrit

A

men: 0.440-0.520
women: 0.397-0.470

72
Q

Factors increasing hematocrit

A

dehydration

polycythemia

73
Q

Factors decreasing hematocrit

A

anemia

overhydration

74
Q

Hypotonic dehydration

A

loss of water with reduced osmolality of blood plasma
caused by excess loss of body fluids replaced with hypotonic fluids
causes a shift from the ECF –> ICF (cellular swelling)

75
Q

Hypertonic dehydration

A

loss of water assoc with increased osmolality of body plasma
caused by excessive loss of body fluids (sweating, tachypnea, emesis)
causes a shift from ICF –> ECF (cellular dehydration)

76
Q

Isotonic dehydration

A

solutes and water are lost in equal concentrations

causes a loss of blood plasma (hypovolemia) but does not cause a fluid shift between ICF & ECF

77
Q

How rapidly should sodium be increased

A

1 mEq/L/kg

78
Q

NICE Fluid Assessment

A

HR, BP, Cap refill, central venous pressure
peripheral edema
orthostatic hypotension

79
Q

Normal BUN

A

3.6-7.2

80
Q

Normal Creatinine

A

50-110

81
Q

S/S of Circulatory overload

A 
tachycardia, increased BP
venous distension
increased central venous pressure
edema 
SOB, cough

BSNC 2000 (9 decks)

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