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HLSC 222 > Fluid & Electrolytes > Flashcards

Fluid & Electrolytes Flashcards

1
Q

List the major ions in our body

A

Potassium, sodium, chloride, magnesium, & calcium

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2
Q

What is the total body water of a normal adult? & list the fluid break down of a normal adult

A

TBW = 60% of body weight
ECF = 35% of TBW, broken into plasma fluid (7%) & interstitial fluid (28%)
ICF = 65% of TBW

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3
Q

What is fluid between cells in the body called? What is fluid within the cell called? what is fluid outside of the cell called? What is fluid in the blood vessels called? & what is fluid in the synovial, intestinal, & intraocular called?

A
  • Interstitial fluid
  • Intracellular Fluid (ICF)
  • Extracellular Fluid (ECF)
  • Intravascular fluid
  • Transcellular fluid
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4
Q

Adult males TBW is..?
Adult females TBW is..?
Children TBW is…?
Infants TBW is…?
In utero TBW is..?
And explain the factor that would cause you to have less water?

A
  • 60%
  • 55%
  • 65%
  • 75%
  • More body fat = less water, since fat tissue (adipose) is hydrophobic; which also means that obese individuals are more susceptible to dehydration
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5
Q

What are the major ions in the ECF & ICF?

A
  • ECF has a higher concentration of sodium and chloride and a smaller amount of potassium
  • ICF has a higher concentration of potassium and a smaller concentration of sodium and chloride
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6
Q

What refers to to thepressurethat any fluid in a confined space exerts ? What causes this pressure to go up? & what occurs in the capillary beds due to said pressure?

A
  • Hydrostatic pressure
  • More water in a closed compartment = higher hydrostatic pressure
  • In capillary beds, when hydrostatic pressure goes up, we have movement of water from plasma into interstitial compartment
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7
Q

What refers to the pulling force due to plasma proteins? What is an example of a major protein that is responsible for this pressure in our body? & what occurs when this pressure increases?

A
  • Oncotic pressure, where the proteins pulls water to it
  • Albumin
  • When oncotic pressure increases, it causes water to come in
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8
Q

What is our main protein called? And what occurs will increases in said protein do to oncotic pressure?

A

Albumin
- increase albumin in blood will increase the pull or increase the oncotic pressure – water will be pulled into the capillary

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9
Q

Capillary oncotic pressure…?
Interstitial oncotic pressure…?

A
  • pulls fluid into the capillary
  • pulls fluid into the interstitial space
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10
Q

What is the major ion that regulates water called? & what occurs if this ion is in high or low amounts in cells?

A

Sodium
- Increases in sodium within cells, water comes into it, causing swelling. You don’t want this happening in vital organs, causing brain edema for example.
- Sodium goes down within the cells, water goes out. And cells shrink.

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11
Q

Describe the net filtration

A

It is the net force of the 4 starling forces acting together

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12
Q

In Capillary hydrostatic pressure …
In Capillary osmotic (oncotic) pressure ..
In Interstitial hydrostatic pressure …
In Interstitial osmotic (oncotic) pressure ..

A
  • Water from capillary to interstitial space
  • water from interstitial space back to capillary
  • Inward movement from interstitial space into capillary
  • ## Attracts water from capillary into interstitial space
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13
Q

Describe the pressure differences between the arterial end and the venous end of the capillary.

A

In the capillary bed. On one side you have oxygenated blood, connected to arteries. The other part is connected to veins, containing deoxygenated blood + waste products. In the beginning hydrostatic pressure is higher than oncotic pressure, since it’s a pushing force. Then at the end, where metabolism is done at cellular level, providing waste products; staying in the interstitial spaces, and you want to pull these waste products in, and oncotic pressure is higher than hydrostatic pressure, for the waste products to come in.

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14
Q

Wherever sodium goes __ follows

A

Water

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15
Q

Plasma fluid is otherwise known as…

A

Intravascular fluid

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16
Q

What regulates extracellular osmotic forces and therefore regulates water balance?

A

Sodium

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17
Q

Describe the renin-angiotensin system & how it responds to drops in blood pressure & fluid volume

A

The renin-angiotensin system regulates sodium (As illustrated above). It is not active, it is created by the liver. This angiotensinogen goes into the lungs, and changes to angiotensin 1. This angiotensin 1 under the affects of process, changes to angiotensin 2, this is the active form. Blood flow to our kidneys is not enough, so these kidneys sense this, and then this stimulates the release of renin from the kidneys. This renin can affect angiotensin making it active (angiotensin 2). This A2 can do 2 things. Affecting the adrenal gland to release aldosterone, and it can affect smooth muscles in vessels and contract smooth muscles & increase BP. When BP goes up, blood volume into the kidneys goes up.

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18
Q

In the renin-angiotensin system, what does aldosterone do?

& What do the natriuretic peptides do?

A
  • stimulates water/NaCl reabsorption in response to a decrease in blood pressure/decrease in fluid volume
  • Released when there is an increase in volume, causing diuresis (increase in urination, but not allowing the kidneys to exert water into urine)
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19
Q

Which major systems show signs & symptoms of sodium imbalance? In particular, which organ? & what are some signs & symptoms of said imbalance?

A

neuromuscular
- The brain, since its sensitive to sodium amounts
- Muscle craps, muscle weakness, altered level of consciousness

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20
Q

What is the normal level of sodium at?

A

Na+ 135-145 mmol/L

21
Q

What are some signs & symptoms of hyponatremia?

A

Headache, confusion, restlessness, irritability – can develop seizures or coma

22
Q

What are some signs & symptoms of hypernatremia?

A

Thirst, confusion, muscle twitching, coma

23
Q

What is the major anion in ECF, is transported passively, always follows sodium, & is inversely proportionate to HCO3-? & what works with sodium to maintain blood pressure, blood volume as well as the pH of body fluids?

A
  • Chloride
  • Bicarbonate (HCO3-)
24
Q

Which hormone regulates water balance? & how does ADH act when there is an increase in plasma osmolarity & decreases in circulating blood volume?

A
  • Antidiuretic hormone (ADH)
  • ↑ Plasma osmolality – occurs with water deficit or sodium excess in relation to TBW. So, the hypothalamus increases thirst & increases water reabsorption
  • ↓ circulating blood volume caused by vomiting, diarrhea, or excessive sweating leads to decrease in blood pressure will follow. So, the hypothalamus increases thirst & increases water reabsorption
25
Q

What is it called when concentration is equivalent to 0.9% NaCl, in our plasma, water freely moves through cells & they are healthy– normal saline solution – no shrinking or swelling

A

Isotonic

26
Q

What is it called when concentration is > 0.9% NaCl ECF, when the osmolarity goes up, high level of sodium outside of the cell, which water follows – cells are shrunk

A

Hypertonic

27
Q

What is it called when concentration is < 0.9% NaCl ECF, causing water to go into the cell, – cells expanded

A

Hypotonic

28
Q

What is the term that is caused by hemorrhage, severe wound drainage, diaphoresis, inadequate fluid intake, with symptoms such as flat neck veins, weight loss, dry skin and mucous membranes, normal or low BP?

& how is it treated?

A

Hypovolemia
- Isotonic IV solution – 0.9 % normal saline (NS) or D5S, lactated ringers

29
Q

What is the term that is caused by isotonic fluid excess, excessive IV fluids (namely blood products), or hypersecretion of aldosterone; with symptoms such as increased neck veins, edema, increased BP

& how is it treated?

A

Hypervolemia
- Diuretics

30
Q

What is characterised by an increase of osmolarity of the ECF or concentrations of NaCl in ECF is > 0.9%? & is caused by inadequate water intake (such as losing thirst mechanism in elderly), or excessive water loss because of:( increase in urination due to decrease in vasopressin (Antidiuretic Hormone), use of diuretics, renal dysfunction, vomiting, diarrhea, excessive sweating during exercise

& list the signs & symptoms as well as which organ is affected the most

Also, what is its mechanism of action?

A

Hypernatremia

  • Signs & symptoms: Confusion, hallucination, and may cause death if left untreated . Elderly who don’t drink water due to compromised thirst mechanisms, are prone to hypernatremia
  • Brain is the most sensitive organ in this case => neurologic sings and symptoms (headache, confusion, seizure, death)
  • Hypernatremia cause body cells to shrink as ICF moves toward vessels with high concentration of Na+
31
Q

Describe what occurs in sodium deficits

& describe what occurs in water excess

A
  • Sodium deficit = osmotic pressure of ECF ↓ = water moves into cell = plasma volume decreases = signs of dehydration
  • Water excess - ↑ in both ICF and ECF = symptoms of hypervolemia & water intoxication
32
Q

Which term refers to normal body sodium with increase in total body water? What is its most common cause? & what does this syndrome involve?

A

Euvolemic hyponatremia
- SIADH (syndrome of inappropriate antidiuretic hormone secretion) causing increased water retention
- Involving increases in antidiuretic hormone, not allowing water to be exerted.

33
Q

Which term refers to increase in total body sodium with greater increase in total body water→ dilution of sodium in ECF? & what are some causes of said state?

A

Hypervolemic hyponatremia
- Heart failure, renal failure (kidneys are unable to exert sodium), cirrhosis of the liver(edema is present)

34
Q

Which term refers to total body water & sodium content are decreased, with greater sodium loss? & what are some causes of said state?

A

Hypovolemic hyponatremia
- prolonged vomiting (we lose most electrolytes, & water) & diarrhea, inadequate aldosterone (addison’s disease), & diuretics

35
Q

Which term refers to water intoxication, most common in marathon runners who excessively sweat & intake large amounts of water for thirst, causing sodium to be diluted?

A

Dilutional hyponatremia

36
Q

List some of the manifestations associated with hyponatremia

A
  • Cell swelling, especially dangerous is cerebral edema
  • Muscle cramps or weakness decreased reflexes, lethargy, mental status changes, seizure, & coma
37
Q

What is the major intracellular electrolyte
called?

A

Potassium

38
Q

Which term refers to Serum K+ below 3.5 mmol/L, in the blood, generally due to ↓ intake, ↑ movement of K+ into cells, ↑ loss of K+? Also, what are some specific causes & manifestation?

A

Hypokalemia
- Poor diets in the elderly, alcoholism, anorexia. poor intake usually needs to be combined with other causes of potassium depletion such as using some medication (furosemide)
- Usually in the neuromuscular system & cardiac system.
muscle weakness and cramping, paralytic ileus, hypotension, hypoventilation, cardiac dysrhythmia

39
Q

Which term refers to serum K+ higher than 5.0 mmol/L, in the blood? Also, what are the causes of said state & manifestations?

A

Hyperkalemia
- Acidosis & Diabetic ketoacidosis: A shift of potassium from the intracellular to the extracellular space in an exchangewith hydrogen ions that accumulate extracellularly in acidosis.
-Hypoxia: Diminishes efficiency of cell membrane active transport
-Renal failure: Decreased excretion of K+
- Manifestations: Mild; neuromuscular irritability- restlessness, intestinal cramping, diarrhea
Severe; ↓membrane resting potential leading to…muscle weakness, loss of tone, paralysis – rapid repolarization of cardiac – changes in ECG (dysrhythmia) cardiac arrest

40
Q

What are the major systems that show signs & symptoms of potassium imbalances? & what are they?

A

cardiac and neurological
- Cardiac: dysrhythmias, cardiac arrest
- CNS: Reflexes, level of consciousness

41
Q

Which term refers to a condition where the calcium level in your blood is above normal? What are its causes & manifestations?

A

Hypercalcemia
- Overactive parathyroid, otherwise known as hyperparathyroidism. & cancer – metastases (spreading) to the bone, overtaking Vitamin D
- Manifestations: Fatigue weakness, lethargy, impaired renal function, kidney stones, dysrhythmias, cardiac arrest, & osteoporosis

42
Q

Which term refers to a condition where the calcium level in your blood is below normal, & is similar to hyperkalemia? What are its causes & manifestations?

A

Hypocalcaemia
- ↓ absorption of calcium in intestinal tract, blood administration, inadequate dietary intake – low Vitamin D (Vitamin D helps our GI tract absorb calcium)
- Manifestation: Neuromuscular excitability, & hyperactive bowel. In its severe form it can cause convulsions, prolonged QT interval, & cardiac arrest

43
Q

Which term refers to excessive accumulation of fluid within the interstitial spaces? & what are its causes?

A

Edema
- ↑ capillary hydrostatic pressure –1) local – chronic venous insufficiency 2) systemic – congestive cardiac failure, renal failure, anemia, pregnancy – increased BP
- ↓ plasma oncotic pressure systemic causes – protein deficient states, liver diseases, nephrotic syndrome (pass too much protein in urine)
- ↑ capillary membrane permeability – local causes – cellulitis – systemic causes – hypersensitivity reactions, sepsis
- Lymphatic channel obstruction – tumour, trauma, & radiation

44
Q

Which term refers to to fluid accumulation at a specific area – can be localized to an organ – cerebral, pulmonary, laryngeal?

A

Localized edema

45
Q

Which term refers to gravity-relatedswellingin the lower body?

A

Dependent edema

46
Q

Which term refers to fluid accumulation that affects the whole body rather than particular organs or body areas?

A

Generalized edema

47
Q

Which term refers to swelling that generally occurs in one of your arms or legs - caused by the removal of or damage to your lymph nodes in that limb?

A

Lymphedema

48
Q

List the manifestations (list all 7) & treatments (list all 9) for edema

A

Manifestations: Weight gain, swelling, puffiness, limited movement of joints, blood flow impairment causing decreased speed of wound healing, increased risk of infection, &increased risk of pressure sores.

Treatment: Fix underlying condition, elastic support stockings (which apply pressure maintain blood flow ),reduce discomfort & swelling, elevation of swollen limb, avoid prolonged standing, restrict sodium intake, diuretics, & IV administration of albumin

HLSC 222 (19 decks)

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