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Block 1 Nursing SCC > Fluid & Electrolytes > Flashcards

Fluid & Electrolytes Flashcards

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1
Q

Define Electrolyte

A

A solute that develops an electrical charge (sodium and potassium).

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2
Q

Intracellular fluid

A

Fluid contained within the cells. 40% of body weight and is responsible for cell function and metabolism. ~28L in adult

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3
Q

Extracellular fluid

A

Fluid outside the cells. 20% body weight, carries water, oxygen, electrolytes, nutrients to cells and removes waste products from cellular ,metabolism. ~14L in adult

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4
Q

Major electrolytes in ICF; cations and anion

A

Cations: Potassium, magnesium
Anion: phosphate

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5
Q

Main electrolytes in ECF; cations and anion

A

Cations: sodium, chloride
Anion: bicarbonate

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6
Q

Define interstitial fluid

A

ECF located in the spaces between the cells. Excess fluid here is called edema. Second spacing

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7
Q

Define intravascular fluid

A

ECF located within the blood vessels. It is the plasma located in the blood. Transports blood cells

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8
Q

Define transcellular fluid

A

ECF that includes specialized fluids that are contained in body spaces ( cerebrospinal, pleural, peritoneal, and synovial fluids) and digestive juices. ~1L

Fluid movement into a compartment is known as third spacing (Ascities).

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9
Q

Define osmolality (tonicity)

A

The concentration of solutes creating pressure in body fluid.

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10
Q

Isotonic solution

A

Of the same osmolality of blood ; no osmosis will occur

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11
Q

Hypotonic solution

A

Of lower osmolality than blood ; water will move into cells by osmosis from vascular system

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12
Q

Hypertonic solution

A

Contains a higher concentration of solutes than blood ; water moves by osmosis out of cells into ECF

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13
Q

Define osmosis

A

The movement of water (passive) from a lower solute concentration to a higher solute concentration to achieve dilution of higher solute concentration to reach equilibrium

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14
Q

Define diffusion

A

Movement (passive) of molecules of a solute from a higher concentration to a lower concentration to reach equilibrium

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15
Q

Factors affecting rate of diffusion

A

Size of molecule, concentration of solution, and temperature of solution.

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16
Q

What are crystalliods

A

Solutes that readily dissolve ( electrolytes)

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17
Q

What are colloids

A

Larger molecules that do not dissolve readily ( proteins)

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18
Q

Define filtration

A

The movement of both water and smaller solutes from an area of high pressure to area of low pressure

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19
Q

Define hydrostatic pressure

A

The force created by fluid within a closed system ; responsible for normal circulation of blood

High pressure (arteries) to low pressure (capillaries and veins)

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20
Q

Define osmotic pressure

A

The power of a solution to draw water.

A highly concentrated solution draws water and has a high osmotic pressure.

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21
Q

Filtration pressure

A

When hydrostatic pressure exceeds osmotic pressure fluid leaves the vessels.

Represents the net pressures that move fluid and solutes

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22
Q

Active transport

A

Occurs when molecules move across cell membranes against the concentration gradient with the use of ATP (from an area of low concentration to an area of high concentration)

Ex: sodium-potassium pump

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23
Q

Define Solute

A

Solid substance that dissolves in body fluids

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24
Q

Factors that increase plasma osmolality

A

excessive fluid loss, excessive sodium intake, and decreased fluid intake.

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25
Q

changes in plasma osmolality signal which center in the brain

A

the thirst center in the hypothalamus

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26
Q

sensible fluid loss

A

measurable and perceived

ex: urine 1500mL, diarrhea, ostomy, gastric drainage, skin 300-600mL, feces 100-200mL

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27
Q

insensible fluid loss

A

loss that we do not perceive and cannot measure accounts for about 900mL per day
ex: lungs about 300mL per day

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28
Q

what is the principal regulator of fluid and electrolyte balance

A

kidneys

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29
Q

what hormones are involved in regulation

A

ADH, Renin-Angiotensin System, Aldosterone, Thyroid, ANP & BNP & CNP

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30
Q

define ADH and function

A

pressure sensors from the vascular system stimulate or inhibit the release of antidiuretic hormone from pituitary gland. ADH causes kidneys to retain fluid. ADH is also produced in response to a rise in serum osmolality, fever, pain, stress, and some opioids.

ex: if fluid volume in the vascular system is low, fluid pressures decrease, and more ADH is released to signal kidneys to retain more fluid.

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31
Q

define Renin-Angiotensin System and function

A

when intravascular fluid volume is decreased, receptors in the glomeruli respond to the decreased perfusion of the kidneys by releasing renin. Renin is responsible for a chain reaction that converts angiotensin into angiotensin 2.
Angiotensin 2 acts on the nephrons to retain sodium and water and directs the adrenal cortex to release aldosterone.

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32
Q

define aldosterone and function

A

when released, it stimulates the distal tubules to reabsorb sodium and excrete potassium. with this, water is passively reabsorbed thereby increasing fluid volume and renin is not released and this process stops.

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33
Q

define thyroid hormone and function

A

affects fluid volume by influencing cardiac output. and increase in thyroid hormone causes increase in CO and increases glomerular filtration rate and urine output. a decrease does the opposite.

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34
Q

define Natriuresis (ANP, BNP, CNP) and functions

A

natriuretic is the discharge of sodium through urine

BNP is released from brain and right atrium. can be measured to help determine presence of heart failure with fluid excess and to distinguish heart failure from pulmonary edema.

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35
Q

Sodium (Na+)

A

major cation in the ECF. primary function to regulate fluid volume. reabsorbed and excreted by kidneys.
Moves by active transport via sodium-potassium pump, regulated by ADH and aldosterone levels (pituitary)

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36
Q

Potassium (K+)

A

major cation in the ICF (98% in icf). key electrolyte in cellular metabolism. necessary transmission/conduction of nerve and muscle impulses, maintenance of cardiac rhythms, cellular growth, acid-base balance. Na+ K+ pump (3sodiums out 2 potassiums in) regulated by aldosterone. excreted and conserved primarily by kidneys ~90% daily K+. Sodium retention = potassium loss in urine

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37
Q

Calcium (Ca++)

A

responsible for bone health, neuromuscular, and cardiac function. essential factor in blood clotting. 99% is found in bones and teeth, the remainder 1% circulates in the blood and affects system functions. as serum calcium levels drop, ca++ is leached from bones and into the blood to compensate.

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38
Q

Magnesium (Mg++)

A

mineral used in more than 300 biochemical reactions in the body. like calcium, only about 50-60% is found in the bone. 2% is in the ECF. coenzyme in metabolism of protein and carbs. required for nucleic acid and protein synthesis. necessary for na-K pump. skeletal muscle relaxation.
Mistaken for Ca+ imbalance; if you replace K, also replace Mg++

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39
Q

Chloride (Cl-)

A

most abundant anion in the ECF. usually bound with other ions especially sodium or potassium. essential for hydrochloric production for gastric sectretions. found in food high in sodium

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40
Q

Phosphorus (Phosphate [Po4-])

A

Most abundant ICF anion. most phosphorous in the body is combined with oxygen forming phosphate-mostly bound with calcium in teeth and bones as calcium phosphate.
phosphate and calcium exist in an inverse relationship.
Phosphate in the ECF is known as phosphorus.

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41
Q

Bicarbonate (HCO3-)

A

present in both ICF and ECF. The kidneys regulate EC bicarbonate to maintain acid-base balance. when serum levels rise, kidneys excrete excess bicarbonate. It is not consumed in the diet but is produced by the body to meet current needs. a major buffer.

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42
Q

what is an acid

A

any compound that contains hydrogen ions that can be released. acids are referred to cation donors.

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43
Q

what is a base/alkali

A

a compound that combines with (accepts) hydrogen ions in solution. bases are referred to cation receptors.

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44
Q

what is pH

A

the amount of acid or base present in a solution; measured as 1-14. 1-6.9 as being acidic 7 is neutral and 7.1-14 is basic.

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45
Q

Hgb Female

A

12-16 g/dL

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46
Q

Hgb Male

A

14-18 g/dL

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47
Q

HCT

A

Hgb x 3 %

48
Q

BUN

A

10-20 mg/dL

49
Q

Creatinine

A

0.5-1.5 mg/dL

50
Q

Urine Specific Gravity

A

1.003-1.03

51
Q

Serum Osmolality

A

280-300 mOsm/kg of H2O

52
Q

Glucose

A

70-100 mg/dL

53
Q

Na+

A

135-145 mEq/L regulation of fluid volume, ECF, Most abundant electrolyte in the body

54
Q

K+

A

3.5-5 mEq/L ICF, muscle contraction, cardiac conduction

55
Q

Cl-

A

95-105 mEq/L ECF, bound to other ions

56
Q

Mg++

A

1.5-2.5 mEq/L many cellular functions, ICF, bone 300 biochemical reactions

57
Q

Phosphorous

A

2.5-4.5 mg/dL ICF anion, bound with calcium in teeth and bones, inverse relationship, combined with O2

58
Q

Ca++

A

8.5-10.5 mg/dL bone health, neuromuscular function, cardiac function, insufficiency leads to osteoporosis

59
Q

pH

A

7.35-7.45

60
Q

PaCO2

A

35-45mmHg

61
Q

HCO3

A

22-26 mEq/L

62
Q

PaO2

A

80-100 mmHg

63
Q

SaO2

A

95-100 %

64
Q

Define nonelectrolyte

A

does not emit electrical charge when dissolved into water

ex: glucose, urea

65
Q

Functions of body fluids

A

maintain blood volume, regulate body temp, transport materials to and from cells, medium for cell metabolism, assist with digestion of food, medium for excreting waste.

66
Q

Infant, Adult, & Older Adult body water composition

A

70-80%, 50-60%, & 45-55%

67
Q

First Spacing

A

normal distribution between ECF & ICF (homeostasis)

68
Q

Second Spacing

A

abnormal accumulation of interstitial fluid (edema) -hypervolemic

69
Q

Third Spacing

A

fluid is trapped and unavailable for functional use - loss of ECF - hypovolemic -increased fluid in peritoneal cavity = ascities

70
Q

ICF Cations and Anions

A

Potassium, Magnesium, Sodium

Phosphate, Sulfate, Bicarbonate

71
Q

ECF Cations and Anions

A

Sodium, Potassium, Calcium, Magnesium

Chloride, Bicarbonate, Sulfate, Phosphorous

72
Q

IOM recommendation of fluid intake men and women

A

3500mL/day men ; 2700 mL/day women

73
Q

Daily urine output

A

1500 mL

74
Q

Daily skin output

A

650-900 mL - sensible 300-500mL (sweat) - insensible 350-400 mL (diffusion)

75
Q

Daily lung output

A

300-400 mL

76
Q

Daily feces output

A

100-200mL

77
Q

Sources of electrolytes

A

fruit, veggies, grains, enriched foods, supplements

78
Q

dietary sources of sodium

A

table salt (40% sodium), cheese, eggs, fish/shellfish, poultry, processed foods

79
Q

dietary sources of potassium

A

fruits(bananas, oranges), veggies, salt substitutes(high potassium)

80
Q

what are the 3 forms of calcium

A

ionized, bound to protein, complexed

when a lab calcium is drawn, a total of all 3 are shown as the result

81
Q

ionized calcium

A

free, active calcium, important for neuromuscular transmission

82
Q

bound to protein calcium

A

albumin ; alteration of albumin levels will alter the total calcium levels but ionized level will not be affected

83
Q

complexed calcium

A

phosphate, citrate, carbonate

84
Q

dietary sources of calcium

A

dairy - milk, yogurt, cheese
dark leafy greens
salmon

85
Q

Calcium Regulation

A

PTH, Calcitonin, Vit. D, Phosphorus

86
Q

Parathyroid hormone r/t calcium regulation

A

stimulates release of calcium from bones and reabsorption from the kidneys and intestines into blood

87
Q

Calcitonin r/t/ calcium regulation

A

blocks bone breakdown and lowers calcium levels -thyroid -against PTH.

88
Q

Vit. D r/t calcium regulation

A

sunlight and diet. stimulates calcium absorption. calcium will not work with out Vit. D

89
Q

Phosphorus r/t calcium regulation

A

inversely proportional to calcium

90
Q

Dietary sources for magnesium

A

green leafy veggies, nuts, legumes, whole grains, chocolate

91
Q

Dietary sources of phosphate

A

meat, fish, poultry, diary products, legumes, whole grains

92
Q

Hyponatremia

A

Na+

93
Q

Hypernatremia

A

Na+ > 145 ; can affect cerebral cells, neuro changes

94
Q

Hypokalemia

A

K+

95
Q

Hyperkalemia

A

K+ > 5 ; can affect cardiac function

96
Q

Hypomagnesemia

A

Mg++

97
Q

Hypermagnesemia

A

Mg++ > 2.5

98
Q

Hypophosphatemia

A
99
Q

Hyperphosphatemia

A

> 4.5

100
Q

Hypocalcemia

A
101
Q

Hypercalcemia

A

> 10.5

102
Q

Hypochloremia

A
103
Q

Hyperchloremia

A

> 105

104
Q

Dehydration

A

loss of water only

105
Q

Hypovolemia (ECF volume deficit)

A

loss of water and electrolytes -blood volume loss

106
Q

fluid volume deficit results from…

A

GI loss, burns, polyuria, loss of blood, inadequate intake, plasma to interstitial fluid shift.

107
Q

S/Sx of Dehydration

A

thirst, dizziness/weakness, mental status change (mild confusion to coma), dry skin/mucous membrane, poor skin turgor, decreased urine output, weight loss, tachycardia, hypotension, seizures, fever

108
Q

Labs of dehydrated pt

A

increased BUN, HCT, serum osmolality, urine specific gravity, sodium

109
Q

Fluid volume excess Overhydration

A

retention of water only

110
Q

Hypervolemia (ECF volume excess)

A

retention of water and electrolytes

111
Q

fluid volume excess results from…

A

excess intake of fluids, abnormal retention of fluids (CHF, renal failure, increased intake sodium), interstitial to plasma fluid shift

112
Q

S/Sx of fluid volume excess

A

elevated BP, bounding pulse, faster/shallow respirations, pale cool skin, edema (tissues and lungs), increase urine volume,

113
Q

Labs of an overhydrated pt…

A

low hematocrit, bun, decreased urine specific gravity, serum osmolality, sodium, pulmonary congestion on cxr

114
Q

MOST accurate way to evaluate fluid volume

A

daily weight

115
Q

Fluid and electrolyte imbalances can severely affect …

A

infants, older adults, the severely ill, disoriented, or immobile pts.

Block 1 Nursing SCC (11 decks)

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