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Nursing Semester 1 > Fluid/Electrolytes > Flashcards

Fluid/Electrolytes Flashcards

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1
Q

Extracellular fluid (ECF)

A

fluid outside the cell

1/3 of body’s H20

more prone to loss

3 types

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2
Q

3 types of extracellular fluid:

A

Interstitial: fluid around/between cells

Intravascular: (plasma) fluid in blood vessels

Transcellular- CSF, synovial fluid, etc

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3
Q

Intracellular fluid (ICF)

A

Fluid inside the cell

Most 2/3 of body’s H20 is in the ICF

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4
Q

Infant fluid compartments:

A

60% of H20 is found in the ECF

40% of H20 is found in ICF

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5
Q

Adults or infants are more prone to fluid loss?

A

Infants!

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6
Q

Body tries to maintain homeostasis of fluids and electrolytes by regulating:

A

volumes

solute charge and osmotic load

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7
Q

What is the minimum output her hour necessary to maintain renal function?

A

30mL/hr

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8
Q

Loss of 10% body fluid= ______-weight loss and is _____

A

8% weight loss and is SERIOUS

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9
Q

Loss of 20% body fluid = _____ weight loss and is _____

A

15% weight loss and is FATAL

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10
Q

Electrolytes:

A

charged particiles

cations- positively charged ions
Na+, K+, Ca++, H+

Anions: negatively charged ions
Cl-, HCO3-, PO43-

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11
Q

Non electrolytes:

A

uncharged particles- proteins, urea, glucose, O2, CO2

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12
Q

Functions of body fluid (6)

A

medium for transport

cellular metabolism

solvent for electrolytes and other constituents

body temperature

digestion and elimination

lubricant

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13
Q

Hypothalamus:

A

thirst receptors

osmoreceptors monitor serum osmolarity.

If it rises, thirst mechanism is triggered

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14
Q

Sodium is found in the

A

extracellular compartment

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15
Q

Potassium is found in the

A

intracellular compartment

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16
Q

Magnesium is found more in the

A

intracellular compartment

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17
Q

Chloride is found in the

A

extracellular compartment

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18
Q

Solute homeostasis is maintained by

A

ion transport

water movement

kidney function

these functions act to keep body fluids:

electrically neutral
osmotically stable

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19
Q

Diffusion

A

movement of particles DOWN a concentration gradient

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20
Q

Facilitated diffusion

A

addition of specific carrier molecules to aid/accelerate diffusion (glucose transport into cell facilitated by insulin)

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21
Q

Osmosis

A

diffusion of water across a selectively permeable membrane

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22
Q

Active transport

A

movement of particles UP a concentration gradient; REQUIRES ENERGY

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23
Q

Osmolarity (tonicity)

A

concentration of particles in a solution

the greater the concentration (osmolarity) of a solution, the greater the pulling force (osmotic pressure)

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24
Q

A solution that has a HIGH osmolarity is a _____ solution

A

HYPERTONIC solution

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25
Q

A solution that has a LOW osmolarity is a _____ solution

A

HYPOTONIC solution

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26
Q

A solution that has EQUAL osmolarity is a ________ solution

A

ISOTONIC (normal saline)

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27
Q

Hypertonic fluids have a _____ concentration of particles (high osmolality) than ICF

A

higher!

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28
Q

Higher osmotic pressure shifts fluid from the cells into the

A

ECF

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29
Q

Cells placed in a hypertonic solution will

A

SHRINK!!!!!!

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30
Q

Hypertonic solution is used to

A

temporarily treat hypovolemia

expand vascular volume

fosters normal BP and good urinary output (often used post op)

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31
Q

Hypotonic fluids have less concentration of particles than

A

ICF

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32
Q

The low osmotic pressure shifts fluid from

A

ECF into cells

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33
Q

Cells placed in a hypotonic solution will

A

SWELL!

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34
Q

Hypotonic solution is used to

A

dilute plasma particularly in hypernatremia

treats cellular dehydration

do not use for patients with increased ICP risk or third spacing risk- edema!

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35
Q

Isotonic fluids have the same concentration of particles (osmolality) as

A

ICF

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36
Q

Osmotic pressure is therefore the _____ inside and outside the ____

A

SAME

cell

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37
Q

Cells do not ___ or ____ in an isotonic solution. They _____

A

DO NOT SWELL OR SHRINK

THEY STAY THE SAME!

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38
Q

Isotonic solution expands…

A

both intracellular and extracellular volume

used commonly for excessive vomiting and diarrhea

0.9% normal saline

D5W

Ringer’s Lactate

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39
Q

Albumin is a

A

serum protein that has osmotic properties called colloid pressure

40
Q

Albumin pulls…

A

H2O from the interstitial compartments into the intravascular compartments (serum)

Helps to maintain BP

41
Q

persons with low serum albumin levels tend to

A

retain fluid in their interstitial layers

42
Q

What are abnormal assessments might you find in the client with low serum albumin levels?

A

EDEMA

HYPOTENSION

43
Q

Third spacing is

A

when tissue injury occurs, proteins pathologically leak from the intravascular space into the interstitial space

44
Q

Fluid volume deficit FVD (Hypovolemia)

A

Loss of both H20 and electrolytes from ECF

45
Q

Causes of FVD (Hypovolemia)

A

Increased output

hemorrhage

vomiting

diarrgea

burns

OR

fluid shift out of vascular space (“third spacing”) into interstitial spaces

46
Q

Isotonic dehydration:

A

H20 and electrolyte loss in equal amounts; diarrhea and vomiting

47
Q

Hypertonic dehydration:

A

H20 loss is greater than electrolyte loss

excessive perspiration

diabetes

48
Q

Assessment of fluid volume deficit Cardiovascular

A

Diminished peripheral pulses; quality 1+

decreased BP and orthostatic hypotension

Increased HR

Flat neck and hand veins in dependent position

Elevated Hematocrit (HCT)

49
Q

Assessment of fluid volume deficit Gastrointestinal

A

Thirst

Decreased motility

diminished bowel sounds

possible constipation

50
Q

Nursing diagnosis deficient fluid volume:

A

R/T loss of GI fluids via vomiting

AEB elevated Hct, dry mucous membranes, decreased output, thirst

51
Q

Interventions for deficient fluid volume (hypovolemia)

A

prevent further fluid loss

oral rehydration therapy

IV therapy

Medications- antiemetics, antidiarrheals

Monitor VS, resp, renal, GI status

Monitor electrolytes- possible supplement Rx

Monitor weight and I/O

52
Q

Hypervolemia:

A

excess fluid volume in the intravascular area

fluid overload is an excess of body fluid: over hydration

53
Q

Excess fluid volume in interstitial spaces:

A

edema

54
Q

Electrolyte functions:

A

work with fluids to keep the body in balance

regulate water distribution

muscle contraction

nerve impulse transmission

blood clotting

regulate enzyme reactions (ATP)

Regulate acid-base balance

55
Q

Electrolytes are ___

A

solutes that are found in various concentrations and measured in milliequivalent units

anions or cations- homeostasis body needs total body anions-total body cations

56
Q

Electrolyte imbalance of Potassium (K+)

A

Hypokalemia

Hyperkalemia

57
Q

Electrolyte imbalance of Calcium (Ca2+)

A

Hypo/Hyper calcemia

58
Q

Electrolyte imbalance of Magnesium (Mg2++)

A

Hypo/Hyper magnesia

59
Q

Sodium normal range:

A

135-145mEq/L

60
Q

Sodium facts!

A

MAJOR CATION

Chief electrolyte of the ECF

regulates volume of body fluids

Needed for nerve impulse & muscle fiber transmission (Na/K pump)

regulated by kidneys/hormones

61
Q

Hyponatremia range:

A

Serum Na_ < 135mEq/L

62
Q

Hyponatremia facts!

A

Results from excess of water or loss of Na+

Water shifts from ECF into cells

S/S: abd cramps, confusion, N/V

Tx: Diet/IV therapy/fluid restrictions

63
Q

What are some medical conditions that may cause a dilution hyponatremia?

A

CHF

Renal failure

SIADH (cancer, pituitary trauma)

Addisons Disease (hypoaldosteronism & Na loss)

64
Q

What are some conditions that might cause actual loss of sodium from the body?

A

GI losses- nasogastric suctioning, vomiting, diarrhea

Certain diuretic therapies

65
Q

Permanent neurological damage can occur when serum Na levels fall below 110 mEq/L. Why?

A

Hypotonic environment swells cells, increasing ICP- brain damage

66
Q

Hypernatremia range:

A

Serum Na+>145mEq/L

67
Q

Hypernatremia facts

A

Results from Na+ gained in excess of H2O OR Water is lost in excess of Na+

water shifts from cells to ECF

68
Q

Hypernatremia signs and symptoms:

A

thirst

dry mucous membranes & lips

oliguria

increased temp & pulse

flushed skin

confusion

69
Q

Treatment for hypernatremia

A

IV therapy/diet

70
Q

Potassum:

A

3.5-5.0 mEq/L

Chief electrolyte of ICF

Major mineral in all cellular fluids

71
Q

Potassium aids in

A

muscle contraction

nerve/electrical impulse conduction

regulates enzyme activity

regulates IC h20 content

assists in acid-base balance

72
Q

Potassium is regulated by

A

kidneys/hormones

inversely proportional to Na

73
Q

ECF has which two major divisions? minor division?

A

Intravascular- liquid part of blood (plasma)

interstitial- between cells and outside blood vessels

Transcellular (minor)- cerebrospinal, pleural, peritoneal, synovial fluids are secreted by epithelial cells

74
Q

Major cations in body

A

Sodium (Na+)

Potassium (K+)

Calcium (Ca2+)

Magnesium (Mg2+)`

75
Q

Major anions in body

A

Chloride (Cl-)

Bicarbonate (HCO3-)

76
Q

Osmolality

A

measure of the number of particles per kilogram of water. `

77
Q

Isotonic

A

fluid with the same tonicity as normal blood

78
Q

Hypotonic

A

solution is more DILUTE than the blood

Cell will swell

79
Q

Hypertonic

A

solution is MORE CONCENTRATED than normal blood

cell SHRINKS

80
Q

Processes that move water and electrolytes between body compartments

A

active transport

diffusion

osmosis

filtration

81
Q

Active transport:

A

cells maintain their high intracellular electrolyte concentration by active transport

requires energy in form of ATP to move electrolytes across cell membrane AGAINST concentration gradient
(low concentration to high concentration)

Sodium-potassium pump

82
Q

Diffusion

A

Passive movement of electrolytes DOWN a concentration gradient

higher concentration to lower concentration

requires proteins that serve as ion channels

83
Q

Osmosis

A

water moves across cell membranes by osmosis.

water moves through a membrane that separates fluids with different particle concentrations

84
Q

Osmotic pressure

A

an inward pulling force caused by particles in the fluid

85
Q

Hydrostatic pressure

A

force of the fluid pressing outward against a surface

86
Q

Blood colloid osmotic pressure (oncotic pressure)

A

is an inward-pulling force caused by blood proteins that helps move fluid from the interstitial area back into capillaries)

87
Q

Fluid homeostasis includes which three processes

A

fluid intake and absorption

fluid distribution

fluid output

88
Q

Fluid output normally occurs through which 4 organs

A

skin, lungs, GI tract, kidneys

89
Q

Insensible water loss is

A

NOT VISIBLE

CONTINOUS through the skin and lungs

90
Q

Approximately how many L of fluids moves into the GI tract daily and returns to the ______

A

3-6 L daily

Returns to ECF

91
Q

ADH regulates the ____

A

Antidiuretic hormone

osmolality of the body fluids by influencing how much water is excreted in urine

92
Q

ADH is released by

A

Posterior pituitary gland

93
Q

More ADH is released if

A

body fluids become more concentrated

94
Q

Factors that increase ADH levels include

A

severely decreased blood volume (dehydration, hemorrhage)

pain

stressors

some medications

95
Q

ADH causes

A

renal cells to RESORB water, taking water from the renal tubular fluid and putting it BACK INTO BLOOD

96
Q

ADH levels decrease if

A

body fluids become TOO DILUTE

This allows more water to be excreted in urine

97
Q

The RAAS regulates

A

ECF volume by influencing how much sodium and water are excreted in urine

Nursing Semester 1 (24 decks)

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