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Nurs 347 Pathophysiology exam 1 > Fluid & Electrolytes Part 2 > Flashcards

Fluid & Electrolytes Part 2 Flashcards

1
Q

What are the 3 fluid tonicity?

A

Isotonic
Hypertonic
Hypotonic

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2
Q

What is isotonic?

A

Has the same osmolality ( the concentration of solutes in the body ) as ECF, No fluid movement occurs

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3
Q

What is hypertonic?
( more or less concentration ?)

A

ECF solutes are more concentrated than in cells, water leaves the cells, causing cell shrinkage and possibly cell death

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4
Q

What is hypotonic?
( more or less concentration ?)

A

ECF solutes are less concentrated than the cells water moves into the cell and can cause rupture

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5
Q

Hypertonic short

A

Fluid leaves the cells and gets smaller

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6
Q

Hypotonic short

A

Fluid goes in the cell
Cell gets bigger

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7
Q

What is osmotic pressure?
(ST, F)

A

The amount of pressure required to stop osmotic flow of water

( power to pull water through a semi permeable membrane )

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8
Q

How is osmotic pressure determined by?
(SS,HH)

A

By the concentration of solutes in solution ; the higher the concentration the higher the pressure
( more pressure in a crowed )

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9
Q

What starts or stops the movement of fluid?

A

The pressure

determines the amount of fluid in cell

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10
Q

What type of solution do we use for hypotonic ?

A

Normal Saline

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11
Q

What type of solution do we use for hypertonic?

A

D50%

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12
Q

What is hydrostatics pressure?
( generated by what?)
(FC)

A

Force within a fluid compartment
Blood pressure generated by heart contraction

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13
Q

What is oncotic pressure caused by

A

Caused by plasmas colloids in solution

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14
Q

What is osmotic pressure caused by?

A

Plasmas proteins

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15
Q

Fluid movement in capillaries
Amount and direction of movement determined by?
Moves water out of capillaries
(C, IT)

A

Capillary hydrostatics pressure
Interstitial hydrostatic oressure

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16
Q

Fluid movement in capillaries
Amount and direction of movement determined by?
Moves fluid into capillaries
(P, IT)

A

Plasma oncotic pressure
Interstitial oncotic pressure

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17
Q

What organs or structures in the body contribute to fluid balance and how so?

A

The kidneys ( controls BP up or down )

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18
Q

Why isn’t the heart an organ in the body that contribute to the fluid balance?

A

the heart doesn’t control blood pressures because there are other sensors in the body that want all the perfusion

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19
Q

What is perfusion?

A

Organs having enough blood oxygen and fluid, perfect organ condition

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20
Q

The kidneys will signal the heart to push the blood but what’s actually controlling the blood pressure from up and down is ?

A

The kidneys

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21
Q

When the kidneys wants more perfusion they release ?

A

Renin

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22
Q

Oncotic pressure is ____ within the ____?

A

Pulling pressure within the intravascular space

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23
Q

What is the purpose of oncotic pressure?

A

To keep the fluid in the intravascular space

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24
Q

How does the oncotic Pressure keep the fluid in the intravascular space?
(2)

A

by either holding on to it or pulling it from the interstitial or intracellular spaces

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25
Q

Hydrostatic pressure is ___within the _____?

A

Pushing pressure within the intravascular space

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26
Q

Where does the hydrostatic pressure push fluid out and into what?

A

Pushes it out of the intravascular space into the interstitial or intercellular spaces

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27
Q

How is the hydrostatic pressure influence by?
(increase, FOB, v)

A

By any condition that will increase the amount of force the blood within the intravascular space exerts against the vessel walls

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28
Q

What is the oncotic pressure influenced by, examples and where can it be found?(3)

A

Large proteins
Albumin
Intravascular space

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29
Q

If albumin levels are low patients will have fluid ____ out of the vessel into the ______ this is called_____

A

Fluid leak out of the vessel
Into the interstitial space

This is called 3rd spacing

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30
Q

Plasma to interstitial fluid shift results in?

A

Edema

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31
Q

Interstitial fluid to plasmas results in?

A

Decreases edema

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32
Q

How many fluid spacing are there?

A

3

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33
Q

First spacing is?

A

Normal distribution

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34
Q

Second spacing is ?

A

Abnormal amount of interstitial fluid (edema)

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35
Q

Third spacing is?

A

Fluid accumulation in part of body where it is not easily exchanged with ECF

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36
Q

Third spacing is also known as what type of swelling?

A

Fluffy swelling

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37
Q

In third spacing, does the cell shrink and what type of tonic is it?

A

Yes it does
Hypotonic pressure

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38
Q

Oncotic pressure and hydrostatic pressure working together creates?

A

Equilibrium

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39
Q

What are the 6 ways to regulation water balance?
(A,A,G, M,R, N)

A

ADH
Aldosterone
Glucocorticoids
Mineralcorticoids
RAAS system
Nateiuretic peprides

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40
Q

ADH stands for what/means?

A

Anti diuretic hormone
Not urinate

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41
Q

What does diuretic mean?

A

Pee

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42
Q

What releases ADH?

A

Hypothalamic pituitary regulation

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43
Q

Fluid deficit stimulates what’s and does what to ADH?
( stimulates as in, what will the patient feel )

A

Stimulates thirst
And releases ADH

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44
Q

When the hypothalamus release ADH what does that cause for the body?

A

To reabsorb water and not pee

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45
Q

What does fluid excess do to ADH?

A

Suppresses it

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46
Q

What happens when we suppress ADH?

A

We excrete water ( we pee )

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47
Q

Average adults produces how much urine daily?

A

1.5L

48
Q

Where is the action of ADH and Aldosterone?

A

Renal tubules ( kidneys )

49
Q

Adrenal cortical regulations helps with water balance, but what are the 2 groups that help with this?
(G,M)

A

Glucocorticoids
Mineralocorticoids

50
Q

Under glucocorticoids, what is the hormone that helps water balance?

A

Cortisol

51
Q

Cortisol is what effect and increases what?
(ANTI IN INC SER GL$

A

Anti inflammatory effect
Increases serum glucose

52
Q

Large doses of cortisol has three what effects?

A

Glucose elevating & anti inflammatory
Sodium retention effects

53
Q

Mineralcorticoids hormone is?

A

Aldosterone

54
Q

Aldosterone is in the what?

A

Adrenal cortex

55
Q

Cortisol is also knows as a what hormone ?

A

Stress

56
Q

Cortisol is used in steroids and we should be careful with what type of patients and why?

A

Diabetics because of high glucose increase

57
Q

What happens to the body when there is a decrease in aldosterone?
(RP,DS)

A

It decreases renal perfusion/sodium delivery to kidneys

58
Q

When we have decrease aldosterone what do we activate?

A

Renin-angiotensin-aldosterone-system
(RAAS)

59
Q

What does increase aldosterone do to the body?
(Sr,Pe)

A

Causes sodium retention and potassium excretion

60
Q

When we have increased aldosterone is water retained with sodium?

A

Yes

61
Q

Cardiac regulation of water balance, or natriuretic peptides are what to the RAAS?

A

Antagonists

62
Q

What are natriuretic peptides produced in response to?
(AP)

A

They are produced in response to
Increase atrial pressure

63
Q

What is the function of natriuretic peptides?

A

To suppress secretion of aldosterone, renin, ADH to decrease blood volume & pressure

64
Q

What does the natriuretic peptides promote?

A

Excretion of sodium and water

65
Q

What is the normal intake and output of gi fluid in a day?

A

2000-3000ml per day

66
Q

How many literals does the GI tract produce in a day?

A

8000L

67
Q

Can diarrhea and vomiting lead to significant fluid and electrolyte loss?

A

Yes

68
Q

Is the 8000L that the GI produces mostly reabsorbed?

A

Yes

69
Q

How much plasma is in the body?

A

3L

70
Q

how much Interstitial fluid is in the body?

A

10L

71
Q

How much intracellular fluid is in the body?

A

28L

72
Q

What is insensible water loss?

A

Invisible vaporization from lungs and skin

73
Q

How much insensible water loss do we lose in a day?

A

600-900ml

74
Q

Do we lose electrolytes with normal perspiration?

A

No

75
Q

Do we lose electrolytes with excessive sweating?

A

Yes

76
Q

Is the intake and output of the adult fluid going to be the same?

A

No

77
Q

Clinical implications ; nursing management

A
78
Q

Gerontologic considerations ( eldery )
What does the elderly lose ability in?

A

To concentrate urine and conserve water

79
Q

When elderly lose concentration to urinate and conserve water, what happens to their renal perfusion?

A

Decreases

80
Q

What are the other two things that decrease in elders ( other than renal perfusion )?

A

GFR
Cr clearance

81
Q

Horomonal changes lead to what in the elderly? (2)
(D&R,A, I&A,AN )

A

Decrease in renin and aldosterone
Increase in ADH & ANP

82
Q

Loss of subcutaneous tissue leads to what in the elderly?

A

Increase loss of moisture

83
Q

When the elderly have reduced thrist mechanisms, what does that result in?

A

Decrease fluid intake

84
Q

When the elderly lose functional and mental statues, it affects their ability to what?

A

Independent obtain fluids

85
Q

Fluid and electrolyte imbalances are directly caused by? Examples (3)

A

Illness and disease
( burns or heart failure )

Therapeutic measures
(IV fluid replacement or diuretics)

86
Q

Who are at the highest of risk to experience body fluid imbalances?
Age -2
Gender -1
Body size -1
Environment -1
Lifestyle -1

A

Infant and elder
Female ( more body fat than men )
Fat ( muscle/water fat/no water )
Heat ( sweating )
Exercise,stress,alcohol

87
Q

What are some more causes of imbalances?
(R,C,D,CA,CO,CF,V,D,N,B,M)

A

Renal disease
Cardiovascular disease
Diabetes mellitus
Cancer
COPD
Confusion leading to poor fluid intake
Vomiting
Diarrhea
Nasogastric suction
Burns
Medications (diuretics)

88
Q

What is another name for extracellular fluid volume deficit ?

A

Hypovolemia

89
Q

What is extracellular fluid volume deficit ( hypovolemia )?

A

Abnormal loss of normal body fluids, poor intake, or
Plasma to interstitial fluid shift

90
Q

Is ECF deficit the same as dehydration and why?

A

It isn’t
Because dehydration is the loss of water without loss of Na(sodium)

91
Q

What are some clinical manifestations for hypovolemia, EFC deficit ?
(r,d, l,c, ph, T, d, w, s, cr)

A

Restlessness
Tachycardia
Postural hypotension
Skin tutor
Capillary refill
Confusion
Lethargy
Drowsiness
Weight loss

92
Q

What is the treatment of hypovolemia? ECF deficit?

A

Normal saline

93
Q

What are the physical findings for ECF deficit?
( Dw, st, u, bp, et, I&hp, DM )

A

Decreased weight
Skin tugor
Urine output
Blood pressure
Extremity temperature
High pulse
Dry mucous membranes

94
Q

What are the lab findings with FVD ( fluid volume deficit ) hypovolemia ( EFC Defict )?
Increase or decrease
(H,U,B,S)

A

Increase
Hemoglobin
Urine specific gravity
BUN
Serum sodium

95
Q

The hemoglobin increase to ____ the hematocrit in the labs results for hypovolemia?

A

Triple

96
Q

Nursing interventions for fluid deficit?
(f,L,W,U,V,I)

A

Increase fluids (IV-isotonic)
Monitor LOC(level of conscious)
Monitor weight
Monitor urine output
Asses vital signs
Monitor I&O

97
Q

What should we look out for in vital signs for someone who is FVD? Fluid volume deficit?

A

Blood pressure goes down
Heart rate goes up

98
Q

What is another name for extracellular fluid volume imbalances?

A

Hypervolemia

99
Q

What is hypervolemia? EFC imbalances?
Interstitial to plasmas or
Plasma to interstitial ?

A

Increase intake of fluids
Abnormal rention of fluids or
Interstitial to plasma fluid shift

100
Q

What are clinical manifestations for extracellular fluid volume imbalances ( hypervolemia )
(B, H, D, C, PE, W )

A

Bounding pulse
Hypertension
dyspnea
Crackles
Pulmonary edema
Weight gain

101
Q

What is the treatment to extracellular fluid volume imbalances ( hypervolemia)

A

Remove fluid without changing electrolyte composition

Diuretics
Fluid restriction
Sodium restriction

102
Q

Physical findings for FVE ( hypervolemia )
(W,p, BP, c, e, cr, a )

A

Increased
Weight
Pulse
Blood pressure
Confusion
Edema
Crackles
ascites

103
Q

What is crackles?

A

Abnormal lung sounds

104
Q

What are the lab findings for FVE? Hypervolemia?
(2)

A

Decrease in Hct & bun

105
Q

Nursing interventions for fluid volume excess ( FVE )
R.E.S.T.R.I.C.T

A

Reduce IV rate
Evaluate breathe sounds/respiratory
Semi flowers position
Treat with O2 & diuretics
Reduce fluid/sodium intake
Intake and output weights
Circulation color and edema
Turn and reposition every 2 hours

106
Q

Nursing diagnosis for hypovolemia?(2) and what is the complication?

A

Deficient fluid volume
Decreased cardiac output
Risk for deficient fluid volume
Potential complication
Hypovolemia shock

107
Q

What is the nursing diagnosis for hypervolemia and what is the potential complication?
(e, I, r, d, a, )
(pe, As)

A

Excess fluid
Impaired gas
Risk for skin integrity
Disturbed body image
Activity intolerance

Complication
Pulmonary edema, ascites

108
Q

What are the nursing implantations for intake(how to take it) and output(what comes out)?

A

Oral, enteral, irrigation ( meds )
Urine, diarrhea, sweat, wound drainage

109
Q

SG ____=dilute
Concentration ____

A

1.010
1.025

110
Q

Nursing implementation monitor changes?
( what will you find on the monitor?)
(BP.p,j, o)

A

Blood pressure
Force of pulse
JVD
Orthostatic hypotension

111
Q

Checking someone weight is important during fluid imbalance because?

A

You gain weight too much fluid
Lose weight too little fluid

112
Q

Assess respiratory changes for increase ECF? What should you look out for?

A

Crackles, congestions, edema pulmonary

113
Q

Assess respiratory changes in decreased ECF? What should you look out for?
(H)

A

Hypoxia
(Gasping for air, not enough air in lungs)

114
Q

Neurological changes for both hypo and hypervolemia?

A

Pupils response
Cerebral edema
Decrease perfusion

115
Q

What should you do for skin turgor care?

A

Assess temperature, mucous membrane

And encourage fluids ( avoid NG tube )

Nurs 347 Pathophysiology exam 1 (7 decks)

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