Fluid Imbalances Flashcards
What does an increase in thirst mean regarding fluid levels
Fluid levels are decreasing which causes cellular dehydration, an increase in serum osmolality and a drop in circulating blood volume.
What does a decrease in thirst mean in regards to fluid levels
Fluid levels are increasing, cells are rehydrating, decrease in serum
Osmolality, and an increase in circulating blood volume
What would we expect to happed to fluid levels if the secretion of ADH is increased
ADH causes the body to hold fluids in, meaning fluid levels would increase
What would we expect to happen to fluid levels if ADH is decreased?
ADH causes the body to hold onto water, so fluid levels would decrease
If a patient is dehydrated, what signs and symptoms would you expect to see
Headache, dry mouth, dry mucous membranes, decreased skin turgor, dark/concentrated urine, constipation
What is a dehydrated patient at risk for?
Hypokalemia (lost to however fluid was lost), cardiac issues (K+ is needed for cardiac muscle to function), Kidney stones (not enough water to dilute solutes in urine so they build up in stones), Constipation (increased water absorption in the intestines causing firm stool), UTI (peeing less frequently so more time for bacteria to travel up urethra).
What is the main function of aldosterone
Produced by the adrenal cortex, aldosterone is a hormone that helps regulate BP by managing levels of sodium and potassium, impacting blood volume
What would we expect to happen to fluid balance if we administer spironolactone to a patient?
Spirinolactone is a K+ sparing diuretic, meaning it allows the body to hold onto k+ to help with electrical impulses in the cardiac muscle. Fluid and other electrolytes would still be excreted.
How does the body gain water naturally
Drinking, eating, oxidative metabolism
What is oxidative metabolism
Chemical process in which oxygen is used in order to make energy (ATP) from carbs. 2 parts: Catabolism (break cell down into molecules) and Anabolism (put it back together into tissues and organs). H20 is a metabolic byproduct of oxidative metabolism.
What are some interventions of decreased water input and increased output
IV fluids, encourage drinking, elevate legs if hypotensive, blood transfusion
What are some interventions for high fluid intake and low fluid output
Education on thirst cues, managing edema, monitor intake and output closely, administer hypertonic solutions, diuresis, catheterization,
What are the normal functions of fluids in the body?
Transports gas to exchange oxygen and co2, transports nutrients and wastes, helps with generating electrical activity, aids in making energy from food.
How much water does the body need for each 100 calories eaten?
100mls
What does increased body fat put patients at risk for regarding fluids
Dehydration because water is hydrophobic. Your TBW should be 60% of body weight. Little water is found in adipose cells so total body water is decreased.
Why would 2 patients with the same diagnosis have different orders for fluids?
Fluid orders vary based on age and body composition.
What are the 2 ways water is outputted from the body
Renal excretion (largest amount) and insensible loss (skin, stool, emesis)
How does fluid balance differ in the stages of life/different ages
Newborns: store less fat, highest amount of TBW. Childhood-adolescent: TBW decreases to adult proportions. Older adult: Increased fat, decreased muscle, loss of TBW, ability to regulate fluid balance lessens (renal system is less efficient, sodium content less efficient)
What are 3 age related changes that lessen the ability to regulate fluids in the body
Increased body fat, immature renal system, decreased muscle mass
Does the ICC or ECC contain more fluid
The ICC
Describe the components of fluid in the ICC
More k than Na, moderate amounts of mg, small amounts of NaCl, bicarbonate, and phosphorus
Describe the 2 compartments of the ICC and the components of the fluid
Plasma and interstitial fluid. More Na than K, large amounts of Na and Cl, moderate amounts of bicarbonate, small amounts of K, mg, Ca, and P
What is total body water
The sum of fluids within all compartments
What is the ratios of the body’s water in the ICF and ECF
ECF is 1/3 and ICF is 2/3
What is interstitial fluid
Gelatinous fluid between cells and vascular space, transports sugars, fatty acids, amino acids, coenzymes, hormones, neurotransmitters, minerals, and metabolic wastes
What is intravascular fluid
Fluid in veins (blood). Transports oxygen and other molecules throughout the body
What is transcellular fluid
CSF, abdominal fluids, pelvic fluids
What is 3rd spacing
The transcellular space fills up significantly with fluid, common with burns and cancer
What does the Na/K-ATPase membrane pump do
Prevents Na from moving into the ICC unregulated
What do osmolarity and osmolality mean (in general)
How much solute there is in the solvent. High=lots of stuff in the liquid, low=not much stuff in the liquid
Why is osmolality preferred clinically?
Because it is temperature independent
What is tonicity
The ability of an extracellular solution to make water move into or out of a cell by osmosis
What does sodium do
Most responsible for osmotic balance in the ECF and regulation of water balance overall. Regulates acid-base balance, plays a role in chemical reactions, membrane transport, most abundant cation in body
How do we gain and lose sodium in our bodies
Intake: diet (recommendations based on age) 1000-1500mg per day
Output: renal losses, diaphoresis, GI tract
How is the steady state created (fluid homeostasis)
Osmolality of ECF=Osmolality of ICF
