Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NRS 105 Exam #1 > Fluid Imbalances > Flashcards

Fluid Imbalances Flashcards

1
Q

The process by which solutes move from an area of higher concentration to one of lower concentration is called ________________________.

A

Diffusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Tonicity is fluid _________________or the effect that osmotic pressure of a solution with impermeable solutes exerts on cell size because of water movement across the cell membrane.

A

Tension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

TRUE or FALSE
The cardinal feature of metabolic acidosis is a decrease in the serum bicarbonate level.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

TRUE or FALSE
A nurse should assess a patient with hypervolemia for indicators of hypotension, increased hematocrit and hemoglobin, and oliguria.

A

False

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

TRUE or FALSE
Body fluid is located in two fluid compartments: the intracellular space (fluid in the cells) and the extracellular space (fluid outside the cells).

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

TRUE or FALSE
Vital to the regulation of fluid and electrolyte balance, the kidneys of a well-hydrated adult excrete 1 to 2 L of urine per day.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

The major electrolytes in the extracellular fluid are ________________ and chloride.

A

Sodium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

________________ is the unintentional administration of a nonvesicant solution or medication into surrounding tissue.

A

Infiltration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

________________ is the excretion of less than 400 mL or urine per day in an adult.

A

Oliguria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

TRUE or FALSE
The nurse monitoring a patient’s potassium level knows tall, tented, “T” waves on an ECG are an indication of hypokalemia.

A

False

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How much fluid is lost through the kidneys?

A

1 mL/kg/hr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the gerontological considerations for fluid imbalances?

A
  • Clinical manifestations may be subtle
  • Fluid deficit may cause delirium
  • Level of conciousness may be affected
  • Decreased cardiac reserve
  • Reduced renal function
  • Dehydration is common
  • Blunted response to the thirst signal
  • Age related thinning of the skin, loss of strength and elasticity = more fluid loss
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is intercellular fluid?

A
  • Fluid in the cells
  • Contained in skeletal muscle mass
  • makes up 2/3 of bodily fluid
  • 40% of typical adult body weight
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is extracellular fluid?

A
  • Fluid in the Intravascular space (blood vessels)
  • Fluid in the interstitial space (lymph)
  • Transcellular fluid = cerebrospinal fluid, pericardial fluid, synovial fluid
  • 20% of typical adult body weight
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is osmolality?

A
  • Determined by the solutes in body fluid
  • Normal serum = 280-295 mOsm/kg
  • Normal urine = 100-1300 mOsm/kg
  • Lots of solutes = high osmolality = water moves IN
  • Fewer solutes = low osmolality = water moves OUT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is osmosis?

A

Water moving from an area of low solute concentration to an area of high solute concentration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What determines fluid moving through capillary walls?

A
  • Osmotic pressure = exerted by the proteins in plasma (draws water INTO the vessels)
  • Hydrostatic pressure = exerted on walls of blood vessels by plasma (Pushes water and small particles OUT of the vessels)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How can you affect osmotic pressure?

A

Administering colloids or hypertonic solutions INCREASES osmotic pressure and draws more fluid INTO plasma from interstitial spaces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What mainly affects hydrostatic pressure?

A

Blood pressure
Higher blood pressure = higher hydrostatic pressure = more fluids LEAVE the vessels and enter interstitial space

20
Q

Why does fluid shift into interstitial spaces in the body?

A
  • Increase in venous pressure (pushing fluid out of vessels)
  • Increase in interstitial oncotic pressure (drawing fluid into interstitial space)
  • Decrease in plasma oncotic pressure
21
Q

How are interstitial fluid shifts decreased?

A
  • Reduce venous pressure = Administer colloids, mannitol, hypertonic solutions
  • Increase tissue hydrostatic pressure = wear elastic stockings (TED hose)
22
Q

What is first spacing?

A

Fluids in the normal distribution (ECF, ICF)

23
Q

What is second spacing?

A

Abnormal accumulation of fluid in the interstitial space (edema)

24
Q

What is third spacing?

A

Fluid is trapped where it is difficult or impossible for it to move back into cells or blood vessels
(ascites)

25
Q

Explain the Hypothalmic-Pituitary regulation of water balance

A
  • Osmoreceptors in the hypothalamus sense changes in body fluids
  • In fluid deficit = stimulates thirst and triggers release of ADH
  • In fluid excess = supresses release of ADH
26
Q

Explain the Adrenal Cortical Regulation of Water Balance

A
  • Hormones are released to regulate water and electrolytes
  • Glucocorticoids = Cortisol = may cause Sodium and fluid retention
  • Mineralcorticoids = Aldosterone = causes sodium retention (with water) and Potassium excretion
27
Q

Explain the Renin-Angiotensin II Regulation of Fluid Balance

A
  1. Kidneys detect a drop in BP, loss in sodium, or low Blood Volume
  2. Kidneys release Renin
  3. Renin converts Angiotensinogen (made by liver) to Angiotensin I.
  4. Angiotensin I travels to lungs where enzyme ACE (Angiotensin converting enzyme) converts it to Angiotensin II
  5. Angiotensin II = powerful vasoconstrictor (raises BP), stimulates Aldosteronerelease (retain Na and water), stimulates ADH release (retain water), stimulates thirst signal
  6. Result = retained fluids, increase in BP and blood volume
28
Q

Explain the Cardiac regulation of Water Balance

A

Natriuretic peptides antagonize the RAAS system
ANP and BNP are produced by cardiomyoctes in response to increased atrial pressure and/or high Na levels
End result = lower blood pressure and volume

29
Q

Explain the gastrointestinal regulation of water balance

A
  • Oral route accounts for most water intake
  • Small amounts of water are eliminated by the GI tract in the feces
  • Diarrhea and vomiting can lead to significant fluid and electrolyte loss
30
Q

What is dehydration?

A

Loss of WATER ALONE with increased Na levels

More common in: children, elderly, confused, with overexertion

31
Q

What is Fluid Volume Deficit (hypovolemia)?

A
  • ECF fluid loss exceeds intake ratio of water
  • Electrolytes lost in same proportion as they exist in normal body fluids
32
Q

What is Fluid Volume Excess (hypervolemia)?

A
  • Isotonic expansion of the ECF caused by abnormal retention of water and sodium (in the same proportions as they normally are)
33
Q

What are possible causes of Fluid Volume Deficit (hypovolemia)?

A
  • Abnormal fluid loss (vomiting, diarrhea, sweating, GI suctioning)
  • Decreased Intake (nausea, lack of access to fluids)
  • Third Space Fluid Shifts (due to burns or ascites, or edema)
  • Diabetes insipidus
  • Adrenal insufficiency
  • Hemorrhage
  • Trauma
34
Q

What are some causes of Fluid Volume Excess (hypervolemia)?

A
  • Heart failure
  • Renal injury/failure
  • Liver failure (cirrhosis)
  • Excessive IV solutions and/or blood transfusions
  • Excessive oral sodium intake
  • Abnormal retention of fluids and sodium
  • Fluid shift increasing to intravascular volume
  • Pregnancy
  • Medication side effects
  • SIADH (Syndrome of Inappropriate Antidiuretic Hormone secretion)
35
Q

What are colloids?

A
  • Human plasma products (albumin, fresh frozen plasma, blood)
  • Semisynthetics (dextran and starches, Hespan)
  • Sometimes referred to as volume or plasma expanders
  • Stays IN vascular space and increases osmotic pressure (Pulls fluid INTO blood vessels)
36
Q

What are crystalloids?

A
  • Solutions with small molecules which can move around easily when injected into body
  • 0.9% NaCl (NS) isotonic
  • Lactated Ringers (LR) isotonic
  • 0.45% NaCl hypotonic
  • 3% NaCl hypertonic
  • 5% Dextrose in water (D5W) both hypotonic and isotonic)
37
Q

What do hypotonic IV fluids do?

A
  • ECF ➡️ ICF
  • Moves water OUT of vessels and INTO cells
  • 🦛 Hypo = “Hippo” = PLUMPS cells 🦛
  • Contains more water than electrolytes
  • Never inject pure water into a vein - will lyse RBCs
  • Monitor for changes in mentation
38
Q

What do isotonic IV fluids do?

A

Stays in the ECF
* Expands volume in ECF only

39
Q

What do hypertonic IV fluids do?

A
  • ICF ➡️ ECF
  • Raises osmolality of ECF
  • Pulls water out of cells and into blood vessels
  • Cells shrink
  • Requires frequent monitoring of: blood pressure, lung sounds, serum sodium levels
40
Q

Clinical manifestations of FVD (hypovolemia)

A
  • Hypotension
  • Tachypnea
  • Tachycardia
  • lethargy, weakness
  • dizziness
  • seizures, coma
  • increased thirst
  • decreased skin turgor, cap refill, urine output
41
Q

Treatment for FVD (hypovolemia)

A
  • Correct underlying cause
  • Oral route preferred
  • Isotonic solutions (0.9% NS, LR)
  • Blood Products
  • Hypertonic Solutions (very carefully monitored)
42
Q

FVD (hypovolemia)
Nursing Management

A
  • Monitor I/O
  • Daily weights
  • Vital signs closely monitored
  • Assess skin and tongue turgor, mucosa, urine output, mental status
  • Minimize fluid loss
  • Administer oral fluids
  • Administer parenteral fluids
43
Q

Clinical manifestations of FVE (hypervolemia)

A
  • Hypertension
  • Pulmonary edema
  • crackles in lungs
  • S3 heart sound
  • headache
  • increased urine output
  • weight gain
  • peripheral/sacral edema
  • bounding pulse
44
Q

Treatment for FVE (hypervolemia)

A
  • Remove fluid while maintaining adequate electrolyte composition (osmolality) of ECF
  • Diuretics
  • Fluid restriction
  • Restrict sodium intake
  • Aquapheresis (ultrafiltration)
  • For 24 hr fluid restriction: give ~ 70% during day hours, ~ 30% at night
45
Q

Treatment for
second spacing hypervolemia

A
  • Hypertonic fluids (mannitol, D5 1/2 NS)
  • Plasma proteins (albumin) to shift water from interstitial space to vascular space; followed by diuretics
46
Q

Treatment for
third spacing hypervolemia

A
  • Thoracentesis
  • Paracentesis
  • Albumin
47
Q

FVE (hypervolemia)
Nursing Management

A
  • Monitor I/Os
  • Daily weights
  • Monitor VS
  • Assess respiratory changes/lung sounds
  • Assess CV status
  • Monitor edema
  • Monitor lab values
  • Skin assessment (turgor, color, temperature)

NRS 105 Exam #1 (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions