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Nursing 105 > Fluid Imbalances- Exam 1 > Flashcards

Fluid Imbalances- Exam 1 Flashcards

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1
Q

5 uses of water in the body:

A
  1. Metabolic reactions
  2. Transport
  3. Lubricant
  4. Insulator
  5. Body temperature
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2
Q

How do healthy people gain fluids?

A

eating and drinking

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3
Q

Daily intake and output of water should be what in healthy people?

A

Roughly equal

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4
Q

What is the urine output formula for healthy kidneys?

A

1 mL/kg/hr

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5
Q

A patient presents with .4 mL/kg/hr output- what does this indicate?

A

Decreased output - decreased kidney function

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6
Q

How does the body lose fluid?

A

Kidneys, lungs, skin, GI tract

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7
Q

How does the skin lose fluids?

A

Sweating, fever, exercise, and burns

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8
Q

How much fluid do the lungs excrete per day on average?

A

300 mL

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9
Q

5 factors affecting water balance in the body:

A
  1. Age
  2. Sex
  3. Body habitus (body build)
  4. Temperature
  5. Disease state
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10
Q

Increased fat = ______ fluid

A

decreased

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11
Q

Increased muscle = ___________ fluid

A

increased

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12
Q

Fluid deficit may cause ? in older adults

A

delirium

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13
Q

Approximately __% of a typical adult is fluid

A

60%

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14
Q

Definition - fluid in cells

A

intracellular fluid

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15
Q

intracellular fluid makes up how much of the fluid in the body

A

2/3

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16
Q

Definition - fluid outside the cells

A

extracellular fluid

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17
Q

Examples of intravascular fluid

A

plasma, erythrocytes, leukocytes, thrombocytes

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18
Q

Example of interstitial fluid

A

lymph

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19
Q

examples of transcellular fluid

A

cerebrospinal, pericardial, and synovial

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20
Q

intracellular fluid makes up __% of body weight

A

40%

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21
Q

extracellular fluid makes up __% of body weight

A

20%

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22
Q

Normal serum level range in body osmolality

A

280-295 mOsm/kg

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23
Q

Normal osmolality urine range:

A

100-1300 mOsm/kg

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24
Q

Describe an isotonic solution

A

Fluids with the same osmolality

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25
Q

Describe a hypotonic solution

A

Solutes are less concentrated than the cells

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26
Q

Describe a hypertonic solution

A

solutes are more concentrated than the cells

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27
Q

How does an isotonic solution affect the movement of water

A

there is no net movement of water

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28
Q

How does a hypotonic solution affect the movement of water?

A

Moves water into the cells

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29
Q

How does a hypertonic solution affect the movement of water?

A

moves water out of the cells

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30
Q

Water moves from an area of low solute concentration to a high solute concentration

A

Osmosis

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31
Q

During osmosis, the movement of fluid through capillary walls depends on what?

A

Hydrostatic pressure and osmotic pressure

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32
Q

the pressure that is exerted on walls of blood vessels

A

Hydrostatic pressur

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33
Q

The pressure exerted by proteins in plasma (solutes)

A

osmotic pressure

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34
Q

In osmosis, the direction of fluid movement depends on what?

A

Differences in hydrostatic and osmotic pressure

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35
Q

Does osmosis allow solutes to cross the membrane?

A

No, fluid only

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36
Q

Blood pressure generated by heart contraction is known as?

A

Hydrostatic pressure

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37
Q

Where does hydrostatic pressure push water from and to?

A

Pushes water from the vascular system into the interstitial space

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38
Q

What does hydrostatic pressure prevent?

A

Prevents fluids from moving back into the vascular spaces

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39
Q

What protein molecule attracts water into the vascular spaces during osmosis?

A

Albumin

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40
Q

Administering colloids or hypertonic solutions ________ osmotic pressure and draws fluid from _______ ________ into plasma

A

increases

interstitial spaces

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41
Q

Fluid shifts from plasma spaces to interstitial spaces due to:

A
  1. increase in venous hydrostatic pressure
  2. increase in interstitial oncotic pressure (increased solutes)
  3. decrease in plasma oncotic pressure (decreased solutes)
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42
Q

How do you decrease interstitial shifts?

A

Reducing venous hydrostatic pressure (decreased BP) by drawing interstitial fluid into plasma or administer colloids, mannitol, or hypertonic solutions

OR

increase tissue hydrostatic pressure by wearing TED hose or administer diuretics

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43
Q

Normal distribution of fluid spacing is called

A

First spacing

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44
Q

Abnormal accumulation of interstitial fluid (edema) is called

A

Second spacing

45
Q

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

A

Third spacing

46
Q

What is the primary organ that regulates fluids and electrolyte balances?

A

Kidneys

47
Q

Renal tubules are the sites of action for which hormones?

A

ADH and aldosterone

48
Q

Where is the site of action for ADH and aldosterone?

A

Renal tubules

49
Q

What receptors sense changes in body fluids? Where in the brain are these receptors located?

A

Osmoreceptors are located in the hypothalamus

50
Q

Fluid deficit leads to ______ plasma osmolality

A

increased

51
Q

Fluid excess leads to ______ plasma osmolality

A

decreased

52
Q

Fluid deficit does what to thirst and ADH in osmosis?

A

stimulates thirst and triggers release of ADH

53
Q

Fluid excess does what to ADH?

A

suppresses the release of ADH

54
Q

How does the adrenal cortical regulation of fluid work?

A

Releases hormones to regulate water and electrolytes

55
Q

What hormones are involved in the adrenal cortical fluid regulation process?

A

Glucocorticoids (cortisol) and mineralocorticoids (adosterone)

56
Q

Aldosterone causes retention of what electrolyte?

A

Sodium

57
Q

Aldosterone causes excretion of what electrolyte?

A

potassium

58
Q

What is retained with sodium?

A

Water

59
Q

Kidneys secrete what when they sense low blood volume, BP, or sodium

A

renin

60
Q

If a patient’s mean arterial pressure is <60, what does this indicate?

A

decreased perfusion

61
Q

Why are ACE inhibitors given to a patient with fluid imbalances?

A

Disrupt RAAS by reducing amount of ACE produced leading to less vasoconstriction and reduced peripheral resistance.
Blocking angiotensin II receptors leads to lower BP

62
Q

Give one example of an ACE inhibitor

A

Lisinopril

63
Q

Natriuretic peptides are ________ to the RAAS

A

antagonists

64
Q

What causes ANP and BNP to be produced?

A

increased atrial pressures and/or high sodium levels

65
Q

How do ANP and BNP affect water balance cardiac regulation?

A

They suppress secretion of aldosterone, renin, and ADH to promote excretion of Na and H2O to decrease BP and volume

66
Q

What hormones do ANP & BNP effect?

A

Aldosterone, renin, ADH

67
Q

Approximately how many mLs of fluid is lost through the GI tract per day?

A

200 mL/day through stool

68
Q

3 types of fluid imbalances

A

Dehydration
FVD
FVE

69
Q

FVE = ?
FVD = ?

A

Fluid volume excess
Fluid volume deficit

70
Q

FVD is also known as

A

hypovolemia

71
Q

FVE is also known as

A

hypervolemia

72
Q

True or False?

Dehydration is the same as fluid volume deficit

A

False

73
Q

Loss of water alone with increase serum sodium levels

A

dehydration

74
Q

Pure water loss is common in:

A

Elderly
Children
Confused
Overexertion

75
Q

Mild dehydration is corrected by?

A

Oral consumption

76
Q

Extracellular fluid loss exceeds intake ratio of water

A

FVD

77
Q

Possible causes of FVD

A
  • abnormal fluid losses (V/D, sweating GI suctioning)
  • decreased intake (N, lack of access to fluid)
    -third space fluid shifts (burns, ascites)
    -diabetes insipidus
    -adrenal insufficiency
    -hemorrhage
    -trauma
78
Q

Isotonic expansion of the ECF caused by the abnormal retention of water and sodium

A

FVE

79
Q

FVE is secondary to increase in what content in the body?

A

total body sodium content

80
Q

Possible causes of hypervolemia:

A

-HF
-AKI or kidney failure
-Liver failure
-Excessive IV solutions or transfusions
-Excessive oral sodium intake
-Abnormal retention of fluids/sodium
-Interstitial to plasma fluid shifts

81
Q

Colloids stay where in the body?

A

vascular spaces

82
Q

Give examples of colloids

A

human plasma products like albumin, blood
semisynthetics like dextran and starches

83
Q

Colloids are sometimes referred to as

A

volume or plasma expanders

84
Q

True or False
Colloids are considered hypertonic

A

True

85
Q

parenteral fluid solutions with small molecules which can move around easily when injected into the body

A

Crystalloids

86
Q

True or False
Crystalloids are considered hypotonic ONLY

A

False
Crystalloids can be isotonic, hypotonic, or hypertonic

87
Q

Types of fluids categorized by tonicity

A

Hypotonic
Isotonic
Hypertonic

88
Q

True or False
Lactated ringers are considered isotonic

A

True

89
Q

True or False
0.9% NaCl is considered hypertonic

A

False - it is isotonic

90
Q

True or False
0.45% NaCl is considered isotonic

A

False - hypotonic

91
Q

True or False
3% NaCl is considered hypertonic

A

True

92
Q

True or False
5% dextrose in water is considered to be hypotonic

A

False - it is considered BOTH isotonic and hypotonic

93
Q

What is the purpose of giving colloids to a patient?

A

Increase osmotic pressure (BP), and pulls fluid into vascular spaces

94
Q

What is the purpose of giving a patient crystalloids?

A

Maintenance (pt can’t eat or drink) or replacement of fluids

95
Q

Decreased osmolality = _____ tonicity

A

decreased

96
Q

100 mOsm/L is what type of solution?

A

Hypo

97
Q

Hypotonic solutions contain more what than electrolytes?

A

Water

98
Q

Never inject what into a vein?
Why?

A

Sterile water without additives
It will lyse the cell

99
Q

Hypotonic solutions move water from ECF to ICF by what?

A

Osmosis

100
Q

Hypotonic solutions move water from ___ to ___

A

ECF to ICF

101
Q

When administering hypotonic solutions, what should the nurse monitor for?

A

Changes in mentation

102
Q

If osmolality is 275-308 mOsm/L - what type of solution is it?

A

Isotonic

103
Q

Isotonic solutions are similar to what in the body?

A

the bloodstream

104
Q

Isotonic solutions effects ECF how?

A

Expands ECF only - there is no net loss or gain from ICF

105
Q

What solution is ideal to replace ECF volume deficit?

A

Isotonic

106
Q

What type of solution initially expands and raises the osmolality of ECF?

A

hypertonic

107
Q

What solution decreases osmolality and tonicity?

A

Hypotonic

108
Q

When administering hypertonic solutions, what should the nurse monitor?

A

BP changes
Lung sounds
Serum sodium levels

Nursing 105 (11 decks)

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