Fluid Regulation Workbook Flashcards
Universal Solvent in the body
Water
What does solute refer to
Substance that is dissolved in a solvent
Describe the process of diffusion
Process where molecules or particles spread from an area of high concentration to low concentration
Describe the process of osmosis
process where molecules move across a semipermeable membrane from an area of low solute to high solute
two main fluid compartment of the body
Extracellular fluid compartment and Intracellular fluid compartment
Location of Extracellular fluid
Body fluid located outside cells
Location of Intracellular fluid
Fluid contained within the cells of the body
Location of Interstitial fluid
Spaces between cells
Main electrolyte found ICF
Potassium (K+)
Main electrolyte found in ECF
Sodium (Na+)
How much of the body is water
75%
Is body fluid content of an adult greater or less than that of an older adult?
Greater
Is body fluid content of an adult greater or less than that of an infant?
Less
Name the four primary organs/organ systems responsible for fluid output:
Skin, Lung, Intestine, Kidneys
What happens to body weight when body fluid is lost -
body weight typically decreases. Results in a reduction in overall body mass
What happens to body weight when body fluid is gained -
body weight typically increases. Since additional fluid adds to the body’s total mass.
Filtration definition:
process by which fluid and solutes are separated from a solution by passing through a filter or membrane.
Reabsorption definition:
Process by which substances are taken back from the filtrate in the kidneys into the bloodstream
Secretion definition:
Process by which substances, such as ions, wastes, or hormones are transported from t he bloodstream into the renal tubules or other ducts for excretion or release from the body
Micturition definition:
the act of passing urine; urination
Are the renal pyramids found in the renal cortex or the renal medulla
The renal pyramids are found in the renal medulla.
Where does filtration function of the nephron occurs…
Glomerulus within the glomerular capsule.
What is Glomerulus?
Network of capillaries
Reabsorption function of kidney…
during reabsorption, essential substances are selectively transported from filtrate in renal tubules back into bloodstream
Secretion function of kidney…
During secretion, substances are actively transported from the blood in the peritubular capillaries into the renal tubules. This process helps to maintain acid-base balance, regulate electrolyte levels and eliminate additional waste products from the bloodstream.
What happens to urine output during low blood volume?
Urine output decreases as the body aims to conserve water and maintain blood pressure.
What happens to blood pressure during low blood volume?
blood typically decreases. This occurs because there is less fluid in the circulatory system to exert pressure on blood vessel walls.
How does aldosterone work to maintain fluid balance and homeostasis?
It maintains fluid balance by promoting sodium and water reabsorption in the kidneys, which reduces urine volume and increases blood volume.
How does Antidiuretic hormone (ADH) work to maintain fluid balance and homeostasis?
by increasing the permeability of the kidney’s collecting ducts and distal convoluted tubules to water. This allows more water to be reabsorbed back into the bloodstream, reducing urine volume and concentrating the urine.
How does Atrial Natriuretic peptide (ANP) work to maintain fluid balance and homeostasis?
helps maintain fluid balance by promoting sodium and water excretion by the kidneys. It acts by increasing GFR and inhibiting the reabsorption of sodium in the renal tubules, which leads to increased urine production and reduced blood volume.
What is the bladder muscle wall called?
Detrusor muscle
Briefly describe micturition reflex
involuntary process where the bladder fills with urine, causing stretch receptors in the bladder wall to send signals to the spinal cord.
Infants’ fluid balance
Infants have a higher percentage of body water compared to adults, making them more susceptible to fluid imbalances. Their higher metabolic rate leads to increased water turnover and greater fluid needs.
Children’s fluid balance
They often have higher activity levels, which can increase fluid loss through sweat and respiration.
Adolescent’s fluid balance
Adolescents experience rapid growth and hormonal changes, which can affect fluid and electrolyte balance.
Older adult’s fluid balance
Typically have a decreased percentage of body water and reduced kidney function, making them more susceptible to dehydration and fluid imbalances.
How does acute illness affect fluid balance?
The body’s response to acute infection often includes fever, which increases insensible water loss through sweat and respiration.
How does chronic illness affect fluid balance?
it can impair the kidneys’ ability to excrete waste and maintain electrolyte levels. This can lead to fluid retention.
How does environmental factors affect fluid balance?
high temperatures and humidity can increase sweating, leading to reduced urine output as body conserves water. Conversely, cold environments can trigger diuresis, resulting in increased urine production.
How can diet affect fluid balance?
High sodium intake can lead to fluid retention, deceasing urine output. While diuretic foods and beverages like caffeine and alcohol can increase urine production.
How can lifestyle affect fluid balance?
High levels of physical activity can increase fluid loss through sweat, leading to reduced urine output if hydration is not adequately maintained. Sedentary lifestyles can contribute to lower fluid intake and potentially result in concentrated urine and reduced kidney function.
How can medication affect fluid balance?
Diuretics increase urine production by promoting the excretion of sodium and water
Describe the reason the registered nurse would promote maintenance of an adequate fluid intake.
Essential for maintaining proper hydration,e ensuring optimal kidney function, and preventing urinary tract infections. Adequate fluid intake helps dilute urine
Describe the reason the registered nurse would promote maintenance of normal bowel functioning.
crucial for preventing constipation and ensuring effective waste elimination. Regular bowel movements help prevent discomfort and complications like haemorrhoids and bowel obstruction.
Describe the reason the registered nurse would educate the client about pelvic floor exercises.
Important for strengthening the muscles that support the bladder and bowel, which can improve control over urinary and bowel functions.
Why does the nurse need to assess skin & mucosal membranes?
helps evaluate hydration status and identify signs of dehydration or fluid imbalance. Changes in skin turgor, colour, and mucosal dryness can indicate underlying issues requiring timely intervention
Why do nurses need to assess weight changes?
to monitor for fluid retention or loss, which can indicate issues such as dehydration, edema, or chronic conditions. Significant or sudden weight fluctuations can help identify and address underlying health problems or the effectiveness of ongoing treatments.
Why do nurses need to assess oral intake?
to ensure that the patient is receiving adequate hydration and nutrition. Monitoring fluid and food intake helps identify potential deficiencies, imbalances, or excesses, which can impact overall health and guide appropriate dietary or fluid adjustments.
Why do nurses need to assess fluid output?
to evaluate the body’s ability to excrete waste and maintain fluid balance. Monitoring urine, stool, and other outputs helps identify potential issues such as dehydration, fluid retention, or renal problems, and guides appropriate interventions to address any imbalances.
Explain the rationale the registered nurse would record all output and input of fluid.
to monitor a patient’s hydration status and detect any early signs of dehydration or overhydration., it helps in detecting complications from medical conditions and evaluating the effectiveness of treatments. What comes in should always come out
List the information that would be recorded on a fluid balance chart
Patient information, fluid intake, fluid output, total. intake and output, balance and additional notes
Explain why a fluid balance chart would be totalled over a 24 hour period.
to give a comprehensive overview of a patient’s fluid status, aiding in the identification of trends and imbalances. This timeframe allows for accurate assessment and informed decisions regarding hydration and treatment adjustments
What are the four techniques for obtaining urine sample?
Clean catch species, midstream sample, sterile sample, timed sample
obtained by collecting urine midstream after cleansing the genital area to reduce contamination
Clean catch specimen
collecting urine after the initial part of urination has passed.
Midstream sample
by using a sterile container.
Sterile sample
collecting urine over a specific period of time
Timed sample
The most common organism responsible for UTI
Escherichia coli (E. coli)
What are the 3 characteristics of urine the nurse should assess?
Colour, odour, clarity
What is the most likely reason found in urine if there is a presence of blood?
UTI, kidney stone, trauma or injury
What is the most likely reason found in urine if there is a presence of protein?
Kidney disease, diabetes, hypertension
What is the most likely reason found in urine if there is a presence of glucose?
Diabetes Mellitus, Renal Glycosuria, Stress or Hormonal Imbalances
What is the most likely reason found in urine if there is a presence of Nitrates?
UTI
Commonly known as bedwetting, involuntary urination that occurs during sleep, typically in children
Nocturnal enuresis
What is the most likely reason found in urine if there is a presence of Leukocytes?
UTI, Kidney infections, inflammatory conditions.
occurs when a person is unable to reach the bathroom in time due to physical or cognitive limitations, rather than a problem with bladder control itself
Functional incontinence
Involuntary leakage of urine during physical activities that increase abdominal pressure, such as coughing, sneezing, laughing or exercising
Stress incontinence
Is the sudden, intense urge to urinate followed by involuntary leakage of urine before reaching the bathroom.
Urge incontinence
Inability to fully empty the bladder, leading to a build up of urine
Urinary retention
inserted into the bladder through he urethra and features a balloon to keep it in place, providing continuous urine drainage
Indwelling catheter (Foley catheter)
An external device that fits over the penis, collecting urine that is non-invasive and is typically used for managing urinary incontinence in men.
Uridome
Four factors the nurse would apply to maintain good infection control procedures when caring for people with catheters
Practice hand hygiene, use sterile techniques, maintain catheter potency and cleanliness, monitor and maintain proper equipment.
Excessive output, over 2000mls
frequency
Increased incidence of voiding
Polyuria
Technically, no urine voided. 24-hour urine output is less than 100mls; probable kidney shut down or renal failure
anuria
Difficulty in voiding: may or may not be associated with pain; a feeling of warm local irritation occurring during voiding is called burning
dysuria
Most often used to describe when a child involuntarily urinates during the night
nocturnal enuresis
Presence of glucose in the urine; if due to an unusually large intake of glucose or marked emotional disturbances and is temporary, is not a problem
glycosuria
Blood in urine; if in large quantities urine maybe pink or even red
haematuria
Inability to control the discharge of urine
incontinence
Frequency of urination during the night
Nocturia
The passing of urine
micturition
Diminished amount of urine in given time: 24hour urine output is 100ml- 400mls
oliguria
Incontinence of urine at night
enuresis
Protein in urine; indication of kidney disease
Proteinuria
Pus in urine; urine appears cloudy
Pyuria
How to collect a mid-stream urine
first clean the genital area to reduce contamination. Begin urinating, then collect the middle portion of the stream in a sterile container, avoiding the initial and final parts of the flow.
How to complete a urinalysis
first collect a fresh urine sample in a sterile container. Analyze the urine’s physical properties, such as color and clarity, and use reagent strips to test for chemical components. Finally, centrifuge the sample and examine the sediment under a microscope to identify any cells, crystals, or microorganisms
How to apply a uridome/sheath
first clean the genital area thoroughly. Then, apply the adhesive sheath over the penis, ensuring it fits snugly but comfortably, and secure it to prevent leaks. Connect the sheath to a drainage bag to collect the urine, and monitor for any signs of irritation or leakage.
How to empty an indwelling catheter bag
first, perform hand hygiene and put on clean gloves. Open the drainage valve or spigot of the bag over a designated receptacle, such as a measuring container, to collect the urine. After emptying, close the valve securely, clean the area around the valve with antiseptic wipes, and document the volume of urine collected.
