Fluids and electrolytes Flashcards

1
Q

Water percentages in different ages

A

Infant= 70%
Adult= 60%
Elderly= 50-55%

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2
Q

Fluid balance
Two types of water losses

A

Intake= output= fluid balance
Sensible losses
-urination
-defecation
-wound drainage
Insensible losses (no way to measure it)
-evaporation from skin
-respiratory loss from lungs

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3
Q

2 types of transport systems

A

Passive eg diffusion, filtration, osmosis
Active eg. pumping, active transport

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4
Q

Sodium

A

-major extracellular cation
-attracts fluid and helps preserve fluid volume
-combines with chloride and bicarbonate to regulate acid-base balance

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5
Q

Sodium potassium pump

A

-Na moves into cells
-K moves out of cells
-uses ATP, Mg and an enzyme to maintain Na, K concentrations
-pump prevents swelling and creates small charge, allowing neuromuscular impulse transmission

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6
Q

Low sodium blood levels and how it occurs

A

Hyponatremia
Occurs by:
-dilutional- Na+ loss, water gain
-depletional- insufficient Na+ intake
-hypovolemic- Na+ loss is greater than water loss, can be renal eg diuretic, non renal eg vomiting
-hypervolemic- water gain greater than Na+ gain, oedema occurs
-Isovolumic- normal Na+ level, too much fluid

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7
Q

High sodium blood levels

A

Hypernatremia
-occurs less often than hyponatremia
-thirst is the body’s main defence
-excess Na+ relative to water
-water deficit or over ingestion of Na+
-causes fluid to shift out of cells

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8
Q

Potassium

A

-major intracellular cation
-changes in K+ levels can lead to serious neuromuscular/ cardiac problems
-majority is excreted by kidneys
Controlled by:
Na+/K+ pump
Renal regulation
pH levels

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9
Q

How is pH controlled in cells

A

-H+ and K+ exchange freely across the membrane
Acidosis= hyperkalemia= K+ out of cells
Alkalosis=hypokalemia= K+ into cells

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10
Q

Cl-

A

-extracellular anion
-Na+ and Cl- regulate water
-secreted by stomach as HCl
-aids CO2 transport in blood

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11
Q

HCO3-

A

-extracellular anion
-concentration increases in blood passing systematic capillaries picking up CO2
CO2+ H2O -> H2CO3
H2CO3 -> H+ + HCO3-
-HCO3- levels drop in pulmonary capillaries when CO2 exhaled

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12
Q

How fluid balance is maintained
(Tissue fluid formed)

A

-fluid movement between capillaries and interstitial tissue governed by net filtration pressure
-Net filtration pressure= hydrostatic pressure (blood pressure) and osmotic pressure (takes place due to differing concentrations)
-High hydrostatic pressure pushes fluid out the capillaries at arterial end via filtration
-High osmotic pressure causes fluid to re enter the capillary at the venous end
-osmotic pressure is caused by the plasma proteins which are too big to leave the capillaries, causing a higher concentration inside the capillary

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13
Q

3 fluid types

A

Hypertonic- high solute concentration, fluid moves out cells, cells shrink
Isotonic- no fluid shifts, solutions are equally concentrated
Hypotonic- low solute conc, fluid moves from hypotonic solution into cells, causing them to swell

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14
Q

What can cause fluid imbalances

A

-dehydration
-hypovolemia- body loses too much fluid
-hypervolemia- body doesn’t lose enough fluid, too much kept in the body, can cause oedema
-water intoxication

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15
Q

Patients at risk from dehydration

A

confused
comatose- in a coma
bedridden
elderly
infants
enterally fed- feeding tube

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16
Q

Signs of dehyrdation

A

irritability
confusion
dizziness
weakness
extreme thirst
decrease urine
fever
dry skin
sunken eyes
poor skin turgor
tachycardia- fast HR

17
Q

Hypovolemia
What is it, what causes it, what you see

A

-fluid loss
-can progress to hypovolemic shock
Caused by:
-excessive fluid loss eg haemorrhage
-decrease fluid intake
-3rd space fluid shifting
Signs
-thirst
-mental status deterioration
-tachycardia
-delayed capillary refill
-nausea
-cold, pale
-orthostatic hypotension- dizzy when standing up due to low BP

18
Q

Hypervolemia
What is it, what you see

A

-excess fluid in extracellular compartment
-leads to congestive heart failure and pulmonary oedema
Signs
-Dyspnea- difficulty breathing
-crackles in lungs
-tachypnea- rapid breathing
-rapid pulse
-hypertension
-oedema

19
Q

Oedema

A

-fluid forced into tissue by hydrostatic pressure
-anasarca- severe generalised oedema
-pitting oedema- legs, ankles, feet
-pulmonary oedema- lungs

20
Q

Water intoxication
what is it, causes, what you see

A

-causes hypotonic ECF to shift into cells to restore balance
-cells swell
Caused by:
-SIADH- syndrome of inappropriate antidiuretic hormone (ADH) secretion
-rapid infusion of hypotonic solution
-excessive water
-psychogenic polydipsia- excessive thirst
Signs:
Early- change in level of consciousness (LOC), weakness, twitching, cramping
Late- bradycardia, seizures, coma

21
Q

Regulation of water and solute loss

A

3 hormones
-aldosterone- Na+ and Cl- reabsorption when dehydrated
-atrial natriuretic hormone (ANP) - promotes excretion of Na+ and Cl- followed by water excretion, to decrease blood vol, this causes vasodilation
-antidiuretic hormone (ADH)/ vasopressin- hypothalamus, posterior pituitary, osmoreceptors

22
Q

Haemostasis

A

-sequence of responses that stop bleeding

23
Q

3 mechanisms to reduce blood loss

A

-vascular spasm
-platelet plug formation
-blood clotting cascade