Fluids and Electrolytes

Question 1

3 Types of extracellular fluids:

Answer 1

1. Intravascular: inside vessels (blood/plasma)
2. Interstitial: fluid between cells and outside vessels
3. Transcellular (special: synovial/spinal/pleural)

Question 2

This type of movement of fluids is found in the kidneys:

Answer 2

Filtration.

It is the movement of water AND solutes

Question 3

What kind of receptors help regulate fluids in our body?

Answer 3

Osmoreceptors

Question 4

This hormone helps regulate fluid balance by acting on the kidneys to hold on to/reabsorb water and Na:

Answer 4

AdH

Antidiuretic hormone

Question 5

This organ is the major regulator of fluid/electrolyte balance:

Answer 5

Kidney

By eliminating or holding on to water and or electrolytes.

Question 6

Is sensible or insensible water loss easily measured?

Answer 6

Sensible

Urine
Stool
Drains/blood
Vomit

Insensible (skin and lungs): sweat/perspiration, respiration

Question 7

About how much of water do we lose every day by insensible water loss?

Answer 7

600 - 800 mL

Need to keep this is the back of our minds when considering measurements I’s and O’s)

Question 8

The loss of water but electrolytes remain:

Answer 8

Dehydration

Pulls fluids from intracellular fluid… cells shrink.

WE can cause imbalance by not making sure patient is drinking water.

Question 9

Loss of electrolytes AND water:

Answer 9

Hypovolemia

Loss particularly of sodium

Question 10

Fluid volume excess:

Answer 10

Hypervolemia

Not gaining any electrolytes, just water.
Fluid intake exceeds fluid out.

Question 11

What is the most accurate way to determine (measure) whether a person has gained or lost fluids?

Answer 11

By weighing them daily at the same time and same amount of clothing.

If they’re on a bed scale, make sure to take off blankets, etc., that can skew accuracy.

Question 12

What is the first sign of fluid volume deficit?

Answer 12

Thirst

Later: tachycardia, hypotension, fever

Question 13

Why do we see tachycardia with fluid volume deficit?

Answer 13

Heart races to try to pump the fluids to meet the needs of the tissues but there’s not enough to support a normal heart rate.

Question 14

Why do we see hypotension with fluid volume deficit?

Answer 14

Blood pressure goes down because volume is low, not much to pump.

Question 15

Why do we see fever with fluid volume deficit?

Answer 15

Water regulates our body temperature (buffer), if low water then can not regulate as well. It is also used to cool our bodies by evaporation.

Question 16

What is the most sensitive measure of fluid loss?

Answer 16

WEIGHT

1 kg (2.2 lbs) = 1 L of fluid loss

Question 17

If a patient is experiencing hypertension what fluid imbalance could they be experiencing?

Answer 17

Hypervolemia : Fluid volume excess

Question 18

What type of fluid imbalance could bradycardia or a bounding pulse demonstrate?

Answer 18

Fluid volume excess : Hypervolemia

Question 19

If urine contains a low specific gravity what does that mean?

Answer 19

Excess urine output (diluted)

High specific gravity would mean it is concentrated and dark.

Question 20

What type of fluid imbalance could be the cause of jugular vein distention?

Answer 20

Fluid volume excess.

Question 21

These two signs may be the first indicators of things going awry with fluid excess:

Answer 21

Lung crackles

Ascites (3rd spacing: fluid in abdomen - difficult to eliminate)

Question 22

Substances that when dissolved in water or a solvent become electrically charged ions:

Answer 22

Electrolytes

Cations +charge
Anions -charge

Question 23

What organ regulates our K levels in the blood?

Answer 23

Kidney

Hyperkalemia is seen in chronic kidney failure

Question 24

Where’s our resevoir for K?

Answer 24

In our cells.

Hypokalemia is seen in acute diarrhea

Question 25

When you think of K, you think of ?

Answer 25

Think HEART.

Regulates conduction of cardiac rhythm.
Also is major electrical impulses in the GI and important with acid base balance.

Question 26

Where is our resevoir for Ca and Na?

Answer 26

Bones

Hypercalcemia: parathyroid regulates Ca levels, those who have impaired parathyroid glands, patients with cancer. Too calm, flaccid.

Hypocalcemia: lack of vit D, condition with parathyroids, pancreas, or kidneys. Leeches Ca from bones. Will experience muscle twitches or inactivity - constipation.

Question 27

When you think of Calcium, think ?

Answer 27

MUSCLE

Question 28

How are electrolytes measured (rate):

Answer 28

mEq/L = grams of electrolyte in liter of fluid

milequivalents

Question 29

Major cation in extracellular fluid:

Answer 29

Na+

Question 30

Which ion is the fluid volume regulator?

Answer 30

Na+

Question 31

This condition is when this electrolyte is too low… you may see a change in level of consciousness (like confusion):

Answer 31

Hyponatremia

If the brain is low sodium then it is also low water (because water follows sodium).

Question 32

This ion’s “big job” is stimulating nerve impulse conduction:

Answer 32

Sodium.

Also interacts with calcium-muscle contraction.

Question 33

This condition is when there is excess of a certain ion, leading to possible seizures due to over-impulse conduction:

Answer 33

Hypernatremia

Includes thirst, restlessness and fatigue.
Due to lack of proper hydration.

Question 34

This is due to the loss of water AND electrolytes:

Answer 34

Hypovolemia

particularly sodium

Question 35

Loss of water but keeps electrolytes:

Answer 35

Dehydration

Question 36

How do we lose K+?

Answer 36

Diuretics and Diarrhea

Question 37

Which electrolyte is the key to cellular metabolism?

Answer 37

K+

Is the major cation of Intracellular Fluid

Question 38

Before you see dysrhythmias you will likely see nausea/vomiting first:

Answer 38

Hyperkalemia/Hypokalemia

Hyper: hyper bowel sounds/movements, and dysrhthmias

Hypo: muscle weakness (diaphragm), hypo bowel sounds, nausea/vomiting, dysrhthmias