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Fundamentals Semester 2 - Exam 1. > Fluids & Electrolytes > Flashcards

Fluids & Electrolytes Flashcards

1
Q

What is a solution composed of?

A

A solvent (fluid) and solutes (particles)

In the context of fluids, the solvent is typically water, and the solutes can include electrolytes and proteins.

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2
Q

What percentage of an adult’s body weight is fluid?

A

60%

This percentage can vary based on age, gender, and body fat.

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3
Q

What are the two major compartments fluid is distributed in?

A

Intracellular Fluid (ICF) and Extracellular Fluid (ECF)

ICF contains two-thirds of body fluid, while ECF contains one-third and is further divided into intravascular, interstitial, and transcellular fluids.

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4
Q

What is third-spacing?

A

Fluid shifts into spaces where it cannot contribute to equilibrium

Examples include ascites and pleural effusion.

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5
Q

Name two major cations in the body.

A
  • Sodium (Na+)
  • Potassium (K+)
  • Calcium (Ca2+)
  • Magnesium (Mg2+)

These cations play critical roles in physiological functions.

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6
Q

How does sodium (Na+) affect extracellular fluid volume?

A

Regulates ECF volume; water follows sodium

Sodium is key for maintaining fluid balance in the body.

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7
Q

What is the function of the Sodium-Potassium Pump?

A

Moves 3 Na+ out and 2 K+ into the cell

This active transport helps maintain cellular ion balance.

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8
Q

Fill in the blank: Water moves from lower to higher solute concentration through _______.

A

Osmosis

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9
Q

What is hydrostatic pressure?

A

Pushes fluid out of capillaries

It contrasts with osmotic pressure, which pulls fluid into capillaries.

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10
Q

What are isotonic solutions used for?

A

Volume expansion

An example is 0.9% NaCl.

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11
Q

What are the main routes of fluid loss in the body?

A
  • Kidneys
  • Skin
  • Lungs
  • GI Tract

Each route contributes to daily fluid loss, with specific volumes varying per individual.

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12
Q

What is the normal range for serum osmolality?

A

275-290 mOsm/kg

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13
Q

True or False: High hematocrit indicates dehydration.

A

True

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14
Q

What role do the kidneys play in fluid balance?

A

Filter 180 L of plasma daily and regulate fluid, electrolytes, and acid-base balance

This is crucial for maintaining homeostasis in the body.

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15
Q

What is hypervolemia?

A

Excess fluid retention due to compromised regulatory mechanisms

It can result from organ dysfunction or excessive sodium intake.

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16
Q

List two signs of dehydration.

A
  • Low blood pressure
  • Dizziness

Other signs include increased heart rate and poor skin turgor.

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17
Q

What are isotonic solutions typically used for in IV therapy?

A
  • Hypovolemia
  • Shock
  • Resuscitation
  • Diabetic ketoacidosis

Examples include Normal Saline and Lactated Ringer’s.

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18
Q

Fill in the blank: The normal pH range for blood is _______.

A

7.35 – 7.45

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19
Q

What does a high BUN level indicate?

A

Dehydration or kidney dysfunction

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20
Q

What is the purpose of IV fluids?

A
  • Provide water
  • Replace electrolytes
  • Administer medications

IV fluids are essential for maintaining hydration and supporting various bodily functions.

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21
Q

What can cause fluid overload?

A
  • Excessive IV fluid administration
  • Kidney failure
  • Heart failure

This condition leads to symptoms such as high blood pressure and pulmonary edema.

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22
Q

What is the Anion Gap formula?

A

AG = Na⁺ - (Cl⁻ + HCO₃⁻)

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23
Q

What are the risks associated with hypotonic solutions?

A
  • Cellular overhydration
  • Cardiovascular collapse
  • Increased intracranial pressure

These risks necessitate careful monitoring during administration.

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24
Q

What is the main function of colloid solutions in IV therapy?

A

Increase oncotic pressure and draw fluid into the intravascular space

Examples include Dextran and Albumin.

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25
Q

What is the formula for calculating the Anion Gap in metabolic acidosis?

A

AG = Na⁺ - (Cl⁻ + HCO₃⁻)

Normal AG is 10-14 mmol/L.

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26
Q

What are the signs and symptoms of Fluid Overload (Circulatory Overload)?

A

High BP, distended jugular veins, pulmonary edema, rapid breathing

Caused by excessive IV fluid administration.

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27
Q

What is the management for Fluid Overload?

A

Slow IV rate, monitor vitals, place patient in high Fowler’s position, notify provider

Important to address symptoms promptly.

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28
Q

What causes an Air Embolism?

A

Air enters the central veins, travels to the right ventricle, and blocks blood flow

Can lead to serious complications.

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29
Q

What are the signs and symptoms of an Air Embolism?

A

Palpitations, dyspnea, jugular vein distention, cyanosis

Indicates a serious condition requiring immediate action.

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30
Q

What is the management for an Air Embolism?

A

Clamp IV line, place patient in left Trendelenburg position, administer oxygen

Aims to prevent further complications.

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31
Q

What are the signs and symptoms of Infection (Sepsis) related to IV complications?

A

Fever, chills, nausea, increased heart rate, back pain

Often caused by contaminated IV solutions or poor hand hygiene.

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32
Q

How can Infection (Sepsis) be prevented in IV therapy?

A

Aseptic technique, change IV sets as per protocol, inspect insertion site regularly

Essential for reducing infection risk.

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33
Q

What causes Phlebitis?

A

Irritating medications, large catheter size, poor aseptic technique

Inflammation of the vein is a common complication.

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34
Q

What are the signs and symptoms of Phlebitis?

A

Redness, warmth, pain, swelling along vein

Indicates inflammation and requires intervention.

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35
Q

What is the management for Phlebitis?

A

Discontinue IV, apply warm compress, restart IV at a different site

Aims to relieve symptoms and prevent further issues.

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36
Q

What is Infiltration in IV therapy?

A

Non-vesicant leakage when IV catheter is dislodged or perforates vein wall

Can lead to tissue swelling and discomfort.

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37
Q

What are the signs and symptoms of Infiltration?

A

Cool, swollen, pale IV site, leakage of IV fluid

Indicates fluid is not entering the bloodstream.

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38
Q

What is the management for Infiltration?

A

Stop infusion, remove IV catheter, apply warm compress

Essential to prevent further complications.

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39
Q

What is Extravasation in IV therapy?

A

Vesicant leakage caused by irritating IV medications leaking into tissue

Can cause severe tissue damage.

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40
Q

What are the signs and symptoms of Extravasation?

A

Burning, pain, redness, swelling, blistering, tissue necrosis

Indicates a serious complication requiring immediate action.

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41
Q

What is the management for Extravasation?

A

Stop IV immediately, administer antidote, apply cool compress

Aims to minimize tissue damage.

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42
Q

What is Parenteral Nutrition (TPN)?

A

Used when patients cannot tolerate oral intake, containing glucose, proteins, fats

Essential for patients with feeding difficulties.

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43
Q

What types of blood products can be administered via IV?

A
  • Whole blood
  • Packed RBCs
  • Plasma
  • Albumin
  • Cryoprecipitate

Used for various medical conditions requiring blood component therapy.

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44
Q

How can IV medications be administered?

A

Given via continuous infusion or intermittent bolus

Requires careful monitoring due to rapid systemic effects.

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45
Q

What are the reference ranges for serum sodium?

A

135 - 145 mEq/L

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46
Q

Define electrolytes.

A

Substances that are dissolved in water and carry a positive or negative charge.

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47
Q

What is hypernatremia?

A

Serum sodium > 145 mEq/L

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48
Q

What causes hypernatremia?

A
  • Excess sodium intake
  • Hypertonic I.V fluids
  • Fluid deprivation
  • Heat stroke
  • Diabetes Insipidus
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49
Q

What are the clinical manifestations of hypernatremia?

A
  • Cellular dehydration
  • Thirst triggered by the hypothalamus
  • Possible neurological effects
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50
Q

What is hyponatremia?

A

Serum sodium < 135 mEq/L

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51
Q

List common causes of hyponatremia.

A
  • SIADH
  • Nausea, vomiting, diarrhea
  • Adrenal insufficiency
  • Excess water intake
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52
Q

What is the normal serum potassium range?

A

3.5 - 5 mEq/L

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53
Q

What is hyperkalemia?

A

Serum potassium > 5 mEq/L

54
Q

What are the causes of hyperkalemia?

A
  • Excess intake of potassium
  • Internal shifts (e.g. acidosis)
  • Renal injury or disease
  • Medications (e.g. ARBs, ACE inhibitors)
55
Q

What are the clinical manifestations of hyperkalemia?

A
  • Changes in cardiac conduction
  • Muscle weakness
  • Abdominal cramps
  • Diarrhea
56
Q

What treatment options are available for hyperkalemia?

A
  • Monitor ECG
  • Limit potassium intake
  • Potassium wasting diuretics
  • Dialysis (if severe)
57
Q

What is hypokalemia?

A

Serum potassium < 3.5 mEq/L

58
Q

List causes of hypokalemia.

A
  • Increased loss via kidneys
  • GI tract losses
  • Magnesium deficiency
  • Metabolic alkalosis
59
Q

What are the clinical manifestations of hypokalemia?

A
  • ST segment depression
  • Skeletal muscle weakness
  • Decreased GI motility
  • Cardiac dysrhythmias
60
Q

What is the normal serum calcium range?

A

8.8 - 10.4 mg/dL

61
Q

What are the functions of calcium?

A
  • Formation of teeth and bone
  • Blood clotting
  • Transmission of nerve impulses
  • Myocardial contractions
62
Q

What is hypocalcemia?

A

Serum calcium < 8.8 mg/dL

63
Q

What are the clinical manifestations of hypocalcemia?

A
  • Tetany
  • Laryngeal stridor
  • Dysphagia
  • Cardiac dysrhythmia
64
Q

What is hypercalcemia?

A

Serum calcium > 10.5 mg/dL

65
Q

What are the causes of hypercalcemia?

A
  • Hyperparathyroidism
  • Malignancy
  • Excessive intake
  • Prolonged immobilization
66
Q

What is the normal serum phosphate range?

A

2.7 - 4.5 mg/dL

67
Q

What are the clinical manifestations of hyperphosphatemia?

A
  • Often asymptomatic
  • Neuromuscular irritability
  • Tetany
68
Q

What is hypophosphatemia?

A

Serum phosphate < 2.7 mg/dL

69
Q

List causes of hypophosphatemia.

A
  • Malnourishment/malabsorption
  • Diarrhea
  • ETOH abuse
  • Use of phosphate-binding antacids
70
Q

What is the normal serum magnesium range?

A

1.8 - 2.6 mg/dL

71
Q

What is hypermagnesemia?

A

Serum magnesium > 2.6 mg/dL

72
Q

What are the clinical manifestations of hypermagnesemia?

A
  • ECG changes
  • Hypotension
  • Lethargy
  • Nausea and vomiting
73
Q

What are the treatment options for hypermagnesemia?

A
  • Restrict magnesium intake
  • Emergency treatment: IV calcium gluconate
74
Q

Fill in the blank: Electrolytes help regulate _______.

A

Cardiac and neurological function, fluid balance, acid-base balance

75
Q

True or False: Sodium is primarily regulated through the liver.

A

False

76
Q

What are the clinical manifestations of hypermagnesemia?

A

ECG changes, Hypotension, Lethargy/Somnolence, N/V, Impaired reflexes, Respiratory and cardiac arrest

Hypotension occurs due to magnesium acting like a sedative, leading to decreased heart contractility and blood pressure.

77
Q

What is the serum magnesium level that defines hypomagnesemia?

A

Serum magnesium < 1.8 mg/dl

This indicates low serum magnesium levels.

78
Q

List the causes of hypomagnesemia.

A
  • Prolonged fasting or starvation
  • Chronic alcoholism
  • Fluid loss from GI tract
  • Prolonged parenteral nutrition without supplementation
  • Diuretics
  • Large blood transfusion

These causes contribute to magnesium deficiency in the body.

79
Q

What are the clinical manifestations of hypomagnesemia?

A
  • Hyperactive deep tendon reflexes
  • Muscle cramps
  • Tremors
  • Seizures
  • Cardiac dysrhythmias (Torsade de pointes, Vfib)

Cardiac dysrhythmias are particularly important to recognize in hypomagnesemia.

80
Q

What is the emergency treatment for hypermagnesemia?

A

IV calcium gluconate

This treatment is critical in counteracting the effects of high magnesium levels.

81
Q

What treatments are used to promote urinary excretion in cases of hypermagnesemia?

A
  • Fluids
  • IV furosemide

These treatments help to reduce magnesium levels in the body.

82
Q

What is the consequence of magnesium acting like a sedative in hypermagnesemia?

A

Losing contractility of the heart, leading to hypotension

This sedative effect can severely impact cardiovascular function.

83
Q

True or False: Impaired reflexes can indicate magnesium deficiency.

A

True

Checking reflexes is a method to assess magnesium levels.

84
Q

Fill in the blank: The treatment for severe hypermagnesemia may include _______.

A

[Dialysis]

Dialysis is considered if magnesium levels are excessively high.

85
Q

What are the primary uses of water in the body?

A

Metabolic reactions, transport, lubrication, insulator, body temperature regulation (rep & sweating)

Water is essential for various physiological functions including maintaining body temperature and facilitating metabolic reactions.

86
Q

How is water gained by the body?

A

Through drinking and eating

Daily intake of fluids is crucial for maintaining hydration and overall health.

87
Q

What should the daily input and output of fluids be?

A

Equal

Maintaining fluid balance is essential for homeostasis.

88
Q

What is the normal fluid loss through the kidneys?

A

1 ml/kg/hr

This is a standard measurement for renal function in terms of fluid output.

89
Q

List the ways fluid is lost from the body.

A
  • Skin (sweat, insensible loss)
  • Lungs
  • GI tract

GI tract losses are typically greater than normal fecal matter.

90
Q

What factors affect water loss in the body?

A
  • Age
  • Sex
  • Temperature
  • Disease stages

These factors can influence hydration levels and fluid balance in individuals.

91
Q

How does aging affect fluid loss?

A

Less lean muscle as we age

Lean muscle tissue holds more water, so a decrease in muscle mass can lead to increased fluid loss.

92
Q

How does sex influence fluid content in the body?

A

Females have higher fat content, which doesn’t hold water like muscle tissue

This biological difference can affect hydration status.

93
Q

What is the typical fluid composition of an adult’s body?

A

60% fluid

Understanding body fluid composition is important for assessing hydration and health.

94
Q

What percentage of body fluid is intracellular and extracellular?

A

2/3 intracellular, 1/3 extracellular

Intracellular fluid is vital for cellular functions, while extracellular fluid is important for transport and communication between cells.

95
Q

What is osmolality?

A

Thickness of body fluid, concentration of solute

Normal sodium osmolality levels range from 280-295 for plasma and 100-300 for urine.

96
Q

What are the types of tonicity in relation to cells?

A
  • Isotonic: Same osmolality as surrounding tissue
  • Hypotonic: Less concentrated solutes than the cell
  • Hypertonic: More concentrated solutes than the cell

These terms describe how fluids move in relation to cells based on solute concentration.

97
Q

Define osmosis.

A

Water moves from low osmolality to high osmolality

Osmosis is a key process in maintaining fluid balance in the body.

98
Q

What is hydrostatic pressure?

A

Pressure exerted on blood vessels

Hydrostatic pressure plays a critical role in fluid movement within the circulatory system.

99
Q

What is osmotic pressure?

A

Volume in plasma

Osmotic pressure is influenced by solutes such as albumin, which attract fluid.

100
Q

How does the heart affect hydrostatic pressure?

A

It extends on the vessels, pushing fluid from vascular spaces into interstitial spaces and pulling fluid into vascular spaces

The heart’s pumping action is essential for maintaining blood pressure and fluid distribution.

101
Q

True or False: Albumin does not attract fluid.

A

False

Albumin is a key protein that helps maintain osmotic pressure by attracting fluid into the vascular space.

102
Q

How much of the water in our bodies is Intracellular fluid?

A

2/3

103
Q

What is extracellular fluid further divided into?

A

Intravascular fluid (plasma)
Interstitial fluid (surrounding cells)
Transcellular fluid (cerebrospinal, synovial, pleural fluid)

104
Q

What does fluid movement between the ICF and ECF maintain?

A

Homeostasis.

105
Q

what are some signs of third spacing?

A

Decreased urine output, increased heart rate, decreased blood pressure, edema.

106
Q

Explain third spacing.

A

Fluid shifts into spaces where it cannot contribute to equilibrium (e.g., ascites, pleural effusion).

107
Q

What are the major cautions (+) in out body?

A

Decreased urine output, increased heart rate, decreased blood pressure, edema.

108
Q

What are the major anions (-) in out body?

A

Chloride (Cl-), Bicarbonate (HCO3-), Phosphate (PO4-).

109
Q

What pulls fluid out of the capillaries?

A

Osmotic pressure

110
Q

Movement of solutes from high to low concentration is______________?

A

Diffusion.

111
Q

Fluid movement due to hydrostatic pressure is_______________?

A

Filtration.

112
Q

What type of IV solution causes no fluid shift?

A

Isotonic for example 0.9 NaCl

113
Q

What type of IV solution treats dehydration? (moves fluid into the cells)

A

Hypotonic solution f.ex. 0.45% NaCL

114
Q

What type of IV solution can be used to treat cerebral edema (draws fluid out of the cells)?

A

Hypertonic, such as 3% NaCl.

115
Q

How much fluid is lost through sweat and insensible loss?

A

approx. 500ml/day

116
Q

how much fluid is lost through the lungs each day?

A

approx. 300ml/day

117
Q

how much fluid is lost through the GI tract each day?

A

100-200 ml/day

118
Q

What does the BUN tell us?

A

Dehydration & kidney dysfunction.

119
Q

What lab is the best indication for kidney function?

A

Creatinine.

120
Q

What does it mean if the hematocrit lvl is high?

A

If the patients hematocrit is high it means that they are dehydrated. Low Hct means that the patient is overhydrates or anemic.

121
Q

What does urine sodium help us assess?

A

Fluid volume status.

122
Q

What does the Pituitary gland release and what is its purpose?

A

ADH (antidiuretic hormone), promotes water retention.

123
Q

what does the adrenal gland release and what is its purpose?

A

Aldosterone, regulates sodium and potassium.

124
Q

What does the RAAS respond to and what does it increase?

A

Low blood pressure. It increases fluid retention.

125
Q

What is the action of the Natriuretic Peptides ANP & BNP?

A

It does the opposite of the RAAS. It promotes the excretion of water and sodium. This can happen if the blood pressure is too high.

126
Q

Why would we give a patient ACE inhibitors and what is their action?

A

We would give a patient ACE-inhibitors (-pril) in response to high blood pressure. They stop the body from converting Angiotensinogen to angiotensin and therefore prevents vasoconstriction.

127
Q

What is dehydration the loss of? And what does it elevate?

A

Water OR sodium - Elevates sodium concentration.

128
Q

What is another name for Hypovolemia?

A

Fluid Volume Deficit (FVD)

129
Q

How is FVD different from Dehydration?

A

Dehydration is loss of Water only, FVD is a proportional loss of water AND electrolytes.

130
Q

What are some clinical manifestations of FVD/Hypovolemia?

A
  • Low BP & increased HR and flattened neck veins
  • Dizziness confusion & thirst
  • Low urine output & concentrated urine
  • Poor skin turgor, sunken eyes, cool/clammy/pale skin
  • Nausea, muscle cramps, fever, increased body temp.
131
Q
A

Fundamentals Semester 2 - Exam 1. (5 decks)

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