Fluids & Electrolytes - Part 2 - Unit 5 Flashcards
Active Transport: Molecules move against a ___ ___ across cell membranes.
Concentration gradient.
Filtration - the movement of fluid and electrolytes through a permeable membrane from __ pressure to ___ pressure by force or pressure between intravascular and interstitial spaces.
High pressure —-> lower pressure.
Hydrostatic Pressure - the pushing force of water & solutes from a solution with ___ hydrostatic pressure to a solution with __ hydrostatic pressure.
High —> lower.
Colloid Osmotic Pressure - the pulling force that occurs by plasma proteins that puts pressure on the permeable membranes. Fluid follows the ____.
Proteins.
Osmolality - def
The measure of a solution’s ability to create osmotic pressure and thus affect the movement of water. Can also be described as the ratio of solutes to water.
Osmolarity - def
another term to describe the concentration of solutions. Reflects the number of particles in a liter of solution - Normal = 275-295 mOsm/kg.
Tonicity is a reflection of what?
Osmolality.
Isotonic - osmolality is…Fluids move?
Same as body fluids, like 0.9% NACL. Fluids do not move. No net transfer!
Hypotonic - osmolality is…Fluids move?
<body fluids, like 0.45% NACL. Fluid moves in the directions of greater solute concentration (INTO cells.)
Hypertonic - osmolality is…Fluids move?
> body fluids, like 3% NACL. Fluid moves in direction of greater solute concentration (OUT of cells.)
Colloids - particles that are too __ to pass through a semipermeable membrane.
LARGE, like protein.
What are some signs of a well-hydrated person?
Stable weight from day to day, moist mucous membranes, adequate food intake, straw colored urine, good tissue turgor, appropriate mental orientation, not thirsty, output equal to intake, no evidence of edema, etc.
Fluid Volume Excess (Isotonic/Hypervolemia) - What happens?
The ECF is expanded, fluid accumulates in interstitial space. It may produce edema!Could be from excessive intake of fluid or saline (Like CHF/CRF), but the gains of water and salt are equal.
What’s some objective data for fluid volume excess (Isotonic))?
Edema, urine pale and colorless (with a decrease in specific gravity), firm tissue turgor, sudden weight gain, increased pulse rate, distended neck veins, mental confusion, dyspnea, decreased hematocrit, na 135-145, Chest xray will show pulmonary edema.
What’s some subjective data for fluid volume excess (Isotonic)?
Statements of “weakness” and “anorexia.”
What are some nursing interventions for Fluid Volume Excess? (Isotonic)
Monitor vitals, restrict fluid intake, teach about NA intake, give diuretics (if ordered), monitor!
Fluid Volume Excess - Hypotonic ECF - what happens?
ICF is expanded - cells are swollen. Can be caused by SIADH, Excessive tap water enema, irrigating NG water, psychogenic polydipsia.
What’s some subjective data for Fluid Volume Excess (Hypotonic?)
Changes in LOC, widened pulse pressure, Na <295, headache. etc.
What are some nursing interventions for Fluid Volume Excess (hypotonic?)
Assess risk, vital signs, monitor weight, I&O, restrict free water, etc.
Hypertonic Fluid Volume Excess - is it common?
No, it’s rare. It occurs secondary to increased salt intake. ECF expands and ICF volume contracts.
Fluid Volume Deficit (Isotonic ECF) what happens?
Body loss of water & electrolytes from ECF, in similar portions. The ECF is contracted. Happens from ABNORMAL GI LOSSES.
What is some objective data for fluid volume deficit? (Isotonic)?
Dry, flaky skin, sunken eyes, oliguria (dark amber urine), decreased tissue turgor, weak/rapid pulse, decreased BP (with possible Orthostatic Hypotension), salivation, etc.
What’s some subjective data for fluid volume deficit (isotonic) ?
Thirst, weakness, Nausea/Vomitting, lethargy, vertigo with Orthostatic hypotension.
Fluid Volume Deficit (Hypertonic) - what is it?
Same as dehydration and hypernatremia. More water is lost than Na+.ECF is hypertonic - cells become dehydrated.
O/S data for Dehydration?
Flushed skin, thirst, dry mucous membranes, increased body temp, weight loss, decreased urinary output <30CC.
Nursing Interventions for Dehydration?
Increase oral intake or give IV fluids per MD order, I & O, Daily weights.