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Funds Exam5 (from ppts) > Fluids + Electrolytes Pt 1 > Flashcards

Fluids + Electrolytes Pt 1 Flashcards

1
Q

Homeostasis

A

Volume + composition of each space remains constant

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2
Q

What can impact homeostasis?

A
  • vomiting
  • diarrhea
  • ace inhibitors
  • diuretics
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3
Q

Amount of plasma in the body

A
  • Plasma: 3L
  • Interstitial fluid (IF): 10L
  • Intracellular fluid (ICF): 28L
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4
Q

Composition of body fluids
-Water

A
  • Primary component of body
  • Accounts for approx 60% of body wt
  • Adequate balance is necessary for
    -maintenance of temp
    -elimination of waste products
    -all transportation within body
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5
Q

Factors that affect body water

A

Age is a huge factor:
* neonates are made of 80% water
* older adults are made of 45% water

Other factors that influence body water:
* The more adipose tissue the less body water you have.
* The more muscle mass you have the more body water you have.

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6
Q

Composition of body fluids
-Solutes

A
  • Electrolytes: Chemical compounds that develop an ionic charge when dissolved in water
  • All body fluids contain electrolytes
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7
Q

Regulation of electrolyte levels is critical for:

A
  • maintenance of body fluid osmolality
  • acid balance
  • neuromuscular function
  • cell metabolism
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8
Q

Composition of body fluids
-Nonelectrolytes

A
  • do not dissociate in solution
  • measured by wt
  • Glucose - Urea - Creatinine - Bilirubin - Proteins
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9
Q

Body fluid compartment
-Transcellular fluids (not subject to significant gains or losses)

A
  • CSF
  • GI tract
  • Pleural
  • Synovial
  • Peritoneal
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10
Q

First spacing?

A

Normal distribution of fluid

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11
Q

Second spacing?

A

Abnormal accumulation of interstitial fluid

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12
Q

Third spacing?

A
  • Abnormal accumulation in areas that have no or little amt of fluid
  • Fluid unavailable for use
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13
Q

Movement of body fluids
-What is it?

A
  • Fluid constantly moves among intracellular, interstitial and vascular spaces to maintain body fluid balance
  • Moves through permeable membranes
    -permits movement of water + some solutes
  • Normally ICF + ECF are isotonic w/ each other
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14
Q

Osmosis?

A
  • Osmosis stops when equilibrium is reached
  • Major force in body fluid movement
  • Important to consider w/ IV therapy
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15
Q

Movement of body fluids
-Osmotic pressure

A
  • Refers to pulling power of a solution for water
  • The higher the osmolality of a solution greater pulling power for water
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16
Q

Movement of body fluids
-Oncotic pressure

A

Refers to pulling force exerted by colloids

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17
Q

Movement of body fluids
-Diffusion

A

Solute moves from area of higher concentration to area of lower concentration until equilibrium.

“coasting downhill”

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18
Q

Movement of body fluids
-Facilitated diffusion

A

Facilitated diffusion is the diffusion of solutes through transport proteins in the plasma membrane.

Facilitated diffusion is a type of passive transport.

Even though facilitated diffusion involves transport proteins, it is still passive transport b/c the solute is moving down the concentration gradient.

19
Q

Movement of body fluids
-Filtration

A
  • Movement of fluids + solutes from an area of high hydrostatic pressure to an area of low hydrostatic pressure into or out of the capillary
  • Dependent on forces favoring filtration + opposing it
  • Think of as a tug of war - pushing and pulling
20
Q

Net filtration
-Forces favoring filtration

A
  • Capillary hydrostatic pressure (blood pressure)
  • Interstitial oncotic pressure (water-pulling)
21
Q

Net filtration
-Forces favoring reabsorption

A
  • Plasma oncotic pressure (water-pulling)
  • Interstitial hydrostatic pressure
22
Q

Fluid shifts
-What is it?

A

Interstitial fluid to plasma
* Fluid drawn into plasma space whenever there is space increase in plasma osmotic or oncotic pressure
* Wearing of compression stockings or hose is a therapeutic action on this effect

23
Q

Movement of body fluids
-Active transport

A
  • Movement of solute from an area of lower solute concentration to an area of higher solute concentration
  • Depends on ATP
  • Example: Sodium-Potassium pump

“pumping uphill”

24
Q

Renin-Angiotensin
-How does it work?

A

1-Blood flow to glomerulus drops + juxtaglomeruluar cells secrete renin into bloodstream
2-Renin travels to liver
3-Renin converts angiotensinogen in liver to angiotensin I
4-Angeiotensin I travles to lungs
5-Angiotensin I converted in lungs into angiotensin II
6-Angiotensin II travels to adrenal glands
7-Angiotensin II stimulates adrenal glands to produce aldosterone

25
Q

Aldosterone
-How does it work?

A

1-Angiotensin II stimulates adrenal glands to release aldosterone
2-Aldosterone causes kidneys to retain sodium + water
3-Sodium + water retention leads to increases in fluid vol + sodium levels

26
Q

Factors affecting aldosterone
secretion

A
  • decreased renal perfusion (e.g., decreased plasma volume) stimulates increased renin secretion leading to increased plasma angiotensin II
  • increased serum K+
  • decreased serum Na+
  • stress, physical trauma leading to increased ACTH
27
Q

Regulation of
body fluids
-Antidiuretic
Hormone (ADH)

A
  • Hormone synthesized by hypothalamus
  • Secreted by posterior pituitary
28
Q

How ADH works

A

1-Low blood vol + increased serum osmality are sensed by hypothalamus, which signals pituitary gland
2-Pituitary gland secretes ADH into bloodstream
3-ADH causes kidneys to retain water
4-Water retention boosts blood vol + decreases serum osmolality

29
Q

Regulation of
body fluids
-Thirst mechanism

A
  • Stimulated by thirst receptors in hypothalamus
  • Primary protection against hyperosmolality
  • Normally occurs w/ even small fluid losses
  • Stimulates release of ADH and aldosterone
  • Depressed in older people
30
Q

Regulations of body fluids
-Atrial Natriuretic Peptide (ANP)

A
  • hormone secreted from cardiac cells of the atria in response to stretch of atria from hypervolemia as well as hypertension
  • when blood sodium levels + pressure increases, ANP is secreted from the heart, binds to kidney + blood vessels to promote salt excretion/low blood volume/relaxation of vessel
31
Q

One liter of
water weighs?

A

2.2 lbs/1 kg

32
Q

Fluid gains

A
  • Oxidative metabolism = approx 300 ml/day gained
  • Oral fluids = 1100-1400 ml consumed daily
  • Solid foods = 800-1000 ml/day
  • Fluid therapy = varied
33
Q

Fluid losses

A
  • Kidneys: Primary regulators of fluid and electrolyte balance = approx 1500 ml urine excreted/day
  • Skin = ave of 500-600 mL of sensible & insensible fluid lost via skin each day (Can be as great as 2 L/hr)
  • Lungs = approx 400 mL insensible fluid
  • GI tract = 100-200 mL
  • Abnormal losses = varied
  • Third space losses = unavailable
34
Q

Fluid Volume Excess
-Causes

A
  • Renal Disease
  • Too rapid infusion of IV fluids
  • Steroid Therapy
  • Production of ADH
  • Cardiac Disease
35
Q

Brawny Edema

A
  • Fluid can no longer be displaced secondary to excessive interstitial fluid accumulation
  • No pitting
  • Tissue palpates as firm or hard
  • Skin surface=shiny/warm/moist
36
Q

Fluid Volume Deficit
-Causes

A
  • NPO
  • drains
  • surgery
  • blood loss
  • fluid loss from GI tract
  • profuse sweating
  • polyuria
  • fever
  • third spacing
  • decreased intake
37
Q

Nurs assessment
-Nursing hx

A

Dz or disorders that may cause disturbances

38
Q

Nurs assessment
-V/S

A
  • body temp
  • RR and depth
  • HR/pulses
  • BP
39
Q

Nurs assessment
-I&O

A
  • Incl all oral, IV fluid intake
  • Incl all output, inclg drains, bleeding (may need to measure linens or chux for accurate output)
40
Q

Nurs assessment
-Systems assessment

A
  • Integumentary
  • Neurologic
  • CV
  • Pulmonary
  • G.I.
  • Genitourinary
41
Q

Laboratory assessment

A
  • Serum osmolality
  • Hematocrit
  • Urea nitrogen
  • Urine osmolality
  • Urine specific gravity
42
Q

Diseases that affect F&E balance?

A
  • Diabetes Mellitus
  • Diabetes Insipidus
  • SIADH
43
Q

Nurs Dxs

A
  • Excess fluid volume
  • Deficient (hyper/hypotonic) fluid volume
  • Fluid volume, risk for imbalance
44
Q

Nurs interventions

A
  • Reflective of dx
  • I&O
  • Daily wts
  • Fluid replacement
    -PO
    -enteral
    -IV
  • Fluid restriction
  • Meds

Funds Exam5 (from ppts) (11 decks)

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