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Adult 300 > N300 Midterm Fluid and Electrolytes > Flashcards

N300 Midterm Fluid and Electrolytes Flashcards

1
Q

Intra or extracellular fluid?

  • 40% of TBW
  • Mostly found in skeletal muscle cells
  • Functions
A

Intracellular

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2
Q

Osmolality or Osmolarity:
A measure of the total solute concentration per kilogram of solvent; used to describe fluids inside the body; test usually used to evaluate the concentration of plamsa and urine.

A

Osmolality

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3
Q

Osmolality or Osmolarity

A measure of the total solute concentration per liter of solution; used to describe fluids outside of the body.

A

Osmolarity

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4
Q

Osmosis?

A

Movement of water from an area of low solute concentration to higher solute concentration.

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5
Q

what are the major determinants of plasma osmolality?

A

Sodium and Glucose

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6
Q

___: is the force within a fluid compartment; the major force that pushes water out of the vascular system at the capillary level.

A

Hydrostatic pressure

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7
Q

___: is osmotic pressure exerted by colloids in solution. The major colloid in the vascular system contributing to the total osmotic pressure is protein. Protein molecules attract water, pulling fluid from the tissue space to the vascular space.

A

Oncoctic pressure

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8
Q

The amount and direction of fluid movement between the capillary and the interstitium is determined by what 4 types of pressure?

A

(1) capillary hydrostatic pressure
(2) plasma oncotic pressure
(3) interstitial hydrostatic pressure
(4) interstitial oncotic pressure

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9
Q 
Capillary hydrostatic pressure and interstitial oncotic pressure move water \_\_\_\_ of the capillaries. 
Plasma oncotic (colloidal osmotic) pressure and interstitial hydrostatic pressure move fluid \_\_\_ the capillaries.
A

OUT

INTO

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10
Q
  1. Accumulation of fluid in the interstitium (edema) occurs if venous hydrostatic pressure ____ ,
  2. plasma oncotic pressure ____,
  3. or interstitial oncotic (colloidal osmotic) pressure ____.
  4. Edema may also develop if there is an obstruction of lymphatic outflow that causes ____ removal of interstitial fluid.
A

Rises
Decreases
Rises
decreased

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11
Q

Increasing the pressure at the venous end of the capillary ____ fluid movement back into the capillary, which results in ___ . Causes of increased venous pressure include fluid overload, ____ and ____ failure, obstruction of venous return to the heart (e.g., tourniquets, restrictive clothing, venous thrombosis), and ____ insufficiency (e.g., varicose veins)

A

inhibits
edema
Heart and liver
venous

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12
Q

_____: is a term used to describe the distribution of body water.

A

Fluid spacing

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13
Q
  1. ____ spacing describes the normal distribution of fluid in the ICF and ECF compartments.
  2. Second spacing refers to an abnormal accumulation of ____ fluid (i.e., edema).
  3. With Third spacing, fluid accumulates in a portion of the body from which it is not easily exchanged with the rest of the ECF Ie the _____ fluid. Third-spaced fluid is trapped and unavailable for functional use.
A

First
interstitial
(transcellular fluid) Ex. peritonitis or appendicitis

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14
Q

Examples of what type of spacing:

  • ascites
  • sequestration of fluid in the abdominal cavity with peritonitis
  • edema associated with burns, trauma, or sepsis
A

Third Spacing

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15
Q

What is the best indicator of hydration?

A

Weight

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16
Q

Water balance is maintained via the finely tuned balance of water intake and excretion. A body fluid deficit or ____ in plasma osmolality is sensed by ____ in the hypothalamus, which in turn stimulate thirst and release of what hormone? Thirst causes the patient to drink water.

A

increase
osmoreceptors
antidiuretic hormone (ADH)

17
Q

ADH (also called vasopressin), which is synthesized in the ______ and stored in the ____ pituitary, acts in the ____ distal and collecting tubules causing water ____.

A

hypothalamus
posterior
renal
reabsorption

18
Q

____ hormones suppress secretion of aldosterone, renin, and ADH, and the action of angiotensin II. They act on the renal tubules to promote excretion of sodium and water, resulting in a decrease in blood volume and blood pressure.

A

Atrial natriuretic peptide (ANP) and b-type natriuretic peptide (BNP)
(hormones produced by cardiomyocytes).

19
Q
  1. ____ water loss, which is invisible vaporization from the lungs and skin, assists in regulating body temperature. Only water is lost through this mechanism.
  2. The excessive sweating caused by fever or high environmental temperatures that may lead to large losses of water and electrolytes is considered ____ perspiration.
A

Insensible

sensible perspiration

20
Q

What are the normal levels for the following anions:
Bicarbonate (HCO3–)
Chloride (Cl–)
Phosphate (PO43–)*

A

Bicarb: 22-26 mEq/L

Chloride: 96-106 mEq/L

Phosphate: 2.4-4.4 mg/dL

21
Q 
What are the normal levels for the following cations:
Potassium (K+)
Magnesium (Mg2+)
Sodium (Na+)
Calcium (Ca2+)
A

Potassium: 3.5-5.0 mEq/L

Magnesium: 1.5-2.5 mEq/L

Sodium 135-145 mEq/L

Calcium total: 8.6-10.2 mg/dL

22
Q

____: generalized in entire body, independent of positioning

A

Anasarca

23
Q

What are 3 sites to evaluate skin turgor?

A

over the sternum
abdomen
anterior forearm

24
Q

The areas to be evaluated for edema are those where soft tissues overlie a bone including what preferred sites?

A

tibia, fibula, and sacrum

25
Q

A nasogastric tube should always be irrigated with water or isotonic?

A

saline solution. Water causes diffusion of electrolytes into the gastric lumen from mucosal cells; the electrolytes are then suctioned away.

26
Q

What is anascara?

A

generalized edema (all over)

27
Q

What causes plasma to intersitial fluid shift?

A
  1. Increased capillary hydrostatic pressure
  2. Decreased plasma protein
  3. Increased capillary permeability
28
Q

What are maifestations of plasma to intersitial fluid shift?

A
  • increase HR (since volume has dropped)
  • decrease BP (due to lower volume)
    compensatory mechanism: ADH release causes:
    -decreased urine output, concentrated
    -EDEMA*****
29
Q

What is dependent edema?
What is weeping edema?
Weeping: weeps through pores of the skin
What locations does Ascites and pleural effusion take place?

A
  • site of edema is determined by gravity. If person is standing, will be located in feet, if laying down will be sacral, if laying on stomach, will be in abdomen.
    Fluid weeps through pores of the skin
    Ascites-in lungs
    pleural effusion- pleural space
30
Q

What are 3 cause of interstital to plasma fluid shift?

A
  1. Decrease in capillary hydrostatic pressure
  2. Increase in colloidal osmotic pressure
  3. Remobilization of fluid following burns or trauma
31
Q

What are manifestations of interstitial to plasma fluid shift?

A
  • HR bounding, may be decreased
  • increased BP
  • kidneys excrete dilute urine
  • Pulmonary edema (Hydrostatic pressure is increased now so fluid pushed out of vessels into lungs)
  • SOB, crackles, labored breathing.
  • hypoxia leads to restlessness and HR will increase.
32
Q

What is hyperosmolarity and what happens to cells?

What causes hyperosmolarity?

A 
too many particles or too little water
Results in cell-shrinking
Caused by:
Decreased water intake
Extracellular solute excess
33
Q

What are manifestations of hyperosmolarity?

A

dehydration: look for skin turgor, dry membranes, brain cell shrinkage will cause mental status change. HR may go up.

34
Q

What is hypo-osmolarity?

What are the symptoms and causes?

A

Too few particles or too much water
Results in cellular swelling: cerebral edema, why football players drink Gatorade! (due to loss of sodium/lytes and water with sweat).
Causes:
Replacing H20 and Na+ loss with only water
Inability to excrete urine (CRF)

35
Q

What are the manifestations of hypo-osmolarity?

A

confusion, nausea, dizzyness

36
Q

With Isotonic imbalances:

  1. Na+ and H20 increase or decrease together in equal proportions?
  2. Cells shrink or swell?
  3. T or F: Volume of ECF changes but the concentration of the solutes remains the same
A
  1. both in equal proportions
  2. neither
  3. True
37
Q

What are the manifestations of isotonic deficit?

A

Ex. If Bleeding: HR will increase, BP will decrease (not 1st sign)
Will become hypoxic, anxious, decreased urine output.

38
Q

With Isotonic Excess, what manifestations would occur?

What treatment should pt receive?

A 
airway: lungs, may have dyspnea, crackles, BP will increase. 
Collaborative Treatment:
Restrict fluids
Careful monitoring of fluids 
Diuretics

Adult 300 (5 decks)

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