NUR 112 Exam 1 Flashcards
Furosemide (Lasix) Direct IV
dilute? With what?
Rate in mg/min
administer UNdiluted
20mg/min
Lorazepam (Ativan) Direct IV
dilute? With what?
Rate in mg/min
Dilute with equivalent amount of: 1. sterile H2O for injection 2. D5W 3. 0.9% NS for injection 2 mg/min
Morphine Direct IV
dilute? With what? (Davis differs from hospital protocols)
Rate in mg/min
Davis: Dilute with at least 5 mL of: 1. 0.9% NS for injection 2. Sterile H2O for injection Hospital Protocol:administer UNdiluted 2.5 - 15 mg over 5 min
What does ANP do with regard to Na+, H2O?
promotes excretion of Na+
H2O follows Na+ so H2O removed from body
What is effect of ANP on Blood Volume and BP?
decrease BV
decrease BP
Functions of aldosterone
1. Na+
2.K+
Produced in response to 1. 2. 3. 4.
- Na+ retained
- K+ excreted
- decreased renal perfusion (BV) sensed by kidney
- dec Na+ sensed by kidney
- inc. plasma K+
- Dec plasma Na+
ADH
- made in the _____________?
- stored in the _______________?
- Released in response to (2 bio) (2 drugs)?
- Function______________
- hypothalamus
- Post. pituitary
3 low plasma osmolality, stress, nicotine, morphine. - causes kidneys to reabsorb H2O
- What is SIADH?
- state 2 causes
- what happens in body?
- Result of SIADH on: plasma osmolality?
- Urine production?
- Urine osmolality?
- syndrome of inappropriate anti-diuretic hormone release.
- Brain injury, small cell lung cancer
- too much ADH = H2O RETENTION
- Decrease
- Decrease
- Increase
Reduction in ADH leads to which metabolic disorder?
list 2 main s/s
Diabetes insipidus
polyuria
polydipsia (thirst)
What is: 1. first spacing?
- second spacing?
- third spacing?
- eg of 3rd spacing
- normal distribution of ECF/ICF
- abnormal accumulation of IF (edema)
- fluid is trapped and unavailable for functional use. Fluid accumulates in part of body where it is not easily exchanged with ECF.
- ascites (many others…)
Main cation in ECF?
Main anion in ECF?
Na+
Cl-
Main cation in ICF?
Main anion in ICF?
K+
PO4 3-
Other cations found in ECF & ICF in small amounts
Ca2+, Mg2+
Other anions found in ICF (2)
Protein, HCO3-
Other anions found in ECF (4)
protein, HCO3-, SO4-, PO4 3-
Define simple diffusion
movement of solute from area of high concentration to area of low concentration until equilibrium.
define facilitated diffusion
give example of substance moving this way
uses carrier molecule to achieve movement of solute from area of high concentration to area of low concentration until equilibrium.
e.g. glucose into cell
define active transport
movement of solute against concentration gradient, requires energy.
osmosis
movement of water molecules from area of high concentration of water to area of low concentration of water across a selectively permeable membrane until equilibrium of water.
- osmo__________ refers to fluids inside the body
2. osmo__________ refers to fluids outside the body
- osmolality
2. osmolarity
normal plasma osmolality per pagana
285 - 295 mOsm/kg
2 substances that determine plasma osmolality
Na+
glucose
What % (fraction) of total body fluid is:
- ICF
- ECF
- 2/3
2. 1/3
What % of ECF is:
- transcellular
- interstitial
- intravascular
- negligible
- 2/3 (includes lymph)
- 1/3 (plasma)
List 2 examples of transcellular fluids
cerebrospinal fluid
GI fluid
pleural
synovial + others…. see Lewis chp 17
- What is hydrostatic pressure (in the body) and what does it do?
- Is hydrostatic pressure greater at arterial or venous end of capillary?
- pressure in blood vessels generated by contraction of heart.
forces fluid from ECF vascular system out of capillary to interstitium to allow exchange with intracellular fluid. - 40 mmHg at arterial end 10 mmHg at venous end.
- What is oncotic (colloidal osmotic pressure)?
2. What is its function in capillaries?
- osmotic pressure exerted by colloids in solution (proteins)
- Protein found in ECF pulls fluid from interstitium back into capillaries at venous end (v. little protein in interstitium relative to intravascular)
Fluid shifts:
- Plasma to interstitium results in ______?
- Caused by ____________ in hydrostatic pressure at venous end.
- edema
2. increase (reduces amount of fluid moving from interstitium to capillary)
Causes of edema due to increase in hydrostatic pressure (5)
- fluid overload
- heart failure
- liver failure
- thrombosis, tourniquets, restrictive clothing (obstruction of venous return to heart)
- varicose veins (venous insufficiency)
2 other causes of edema related to shift of fluid from plasma to interstitium.
- dec in plasma oncotic pressure (P is too low to pull fluid back into capillary)
low plasma proteins caused by renal disorders, liver disease, malnutrition - inc in interstitial oncotic pressure
due to accumulation of plasma protein in IF as result of trauma, burns.
Shift of interstitial fluid to plasma caused by______ (2)
admin of colloids
admin hypertonic IV
Hypertonic solution effects on brain cells?
pulls H2O out of cells - crenate, brain cells shrink - altered CNS responses
Hypotonic solution effects on brain cells?
pushes H2O into cells - swell brain cells - altered CNS response
Values per pagana:
- Na+
- Cl-
- PO4 3-
- K+
- HCO3-
- 135- 146
- 98-106
- 3- 4.5
- 3.5- 5
- 21- 28
Values per pagana:
- Mg2+
- Ca2+
- 1.3 - 2.1
2. 9 - 10.5
