Part one: Disorders of fluid, electrolytes, and acid-base balance

Question 1

What are the components of water?

Answer 1

Intracellular

Extracellular

The exchange of water between vascular and interstitial occurs at the capillary level.

Question 2

What is Extracellular Vascular?

Answer 2

Fluid within the blood vessels.

Question 3

What is Extracellular Interstitial?

Answer 3

Fluid that surrounds cells.

Question 4

What is Extracellular Transcellular?

Answer 4

Water in areas lined with epithelial tissue such as the eyes, joints, cerebrospinal fluid.

Question 5

What is total body water varied by?

Answer 5

Varies by sex and weight and is related to body fat composition.

Young adult males have about 60% TBW.

Young adult females have about 50% TBW.

Question 6

How does aging/infancy relate to TBW?

Answer 6

TBW increases with aging due to increasing fat stored and less muscles.

Infants have highest proportion of TBW with the highest in prematurity.

Question 7

How much body water is inside the cell?

Answer 7

2/3

Question 8

How much body water is extracellular water?

Answer 8

1/3

Question 9

Edema is described as?

Answer 9

Palpable swelling due to expansion of interstitial fluid volume - the spaces between the tissues or parts.

Question 10

What causes edema?

Answer 10

Increased capillary pressure

Increased capillary permeability

Decreased colloidal osmotic pressure. (Decreased production or loss of proteins.)

Obstruction of lymph fluids.

Question 11

What can be considered increased capillary pressure? (There’s 4)

Answer 11

Heart failure

Kidney disease

Pregnancy

Venous Obstruction

Question 12

How is third spacing defined as?

Answer 12

Abnormal fluid movement from extracellular to transcellular.

Question 13

What serous cavities are included in third spacing?

Answer 13

Includes the pericardial space, pleural space, and peritoneal cavity.

Question 14

Third spacing involves areas that…

Answer 14

There is milking action that constantly moves fluid and plasma proteins back into circulation.

Question 15

In third spacing, fluid is exchanged between what?

Answer 15

Fluid is exchanged between the ECF, capillaries, interstitial and transcellular spaces through the capillaries.

Question 16

Third spacing is closely connected to what?

Answer 16

The lymphatic drainage system.

Question 17

In third spacing, lymph flow obstruction will lead to fluid in what serous cavities?

Answer 17

Surrounding the lungs (pleural), heart (pericardial) and abdominal organs (peritoneal)

Question 18

What causes third spacing?

Answer 18

Causes include systematic inflammatory response (sepsis), pancreatitis with its leaky capillary syndrome, hypoalbuminemia with liver failure, and 3rd degree burns.

Question 19

This third space is part of the total body weight but is not a…

Answer 19

Functional need

Question 20

How can lymph drainage be explained?

Answer 20

Lymph returns fluid back into the blood vessels for circulation.

Excess fluids and osmotically active plasma proteins that may have leaked into the interstitium space are picked up by lymph vessels and returned to the circulation.

Question 21

What could make fluid leak out of blood vessels into the interstitium?

Answer 21

Inflammation

Question 22

How can the mechanisms of fluid loss be described?

Answer 22

Status or amount of circulating fluid monitored in an ongoing manner by receptors in carotid arteries, the aortic arch, atria, and other organs.

Loss of fluid volume can occur from hemorrhage, wounds, burns, vomiting, or diarrhea.

Vasodilation of blood vessels:
- Hypersensitivity response (allergic)
- A chemical mediator involved is histamine.

Question 23

What is hypovolemia?

Answer 23

Fluid Volume Deficit

Question 24

What are some manifestations of hypovolemia?

Answer 24

Decreased BP - hypotension

Postural hypotension - orthostatic

Increased HR - tachycardia

Reduced urine output

Thirst

Weight loss

Constipation

Decreased LOC

Question 25

What are some examples of the mechanisms of fluid volume excess?

Answer 25

Excess fluid volume intake

Excess sodium intake

Water and sodium retention:
-Renal failure
-Liver failure
-Heart failure
-Increased aldosterone
-Increased cortisol
-Increased antidiuretic hormone

Question 26

What is hypervolemia?

Answer 26

Fluid Volume Excess

Question 27

What are some manifestations of hypervolemia?

Answer 27

Dyspnea: SOA

Increased BP:
Hypertension

Weight gain

Ankle swelling

Peripheral edema

Ascites: abdominal cavity

Question 28

Ascites can be defined as…

Answer 28

Free fluid in the abdominal cavity.