Part one: Disorders of fluid, electrolytes, and acid-base balance Flashcards
What are the components of water?
Intracellular
Extracellular
The exchange of water between vascular and interstitial occurs at the capillary level.
What is Extracellular Vascular?
Fluid within the blood vessels.
What is Extracellular Interstitial?
Fluid that surrounds cells.
What is Extracellular Transcellular?
Water in areas lined with epithelial tissue such as the eyes, joints, cerebrospinal fluid.
What is total body water varied by?
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.
How does aging/infancy relate to TBW?
TBW increases with aging due to increasing fat stored and less muscles.
Infants have highest proportion of TBW with the highest in prematurity.
How much body water is inside the cell?
2/3
How much body water is extracellular water?
1/3
Edema is described as?
Palpable swelling due to expansion of interstitial fluid volume - the spaces between the tissues or parts.
What causes edema?
Increased capillary pressure
Increased capillary permeability
Decreased colloidal osmotic pressure. (Decreased production or loss of proteins.)
Obstruction of lymph fluids.
What can be considered increased capillary pressure? (There’s 4)
Heart failure
Kidney disease
Pregnancy
Venous Obstruction
How is third spacing defined as?
Abnormal fluid movement from extracellular to transcellular.
What serous cavities are included in third spacing?
Includes the pericardial space, pleural space, and peritoneal cavity.
Third spacing involves areas that…
There is milking action that constantly moves fluid and plasma proteins back into circulation.
In third spacing, fluid is exchanged between what?
Fluid is exchanged between the ECF, capillaries, interstitial and transcellular spaces through the capillaries.
Third spacing is closely connected to what?
The lymphatic drainage system.
In third spacing, lymph flow obstruction will lead to fluid in what serous cavities?
Surrounding the lungs (pleural), heart (pericardial) and abdominal organs (peritoneal)
What causes third spacing?
Causes include systematic inflammatory response (sepsis), pancreatitis with its leaky capillary syndrome, hypoalbuminemia with liver failure, and 3rd degree burns.
This third space is part of the total body weight but is not a…
Functional need
How can lymph drainage be explained?
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.
What could make fluid leak out of blood vessels into the interstitium?
Inflammation
How can the mechanisms of fluid loss be described?
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.
What is hypovolemia?
Fluid Volume Deficit
What are some manifestations of hypovolemia?
Decreased BP - hypotension
Postural hypotension - orthostatic
Increased HR - tachycardia
Reduced urine output
Thirst
Weight loss
Constipation
Decreased LOC
What are some examples of the mechanisms of fluid volume excess?
Excess fluid volume intake
Excess sodium intake
Water and sodium retention:
-Renal failure
-Liver failure
-Heart failure
-Increased aldosterone
-Increased cortisol
-Increased antidiuretic hormone
What is hypervolemia?
Fluid Volume Excess
What are some manifestations of hypervolemia?
Dyspnea: SOA
Increased BP:
Hypertension
Weight gain
Ankle swelling
Peripheral edema
Ascites: abdominal cavity
Ascites can be defined as…
Free fluid in the abdominal cavity.
