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Pathopharm > pathpharm-fluids and electrolytes > Flashcards

pathpharm-fluids and electrolytes Flashcards

1
Q

Water makes up _________-__________% of an infant’s total body composition

A

70-80

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3
Q

Water makes up _________-__________% of an adult’s total body composition

A

50-60

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5
Q

Water makes up _________-__________% of anolder adult’s total body composition

A

45-55

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7
Q

Within bodily fluid __________% is extracellular and ____________% is intracellular

A

20, 40

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9
Q

Within extracellular bodily fluid ________% is plasma, and _________% is interstitial fluid

A

5,15

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11
Q

Infants and elderly are both at risk for_________________

A

dehydration

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13
Q

List the 6 important properties of water (fluid)

A
  1. Universal solvent 2. lubrication 3. Transports O2, nutrients, wastes 4. regulates body temp.(high heat capacity) 5. shock absorber (joints) 6. Gives the body form
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15
Q

Define intracellular fluid:

A

fluid within cells

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17
Q

Define extracellular (plasma/intravascular) water:

A

fluid inside vessels but outside cells

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19
Q

Define extracellular (interstitial/3rd spacing) water:

A

fluid outside vessels and cells

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21
Q

_____________ is responisble for causing edema.

A

interstitial/3rd spacing fluid

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23
Q

What are the 3 major ECF ions?

A

NA+(sodium), Cl-(chloride), HCO3-

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25
Q

What are the major ICF ions?

A

K+, Mg++, HPO4-

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27
Q

Define osmolarity:

A

The measure of solute concentration in a solution

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29
Q

T or F: ICF and ECF are in osmotic equilibrium.

A

TRUE

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31
Q

What are the limits for a normal serum osmolarity?

A

275-290 Osm/L

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33
Q

If you wanted to determine a patient’s serum Osm without running a separate Osm test, what could you use to estimate the value?

A

Take the pt’s Na+ level and multiply by two to get estimated Osm. Ex: Na+= 145. 145x2=290, 290 would be the estimated Osm/L.

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35
Q

Define electrolyte:

A

solutes that form ions

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37
Q

A cation will have a______ charge, while an anion has a ________ charge.

A

positive, negative

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39
Q

What are the body’s major electrolytes that are cations?

A

Na+, K+, Ca++, Mg++

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41
Q

What are the body’s major electrolytes that are anions?

A

Cl-, HCO3-, HPO4–, SO4-

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43
Q

What is the largest determinant of Osm?

A

sodium level

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45
Q

Sodium is necessary for regulation of: a. blood & body fluids b. transmission of nerve impulses c. heart activity d. metabolic functions e.all of the above

A

e

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47
Q

What is the normal values for Na+?

A

135-145 mEq/L

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49
Q

This electrolyte is important for controlling INTRACELLULAR Osm, esp. in heart cells.

A

potassium

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51
Q

Potassium is important because it:

A
  1. regulates heart and muscle contractions 2. plays a role in nerve impulse conduction
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53
Q

Potassium is eliminated by:

A

the kidneys

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55
Q

T or F: Potassium affects the excitability of muscles.

A

TRUE

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57
Q

What is the normal potassium value?

A

3.5-5.0 mEq/L

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59
Q

Renal problems can cause __________ in relation to K+

A

hyperkalemia

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61
Q

Insulin will cause K+ to move from ____________ to _____________

A

ECF to ICF

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63
Q

Acidosis, trauma, and exercise cause K+ to move from ______________ to______________

A

ICF to ECF

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65
Q

Sugar, lipids, amino acids, uric acid, urea, and creatinine are examples of:

A

non-electrolytes

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67
Q

The major functions of HCO3 and H are:

A

acid/base balance

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69
Q

The electrolyte in charge of skeletal integrity, coagulation, neurotransmitters, and cardiac conduction is:

A

Calcium

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71
Q

The electrolyte involved in skeletal, energy/ATP is:

A

PO4

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73
Q

The electrolyte whose main functions include GI, neuro, and cardiac is:

A

Mg

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75
Q

T or F: Fluid/electrolyte disorders are when fluids and electrolytes interact with eachother to cause a harmful response for the host.

A

FALSE. Fluid/electrolyte disorders occur when there is a problem with the balance between electrolytes and fluids.

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77
Q

When a person drinks too much water they are at risk of________________in terms of electrolytes.

A

dilution

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79
Q

When a person does not drink enough water they are at risk of ________________ in terms of electrolytes.

A

increased concentration

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81
Q

What are the two main pressure gradients in our bodies?

A

hydrostatic pressure, oncotic pressure

83
Q

What are two examples of hydrostatic pressure?

A

blood pressure, blood volume

85
Q

Oncotic pressure refers to:

A

plasma proteins

87
Q

ADH, aldosterone, renin-angiotensin, PTH, and naturietic hormone all work to:

A

regulate the fluid and electrolyte balance in our bodies

89
Q

What is the main function of the kidneys?

A

to maintain a normal ECF level/concentration

91
Q

T or F: Osmosis is the movement of solutes from an area of high to low concentration across a semi-permeable membrane.

A

FALSE! OSMOSIS refers to the movement of water NOT solutes.

93
Q

Define diffusion:

A

The movement of SOLUTES from an area of high concentration to low concentration across a semi-permeable membrane.

95
Q

What is the purpose of osmosis and diffusion?

A

to reach equilibrium on both sides of the membrane

97
Q

Cell membranes have ______________________, which means some solutes cross freely, some cross with assistance, and others do not cross at all.

A

selective permeability

99
Q

_______________ refers to an IV solution that contains small particles that can eventually cross semi-permeable membranes while a __________ IV solution contains large protein or sugar molecules that cannot cross membranes.

A

crystalloid, colloid

101
Q

Define isotonic solution as it relates to IV fluids:

A

a solution that has a concentration of solute equal to that of normal body fluids

103
Q

What is an example of an isotonic IV fluid?

A

Normal saline

105
Q

Infusing a patient with an IV of .9%NSS (normal saline solution) will create what change in regards to body fluids?

A

No change-.9% is the same concentration as our body’s fluids, so fluid will stay where it is.

107
Q

Define hypotonic solution in terms of IV fluids:

A

A solution with a solute concentration less than normal body fluids

109
Q

What is an example of a hypotonic IV solution?

A

D5.45%NS (5% dextrose in half normal saline)

111
Q

When infusing a patient with D5.45%NS, what will happen internally in regards to body fluids?

A

The IV solution will move from the intravascular space(portal of entry) into the interstitial space and into body cells

113
Q

What is the danger of a hypotonic IV solution?

A

can cause cells to rupture

115
Q

Define hypertonic solution in terms of IV fluids:

A

The particle concentration of the solution is higher than that of normal body fluids

117
Q

What is an example of a hypertonic IV solution?

A

3.0% NaCl

119
Q

Infusing a patient with an IV of 3.0% NaCl will create what change in regards to body fluids?

A

Fluid will move out of cells into the intravascular space (poratl of entry for IV fluid)

121
Q

What is the danger of using a 3.0% NaCl solution?

A

Can cause cells to shrivel up and die

123
Q

Define hydrostatic pressure:

A

any pressure that is exerted by a liquid within a closed system, such as blood as it presses against vessel membranes in response to pumping of the heart

125
Q

The overall osmotic effect of colloids, such as plasma proteins, is called the ________________ or _______________.

A

oncotic pressure, colloid osmotic pressure

127
Q

Oncotic pressure tends to pull water__________________

A

into the circulatory system

129
Q

Albumin cannot move through normal capillary pores, while water and smaller structures can move freely. Na+ is highly attracted to albumin, thus, together they maintain __________________ by attracting water into the intravascular space.

A

oncotic pressure (or colloid osmotic pressure)

131
Q

This pituitary hormone controls water reabsorption-has direct control over how much fluid is excreted in urine

A

ADH

133
Q

This adrenal hormone controls Na+ absorption and plays a major role in Na+ balance and volume

A

aldosterone

135
Q

Aldosterone is stimulated by:

A

a decreased Na+ volume to the kidneys

137
Q

This hormone is in charge of Na+ excretion

A

naturietic hormone

139
Q

This hormone controls Ca++ levels

A

PTH

141
Q

What is the function of erythropoietin?

A

triggered by decreased oxygen delivery in the kidneys, stimulates bone morrow to produce RBC’s in response to tissue hypoxia

143
Q

List the steps that occur in the renin-angiotensin response

A

START: angiotensinogen circulates in blood stream ->Renin secreted by kidneys in response to low blood pressure -> renin converts angiotensinogen into Angiotensin I -> Enzyme in lungs -> Angiotensin II -> (2 effects) 1. aldosterone secretion stimulated =increased Na+ and water retention 2. vascular smooth muscle constricts

145
Q

What is the goal of the renin-angiotensin response?

A

To increase blood volume, thus, increasing blood pressure

147
Q

Kidney function is totally dependent on:

A

blood flow

149
Q

What is the normal level for Cl?

A

95-104 mEq

151
Q

What is the normal value for HCO3?

A

22-26

153
Q

What is the normal serum Ca level?

A

8 to 10

155
Q

What is the normal value of P?

A

2 to 4

157
Q

What is the normal value of Mg?

A

1.5-2 mEq

159
Q

What is a normal BUN?

A

10 to 20

161
Q

What is a normal creatinine?

A

.5-1

163
Q

What is a normal Osm?

A

280-300 mOsm/dl

165
Q

What is a normal specific gravity?

A

1.0010-1.0020-the higher the #, the more diluted the urine

167
Q

What is an absolute minimum urine output?

A

20-30 ml/hr

169
Q

What are 2 examples of fluid status indicators one could sue during a physical exam?

A

mucous membranes, turgor

171
Q

What is a fluid status indicator that could be used in a blood test?

A

hemotocrit

173
Q

A BUN test measures:

A

plasma-a direct measure of kidney finction.

175
Q

A high BUN indicates:

A

the kidneys are not concentrating urine

177
Q

Fluid status indicators in urine include:

A

output (volume), specific gravity (concentration), electrolytes (Na+, K+)

179
Q

Observable manifestations of fluid status may include:

A

Drop in urine output, dyspnea, hypertension, hypotension, shock, hemodilution, hemoconcentration

181
Q

Excess fluid volume in intravascular compartment is known as:

A

hypervolemia

183
Q

Excess interstitial fluid is called:

A

edema

185
Q

Excess fluid inside cells is called:

A

Intracellular (IC) swelling

187
Q

IC swelling can cause

A

hypoxia

189
Q

Impeding movement between vascular & interstitial space, decrease in capillary flow d/t increase tissue pressure, and interference w/ organ function are all complications due to:

A

edema

191
Q

Define interstitial edema(3rd spacing):

A

increase in filtration and/or decrease in reabsorption due to altered capillary forces

193
Q

What are the 4 mechanisms of 3rd spacing(interstitial edema)?know for test

A

massive inflammation, venous obstruction, increased blood volume, low serum albumin

195
Q

T or F: 3rd spacing is always due to a fluid excess in the body.

A

FALSE-a distribution problem, not necessarily related to amount of fluid in the body

197
Q

3rd spacing can effect what regions inside the body?

A

interstitial spaces (edema) or potential spaces (effusion) ex: in heart, lungs, joint cavities, chest cavity

199
Q

Dyspnea, crackles, decreased urine output, irregular RR, HR, BP, and peripheral edema are all signs of:

A

congestive heart failure

201
Q

A decreased blood volume capable of causing hypotension, tachycardia, and decreased urine output is:

A

hypovolemia

Pathopharm (11 decks)

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