Week 3 Flashcards
___/___ of fluid is intracellular. ___/___ is extracellular.
2/3 ; 1/3
What are some signs and symptoms of fluid deficit?
Decreased turgor Dry bucal area Decreased UO Increased BUN and creatinine Increased HR, RR, temp Decreased BP Decreased weight Thrist Dry/cracked mucous membranes Dizziness Syncope
What are the S/S of excess fluid volume?
Weight gain Edema Crackles Dyspnea Cough Orthopnea Bounding pulse Distension of vessels Decreased BUN/Creatinine Increased BP, RR, HR Headache S3 gallop
Where do electrolytes move towards?
They move towards decreased concentrations, opposite charge and their concentration gradient.
What is facilitated diffusion?
Via a passive protein carrier.
_____ is passive with concentration gradient.
Diffusion
What form of diffusion uses the sodium/potassium pumo?
Active transport.
What is osmology?
Solute to water ratio. osmotic force per unit weight of solvent or the conc. of molecules per weight of water.
What is an isotonic solution?
Equal solute, equal water. Normal Saline, LR.
What is a hypertonic solution?
Less water than solute. 3% NS, 5% NS. (used to treat cerebral edema) used to pull water from the cells.
What is a hypotonic solution?
More water than solute. 1/2 NS. D5W. Used to push water into the cells.
What is the normal range of pH in the blood?
7.35 to 7.45. Measured by H+ concentration.
How does the body usually regulate acids?
Neutralized by bicarb, regulated by the kidneys.
What is the normal CO2 level?
45-35.
What is the normal HCO3 level?
22-26.
What is hydrostatic pressure?
Force within the fluid compartment on the walls, like BP on the blood vessels.
What is oncotic pressure?
Osmotic pressure extended by colloids in a solution, main contributor is protein.
What is hypothalamic regulation?
When plasma osmolarity is sensed to be off by the hypothalamic osmoreceptors. Stimulate the release of ADH for thirst, inducing water reabsorption. Once restored they stop releasing ADH.
What is pituitary regulation?
When the posterior pituitary gland releases ADH under the control of the hypothalamus for more water retention. When it is uneccesarily secreted, water retention occurs. Increases urine osmolality.
What is adrenal cortical regulation?
EFV control influenced by hormonal factors to regulate electrolytes and water through GLUCOCORTICOIDS and MINERALCORTICOIDS.
What are glucocorticoids?
Anti-inflammatory components and increase serum glucose levels. Crotisol in large doses act as both glu and min.
What are mineralcorticoids?
Enhance sodium retention and potassium excretion such as aldosterone.
What is renal regulation?
Kidneys play a key role in electrolyte and water regulation. Filter and excrete wastes and water to produce urine.
What is caridac regulation?
Atrial Natriuretic Factor released by the atria to increase atrial pressure and high sodium serum levels to increase sodium and water excretion.
What is Gastro-Intestinal Regulation?
Water is mostly consumed and processed through the body, chooses to excrete the excess water intake.
What is insensible water loss?
Defined by invisible evaporation of water from the lungs to the skin where also it increases the excretion from the increase in metabolic waste.
What is hypernatremia?
Excess sodium that cannot be maintained by excreting sodium, from extreme water loss where water shifts out of the cells, killing them.
What is the treatment for hypernatremia?
Rapid fluid replacement using isotonic solutions.
What are the symptoms of hypernatremia?
Fever and flushed skin Restlessness Increased fluid retention Edema and extreme confusion Decreased urine output and dry mouth
What is hyponatremia?
Low serum sodium, occuring from loss of sodium, fluids leave the cells leading to cellular edema. Can be caused by IV hypotonic solutions.
what are treatments for hyponatremia?
Fluid restriction, hypertonic IV solutions.
What is euvolemic hypernatremia?
Water increase, but salt doesn’t.
What is hypovolemic natremia?
dehydration due to excessive fluid loss.
What is hypervolemic natremia?
Sodium is diluted due to increased sodium and water, but more water than Na.
What are the symptoms of hyponatremia?
Seizures and stupor Ab cramps, altered mental state Lethargy Tendon reflexes decreased Loss of appetite Orthostatic hypertension Shallow resps Spasms of muscles.
What is hyperkalemia?
High serum levels of K+. Cause by high K+ intake, impaired renal function, fluid shift to ECF, or combo with metabolic acidosis.
What are the treatment options for hyperkalemia?
Nutritional therapy, increase K+ excretion, IV insulin, admin calcium gluconate IV.
What are the symptoms of hyperkalemia?
Muscle weakness Urine production low Resp failure due to muscles Diminished cardiac contractibility Early signs of muscle cramps Rhythm changes
What is hypokalemia?
Low serum levels of K+, from loss of excretion, deficient K+ intake, diarrhea, laxative abuse, vomiting, ileostomy drainage.
What are some treatments for hypokalemia?
Admin KCl, increase K in diet.
What are the symptoms of hypokalemia?
Lethargic Low shallow resps Loss of urine Lethal cardiac changes Leg cramps Limp muscles Low BP and HR.
What is hypercalcemia?
High serum Ca. Caused by hyperparathyroidism and cancers.
What is the treatment for hypercalcemia?
Adim loop diuretic and hydration from IV saline.
What are the symptoms of hypercalcemia?
Confusion Hyperactive reflexes Arrhythmias Muscle Cramps Positive trousseaus Sign of Chvoski's
What is hypocalcemia?
low serum Ca. Decrease in PTH from damage to parathyroid which increases blood pH.
What is the treatment of hypocalcemia?
change in diet, correct cause, Ca infussion, solutions and supplements.
What are the symptoms of hypocalcemia?
Confusion Hyperactive reflexes Arryhthmias Muscle spasms Positive trousseaus Sign of chvostkis
What is hypophosphatemia?
Low serum phosphate. Caused by. malnourishment, alcohol withdrawal, poor O2 delivery.
What is hyperphosphatemia?
High serum phosphate, result of chemotherapy. Causes neuro-muscular irritability. Treat underlying cause, and change diet.
What is hypermagnesemia?
High serum mag. CAused by increased intake and renal insufficiency.
What are the symptoms of hypermagnesemia?
Lethargic EKG changes Tendon reflexes diminished Hypotension Arrhythmias Resp arrests GI issues Impaired breathing Cardiac arrest
What is hypomagnesemia?
Low serum mag. Caused by poor diet, GI problems, fasting, similar to hypocalcemia.
What are the symptoms of hypomagnesemia?
Trouseaus + Weak resps Irritable Trouseaus + Cardiac changes Hypertension Involuntary movements Nausea GI issues
What is hyperproteinaemia?
Caused by high protien levels, rare. Dehydration symptoms
What is hypoproteinemia?
Caused by decreased food intake, starvation, diseased liver, massive burns, loss of albumin.
What are the S and S of hypoproteinemia?
Edema, slow healing, anorexia, fatigue, anemia, low BP, muscle loss.
What are the interventions for hypoproteinemia?
High protein diet, increase carb intake, vitamins.
