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NURS2500: Pathophysiology/Pharmacology/Assessment > Week 5 - Osmolality > Flashcards

Week 5 - Osmolality Flashcards

1
Q

What is osmolality?

A

-indicator of water balance (concentration)

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2
Q

What is the range for N Plasma Osmolality?

A
  • 285-295 mOsm/kg
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3
Q

What does it mean if plasma osmolality is higher than >295?

A

water deficit - too little water or too much solute

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4
Q

What does it mean if plasma osmolality is less than 285?

A

Water excess - too little solute or too much water

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5
Q

Cells are affected by osmolality of fluids around them. What osmolality do isotonic fluids have? (2)

A
  • equal osmolality
    aka neutral concentration between ICF and ECF
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6
Q

What osmolality do hypertonic fluids have?

A
  • have higher osmolality (shrinks cells)
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7
Q

What osmolality do hypotonic fluids have?

A
  • have lower osmolality (swell cells)
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8
Q

Fluid shifts diagram*

A
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9
Q

Which area of the brain is responsible for regulation of water balance?

A
  • hypothalamus-pituitary gland in brain
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10
Q

What is the mechanism in which the hypothalamus regulates water balance? (4)

A
  1. Hypothalamus osmoreceptors sense increased osmolality
    - too many particles, not enough fluid
  2. Thirst triggered (decreased in older adult)
  3. ADH released from pituitary gland
    - in kidney, free water absorption (not Na)
  4. ADH release can be triggered by increased plasma osmolality, stress, nausea, nicotine, and morphine
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11
Q

Why happens to osmolality if you are dehydrated?

A
  • osmolality goes up and thirst is triggered
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12
Q

Must know RAAS, in perfusion unit

A

ok

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13
Q

What is aldosterone’s role in the kidneys?

A
  • stimulates kidneys to reabsorb water and sodium
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14
Q

What is the role of ADH? (2)

A
  • kidneys reabsorb more water, not Na+
  • This dilutes our blood so the Na+ concentration drops
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15
Q

What occurs in the GI regulation of water? (2)

A

Intake: source of new water for the body
Output: Diarrhea and vomiting may lead to excessive water loss and electrolyte loss
In lecture, hypokalemia and decreased water

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16
Q

What occurs in the genitourinary regulation of water? (2)

A
  • Output: Urine
  • Renal excretion provides largest output
17
Q

What is insensible water loss? (3)

A
  • water loss from breathing and insensible perspiration (water only)
  • excessive sweating (sensible perspiration) may lead to excessive water and electrolyte loss (fever, hot environment)
  • water used in metabolic processes
18
Q

How much water is lost per day with insensible water loss?

A

900 mL a day

19
Q

What are age-related considerations that increase the risk of imbalances? (5)

A
  • reduced renal function
  • reduced hormone regulation
  • reduced thirst trigger
  • reduced temperature regulation
  • impaired functional and cognitive ability may interfere with oral consumption of water
20
Q

What are nursing implementations for intake and output of the GI and GU system? (3)

A
  • use of 24h record of I&O
  • types of fluid intake: drinking, eating, IVs, GI tubes
  • Types of fluid output: urine, vomit, diarrhea, sweat, breathing
21
Q

What are nursing implementations for daily weight measurements? (3)

A
  • accurate daily weight estimates volume status
  • rapid increase of 1kg body weight approximates 1000 mL of fluid retention
  • obtained under standardized conditions (same time everyday with the same clothes and scale)
22
Q

What are the sources of fluid and sodium for oral intake? (4)

A
  1. “free” water (“tap” water)
  2. Electrolyte-replacement beverages
  3. Food and other beverages
  4. Caffeine beverages
23
Q

How is free water a source of fluid and sodium? (3)

A
  • no significant Na
  • will provide water to dilute plasma Na
  • if un-needed, kidneys will excrete excess water
24
Q

How are electrolyte-replacement beverages like sports drinks or pedialyte, a source of fluid and sodium?

A
  • provides electrolytes commonly lost through sweat, vomiting, diarrhea as well as water
25
Q

How do food and other beverages provide a source of fluid and sodium?

A

most food also contains water

26
Q

How do caffeine beverages provide a source of fluid and sodium?

A

may result in increased urine output

27
Q

What may occur if a patient cannot swallow food/fluids? (2)

A

GI tube may be inserted down a nasal passage and into the stomach or small bowel
- fluids/liquid foods may be instilled through this tube

28
Q

Fluid volume deficit diagram

A
29
Q

Fluid volume excess diagram

A

NURS2500: Pathophysiology/Pharmacology/Assessment (107 decks)

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