Week 6: Fluid Homeostasis and Imbalances

Question 1

What are 3 main functions of body fluids?

Answer 1

1. Solvent
2. Transportation of oxygen, nutrients, hormones and chemicals, waste products
3. Regulation of body temperature

Question 2

What is total body water of women and men? (TBW). The percentage of TBW decreases with what?

Answer 2

60% of body weight is water in men
50% of body weight is water in women

• Decreases with age and increasing obesity

Question 3

What % of intracellular fluid (ICF) makes up our body weight?

Answer 3

40% of body weight

Question 4

What % of extracellular fluid (ECF) makes up our body weight?

Answer 4

20%

Question 5

Normal urine output for adults?

Answer 5

0.5-10mL/kg/ h

Question 6

What happens when osmolarity increases?

Answer 6

Osmoreceptors shrink

Question 7

What does hypovolemia mean?

Answer 7

Not enough extracellular fluid

Question 8

6 Causes of hypovolemia?

Answer 8

1. GI losses
2. Third spacing: fluid leaks into abdomen or burns and fluids a lot of blisters
3. Inadequate intake
4. Polyuria (DKA) (Urinating too often)
5. Sepsis (Infection)
6. Insensible Losses

Question 9

What does renin do?

Question 10

What does angiotension I and II do?

Question 11

What is aldosterone?

Question 12

What is ADH?

Question 13

What is ANP?

Question 14

What are CNS findings with hypovolemia?

Answer 14

Mental status changes, sleepiness, apathy

Question 15

What are cardiovascular findings with hypovolemia?

Answer 15

Orthostatic hypotension, tachycardia

Question 16

What are skin findings/ changes with hypovolemia?

Answer 16

Poor skin tugor, hypothermia, pale extremities, dry tongue

Question 17

What are kidney/ renal changes with hypovolemia?

Answer 17

Oliguria (urinary output less than 400 ml per day or less than 20 ml per hour) and acute kidney injury

Question 18

For treatment of hypovolemia- Urine output should be maintained at what?

Answer 18

0.5-1 mL/kg/h

Question 19

What causes hypervolemia?

Answer 19

Fluid-retaining states: congestive heart failure (CHF), nephrotic syndrome, liver cirrhosis, end stage renal disease (ESRD)

• Or iatrogenic (parental overhydration)

Question 20

What are general clinical manifestations of hypervolemia?

Answer 20

• weight gain
• peripheral edema or pulmonary/ ascites
• jugular venous distention
• pulmonary rales
• low hematocrit and albumin concentration

Question 21

What are treatments for hypervolemia?

Answer 21

• Fluid restriction
• Judicious use of diuretics
• Monitor urine output and daily weights