Week 8 Flashcards
Total Body water
accounts for 60% of a healthy adult body weight
influenced by age, gender, and overall health
regulate body temp
lube joints
shock absorption for internal organ
transport nutrient and waste
metabolic reactions inside of cells
TBW for ICF
67%
TBW ECF
33%
types of fluid
intracellular (inside cell)
interstitial (between the cell in the tissue)
extracellular (outside cell)
intravascular (inside the vessel)
transcellular (outside the vessel)
composition of fluid
water is responsible for the transport of molecules throughout the body
water is the body’s major solvent
solutes
particles that completely or partially dissolve in a solvent and can be classified as either crystalloid or colloid
crystalloid sollute
small and completely dissolved in solvent
easily passed through capillary veins
intravenous fluids often referred to as crystalloid solution
electrolyte
a type of crystalloid
charged atom molecules measured in milliequivalent per liter of water (mEq/L)
have a positive (cation) and negative
(anion) charge
examples are sodium, potassium, calcium, magnesium, and chloride
nonelectrolytes
molecules without a charge
glucose, amino acid, gases (oxygen and carbon dioxide)
colloid solute
particles that are too large and do not fully dissolved in a solvent
does not easily pass through walls and cell membrane
proteins and starches (albumin and clotting protein)
blood and blood product
difference of TBW
males have 60%
females have 60%
elderly and obese have 45%
osmosis
the passive transport of water between fluid compartments
movement of water in and out of the cells
from low concentration to high concentration
allow water to move across but not solutes
osmotic pressure
solution exerts a force on either side of the selectively permeable membrane
pressure increases as concentration between compartments becomes greater
inward pulling force of solutes that move the water across a semipermeable membrane to an area of higher solute concentration
osmotic pressure in intravascular controlled by concentration plasma protein (albumin)
osmolality
concentration of solute in body fluids
measured in milliosmoles/kilogram (mOsm/kg)
equalizes rapidly
dehydration increase concentration of solute extracellularly cause rapid movement of water from the cells
Filtration
movement of water and solute together between vascular and interstitial compartments
move from high pressure to low pressure
hydrostatic pressure
exerted by fluid in the blood vessel
controlled by arterial blood pressure (heart rate, strength of cardiac contraction, systemic vascular resistance) and blood flow in the capillary bed
capillary hydrostatic pressure is higher on the arterial side than on the venous side
osmotic pressure is lower in the arterial side than venous side
the net effect contribute to constant shifting of water and solute
blood cells and plasma protein does not get filtrated in kidney
oncotic pressure
a type of osmotic pressure (colloid osmotic pressure)
the pressure in intravascular space is controlled by concentration of plasma protein (albumin)
plasma proteins attract water molecules to them and are responsible for water in the intravascular space.
hydrostatic pressure
the outward-pushing force of water against the walls
as blood flows through the capillaries, it pushes (exerts pressure) against the vessel walls
hydrostatic pressure must be greater than oncotic pressure for filtration across capillaries to occur
Edema in patients
means imbalance where hydrostatic pressure is greater than intravascular osmotic pressure leading to a fluid accumulation in the tissue
fluid intake
comes from consumption of fluids or food
some generated from metabolic processes (digestion of carbs)
influenced by habit and social and cultural factors
thirst sensation decrease as a normal part of aging
fluid output
done through kidney (excreted as urine)
loss through diaphoresis, insensible perspiration, and respiration
small amount of loss through feces
aldosterone and natriuretic
regulate extracellular fluid volume
antidiuretic hormone (ADH)
regulate osmolality
high serum osmolality causes the secretion of ADH
cause reabsorption of water in the kidney leading to concentrated urine and less concentration of plasma
low osmolality will prevent secretion of ADH.
This cause a decrease in water reabsorption in the kidney, leading to a dilute urine and concentrated plasma
fluid volume and composition maintain homeostasis by which mechanism
renal system
renin-angiotensin system
secretion of ADH
thirst mechanism
renin-angiotensis-aldosterone system
regular BP and extracellular volum balance
done through vasoconstriction (narrowing) of the arterioles
excretion or reabsorption of sodium and water
the liver releases angiotensinogen and the kidney release renin which turns angiotensinogen into angiotensin I. The lungs release angiotensin-converting enzyme which converts angiotensin I into angiotensin II. Angiotensin II regulates the release of ADH which causes the kidney to release aldosterone and vasoconstriction (increase BP). Aldosterone causes retention in sodium and water in the kidneys which increases extracellular fluid which also increase BP
aldosterone
conserves body water by reducing urine formation and maintaining fluid balance in the body
secreted posterior pituitary gland in response to plasma osmolality which is stimulated in osmoreceptors in the Hypothalamus or decreased plasma volume which stimulates volume receptor
maintain serum osmolality by controlling the amount of water excreted in the urine by having the kidney reabsorb water and reduce urine output
ADH release causes water to move back to the bloodstream and plasma osmolality decreases and return to normal
when osmolality is normalize, the posterior pituitary stop producing ADH (through negative feedback loop)
Thirst mechanism
- osmoreceptor and volume receptor continuously monitor plasma osmolality and volume
- if receptors detect dehydration ( increase in osmolality and decrease in volume)
- posterior pituitary secrets ADH in response to dehydration
- the osmoreceptor stimulates the thirst center in the hypothalamus
- the cerebral cortex produces a conscious awareness of thirst
- as the person drinks, the kidney reabsorbs water and osmolality decrease, restoring homeostasis
which which activity must the nurse carry out immediately before and after administering medication via intermitten IV access device
Flush the intermitten access device with saline before and after medication administration ensures that the medication is properly infused and does not interact with or remain in the access device.
precise control of a 100 mL IV medicaiton is necessasry. Which device will the nurse use to administer the medication
when administering small amounts of intravenous fluids to children such as medication requiring precise control, volume control devices can be used to reduce the risk of fluid and drug overdose.
what are the parts of the primary administration infusion set from top of infusion set to the part that inserts into the IV tubing
spike - puncture IV solution/medication
drip chamber
roller clamp (fast or slow drip)
sliding clamp (stop flow of solution/meds until ready)
protective cap (put on if not infusion)
types of vascular access
peripheral short site –short-term access for less than 1 week for IV drugs and fluids
peripheral midline site–is used for access of 2-4 week
central venous catheter and peripheral inserted central catheter— used when longer terms and central access are needed. not used for short-term use unless the situation calls for it. has greater complications.
which will the nurse gather when preparing to administer a prescribed blood transfusion to a patient
y-set tubing
normal saline
infusion pump
