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NUR151-Evolve1-test2

Extra Evolve Resources for Test 2 - Part 1

QuestionAnswer
Exchange in both directions between plasma and interstitial fluid is governed by? diffusion, oxmotic factors, and hydrostatic pressure.
Colloid osmotic pressure is caused by? proteins
Osmotic pressure is created by sodium
Capillary fluid flow is related to difference of pressure between arterial and venous ends of capillaries
What pushes water, electrolytes, and nutrients through capillary walls? arterial hydrostatic pressure (caused by pumping action of heart)
What pulls water, electrolytes, and cell waste into capillaries? venous colloid pressure (caused by plasma proteins)
What elements are carried between the blood and cells? oxygen, co2, nutrients, cell waste, and electrolytes.
What helps govern the movement of materials between the blood an cells? diffusion, hydrostatic pressure, osmotic pressure, colloid osmotic pressure
Fluid shifts can occur in several ways decreased vacular colloid osmotic pressure, increased capillary hydrostatic pressure, increased capillary permeability, lymph obstruction.
What results in low colloid osmotic pressure? A decrease in serum protein due to malnutrition, burns, nephrosis, or liver disease
What would be the result of low colloid osmotic (oncotic) pressure? Less water pulled into the blood vessels from the interstitial spaces.
Colloid oncotic pressure pulls fluid back into blood vessels at the venous end of the capillary bed.
If less water is pulled back into the blood vessel from the interstitial space, total blood volume will decrease.
Increase in capillary hydrostatic pressure can cause fluids and solutes to be forced out of blood vessels which would increase the amount of fluid in the interstitial space.
What causes proteins to leak into interstitial space? burns or trauma
What conditions would cause vasodilation? inflammation, burns, or allergic reactions – causes increased capillary permeability and causes edema.
Obstruction to lymph capillaries would creat? edema because lymph fluid is forced out into the interstitial space.
Hypervolemia is? Na and water excess – occur during excess Na+ intake, heart failure, aldosteronism, cushing’s syndrome, corticosteroid drugs.
During hypervolemia, serum sodium levels may be normal or decreased.
During hypervolemia, BUN levels would be low
Hypovolemia will activate all regulartory mechanisms like – kidneys, adrenal gland, ADH, CNS – body will attempt to conserve water and Na+ to increase blood volume.
Hypovolemia results in? lower CO, reduced BP, and decreased renal blood flow – ADH secretion increases, and the renin-aldosterone-angiotensin mechanism is triggered.
Reduced renal blood flow results in? activation of the renin-angiotensin-aldosterone mech
Low blood volume reduces stretch on carotid Baroreceptors which then thriggers? ADH relase from anterior pituitary gland.
What is “third spacing”? a shift of fluid from vascular bed to interstitial space – vascular volume is reduced, but person will have edematous tissue – caused by lymph obstruction, heart failure, decreased plasma proteins of malnutrition, burns, kidneys, inflammation, or kidney d
Signs of hypovolemia? drop in BP, urine output less than 30 mL/hr, weak rapid pulse, dry mucous membranes, low body temp, flat neck veins.
Pregnant woman has edema due to? pressure of baby on veins increasing venous hydrostatic pressure.
Why patient has edema due to thermal burns? increased capillary permeability allows protein molecules to go to the third space
During hemorrhage, heart rate increases
Which assessment finding would be indicative of fluid volume excess? moist rales
If person hemorrhages, what compartment is losing fluid? vascular
If fluid moves from interstitial space to blood, what would skin have? dryness with poor turgor.
If decrease in ECF volume, it becomes hypertonic and the ___ stimulate the ___ to increase ADH output. hypothalamus, pituitary
What influences thirst and ADH output? osmolarity – rapid secretion of ADH will occur with high solute concentrations.
What occurs when we are thirsty? ADH secreted, Renin-angiotensis-aldosterone activated, water and sodium retained, urine output decreases.
Glucose attracts? water – it is an osmotic diuretic
If blood sugar is high and kidneys filter out some of the excess sugar, what will be the result? water will be eliminated
If water follows glucose out of the kidney, total blood volume will then decrease
What are the main negatively charged intravascular fluid anions? plasma proteins – the pull water into vascular space and balance the positive charge of sodium in osmolarity.
Concentration of plasma proteins is greater in vascular bed
ADH acts on? renal collecting tubes
How will increased osmolarity affect ADH output? It will cause the pituitary to release ADH.
What effect do prostaglandins have on renal capillaries? It dilates them and increases blood flow to kidneys.
If patient has lost vascular volume, their skin would be? Cold and clammy
What would patient with high blood sugar and sugar in the urine experience regarding urine output and blood volume? output would increase (due to glucose pulling water), and blood volume would increase (due to diuresis).
If hydrogen is greater than potassium, kidney tubules will secrete Hydrogen instead of potassium – causing serum potassium levels to rise.
Increased potassium levels stimulate aldosterone release from adrenal gland with promotes potassium loss in the urine.
Potassium balance effects cells how? cells will fire excessively with little stimulation or will barely respond to stimulation.
How does hypokalemia affect the heart? Arrest can occur
Hypokalemia can result in metabolic alkalosis
Hypokalemia will result in __uria poly
What kind of fibrillation will occur with hypokalemia? ventricular and PVC
Hyperkalemia results in __uria olig or anuria
What will potassium levels be in patient with burns? high – because cell damage has occurred and potassium is leaking out.
Which hormone is essential in control of potassium? aldosterone
In metabolic acidosis (high hydrogen and low pH), what would be serum potassium levels? high serum potassium and increased urinary hydrogen.
With increase or decrease in potassium levels, you would assess for changes in? cardiac rhythm
What nursing action is appropriate with a patient who had had potassium chloride added to the IV for several days? ask for lab work; observe for bradycardia
Which natremia is relatively uncommon? hyponatremia – due to excess water
Hyponatremia does what to person’s mental state? confusion, seizures
Created by: Ladystorm
 

 



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