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SOPN Fluid & more 3
SOPN Fluid and Electrolytes Test 3
| Question | Answer |
|---|---|
| Homoestasis | state of equilibrium in the body, naturally maintained by adaptive responses. |
| Fat contains little | water |
| Intracellular fluid (ICF) | 2/3 to 3/4 WITHIN THE CELL (42% of body weight) |
| Extracellular fluid (ECF) | 1/3 to 1/4 OUTSIDE THE CELL (1/3 body weight) |
| Intravascular (plasma) | fluid of the body vessels |
| Interstitial | fluid that surrounds the cells and includes lymph |
| Transcellular | small part of ECF (extracellular fluid). INCLUDES: fluid in the cerebrospinal fluid, GI tract, pleural spaces, synovial spaces, and peritoneal spaces |
| Edema | extracellular water pools in the extremeidities |
| average daily intake of fluid for adult | 2000-2500 ml / day |
| 4 ways water is excreted from the body | SKIN - LUNGS - FECES - KIDNEYS(mostly thru kidneys) |
| body fluid lost must be replaced in an effort to maintain what? | homeostasis |
| external influences that effect fluid balance of the body | temperature and humidity |
| Electrolytes are lost primarily through the | kidneys |
| cations | positively charged ions |
| anions | negatively charged ions |
| what fluid has a greater amount of protein due to its large size and general inability to pass thru capillaries due to its mamma jamma size | intervascular fluid |
| favors sodium re-absorption and excretion of potassium | aldosterone |
| mechanisms by which H2O and solutes move are: | diffusion, fecilitated diffusion, active transport, osmosis, hydrostatic pressure, and oncotic pressure |
| diffusion *REQUIRES NO ENERGY* | movement of molecules from a higher concentration to an area of lower concentration |
| Facilitated Diffusion *WITHOUT ENERGY* | Movement from high to low concentration |
| active transport | process in which molecules move against concentration gradient |
| what is required in the form of ATP, which is produced by the cells mitochondria | External Energy |
| Osmosis * REQUIRES NO ENERGY* | movement of water between two compartments by a membrane (semi-permeable) to water but not to solute |
| osmolarity | amount of pressure required to stop osmotic flow of water |
| The presence of protein in the intravascular fluid creates a pressure called *WHAT* whose function is to hold water in within the compartment | Colloid Osmotic Pressure |
| Major force that pushes water out of the vascular system at a capillary level | Hydrostatic Pressure |
| In blood vessels, hydrostatic pressure is the pressure generated by what means | contraction of the heart |
| Three hormones that play a vital role in maintaining fluid and electrolyte balance | ADH * ALDOSTERONE * PARATHRYOID HORMONE |
| Produced and stored in the hypothalamus but released from the posterior pituitary gland | ADH |
| Acts on the renal tubules to retain water and to decrease urinary output | ADH |
| secreted by the adrenal cortex and acts on the renal tubules to reabsorb sodium and excrete potassium | ALDOSTERONE |
| Increases circulatory volume by reabsorbing water along with sodium | ALDOSTERONE |
| produced by the parathyroid and promotes absorption of Calcium from the intestine | Parathryoid Hormone |
| Promotes release of calcium from the bone and increases the excretion of phosphate ions from th kidney | Parathryoid Hormone |
| What is the site of action for ADH and ALDOSTERONE | renal tubules |
| primary organs for regulating fluid and electrolyte balance | KIDNEYS |
| what activity can lead to signigicant fluid and electrolyte loss | diarrhea and vomitting |
| reduced thirst mechanism leads to | decreased fluid intake |
| what is determined by the total number of particles dissolved in a UNIT OF SOLVENT | osmolarity |
| what is the normal osmolarity of the body fluid | 300 milimoles per kg of water |
| ISOMOLAR | same osmolarity as body fluids |
| Hypo-Osmolar | less osmolarity than body fluids |
| Hyperosmolarity | greater osmolarity than body fluids |
| a loss of water in EXCESSSSSSS equals | dehydration |
| ECF (extracellular) fluid volume deficit | hypovolemia |
| hypovolemia | abnormal loss of normal body fluids ie: diarrhea, fistula drainage, hemorrhage) |
| treatment for hypovolemia | replace water and electrolytes with balanced IV solutions |
| Another name for extracellular fluid deficit | Iso-osmolar fluid deficit |
| sodium ions constitute most of the osmolarity of extracellular fluid. If *BOTH* water and sodium are lost the result is......extracellular fluid becomes depleated and circulatory blood volume is decreased | Iso-osmolar volume loss |
| Iso-osmolar fluid volume loss causes what conditions/ | Hemorrhage, GI losses, profuse diaphoresis |
| Nursing interventions for Isoosmolar fluid deficit | postural vital signs |
| Hyperosmotic | when more water is lost from the body than sodium or other electrolytes ORRRRR when intake is inadequate to replace normal losses then the extracellular fluid becomes.... |
| When water moves out of the cell by OSMOSIS to dilute extracellular fluid what can occur | cellular dehydration |
| nursing interventions for hypersomplarity | mouth care, safety, I&O |
| fluid volume excess | hypervolemia |
| Hypo-osmolar fluid EXCESS | excess of H2O without an increase in electrolytes. Water enters the cell through osmosis causing the cell to swell |
| Occurs when fluid intake EXCEEDS kidney excretion | Hypo-Osmolarity |
| When would you see excessive amounts of ADH | acute stress, trauma, or surgery |
| Low blood flow is seen | CHF or renal insufficiency |
| anasarca | term used for accumulation of large amounts of fluid in all body tissues |
| Thiazides | block sodium reabsorption by the renal tubules ie: chlorothiazied and hydrochlorothiazide |
| Loop Diuretics | act on the Loop of Henle: Lasix, Edecrin, Bumex |
| Aldosterone antagonist = potassium saver | aldactone |
| if EDEMA is caused by decreased intravascular ONCOTIC pressure then what is given | Albumin |
| No single electrolyte can be out of balance without what result occuring | all other electrolytes being out of balance |
| Na - K - Ca are all essential for? | passage of nerve impulses. Any increase of decrease of these substances is reflected in the stimulation of muscles or nerves |
| decrease of what in body fluids causes the stimulus to be increased and results in muscle spasms? | CALCIUM............happy cows! |
| Hypernatremia | sodium excess level greater than 145normal level is 135 - 145 |
| primary protection from thirst comes from the | hypothalamus |
| what causes hypersmolarity leading to cellular dehydration (more water than sodium is lost from the body) | hypernatremia |
| what would you use to remove salt from water | diuretics |
| if sodium levels in the body are severe how would you treat it? | renal dialysis |
| serum sodium levels must be reduced gradually to avoid what condition? | cerebral edema |
| Sodium level up what would you do to remedy? | DEXTROSE |
| ecf | extra cellular fluid |
| ics | intercellular space |
| polydipsia | patients who excessively drink fluids to where they become hypernatremic and could potentially DIE (also have a lack of ADH) |
| polydipsia is almost always associated with what condition | diabetics |
| results from loss of sodium-containing fluids or from water excess. (potential complications: severe neurologic changes | hyponatremia |
| nursing implementation for hyponaremia | fluid restriction is needed, seizures (give a small amount of IV hypertonic saline solution 3% NaCl) |
| Major ICF cation normal level 3.5 - 5.0 and is necessary for the transmission and conduction of nerve and muscle impulses, maintance of cardiac rhythms, and acid-base balance | potassium |
| where can you find potassium | fruits - veggies - bananas and oranges - salt substitutes - potassium medications - Stored Blood |
| whenever there is severe tissue damage WHAT is released from the cells into the extracellular fluids? | Potassium |
| A patient with renal insufficiency should not be given what | potassium |
| nursing intervention for hyperkalemia | IV 10% glucose with 50 units regular insulin to induce transfer of K from the serum to the intracellular fluid. (NEED INSULIN TO AID IN TRANSPORT) |
| hypokalemia below 3.5 | whenever sodium is being retained in the body through reabsorption by the kidney tubules, K is excreted. |
| what could be lost in the urine as result of diuretics such as lasix | Potassium |
| When a patient is being treated for acidosis and alkalosis what shifts into the cells | Potassium |
| Manifestations of hypokalemia | diminished deep tendon reflexes, muscle weakness, leg cramps, N/V, anorexia, decreased gastric motility, lethargy **** MOST SERIOUS are cardiac arrthymias, EKG changes, weakness of respiratory muscles |
| To prevent hyperkalemia and cardiac arrest | never give potassium IV PUSH |
| what must be maintained for the functioning of neuromuscular irritability and blood clotting | Normal Calcium level |
| Two forms of calcium present in the blood | free ionized calcium & calcium bonded to protein |
| most calcium is formed where | bones |
| what is needed to form bones and teeth | calcium |
| What 2 things are needed fro the absorption of calcium from the GI tract and re-absorption of calcium from bone to maintain normal levels | parathyroid hormone and Vit D |
| pathological fracture | bone breaks for no good reason or a bad one either for that matter |
| Hypocalcemia manifestations | Positive Trousseau's orrrrrChvostek's Sign |
| Phosphate 2.5 - 4.5 | primary ion in the ICF. Essential to function of muscle, red blood cells, and nervous system. Deposited with calcium for bone and tooth structure |
| You need phosphate to absorb what? | GLUCOSE |
| Magnesium | co-enzyme in metabolism of protein and carbohydrates. Acts directly on myoneural junction, important for normal cardiac function |
| HYPOMAGNESEMIA | prolonged fasting or starvation. Chronic alcoholism. Diuretics can cause what condition? |
| D5W | isotonic, 170 cal, free water.INCREASES RENAL SOLUTE EXCRETION. SUGAR AND WATER NOOOO ELECTROLYTESused to replace water losses and treat hyponatremia |
| NORMAL SALINE | isotonic. no calories. more NaCl than ECFPREFERRED FLUID FOR IMMEDIATE RESPONSE*RISK FOR FLUID OVERLOAD IS HIGHER* |
| Lactated Ringer | isotonic ---expands ECFHAS OSMOTIC PRESSURE SIMILIAR TO BODY |
| D5 1/2 NS | ****HYPERTONIC***common maintenance fluid and KCl added for maintenance or replacement |
| D10W | *HYPERTONIC* provides 340 calories per LiterFREE WATER limit of dextrose concentration may be infused peripherally |
| Plasma Expanders | stay in vascular space and increase osmotic pressure. COLLOIDS (protein solutions) packed RBC's, Albumin, Plasma |
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Beezle
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