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IV Therapy - WK3
Electrolytes
| Question | Answer |
|---|---|
| Body fluid compartments | celluar water: 40% Interstitial Water: 15% Intravascular water (plasma): 5% Total body weight: 60% |
| Fluid Function | Maintains blood volume Regulates body temperature Transports material to and from the cell Serves as aqueous medium for cellular metabolism Assists digestion of good food through hydrolysis Acts as a solvent in which solutes are available for cell fu |
| Passive transport | diffusion, filtration, osmosis |
| Diffusion | passive movement of water, ions and lipid soluble molecules randomly in all directions from a region of high concentration to low concentration. |
| Filtration | transport of water and dissolves substances from a region of high pressure to low pressure - The force that moves it is hydrostatic pressure. |
| Osmosis | movement of water from low concentration to area of high concentration across a semi-permeable membrane. Between intracelluar to extracellular fluid compartments. |
| Active transport | ATP released from cell membrane – can't pass thru w/o energy (ATP) -Certain molecules can't pass thru w/out a pump (sodium-potassium pump) |
| Sensible fluid loss | measurable – urine output, anything that comes thru the GI tract, lose about 100 to 200 mL/day thru GI |
| Insensible fluid loss | unmeasurable – lose about 500 to 1000 mL/day of insensible fluid loss; we lose 300-500mL of fluid from lungs/day; 500mL/day from skin – increased by activity; fever; takes about 72 hours for intake and output to balance out- Renal and burns pts rehydrate |
| Renal system | main regulator of sodium in body – monitors arterial pressure in the body (low pressure = holds sodium); regulates fluid vol, electrolyte values, and pH of extracellular fluid; excretes metabolic wastes and toxic substances. Kidneys filter 170 L/day (avg |
| Cardiovascular system | pumping of cardiac muscle creates blood flow to kidneys under pressure; 20% of circulating blood vol reaches kidneys; receptors in carotid sinus and aortic arch to monitor the stretch in the vessel wall. If not stretching “hypovolemic” (pressure is low) |
| Lymphatic system | back up to cardiac system; carries excess interstitial fluid, protein, and large particle matter and returns to circulatory system; total vol/min 1.7 mL/min |
| Respiratory system | main regulatory organ for fluid and acid based balance; done by regulating hydrogen ions; the medula controls lungs by regulating carbon dioxide levels in extracellular fluid. |
| Endocrine system | adrenal, pituitary and parathyroid glands – each gland produce hormones which help maintain homeostasis. |
| Antidiuretic hormone | ADH comes from pituitary and influences reabsorption of water; ADH controlled by extracellular volume; blood vol decrease of 5-10% will cause max increase of ADH hormone; certain meds, severe head trauma, lung and brain tumors can affect how well ADH horm |
| Parathyroid hormone | regulates calcium and phosphate balance by increasing calcium and decreasing phosphate levels. |
| Aldosterone | comes from adrenal cortex; causes kidneys to reabsorb sodium; if sodium is reabsorbed we are retaining water as well as chlorides – potassium is excreted. |
| Epinephrine | adrenal hormone that increases b/p; causes us to breathe, dialates blood vessels; |
| Cortisol | adrenal cortico hormone from adrenal gland causing sodium and fluid retention |
| Osmolarity | refers to osmolar concentration in 1L of solution (referring to fluid outside of the body) |
| Osmolality | refers to osmolar concentration in 1Kg of water (Inside of the body) |
| Extracellular fluid volume deficit etiology | excess loss of body water or inadequate compensatory intake; GI dysfunction — most common Use of diuretics, diaphoresis Third spacing – accumulation of fluid in the interstitial space |
| Extracellular Fluid Volume Excess etiology | usually caused by organ dysfunction |
| Extracellular Fluid Volume Excess signs and symptoms | Weight gain, htn, Shortness of breath, Hyperventilating, crackles, tachycardia |
| Central Venous Pressure | CVP is important to monitor in fluid volume excess - distended jugular vein |
| electrolytes | have more than one physiologic role; They often work together to mediate chemical events |
| Ions | Dissociated particle of an electrolyte that carry an electrical charge Positive – cations(Na+, K+, Ca+, Mg++) Negative – Anions (Cl–, HPO4–, HCO3–) |
| four cations that are the most commonly administered via parenteral infusions | Sodium — Na+ Potassium — K+ Calcium — Ca+ Magnesium — Mg++ |
| mEq measures | measures chemical activity by combining power |
| milligrams measures | measures weight |
| Acid-base balance depends on the regulation of free hydrogen ions (H+) | When (H+) concentration increases, pH decreases: acidosis When (H+) concentration decreases, pH increases: alkalotic Recipricol relationship |
| Frequent assessments for electrolyte imbalances | Monitor: Neuro, cardio, skin, resp, head to toe; Lab Values, EKG, signs of fluid overload, phlebitis, ABG (arterial blood gases), Digoxin toxicity, I&O, confused pt |
Created by:
MarieG
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