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Nursing Fundamentals

Electrolytes & Acid-Base Balances

FLUID water that contains dissolved or suspended substances such as glucose, mineral salts, & proteins
BODY FLUIDS ARE DISTRIBUTED IN 2 MAJOR COMPONENTS Intracellular fluid (ICF) - inside cells 2/3 body water Extracellular fluid (ECF) - outside cells 1/3 body water
INTRACELLULAR inside cells
INTRAVASCULAR within blood vessels
INTERSTITIAL within tissues
ELECTROLYTES mineral salts, separates into ions when dissolved in water; measured in milliequivalents (mEq)
IONS charged particles
CATIONS + positively charged ions
ANIONS - negatively charged ions
NA Sodium 135 - 145 mEq/L
K Potassium 3.5 - 5 mEq/L
Ca Calcium 8.4 - 10.5 mg/dL
Mg Magnesium 1.5 - 2.5 mEq/L
ACTIVE TRANSPORT energy-requiring movement of electrolytes or other substances across cell membranes against a concentration gradient --> low concentration to high concentration --> requires ATP
DIFFUSION passive movement of electrolytes or other particles from an area of high concentration to one of low concentration
OSMOSIS movement of water across a semipermeable membrane from a compartment of low particle concentration to high particle conentration
OSMOTIC PRESSURE inward-pulling force of a particle in any fluid compartment to more concentrated side
HYPERTONIC pull fluid out of the cells by osmosis; causing them to shrink 3% sodium chloride
ISOTONIC SOLUTION same osmolality as normal blood; no shift in or out of cells 0.9% sodium chloride
HYPOTONIC SOLUTION less concentrated than normal blood; causing then to swell 5% in water/dextrose (simple sugar)
FILTRATION net effect of several forces that tend to move fluid across a membrane
HYDROSTATIC PRESSURE the force of a fluid pressing outward against the walls of its container
COLLOID OSMOSTIC PRESSURE an inward pulling force caused by the presence of protein molecules
OSMORECEPTORS continued monitor plasma osmolality; when osmolality increases, the hypothalamus stimulates thirst
INSENSIBLE WATER LOSS fluid loss in the lungs & skin
ADH regulates osmolality of body fluids by influencing how much water is excreted in urine (prevents body to save water)
ALDOSTERONE regulates ECV by influencing how much sodium & water are excreted in urine (water retention)
ANGIOTENSIN polypeptide occurring in the blood, causing vasoconstriction, increased blood pressure & the release of aldosterone from the adrenal cortex
RENIN produces A1 which converts to AZ & causes vasocontriction
ATRIAL NATRIURETIC PEPTIDE (ANP) a hormone that opposes the action of aldosterone & promotes vasodilation
CHLORIDE 95 - 105 mEq/L
BICARBONATE normal arterial 22 - 26 mEq/L normal venous 24 - 30 mEq/L
PHOSPHATE 2.7 - 4.5 mg/dL
BUFFERS pairs of chemicals that work together to maintain normal pH of body fluids
THE BODY HAS 2 ACID EXCRETION MECHANISMS: 1. lungs (excrete carbonic acid ) CO2 2. kidneys (excrete metabolic acid)
ECV EXCESS to much isotonic fluid in the extracellular tissue
HYPOVOLEMIA the decreased vascular volume in ECV deficit (eg: hemorrhage)
HYPERNATREMIA abnormally high NA (salt) concentration in ECF caused by loss of relatively more water than salt or gain of relatively more salt than water
HYPOKALEMIA abnormally high blood K (potassium) concentration
HYPERKALEMIA abnormally high CA concentration in the blood
HYPONATREMIA abnormally low Na (salt) in the ECF, occurs from gaining relatively more water than salt or losing more salt than water
HYPERMAGNESEMIA abnormally high Mg (magnesium)
HYPOMAGNESEMIA abnormally low Mg (magnesium)
HYPOCHLOREMIA abnormally low blood chloride level (eg: alkalosis)
HYPERCHLOREMIA abnormally high blood chloride level (eg: acidosis)
ARTERIAL BLOOD GAS (ABG) method of evaluating acid-base balance & oxygenation
pH 7.35 - 7.45
PaCO2 35 - 45
PaO2 80 - 100
FLUID VOLUME DEFICIT fluid/electrolyte disorder caused by failure of the body's homeostatic mechanism to regulate the retention & excretion of body fluids
FLUID VOLUME EXCESS fluid/electrolyte disorder by an increase in fluid retention & edema, failure of body's retention & excretion of fluids
Created by: Smccunn