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Fluid & Electrolytes
Medical Surgical Nursing in Canada - Ch. 19
| Term | Definition |
|---|---|
| Body weight | an excellent indicator of overall fluid volume loss or gain |
| Cations | positively charged molecules |
| Anions | negatively charged molecules |
| Potassium | prevalent cation in intracellular fluid |
| Sodium | prevalent cation in extracellular fluid |
| Diffusion | Movement of molecules from high to low concentration |
| Facilitated Diffusion | Movement of molecules from high to low concentration without energy |
| Active Transport | Process in which molecules move against concentration gradient (an area of lower concentration to an area of higher concentration) |
| Osmosis | Movement of water between two compartments by a membrane permeable to water but not to solute |
| Osmotic Pressure | Amount of pressure required to stop osmotic flow of water |
| Hydrostatic Pressure | Force within a fluid compartment |
| entering the capillary | If our hydrostatic pressure is less than the oncotic pressure we will have fluid |
| leave the capillary | If our hydrostatic pressure is greater than our oncotic pressure we will have fluid |
| Edema | When Plasma-to-interstitial fluid shifts |
| Water deficit (increased ECF/decreased ICF) | Associated with symptoms that result from cell shrinkage as water is pulled into vascular system |
| Water excess (decreased ECF/increased ICF) | Develops from gain or retention of excess water |
| Atrial natriuretic factor | This hormone causes vasodilation and increased urinary excretion of sodium and water when there is increased atrial pressure (from increased volume) |
| Insensible Water Loss | Invisible vaporization from the lungs and the skin, cannot be measured and the individual is unaware that the loss of water occurred |
| sodium | This electrolyte is controlled by kidneys and action of aldosterone and ADH |
| Sodium | Normal values 136-145 mmol/L |
| hypernatremia | Excessive sodium intake with inadequate water intake can lead to |
| Hyponatremia | Results from loss of sodium-containing fluids or from water excess |
| hyponatremia | Manifestations are due to cellular swelling and first appear in CNS |
| osmotic demyelination syndrome with permanent damage to nerve cells in brain | If you correct sodium too quickly it can lead to |
| Potassium | Normal values 3.5-5.1 mmol/L |
| Potassium | If the kidneys are not working, this electrolyte will accumulate at high levels |
| Hyperkalemia | common in clients with massive cell destruction |
| Hyperkalemia | Cardiac disturbances are most clinically significant in this electrolyte |
| Hypokalemia | <3.5 mmol/L |
| Ionized Calcium | Normal Values are 1.15-1.35mmol/L |
| Total Calcium | Normal Values are 2.10-2.50 mmol/L |
| Phosphorus increases | If calcium decreases |
| Hypercalcemia | leads to reduced excitability of both muscles and nerves |
| Hypocalcemia | increased nerve excitability and sustained muscle contraction (tetany) |
| Trousseaeu’s sign | Carpal spasms induced by inflating a blood pressure cuff above the systolic pressure |
| Chvostek’s sign | Contraction of facial muscles in response to a tap over the facial nerve in front of the ear |
| Phosphate | Normal values 1.0-1.50 mmol/L |
| Hyperphosphatemia | Neuromuscular irritability and tetany (related to low serum calcium levels associated with high phosphate levels) |
| Magnesium | Normal Value 0.65-1.05 mmol/L |
| Hypermagnesemia | Deep tendon reflexes lost (as levels increase) followed by muscle paralysis and coma |
| Hypotonic | These solutions provides more water than electrolytes which dilutes the ECF and causes a movement of water from the ECF into the ICF |
| Isotonic | Expands only the ECF and is ideal for fluid replacement |
| Hypertonic | Raises the osmolality of ECF, the higher osmotic pressure causes water to shift out of cells and into ECF |
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