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Fluid Movement
Balancing Fluids
| Question | Answer |
|---|---|
| Water evaporation from skin is related to BSA so why are little babies at a higher risk for fluid loss than grown people? | because their BSA relative to their weight is higher when compared to adults |
| Insensible | fluid loss that cannot be measured |
| Sensible | fluid loss that can be measured |
| Sources of insensible fluid loss | breathing – Tachypnea = more loss, bradypnea = less; skin- humidity affects the amount lost |
| What is the average adult intake and output? | 2, 600mL |
| What is the average amount of fluid lost through the skin? | 600mL |
| What is the average amount of fluid lost through the lungs? | 400mL |
| What is the average daily amount of fluid lost through the kidneys? | 1, 500mL |
| What is the average daily amount of fluid lost trough the intestines? | 100mL |
| Account for 2600mL of intake. | 1,500mL liquid intake, 800mL solid foods, 300mL oxidation |
| 5000mL can be lost if this condition is severe. | Diarrhea |
| 1,500mL | average daily liquid intake and average daily amount eliminated by the kidneys |
| 100mL | fluid lost through the intestines |
| 300mL | average amount of water provided to the body by oxidation |
| 800mL | average amount of liquid intake from solid food |
| 600mL | average daily amount of liquid lost through the skin |
| 400mL | average amount of liquid lost through the lungs |
| 40% or about 28 liters | amount of a person’s weight made up of intracellular fluid |
| 20% or about 14 liters | amount of a person’s weight made up of extracellular fluid |
| 75% | amount of extracellular fluid that is interstitial |
| 25% | amount of extracellular fluid that is plasma (intravascular) |
| 80% | the amount of a newborn’s weight that is water |
| 90% | the amount of a premature infant’s body weight that is water |
| 60% | amount of body weight that is water in a lean adult male |
| Increased for the elderly | Risk for fluid imbalance |
| 45% | water content decreases to 45% after age 60 |
| A liquid with equal solute concentration as another | Isotonic |
| What kind of fluid means no fluid shift if found on either side of a semi-permeable membrane? | isotonic |
| Contains less solute concentration than another | Hypotonic |
| What happens to the fluid in a hypotonic solution if placed on one side of a semi-permeable membrane? | Fluid shifts to the more concentrated solution |
| What type of solution is half normal saline considered? | hypotonic – less sodium than blood |
| What type of solution is normal saline? | Isotonic – same sodium as blood |
| Contains more solute concentration than another | Hypertonic |
| Where does fluid go if a hypertonic solution is placed on one side of a semi-permeable membrane? | It is drawn into the hypertonic solution. |
| What type of solution is dextrose 5% in normal saline? | Hypertonic – more solutes than blood |
| Solutes move from an area of higher concentration to an area of lower concentration | diffusion |
| What kind of solution given by IV could cause fluid to shift from the veins to the cells? | hypotonic or half normal saline |
| What kind of solution given by IV could cause fluid to shift from the cells into the blood stream? | hypertonic |
| ATP muscles solutes from an area of lower concentration to an area of higher concentration | Active transport |
| Active transport | ATP is utilized to move solutes from an area of lower concentration to an area of higher concentration |
| What stops all this Fluid Shifting? | balance |
| Osmosis | an area of higher solute concentration soaks up water from an area of lower solute concentration - like a sponge |
| Movement of fluids through capillaries | Capillary filtration |
| Fluid pushing or blood pushing against the capillaries | Hydrostatic pressure |
| Plasma colloid osmotic pressure | The water pulling force of albumin in the intravascular space |
| Reabsorbtion | fluid being pulled back into the capillaries |
| What happens when the pressure inside the capillary is less than the pressure outside of it? | Fluid goes into the capillary |
| What happens when the pressure inside the capillary is more than the pressure outside of it? | Fluid goes out of the capillary |
| What pressure pushes fluid out of capillaries? | hydrostatic pressure |
| What pressure pulls fluid into capillaries? | plasma colloid osmotic pressure |
| A cluster of capillaries that filters blood in the Bowman ’s capsule | Glomerulus |
| 180 Liters | the amount of blood filtered by nephrons in a day |
| 125mL | the amount of blood filtered by nephrons in a minute |
| 1 to 2 Liters | the amount of urine produced from all that filtration of blood, so 178 liters are returned to the body filtered |
| What amount of urine indicates renal failure? | less than 20mL per hour or 500mL per day |
| Two reasons infants and young children pee more than adults | 1) higher rate of metabolism produce more waste 2) less efficient kidneys (baby kidneys cannot concentrate urine until about 3 months and don’t work at full power until about age 2) |
| Reduces dieresis, increases water retention, comes from the hypothalamus and stored in the posterior pituitary gland | ADH |
| Another name for ADH | vasopressin |
| 2 things that stimulate the release of ADH | Increased serum osmolality and decreased blood volume |
| 4 Steps of fluid adjustment by ADH | 1) hypothalamus notices there’s a problem 2) pituitary spits ADH into the blood stream 3) ADH causes kidneys to retain water 4) blood volume increase/serum osmolality decreases |
| What happens to urine when ADH is working? | It becomes more concentrated |
| Two things that angiotensin II does | peripheral vasoconstriction and stimulate adrenal glands to produce aldosterone |
| Describe the steps in the rennin-angiotensin-aldosterone system | low pressure in the glomerulus causes the juxtaglomerular cells to secrete renin; renin goes to the liver and converts angiotensinogen into angiotensin 1; in the lungs 1 become 2; 2 causes vasoconstriction and release of adolsterone. |
| How does the renin-angiotensin-aldosterone system turn off? | when blood pressure returns to normal the juxtaglomerular cells stop making renin |
| Two things that activate renin secretion | 1) low blood flow to kidneys 2) reduced sodium content in the blood reaching the kidneys |
| Two things that turn off renin secretion | higher blood pressure or more sodium reaches the kidneys |
| What does aldosterone cause the kidneys to reabsorb? | sodium and water |
| Initiates the active transport of sodium from the distal tubules and the collecting ducts into the bloodstream | aldosterone |
| What happens when aldosterone forces more sodium into the blood stream? | the blood volume increases because water follows sodium |
| Where does ANP come from? | The cells of the atria |
| What causes the release of ANP? | Increased pressure in the artia |
| What does arterial natriuretic peptide do? | It counteracts the renin angiotensin aldosterone system by reducing intravascular blood volume and pressure |
| Name 4 things that ANP does. | 1) suppresses serum renin levels 2) decreases release of aldosterone 3) decreases release of ADH 4) causes vasodilation |
| Two conditions that would cause the amount of ANP released by the atria to increase | Chronic renal failure and heart failure |
| Fluid in the cerebrospinal column, pleural cavity, lymph system, joints and eyes that remains fairly constant | transcellular fluid |
| What is the normal range for serum osmalality? | 275 to 295 mOsm/kg |
| Serum osmolality below 275 | Water excess/ solute deficit |
| Serum osmolality above 295 | Water deficit / solute excess |
| What is the formula for figuring effective serum osmolality? | Effective Osmolality = (2 x NA+) + (glucose/18) |
Created by:
Perseverandovercome
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