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CARDIAC 1
FLUIDS & ELECTROLYTES
| Term | Definition |
|---|---|
| FUNCTIONS OF WATER IN THE BODY | Be a vehicle for the transportation of substances to and from the cells, Aid heat regulation by providing perspiration, Assist in maintenance of hydrogen (H+) balance in the body, Serve as a medium for the enzymatic actions of digestion |
| Extracellular Fluid | is outside of the cells, transports water, nutrients, oxygen, waste to and from cells, is regulated by renal, metabolic, and neurologic factors |
| 3 divisions of extracellular fluid | Intravascular, interstitial, transcellular |
| Intravascular Fluid | the fluid within blood vessels, consists of plasma and fluid within blood cells, contains large amounts of protein and electrolytes |
| Interstitial Fluid | fluid in the spaces surrounding cells, high in sodium and chloride |
| Transcellular Fluid | includes aqueous humor, saliva, CSF, pleural, peritoneal, synovial, and pericardial fluids, GI secretions, and fluid within the urinary and lymphatic systems |
| Intracellular Fluid | is within cells, the fluid is contained within the cell wall, high in potassium and phosphate |
| How does fluid move throughout the body? | Osmosis, Diffusion, Filtration, Hydrostatic Pressure, Osmolality |
| osmosis | movement across a membrane in response to a concentration gradient-usually from lower to higher concentration |
| diffusion | a dissolved substance may spread through a solution |
| flitration | moves by hydrostatic pressure -usually from greater pressure to lower pressure |
| hydrostatic pressure | force within a fluid compartment: the major force that pushes water out of the vascular system at the capillary level |
| Osmolality | the number of osmotically active particles per kilogram of water-the concentration of a solution |
| What are the types of fluid shifts? | *Interstitial to plasma= fluid is drawn into plasma space when there is an increase plasma osmotic or oncotic pressure *Plasma to interstitial=edema, increase in hydrostatic pressure =decrease in plasma osmotic pressure=increased interstitial pressure |
| Fluid Spacing | *1st=normal distribution of fluid between ICF & ECF *2nd=abnormal accumulation of interstitial fluid *3rd=fluid accumulation in a part of the body where it is not easily exchanged with ECF |
| Which systems are responsible for the regulation of fluid in the body? | *Hypothalamic, *Pituitary, *Adrenal Cortex, *Renal, *Cardiac, *Gastrointestinal |
| Hypothalamic | Osmoreceptors in hypothalamus sense fluid deficit or increase in plasma osmolality Stimulates thirst and ADH release Results in increased free water and decreased plasma osmolality |
| Pituitary | Under control of the hypothalamus, posterior pituitary releases ADH |
| Adrenal Cortex | Releases hormones to regulate both water and electrolytes Hormones are glucocorticoids and mineralocorticoids Aldosterone is the major mineralocorticoid |
| Renal | Kidneys are the primary organs for regulating fluid & electrolyte balance, Selective reabsorption of water and electrolytes, Excretion of electrolytes occurs, Renal tubules are the site of action for ADH and aldosterone |
| Cardiac | Atrial natriuretic peptide (ANP) is released by the atria in response to increased atrial pressure ANP causes vasodilation and increased urinary excretion of sodium and water |
| Sodium Indication | Evaluate/monitor electrolyte balance and therapy |
| Sodium Regulation | Aldosterone conserves sodium, Natriuretic hormone gets rid of sodium, ADH fosters dilution and concentration-As free water level is increased, sodium is diluted-As free water is decreased, sodium becomes more concentrated |
| Potassium Indication | Evaluation of electrical function in cardiac function, nerve transmission and muscle contraction |
| Potassium Regulation | Changes within renal absorption and excretion especially sodium |
| Calcium Indication | Evaluation of muscle contraction, cardiac function, nerve transmission and blood clotting |
| Calcium Regulation | When levels decrease, PTH is activated and calcium is released into the bloodstream |
| Magnesium Indication | To detect deficiency or overload |
| Magnesium Regulation | Works with calcium and potassium If low, one of these works to maintain excitability in the intracellular space |
| Phosphorus Indication | Evaluate parathyroid and calcium abnormalities |
| Phosphorus Regulation | Phosphorous Evaluate parathyroid and calcium abnormalities o Phosphorous levels are determined by calcium metabolism, PTH and renal excretion o Phosphorous and calcium compensate for each other |
| Hyponatremia Causes | Decreased sodium intake; increased sodium excretion through diuresis or GI suctioning; adrenal insufficiency |
| Hyponatremia Assessment | o N/V; abdominal cramps; cold, clammy skin; decreased skin turgor; headache; weakness; postural hypotension; rapid, thread pulse |
| Hypernatremia Causes | Excessive/rapid IV administration of NS; inadequate water intake; kidney disease |
| Hypernatremia Assessment | o Dry, sticky mucous membranes; flushed skin; dry tongue; firm skin turgor; intense thirst; edema; oliguria to anuria |
| Hypokalemia Causes | Anorexia; alcoholism; GI suctioning; surgery; vomiting; diarrhea; laxative abuse; thiazide diuretics; steroids; alkalosis |
| Hypokalemia Assessment | o Thready/rapid pulse; faint heart sounds; decreased BP; decreased or absent reflexes; malaise; shallow respirations; confusion; weight loss; abdominal distention |
| Hyperkalemia Causes | Renal insufficiency; adrenocortical insufficiency; burns; acidosis; rapid infusion of KCL; high intake of potassium |
| Hyperkalemia Assessment | o Thready/slow pulse; shallow breathing; NVD; colic; muscle weakness/numbness; flaccid paralysis; difficulty with pronation |
| Hypocalcemia Causes | Acute pancreatitis; diarrhea; hypoparathyroidism; lack of vitamin D; long term steroid use |
| Hypocalcemia Assessment | o Facial spasms; laryngospasm; Trousseau’s and Chvostek’s signs; dyspnea |
| Hypercalcemia Causes | Hypercalcemia Hyperparathyroidism; immobility; increased Vitamin D; osteoporosis o N/V; anorexia; headache; confusion; decreased muscle tone; deep bone pain; flank pain |
| Hypercalcemia Assessment | o N/V; anorexia; headache; confusion; decreased muscle tone; deep bone pain; flank pain |
| Hypomagnesemia Causes | Low intake of magnesium in diet; prolonged diarrhea; massive diuresis; hypoparathyroidism |
| Hypomagnesemia Assessment | o Paresthesia; confusion; ataxia; tremors; hyperactive DTR; flushing of the face; diaphoresis |
| Hypermagnesemia Causes | Renal insufficiency; dehydration; excessive use of magnesium-containing antacids or laxatives |
| Hypermagnesemia Assessment | o Lethargy; N/V; depressed reflexes; weakness; decreased pulse and respirations |
| Hypophosphatemia Causes | Chronic antacid ingestion; hyperparathyroidism; hypercalcemia; alcoholism |
| Hypophosphatemia Assessment | o Weakness; diplopia; dysphagia; respiratory and cardiac depression; paresthesia; confusion; hypotension |
| Hyperphosphatemia Causes | Hypoparathyroidism; renal failure; bone metastasis; hypocalcemia; rhabdomylosis; hemolytic anemia o Tetany; tachycardia; anorexia; N/V; weakness |
| Hyperphosphatemia Assessment | o Tetany; tachycardia; anorexia; N/V; weakness |
Created by:
bmccorkle
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