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Fluids Electrolytes
| Question | Answer |
|---|---|
| Total body fluid Infant | 70-80% |
| total body fluid 1 y.o. | 64% |
| Total body fluid Puberty to 39 y.o. Male & Female | Male 60% Female 54% |
| Intracellular | Fluid within the cell (2/3 of body fluid-40% body wt |
| Extracellular | Fluid outside thee cell 1/3 body fluid-20% body wt (5% plasma/15% interstitial) |
| trans cellular | All secretions/cerebral spinal fluid (approx 1L) |
| Composition of body fluids | Water, Non-Electrolytes, Electolytes, Ca/Mg |
| Non-Electrolytres | Urea, dextrose, creatinine, albumin |
| Electroltyes | Potassium/Phosphate (intracel), Sodium/Chloride (extracel) |
| Calcium/Magnesium | 1% extracellular, 60% bone, 39% intracellular fluid |
| Osmotic pressure (1st method of transport) | Drawing power for water < into >, dependent on # of molecules in solution |
| Oncotic pressure (2nd method of transport) | Drawing power of colloids (albumin) |
| Diffusion | random movement of molecules from high concentration to low concentration |
| Active transport | Ions move from areas of lesser concentration to higher via ATP (enzyme) Na K amino acids |
| Filtration | Transfer of H2O and a dissolved substance from high pressure to low pressure (urine) |
| Kidneys filter | 170L of Plasma per day |
| How Kidneys regulate blood pH | via excretion or retention hydrogen ions |
| Kidneys regulate extracellular fluid Vol & osmolality | by retention or excretion of H2O |
| Kidneys regulate which electrolytes | ECF electrolytes (Na & Cl) |
| Normal urine output | 1000-1500ml/24hr (ave 40-80ml/hr) |
| oliguria | <400ml/24hr |
| Anuria | <50-100ml/24hr |
| total anuria | No urine |
| polyuria | >1500-2000ml/24hr (200ml or >/hr) |
| Circulatory system | Blood flow to kidneys |
| Circulatory system circulates | hormones (aldosterone, antidiuretic, parathyroid, calcitonin) |
| Lungs | Effect blood pH by regulation of hydrogen ions via CO2 retention or exhalation |
| pituitary gland | Releases ADH which stimulates the kidney to retain H2O |
| Pituitary gland ADH is manufactured in | hypothalamus |
| adrenal glands | Releases aldosterone which regulates NA & K |
| Thyroid/parathyroid | Regulates calcium (thyroid-calcitonin & parathyroid-PTH parathy horm) |
| hypervolemia | SOB, peripheral edema, distended neck veins, >BP, Wt gain |
| Causes hypervolemia | Altered renal function, < excretion Na & H2O, excess saving Na or H2O (SIADH) |
| hypovolemia | Dry sticky mucous membranes, thirst, wt loss, wk rapid pulse < BP |
| causes hypovolemia | Third spacing phenom, polyuria, GI renal skin losses |
| Third spacing (burn pt) | Tissue edema, <BP, cool extremities, rapid pulse |
| Third spacing causes | Severe burns, < oncotic press, > capillary permeability, severe cell trauma |
| hypernatremia | Flushed skin, intense thirst, NA >147, agitation, < urine |
| hypernatremia causes | Rapid adm IV NaCl 3% or 5% |
| Na+ | 135-145 mEq/L |
| hyponatremia | Confusion, N/V, muscle spasms, h/a, Na <135 (symptoms 125) |
| hyponatremia causes | Excessive water gain from SIADH or na free IV fluids, diuretics, gi fluid loss |
| potassium K+ | 3.5-5.0 mEq/L |
| hyperkalemia | Peaked narrow T waves, muscle weak, parenthesis face/tongue/hands/feet cardiac arrhythmia, QRS complex widens |
| hyperkalemia causes | Tissue trauma, chemo, kidney failure, RBC tx end of shelf life |
| hypokalemia | Flatter T waves, leg cramps, fatigue, confusion, musc weak |
| hypokalemia causes | K movement into cells (IV insulin), K deplet diuretics, loss GI fluids |
| Serum Calcium Ca+ | 8.9-10.5 mg/dl |
| Ionized Ca+ | 4.0-5.5 mEq/L |
| hypercalcemia | Musc weak, lethargy, polydipsia, N/V, anorexia |
| hypercalcemia causes | Hyperparathyroidism, solid tumor w/mets |
| hypocalcemia | Numb ting toes/fingers, Trousseau’s sign (hand w/BP cuff); Chvoste’s sign (facial tapping cause musc spasms) |
| hypocalcemia causes | Parathyroid hormone deficit (PTH), multiple units of citrated blood |
| Chloride Cl- | 100-106 mEq/L |
| Hyperchloremia | Cl >110L, Kussmal’s breathing, intense thirst |
| hyperchloremia causes | CRF, Eclampsia |
| Hypochloremia | Metabolic alkalosis d/t >bicarbonate w/loss of Cl- |
| hypochloremia causes | Excessive vomiting, GI suctioning |
| Phosphorous PO4 | 2.5-4.5 mg/100ml |
| Hyperphosphatemia | Tetany, low ca level, pPO4 >4.5, >serum bicarbonate |
| Hyperphosphatemia cause | >catabolism, chemo (destroys cells and loses PO4) |
| hypophosphatemia | Dysphasia, ataxia PO4<2.4 |
| hypophosphatemia causes | Hypothyroidism, hyperparathyroidism, ETOH abuse |
| magnesium Mg2+ | 1.5-2.5 mEq/L |
| hypermagnesemia | Flushing, sweating, n/v, <BP, depressed deep tendon reflexes |
| Hypermagnesemia causes | Excessive MG admin via IV, Chronic renal disease, hemodialysis w/hard water |
| hypomagnesemia | Agitation, neuromuscular irritability, confusion, + Chvostek’s sign, + trousseau’s sign, card arrhythmia |
| hypomagnesemia causes | Chronic ETOH. Severe malnutrition |
Created by:
HeatherD1974
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