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NURS 106 Exam 3
Fluid & Electrolyte Class Notes
| Question | Answer |
|---|---|
| Water fluid varies due to what? | Gender, Age, and Body Mass |
| What are water/fluid functions? | transport nutrients, electrolytes and O2 to cells, carries waste away from cells, regulates body temperature, lubricates joints/membranes and digests foods |
| What % of our body weight is composed of Intracellular fluid (ICF)? | 40% |
| What % of our body weight is composed of Extracellular space (ECF)? | 20% |
| What is ECF primarily composed of? | NaCl and NaHCO3 solutions |
| Describe the ICF? | A non-homogeneous solution of potassium, organic anions, and proteins controlled by cellular membranes and cell metabolism |
| What does the ECF include? | interstitial fluid, intravascular (plasma), and transcellular fluid |
| What are electrolytes? | substances whose molecules split into ions when placed into water. |
| Name prevalent cations in the body? | Na+, K+, CA2+, Mg2+ |
| Name prevalent anions | HCO3-, Cl-, PO4- |
| How are concentrations of electrolytes expressed? | as mEq/L |
| What is the most prevalent cation in the ICF? | K+ |
| What is the most prevalent anion in the ICF? | HPO4- |
| What is the most prevalent cation in the ECF? | Na+ |
| What is the most prevalent anions in the ECF? | Cl- |
| What is osmosis? | Movement through a semi-permeable membrane from area of lessor solute concentration to an area of higher solute concentration. |
| Does osmosis require energy? | No |
| When does osmosis stop? | when equilibrium is reached |
| What does osmolarity mean? | concentration of a solute in a solution |
| What does colloid osmotic (oncontic) pressure mean? | is a form of osmotic pressure exerted by proteins in blood plasma that usually tends to pull water into the circulatory system. |
| What happens when you introduce a hypotonic solution to a body? | fluid moves into cells causing them to enlarge |
| What happens when you introduce a isotonic solution to the body? | expands body's fluid volume without causing a fluid shift |
| What happens when you introduce a hypertonic solution into the body? | fluid is pulled out of the cell causing them to shrink |
| What is diffusion? | movement of molecules from an area of high concentration to an area of low concentration across a permeable membrane requiring no energy |
| What is facilitated diffusion? | Same movement of molecules but requires a carrier molecule to accelerate/facilitate diffusion |
| What does the diffusion rate depend on? | molecule size, concentration, temp of a solution |
| What is filtration? | movement of water and small particles from an area of high pressure to low pressure |
| What is osmotic pressure? | the power of a solution to draw water |
| More concentration equates to what _____ osmotic pressure? | high osmotic pressure |
| What are factors affecting filtration? | size of pores in membrane varies, hydrostatic pressure |
| hydrostatic pressure | Fluid pressure |
| osmotic pressure | power of a solution to draw water (more concentrated, high osmotic pressure) |
| What is the hydrostatic pressure in the atrial capillary? | 40 mm Hg |
| What is the hydrostatic pressure in the venous end? | 10 mm Hg |
| What is the interstitial hydrostatic pressure in the tissue? | 1 mm Hg |
| What is the tissues interstitial oncotic pressure? | 1 mm Hg |
| In active transport where do molecules go? | against there concentration gradient |
| What is required in active transport? | ATP (energy) |
| Do ICF and ECF have the same concentration of Na+ and K+? | Hell no they are very different! |
| What do osmoreceptors monitor? | serum osmolarity |
| Define serum osmolarity? | the total concentration of dissolved material in a serous fluid, regardless of there specific identities expressed in moles and also known as osmotic concentration. |
| Give examples of what osmoreceptors monitor? | decreased fluids or intake of hypertonic fluids, or when hypovolemia occurs |
| What causes hypovolemia? | internal or external bleeding, fluid losses or inadequate fluid intake. |
| Define hypovolemia | A decreased blood volume that may be caused by internal or external bleeding, fluid losses, or inadequate fluid intake. |
| What does the hypothalamus do in response to there is increase osmolarity? | the hypothalamus will stimulate the thirst response |
| When the hypothalamus stimulates the thirst response what is required in the person? | that the individual is in an alert state |
| Who are at risk for dehydration? | infants, cognitively impaired elderly or patients with neurological and or psychological impairments at risk for dehydration. |
| What happens to our sensitivity of thirst as we age? | it decreases |
| How many liters of plasma do the kidneys filter on a daily basis? | 180 L |
| How much do the sensible and insensible water losses through the skin produce? | 500-600 ml daily |
| How much fluid output doe the lungs expire in a day? | 400 ml |
| How much fluid output is moved in the GI tract and returned to the ECF daily? | 3-6 L |
| What gland releases ADH? | pituitary gland |
| What does ADH do? | ADH works directly on the renal tubules to reabsorb water, returning water/fluid to systemic circulation |
| What releases aldosterone? | the adrenal cortex |
| What does aldosterone do? | it works directly on the renal tubules to reabsorb sodium and excrete K+ and H+ leading to water retention |
| What secrets renin? | the Kidney |
| What does renin produce? | angiostensin I which converts to angiotensin II |
| What does renin do? | causes vasoconstriction and improved renal perfusion |
| Define diuresis | elimination of urine |
| Define urinalysis | analysis of a urine sample |
| what could occur if there is damage to the capillary walls such as bruising? | localized edema |
| define edema | the movement of abnormal amts of water from plasma to interstitial fluid |
| What occurs when there is an increase in blood pressure in the pulmonary capillaries? | pulmonary edema |
| What occurs when there is a decrease in blood colloid osmotic pressure? | generalized edema |
| When is aldosterone secreted? | in response to rising K+ or falling Na+ or in response to the activation of renin angiotensin system. |
| What does natriuretic peptides (ANP, BNP) do? | They reduce thirst and block the release of ADH and aldosterone resulting in diuresis (fluid loss at the kidneys) causing a decrease in blood pressure and plasma volume |
| What effect does ADH cause? | stimulates water conservation at the kidneys reducing urinary water losses and concentrating the urine and stimulate the thirst center promoting intake of fluids |
| What hormones make u pee and decreases fluids in the body? | natriuretic peptides (ANP, BNP) |
| What hormones causes water retention? | aldosterone, Antidiuretic hormone, renin, angiotensin I/II |
| What illnesses causes fluid and or electrolyte imbalances? | injury, congestive heart failure or burns |
| What is the normal serum Na+ range? | 135 - 145 mEq/L |
| What is the normal serum K+ range? | 3.5 - 5.0 mEq/L |
| What is the normal atertial pH range? | 7.34 - 7.45 |
| What is the purpose of regulation of acid base balance? | for optimal functioning of cells |
| What regulates the body's acid base balance? | buffers, respiratory mechanisms, renal mechanisms |
| What therapeutic measures can worsen fluid and electrolyte imbalances? | intravenous fluid administration, diuretic use, surgery |
| What nursing assessment should be done in regards to the possibility of a fluid and electrolyte imbalance? | demographic data, past med history, current health concerns, food and fluid intake, fluid elimination, medication and life style |
| What physical assessments should be done in regards to the possibility of a fluid and electrolyte imbalance? | vital signs, skin, mucous membranes, cardio system, resp system, neurological system, weights, intake and output |
| What laboratory tests should be done in regards to the possibility of a fluid and electrolyte imbalance? | serum electrolytes, serum osmolality, urine osmolality, complete blood count, urinalysis - pH, specific gravity |
| What can cause a fluid volume deficit? | Gi losses (N,V,D), hemorrhage, burns, excessive perspiration, fever, decrease oral intake, use of diuretics, increased RR |
| what findings might indicate a fluid volume deficit? | postural hypo-tension, tachycardia, dry mucous membranes, poor skin turgor, confusion, thirst, rapid weight loss, poor perfusion, weak pulse, lethargy, oliguria |
| define oliguria | lil amts of piss |
| what causes fluid volume excess? | CHF, renal failure, cirrhosis of the liver, increased serum aldosterone and steroid levels, excessive sodium intake or administration |
| what findings may indicate fluid volume excess? | rapid weight gain, edema (esp in dependent areas), hypertension, polyuria, neck vein distention, increased venous pressure, crackles in the lungs |
| what preventative measures/interventions could a nurse do in regards to fluid volume issues? | modifying oral fluid intake, parenteral replacement (IV fluids, blood, blood products) |
| What was the purpose of typology of oral hydration conducted by mentes in 2006? | to establish a 6 month prevalence of dehydration and describe common problems of nursing home residents |
| What interventions can be done for individuals who are at risk for dehydration that can drink | educate about how much to drink, use graduated cups, provide preferred beverages, offer drinks frequently, give fluid during activities, establish teatimes/happy hours/beverage cart |
| What interventions can be done for individuals who are at risk for dehydration that are unable to drink due to dysphagic disorder? | swallowing exercises, provide foods rich in fluids (smoothies), oral care, educate fam to help |
| What interventions can be done for individuals who are at risk for dehydration that are unable to drink due to there physical dependency? | use sport cups with staws, have physical aids to assist with drinking |
| What interventions can be done for individuals who are at risk for dehydration that only sips drinks? | give frequent small amounts of fluid at each contact, give fluid with activities, provide preferred beverages |
| What interventions can be done for individuals who are at risk for dehydration that fear incontinence | educate about maintaining fluid intake, kegel exercises (urge inhibition), medication as a last resort |
Created by:
lydia.koo
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