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fluid n electro

fundamentals

QuestionAnswer
where is the majority of body fluid found? vascular fluid(inside the blood and lymph vessels), interstitial fluid (between cells), intracellular(within cells).
Why is vascular fluid essential? For the maintenance of adequate blood volume, blood pressure, and cardiovascular system functioning.
Why is interstitial fluid important Interstitial fluid that surrounds the body's cells is important for the transportation of oxygen, nuttrients, hormones, and other essential chemicals between the blood and the cell cytoplasm.
Why are vascular and interstitual fluid important? They are important for waste removal
Why is intracellular fluid important? to maintain cell size and function.
what does cell function depend on? maintaining the volume and composition of body fluids with a narrow, normal range.
what is the balance of fluid, electrolytes, acids, and bases in the body regulated by? physiologic control mechanisms.
On a hot summer day what increases in a person and what decreases? fluid intake increases and urine output decreases. (at the same time change in RR and urine composition play an important role in regulating acid-base balance).
what are some issues that may temporarily disrupt fluid, electrolyte, and acid-base homeostatis? vomiting, diarrhea, or therapies such as surgery even though someone has general good health.
what are some diseases that seriously disrupt the body's ability to maintain F, E, and acid-base balance heart failure, kidney impairment, or liver dysfunction.
the body is water containing chemical compounds called... electrolytes plus blood cells and other soluble molecules.
the body monitors and controls two aspects of the body fluid balance: 1. the volume of fluid in the extracellular space, particualarly vascular volume 2. The water concentration (osmolarity) of all body fluids, which influences the volume of extracellular and intracellular fluid.
how much of body weight is fluid? 45-80%(also depends on age, body fat, gender
newborn(premature) total body fluid (%body weight) 85%
newborn(fullterm) total body fluid (%body weight) 70-80%
child 1-12years of age total body fluid (%body weight) 64%
puberty to 39 years of age total body fluid (%body weight) male-60% female-52%
40-60 years of age total body fluid (%body weight) male-55% female-47%
older than 60 years of age total body fluid (%body weight) male-52% female-46%
what are the two types of body fluid? intracellular fluid and extracellular fluid
where is intracellular located? within the cell
where is extracellular located? is all the fluid outside of the cell
what are the primary intracellular electrolytes? potassium, phosphate, and sulfate (soda, produces, pee)
what are the primary extracellular electrolytes? sodium, choloride, and bicarbonate (soda, causes, burps)
adults have about ____ of their total within ICF and ____ in the ECF 2/3, 1/3
newborns have more ______ than _______ ECF, ICF
by 3 months of age newborns ICF and ECF are... equal
By the age of 1 babies ICF and ECF.... approach the same distribution as adults
The maintenance of proportional distribution of ECF between vascular and interstitual spaces depends on 3 factors??? protein content of the blood (serum protein, mainly albumin and globulin), integrity of the vascular endothelium (the layer of cells lining blood vessels), and hydrostatic pressure inside the blood vessels.
what keeps fluid within the blood vessels? protein content of the blood and the intact vascular endothelium
what forces the fluid out of the vessels? hydrostatic pressure
In heathly people how do the protein content of the blood, the intact vascular endothelium, and the hydrostatic pressure work together? they are equally balanced so that approx. 1/3 of the ECF is intravascular and 2/3 is interstitial.
what is the most important and regulated aspect of fluid balance? the volume of ECF, particularly vascular volume.
why is it important to regulate the fluid balance of ECF vascular volume? bc w/o adequate vascular volme, BP cannot be maintained. and prolonged periods of low BP are known as shock.
what are stretch receptors or pressure receptors? and what do they do? they are baroreceptors; located in the major arteries and veins and monitor vascular volume.
What do the renin-angiotensin-aldosterone and natriuretic peptide hormone system do? regulate the volume within narrow limits by adjusting fluid intake and the urinary excretion of sodium, cholride, and water.
what can stimulate renin release? decreased arterial BP, decreased renal blood flow, increased renal smpathetic nerve activity, or a low-salt diet
what is the second regulated aspect of body fluid? osmolarity
what are electrolytes? they are chemical compounds that partially dissociate(seperate) in solution into seperate particles
what are ions? electrical charges that are in electrolytes
what are positively charged ions referred as? cations
what are negatively charged ions referred as? anions
biologically what are the important cations called? sodium, potassium, calcium, and magnesium
what are common anions? chloride, bicarbonate, phosphate
what is the serum value of sodium? 135-145 mEq/L
what is the serum value of K? 3.5-5.0 mEq/L
what is the serum value of Ca (8.9-10.1 mg/dL? 4.3-5.3 mEq/L
what is the serum value of Mg (1.8-2.3 mg/dL)? 1.5-1.9 mEq/L
what is the serum value of chloride? 95-108 mEq/L
what is the serum value of Bicarbonate(HCO-3)? 22-26 mEq/L
what is the serum value of Phosphate (2.5-4.5 mg/dL)? 1.7-2.6 mEq/L
how are electrolyte concentrations expressed? in terms of their combining power or the ability of cations to combine with anions rather than by their absolute weight in solution.
how is electrolyte balance maintained? by keeping the concentration of each electrolyte in the serum within normal limits
what is electrolyte imbalance referred to as? an increase or decrease of the concentration of ions within the serum.
what is the most abundant cation in the ECF? Sodium
changes in the serum sodium level reflect... changes in body water balance or osmolarity and therefore do no reflect sodium intake and output directly.
what organ excretes sodium from the body? kidney
how is sodium regulated? sodium along with chloride and a proportionate volume of water(normal saline) are regulated by the renin-angiotensin-aldosterone system and natriuretic peptides
where can sodium be found? table salt, dairy products, meat, eggs, and certain vegetables. food perservatives, and medications
what is potassium essential for? normal cardiac, neural, and muscle function and contractility of all muscles.
what important role does postassium play? in cellular functions, such as protein and glycogen synthesis
what two hormones exert major control over extracellular concentration of potassium? insulin and aldosterone
what role does potassium play with insulin? insulin is a pancreatic hormone, promotes transfer of potassium(also glucose) from the ECF into skeletal muscle and liver cells.
what role does aldosterone place with potassium? enhances renal excretion of K.
an increase in serum potassium does what? stimulates the release of insulin and aldosterone to lower the concentration of the ion
a decrease in serum potassium does what? inhibits the release of aldosterone and insulin to reduce excertion of the ion
a person loses about how much potassium a day? 30mEq
A typical western diet contains about how much potassium a day? 100mEq/day
what organ play an important role in the maintenance of potassium balance kidneys
Potassium is also excreted from the body in? stool and perspiration
approx. 99% of calcium is found where in the body? in the bones and teeth, and the remainder is in the serum
calcium is present in the blood primarily in what two states? ionized and bound to protein.
approx. what percent of calcium is ionized? 50% is ionized and the remainder is bound to proteins, mainly albumin.
The level of ionized calcium determines what? physiological function
Only changes in the ionized calcium levels can cause.... s/s associated with calcium imbalances.
Because a large portion of the calcium is bound to albumin, what should be checked? the serum albumin levels should be checked when lab data is evaluated.
when can serum albumin levels decrease? liver disease or wasting
what happens if serum albumin levels decrease? the total calcium level probably also will be decreased, but the ionized calcium level may be within normal limits.
calcium usually has a reciprocal relationship with... phosphorus
why does the cell membrane structure depend on calcium? bc it promotes cell-to-cell adhesion
what are some things that calcium are important for? wound healing, synaptic transmission in nervous tissue, membrane excitability, muscle contractility, and teeth and bone structure.
what is calcium essential for? blood clotting and is critical in metabolic reactions involed in energy production (glycolysis)
what regulates calcium and phosphate balance? parathyroid hormone(PTH), vit D, and to some extent calcitonin
what does PTH do to serum calcium levels? causes an increase by increasing intestinal and renal reabsorption of calcium and releasing calcium from bone
PTH increases calcium levels but... decreases serum phosphate levels.
The decreased secretion of PTH levels... lowers serum calcium levels and increases serum phosphate concentration
in what foods can you find a good source of calcium? dairy is a great source. also sardines, whole grains, leafy green vegetables.
where is magnesium found in the body 50-60% is found in bone and the rest is in soft tissue and body fluids
Is magnesium an intracellular or extracellular ion? intracelllar ion with only 2% in the ECF
What is magnesium important for? regulating neuromuscular function and cardiac activity
what are changes in magnesium paralleled by? changes in potassium
what is magnesium deficiency often accompanied by? hyocalcemia
What organ regulates magnesium levels? the kidney by reabsorbing the ion when serum levels are low and excreting it when serum levels are high
Which hormones regulate magnesium levels in the body? none
What are some good dietary sources of magnesium? green leafy vegetables, legumes, citrus fruit, peanut butter, and chocolate
Describe the serum levels of phosphorus in children and infants. The serum levels are higher in children and even higher in infants, than that of an adult
Where is phosphorus found in the body? 85%bone, 14% ICF, 0.1% ECF
why is phosphorus important? energy metabolism, structure of bones, and membranes, and synthesis of nucleic acids (RNA and DNA)
What are good dietry sources of phosphorus? dairy products, meats, vegetables, fruits, and cereals.
Diffusion is the movement of a solvent of solutes from an area of higher solvent or solute concentration to an area of lower solvent or solute concentration.
osmosis refers to the movement of a fluid through a semipermeable membrane
active transport is the process by which ions and other molecules are moved across membranes from an area of lesser concentration to an area of greater concentration.
filteration involves the transfer of water and dissolved substances through a permeable membrane from a region of high pressure to a region of low pressure
filteration occurs within the ______ _________ capillaries and in the ________ capillaries kidney's glomerular; blood
who is at greater risk of fluid and electrolyte imbalances? the very young and older adults
Because babies have a greater surface arein in relation to weight, how do they lose most of their volume of fluid? through their skin
why do newborns and infants lack the ability to concentrate urine fully? because their kidneys are immature
what are the general fluid requirements for toddlers and preschoolers? 1000-1200 mL for a 24 hour period
What is the urine output for a 2 year old? increases from 500 to 700mL/day
what is the urine outpt for a 5 year old? increases from 600-850mL/day
In middle age adipose tissue tends to increase, resulting in a continual decline in the percentage of body weight that is fluid after _____ years of age? 40
At what age to the nephrons in the kidney begin to decrease? 25 years of age
when are adults most likely to experience fluid and electrolyte imbalances? After acute illness or elective surgery. (older adults can experience this after a chronic disease;renal failure, heart failure)
Diuretics commonly given to treat high BP and heart failure can cause ECF deficit or loss of electrolytes that include... Potassium, calcium, and magnesium
Excessive use of laxatives can reduce gastrointestinal absorption.... of postassium, promoting hypokalemia and loss of ECF
The use of what oral solution in clients older than 65 years was associated with vascular volume deficit, hyperphosphatemia, hypokalemia, and hypocalcemia? Oral Sodium Phosphate Solution
what are vital functions that depend on a stable acid-base enviroment? nerve conduction, hormonal activity, and cardiac rhythm
Any substance that can donate free H+ ions to a solution is called? acid
Any substance that can decrease H+ in a solution is called? Base
How are acids and bases categorized? strong or weak
Where is Hydrochloric acid(HCL) secreted? and what type of acid is it? by cells in the stomach lining;strong
Is Sodium Hydroxide (lye) a base or an acid? strong base
In the body pH is normally very close to? 7.4; it is rarely less than 7.0 or greater than 7.8
what is the pH of ECF normally? 7.37-7.43
what is a very important acid in the body? carbonic acid
together carbonic acid and bicarbonate ion form? buffer pair; and are most important in clinical setting
Since bicarbonate and carbonic acid system mirro changes in all other systems they need to maintain what? equilibrium
The body regulates the carbon dioxide level by changes in the .... respiratory rate(ventilation) and bicarbonate level by adjustments in the amount of bicarbonate lost in the urine or the amount regenerated by the kidneys
Death ususally occurs when the pH falls below... 6.8-7.8
buffers allow acids or bases to be transported from... where they are produced to where they are excreted without causing a large swing in pH. With compensation the body either excretes or retains acids or bases to compensate for loss.
acid-base balance is commonly evaluted by measuring? arterial blood gases
(normal art.blood gas values) pH-normal 7.37-7.43 reflects the hydrogen ion concentration of arterial blood. acidosis: <7.37, alkalosis: >7.43
(normal art.blood gas values) PaCO2-normal 36-44mm Hg reflects partial pressure of carbon dioxide in arterial blood. Hypocapnia: low partial pressure of carbon dioxide in arterial blood, <35mm Hg; Hypercapnia: High partial pressure of carbon dioxide in arterial blood, > mmHg
(normal art.blood gas values) PaO2-normal 80-100 mm Hg partial pressure of O2 in arterial blood
(normal art.blood gas values) HCO3- normal 22-26 mEq/L and it is the amount of bicarbonate in arterial blood
what is buffering? it is substances that help prevent large changes in pH by absorbing or releasing H+ ions
what are the four main buffer pairs in the body? hemoglobin, carbonic acid-bicarbonate, proteins, and phosphates.
what is the isohydric principle? Bc the activity of all buffer pairs is inter-related, if a clinician knows what is happening with one buffer pair, then they can predict what is happening with the others. This is also why clinicians usually only monitor acid-bicarbonate buffer system
how long does it take for the lungs to compensate for an imbalances? instantly
how long does it take for the kidneys to compensate for an imbalances? hours to days to respond
what is the typical intake for an adult in 24 hour period? break it down. oral fluids-1300mL, fluid in food 1000mL, oxidation of food 300mL=total=2600mL
what is the typical output for an adult in 24 hour period? break it down. urine-1500mL, feces-200mL, perspiration 100-200mL, insensible loss-skin-300-400mL and respiration-300mL=total=2400-2600mL
how much water is in fruits and vegetables? 80-90%
thirst mechanism helps regulate.. fluid intake
where is the thirst center located? and what stimulates it? hypothalamus; by an increase in plasm osmolarity, and also by decrease in blood volume
what are the four ways that electrolytes can be lost from the body? from kidneys as urine, from skin as perspiration, from GI in stool or vomit, and from lungs as insensible water loss
what is the main organ regulating fluid balance? kidney
what permits the kidney to conserve or excrete water and electrolytes as necessary to maintain homeostasis? glomerular filtration and tubular reabsorption
what type of fluid is diaphoresis or sweat? hypotonic
(vomiting) if sufficient gastric juice is lost from the stomach what can occur? hydrogen, sodium, and chloride ions are depleated, increasing the risk for ECF deficit and METABOLIC ALKALOSIS.
(vomiting) since gastric fluid is also high in potassium, what can excessive loss contribute to? hypokalemia
intestinal secretions contain bicarbonate, for this reason diarrhea may result in? metabolic acidosis
Diarrhea can also contribute to ECF deficit and cause? hypokalemia
Diaphoresis contains which electrolyes? sodium, potassium, and chloride
diuretics are prescribed to increase? excretion of sodium, chloride, and water in clients with high BP or with chronic heart, renal, or liver problems
Diuretics promote what? excretion of potassium and magnesium increasing the risk for electrolyte imbalances. (except potassium sparing diuretics)
What happens when stress occurs? aldosterone production increases causing ECF retention. It also increases ADH production, resulting in decreased renal excretion of water
when renal failure occurs, what happens to electrolyte balance? abnormal loss or accumulation of sodium, chloride, potassium, and fluid in the body can result in ECF and water excessess or even deficits. Since the kidneys are no able to regulate as well
what is common with renal failure? hyperkalemia and hypocalcemia
____________ _____________ occurs when the kidneys fail. metabolic acidosis
when cardiac failure occurs what happens to the body? it secrets aldosterone and ADH and results in ECF and water excess. The fluid collects in lungs>increasing risk of pulmonary edema>and rest of the body>and it appears as pitting or dependent edema
what occurs with liver failure? people with liver failure present w/ a water excess thought to be relate3d to increased plasma levels of ADH.
what increases and decreases with liver failure? albumin decreases, vascular decreases, interstitial volume increases.
When is ascites present? liver failure
How much and when should a lactate raner be given? surgery, usually 1000mL
what usually decreases after surgery? potassium
what is the treatment for ECF volume deficit? either oral or IV replacement of sodium, chloride, and water in the same concentration found in body fluids.
what should you give a patient who has ECF deficit? salty liquids such as broth, tomato juice or normal saline.
what is a safety alert for patients with ECF deficit? monitor postural HR and BP when getting them OTB. Have them take several minutes to get up, going in slow steps from lying to a sitting to a standing postion. Make sure someone is present
When does ECF excess usually occur? cardiac failure, renal failure, or liver disease
when excess fluid cannot be eliminated what happens? hydrostatic pressureforces some of it into interstitial space as edema
what are symptoms of ECF excess? increased BP, bounding pulse, and fullness of neck veins.
changes in mental status? hyponatremia
When does metabolic acidosis occur? either when excess acid is ingested or created or when the kidneys are unable to retain enough bicarbonate ions to buffer freee hydrogen ions in the blood. charac. as a pH lower than 7.37 and plasma concentration lower than 22mEq/L
when does respiratory acidosis occur? low pH accompanied by an increased arterial concentration of carbon dioxide. PaCO2 of 44mm Hg.
people with damaged lungs may have? respiratory acidosis
Hyperventilation causes... respiratory alkalosis
when does metabolic alkalosis occur? when there is excessive loss of body acids or with unusual intake of alkaline substances. or K deficit. vomiting or NG suction
is Pureed food considered fluid intake? no
neck veins should not extend more than.. 2cm above sternal angle
what foods contain sodium? salt, msg, soy sauce, dairy products, processed foods, snack foods, bouillon, canned or packaged soup, pickles, olives, sauerkraut, tomato juice
what foods contain potassium? banana, cantaloupe, apricots, peaches, dates, raisins, vegetables avocado, navy beans, potatoes, squash, carrots, cauliflower, orange juice tomato juice
What foods contain Magnesium? nuts peanut butter, egg yolk, milk, whole grain cereals, bananas, citrus fruit, dark green vegetables, legumes, seafood, chocolate
what foods contain Phosphorus? dairy products, meats, fish, bran an wheat cereals, nuts
Created by: sandrasafou1