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Fluid & Electro Nur2

Fluid, Electrolyte and Acid Base Balance ch 17 Lewis test one

Homeostasis is the state of equilibrium in the internal environment of the body, naturally maintained by adaptive responses that promote healthy survival
water content of body Primary component of body: Older adult 45 to 55%, infants 70 to 80%, and adults 40-50%
Intracellular fluid (ICF) the ICF constitutes approximately 40% ib bidt weight.
Extracellular fluid consists of interstitial fluid, composed of fluid in the interstitium(the space between the cells) and lymph;the fluid in the blood plasma, and a very small amount of fluid contained within specialized cavities of the body.
Intracellular fluid ECF consist of one third of the body water or about 20% of total weight;
Electrolytes are substance whose molecules dissociate, or split into ions, when place in water
Diffusion is the movement of molecules from an area of high concentration to one of low concentration. It occurs in liquids, gases, and solids. Net movement of molecules stops when the concentrations are equal in both areas.
facilitated diffusion moves molecules from an area of high concentration to one of low concentration.
active transport is a process in which molecules move against the concentration gradient. External energy is required for this process.by active transport, sodium and potassium moves into the cell to maintain this concentration difference. energy source ATP.
osmosis is the movement of water between two compartments separated by a semipermeable membrane(a membrane permeable to water but not to a solute). water moves through the membrane of area of low concentration to a high solute concentration.
osmotic pressure is the amount of pressure required to stop the osmotic flow of water. osmotic pressure can be understood in terms of imagining a chamber in which 2 compartments,water moves from less concentrated to more concentrated side
osmolality measures the osmotic force of solute per unit of weight of solvent.
osmolarity measures the total milliosmoles of solute per total volume of solution
isotonic fluids with the same osmolality as the cell interior
hypotonic solutions in which the solutes are less concentrated than the cells
hypertonic solutes more concentrated than cells
hydrostatic pressure is the force within a fluid compartment. in the blood vessels, hydrostatic pressure is the blood pressure generated by the contraction of the heart.
oncontic pressure is osmotic pressure exerted by colloids in solution
fluid movement between extracellular fluid and intracellular fluid changes in osmolality of the ECF alter the volume of cells. Increased ECF osmolality(water defecit) pulls water out of cells until 2 compartment have a similiar osmoslality.
fluid movement between extracellular find and intracellular fluid decreased ECF osmolality(water excess) develops as the result of gain or retention of excess water. In this case, cells swell.
fluid spacing is a term sometime used to describe the distribution of body water. first spacing describes the normal distribution of fluid in the ICF and ECF compartments.
fluid spacing second spacing refers to an abnormal accumulation of interstitial fluid. Third spacing occurs when fluid accumulates in the portion of the body from which it is not easily exchanged with the rest of the ECF.
Hypothalmic regulation water balance is maintained via the finely tuned balance of water intake and excretion. a body fluid deficit or increase in plasma osmolality is sensed by osmoreceptors in hypothalamus, which in turn stimulates thirst and antidiuretic hormone release.
pituitary regulation hypothalamic control, the posterior pituitary releases ADH, which regulates water retention by the kidneys. The distal tubules and collecting ducts in the kidneys respond to ADH by becoming more permeable to water so the water is reabsorbed
adrenal cortical regulation glucocorticoids and mineralocorticoids secreted by the adrenal cortex help regulate both water and electrolytes. glucocorticoids cortisol have antiinflammtory effect. mineralocorticoids aldosterone enhance sodium retention and potassium excretion
renal regulation primary organs for regulating fluid and electrolyte balance are kidneys. the kidneys regulate water balance through adjustments in urine volume. urinary excretion of most electrolytes is adjusted so that a balance is maintained
renal regulation total plasma volume filtered by kidneys many times a day. reabsorbs 99% of filtrate, makes 1.5 liters of urine daily
cardiac regulation hormones produced by cardiomyocytes, suppresses aldosterone, renin, and ADH, and the action of angiotensinII, act on renal tubules to promote excretion of sodium and water, resulting decrease of blood pressure and blood volume.
fluid volume deficit (hypovolemia) can occur with abnormal loss of body fluids with diarrhea, hemmorrhage, fistula drainage ,inadequate intake of water, or plasma to interstitial fluid shift
dehydration refers to loss of pure water alone without corresponding loss of sodium
Fluid volume deficit (Causes) insensible water loss, diabetes insipidus, osmotic diuresis, hemorrhage,gi losses, overuse of diuretics, burns
Fluid VD (Clinical Manifestation) restlessnes, drowsiness, lethargy confusion, decreased skin turgor, dry mouth, postural hypotension, increased pulse, decreased CVP, increased respiration, weight loss
Fluid volume excess (hypervolemia) may result from excessive intake of fluids, abnormal retention of fluids, heart failure renal failure or interstitial to plasma fluid shift
Fluid Volume Excess Causes excessive isotonic or hypotonic IV fluids, heart failure, renal failure, primary polydipsia,cushing syndrome
Fluid Volume Excess clinical manifestations headache, confusion, lethargy, peripheral edema, distended neck veins, bounding pulse, increased BP, increased CVP,polyuria, dypsnea, crackles, pulmonary edema,weight gain
Nursing diagnosis: FVD deficient fluid volume related to ECF losses or decrease fluid intake, decreased cardiac output related to excessive ECF losses or decreased fluid intake
Nursing diagnosis: FVE Excess fluid volume related to increased water or sodium retention, impaired gas exchange related to water retention leading to pulmonary edema, risk for impaired skin integrity related to edema
Nursing implementation I/O-24hr intake and output record. All fluids measured. Urine Specific Gravity test. Cardiovascular changes-monitor for fluid imbalances;Respiratory changes-excess fluid & fluid deficit affect respiration.
Nursing implementation cont. Neurological changes-monitor LOC, PERRLA, and movement of extremities; skin assessment and care:skin turgor, injuries, edema; other-regulate IVs, nasogstric suction patients/no access to fluids, older patients have enough intake of fluid
Created by: azchic1973