| Question | Answer |
| Percent of water in total body weight | 55-60%
Babies: Higher water body weight.
Elders: Less water body weight. |
| Intracellular Fluid | Fluid inside cells
*Most fluid in this compartment |
| Extracellular Fluid | Fluid outside of cells.
Consists of interstitial and vascular fluids.
i.e. Plasma |
| Interstitial Fluid | "Third Space" Fluid between cells |
| Define Homeostasis and 3 processes | 1.Filtration
2.Diffusion
3.Osmosis
to control normal fluid and electrolyte imbalance |
| Define Filtration | HIGH to LOW PRESSURE
Movement of fluid through a cell/blood vessel because of pressure differences.This occurs because water volume presses outwards against the walls (Hydrostatic Pressure) |
| Clinical examples of Filtration (2) | *Blood pressure- Moves blood from heart to capillaries where filtration can occur.
*Edema-Occurs from pressure differences |
| Define Diffusion | HIGH to LOW CONCENTRATION to find equalization.
Free movement of particles and electrolytes across a permeable membrane. |
| Clinical examples of Diffusion (2) | *Capillary Membranes-transportation of electrolytes and particles through membranes.
*Sodium Pumps-Active Transport |
| Facilitate Diffusion example | Glucose cannot enter most cell membranes without the help of insulin |
| Define Osmosis | LOW to HIGH CONCENTRATION of WATER ONLY!
Dilute fluid (less concentrated) moves to more concentrated to make it more dilute.
Milliosmoles per Liter/Solution |
| Clinical example of Osmosis | *Thirst Mechanism- feeling of thirst is caused by the activation of brain cells that respond to change in ECF osmolarity |
| Normal Osmolarity Level
AKA "Isotonic" | -Norm: 270-300 mOsm/L
->300:Hypertonic (Pull water from isotonic fluid space)
-<300:Hypotonic (Water pulled from hypo-osmotic fluid into isotonic fluid space |
| Routes of Fluid Loss | *Kidneys most important (Filtration, Re absorption, Excretion)
*Insensible water loss (500-1000mL/day) from skin, lungs stool |
| Define Obligatory Urine Output and norm | (400-600mL/day) Minimum amount of urine needed to excrete toxic waste products |
| Aldosterone | Secreted by adrenal cortex if sodium levels are low.
-Prevents water and sodium loss
-Increases blood osmolarity and volume |
| Antidiuretic Hormone (Vasopressin) | *Acts directly on kidney tubules
-Produced in brain
-Stored in posterior pituitary gland
-Controlled by hypothalamus in response to blood osmolarity
-Results in more water being absorbed from tubules and returned to blood=decreased blood osmolarity |
| Natriuretic Peptides | "Too much fluid, get rid of some"
*Effects opposite of Aldosterone
Secreted in response to increased blood volume and BP which stretch heart tissue
Secreted by the ANP & BNP |
| Dehydration S/S | Hypotension
↑HR
↑RR (may need O2)
Tenting
Dry Mucous Membranes
∆ Mental Status
↑ Temp
Concentrated/Decreased Urine |
| Dehydration Lab Assessment | Hemoconcentration=
Elevated Hemoglobin, Hematocrit, Serum Osmolarity, Glucose, Protein, BUN, Electrolyte |
| Normal Specific Gravity Level | 1.010-1.025 |
| Fluid Overload S/S | Edema
↑HR
↑BP
↑RR
Neck vein Distension
*Daily Weight most accurate measure |
| Define Electrolyte | Substances in body fluids that carry an electrical charge |
| Body Fluids | Are electrochemically neutral (Have equal number of + and - ions) |
| How is the body's homeostasis controlled? | By balance of dietary intake of electrolytes with renal excretion or re absorption |
| Sodium | *Major extracellular cation
Vital for skeletal muscle contractions, cardiac contraction, nerve impulse transmission, normal osmolarity and volume of the ECF. |
| Normal Sodium Level | 135-145 mmol/L |
| Hyponatremia | *Confusion
*Muscle Weakness (First check Respiratory Status!!)
-↑ GI Motility
-Nausea, Diarrhea
-Change in Cardiac Output
(Hyper/Hypovolemia) |
| Hyponatremia Interventions | *Monitor the patients response to therapy and preventing hypernatremia and fluid overload. Treat with fluids and sodium. |
| Hypernatremia | *Twitching
Confusion |
| Potassium | *Cardiac
*Major intracellular cation
*80% of K loss if from kidneys |
| Normal Potassium Level | 3.5-5.0 mEq/L |
| Hypokalemia S/S | *Cardiovascular Changes
-Weak Pulse
-Dysrhythmias
-Muscle weakness
*Decreased Peristalsis
-Confusion |
| Hypokalemia Interventions | -Ensure adequate oxygenation
-Monitor response to therapy
-Prevent injury from K administration *Never IV PUSH,IM, or SubQ Potassium |
| Foods High in Potassium | -Prunes, Raisins
-Apricots
-Nuts/Seeds
-Fish
-Beans
-Avacados
-Dark Chocolate |
| Hyperkalemia | *Cardiovascular problems are most severe and result in most deaths
-Increase GI motility, Diarrhea
-Muscle Twitching |
| Hyperkalemia Interventions | -Cardiac Monitoring
-Drug Therapy (Kayexalate, glucose and insulin, dialysis) |
| Normal Calcium Level | 9.0-10.5 mg/dL |
| Calcium | -Closely r/t phosphorus & magnesium
-Stored in the bones
-Vitamin D is required for absorption |
| Parathyroid Hormone (PTH) is released when... | Calcium levels are low |
| Thyrocalcitonin (TCT) is released when... | Calcium levels are high |
| Percentage of people that are Lactose Intolerant | 75-90% |
| Hypocalcemia S/S | *Risk of bleeding
-Paresthesia (numbness/tingling)
-Trousseaus's or Chvostek's Sign
-↑Peristalsis
-Skeletal Changes(Chronic)
-EKG Changes
*Frequent spasms (Charley horses |
| Trousseaus's Sign | Hand, finger spasm with BP cuff inflated 1-4 minutes |
| Chvostek's Sign | One-sided facial twitching when brushed |
| Hypocalcemia Interventions | -Injury prevention (brittle bones)
-Seizure Precautions |
| Hypercalcemia S/S | *Risk of blood clots
-Cardiovascular changes are most serious and life threatening
-Altered LOC
-↓Peristalsis |
| Hypercalcemia Interventions | -Dialysis
-Cardiac Monitoring |
| Normal Phosphorus Level | 3.0-4.5 mg/dL |
| The most phosphorus can be found where? | In the bones. About 80% |
| What is phosphorus needed for in the body? | For activating vitamins and enzymes, forming adenosine triphosphate, and assisting in cell growth and metabolism |
| The relationship between Calcium and Phosphorus | ↑Calcium = ↓Phosphorus |
| Foods high in Phosphorus | -Meats
-Fish
-Dairy products
-Nuts |
| Clinical situations that would cause Hypophosphatemia | -Malnutrition
-Starvation
-Malignancy
-Alcohol Abuse |
| Hypophosphatemia S/S | -Most apparent in cardia, Musculoskeletal, and hematologic systems, and CNS.
-↓Cardiac Output
-Muscle Breakdown
-CNS Changes(Not til severe) |
| Hypophosphatemia Interventions | -Vitamin D Supplements
*Decreasing intake of foods high in Calcium |
| Hyperphosphatemia | -Can be from renal insufficiency
-Does not cause many problems, worst problems include the relationship with calcium. ↑Phosphorus=↓Ca |
| Hyperphosphatemia Interventions | Since Phosphorus and Calcium have a reciprocal relationship, management of hyperphosphatemia entails management of hypocalcemia |
| Normal Magnesium Level | 1.3-2.1 mg/dL |
| Magnesium | Critical for skeletal muscle contraction, carb metabolism, ATP formation, vitamin activation, and cell growth |
| Hypomagnesemia is caused by... | Increased membranes excitability and the accompanying serum calcium and potassium imbalances. |
| Hypomagnesemia S/S | -Muscle contractions, numbness/tingling
-Chvostek's & Trousseaus's Sign
-Confusion, depression/psychosis
-↓Peristalsis |
| Hypomagnesemia Drug Intervention | Magnesium Sulfate-Give IV, never IM |
| Hypermagnesemia occurs when... | excitable membranes are less excitable and need a stronger-than-normal stimulus to respond |
| Hypermagnesemia S/S | -↓BP, ↓HR
-Cardiac Arrest
-Lethargy/coma
-↓Reflexes
-Respiratory failure r/t muscle weakness |
| OTC Meds high in Magnesium | -Antacids
-Milk of Mag |
| Normal Chloride Level | 98-106 mEq/L |
| Chloride | *Major Extracellular Anion
-Usually occurs as a result of other electrolyte imbalances |
