fluid & electolyte med surge I (Erin's slides)
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| show | 60%
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| How does age affect % of body fluid? | show 🗑
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| show | Men have a greater % of body water than women
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| show | Obese people have lower % of body fluid b/c adipose tissue holds less water
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| show | Water; a liquid that dissolves other substances
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| show | it is necessary to sustain life; affects cell shape and size; maintains body temp; transports gases & wastes throughout the body; almost every organ in the body plays a vital role in maintaining electrolyte balance.
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| Intracellular space (ICF)= | show 🗑
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| show | Intravascular (inside vessels); "plasma"= liquid part of blood, Interstitial (b/w cells)= fl surrounding cell; Transcellular is fl that does not exist in lg amounts & causes no major fluid shifts,(CSF, pericardial, pleural,digestive, & synovial fluids)
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| show | fluid lost from ECF (outside the cell); body can't absorb quickly, pee it out or lose it; appear "Puffy"
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| show | maintain fluid balance
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| show | Intracellular (ICF) and Extracellular (ECF); "Act as a Dam"
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| show | intravascular (inside the vessels) to extravascular (outside the vessels) and from intracellular (inside the cells) to extracellular (outside the cells)
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| show | solutes (electrolytes) and solution (fluid) concentrations
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| show | Minerals (sometimes called salts)present in all of our body fluids; electrically charged chemicals; + or -; unite in various cojmbinations (i.e. Na+Cl- or normal saline soln)
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| Cations ...(has a "t" with a + in it) | show 🗑
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| show | - charge; Cl-, HCO3-, SO4-, PO4-
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| show | ECF (outside the cells) b/c of easier access
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| show | ECF (outside the cell); regulator of of body fluid volume
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| show | ICF (inside the cell)
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| In order to keep Na+ levels higher in ECF (outside the cell) and K+ levels higher in ICF (inside the cell) the body must use_____? | show 🗑
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| Osmosis= Movement of ________ across a semipermeable membrane from ___ ________ concentration to ____ _______ concentration. It is a _______ _________ and does not require ________. | show 🗑
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| Osmola "L" ity= # of particles of solute in a unit of fluid based on________; hint: "L" = Lb for the abreviation of pound. | show 🗑
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| Osmolarity= # of particles of solute in a unit of fluid based on ________ | show 🗑
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| What is the ability of solutes to cause an osmotic driving force and promote water movement from one compartment to another to try to maintain balance in the body? | show 🗑
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| show | USE(TO INCREASE BP)IN HYPOTENSIVE PATIENTS; "low # of electrolytes as compared to water; In other words= more water and less electrolytes;
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| show | USED TO INCREASE BLOOD VOLUME (TO INCREASE BP)"Same"= same # of electrolytes and water; won't see huge fluid shifts; DOES NOT ALTER CELL SHAPE OR SIZE;
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| Hypertonic solutions= High; D5NS (5%Dextrose Normal Saline)or D5LR (Lactate Ringer) | show 🗑
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| show | to increase blood volume/BP
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| Why would you give a hypertonic solution? | show 🗑
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| When would you NOT give Normal Saline? | show 🗑
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| show | requires energy
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| Diffusion is a ..."fish downstream" | show 🗑
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| F & E Homeostasis uses almost every organ in our body in order to maintain fluid balance to regulate homeostasis...a problem with one...? | show 🗑
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| How does the heart affect fluid balance to regulate homeostasis? | show 🗑
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| show | CO; affects how much blood or fluid reaches the kidneys.
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| show | insensible fluid loss; and are involved in acid-base balance; (acid= sour; base= bitter)
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| show | by the "Thirst Center" located in the hypothalmus
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| What does the hypothalmus produce? | show 🗑
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| What does ADH do? | show 🗑
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| show | it is the most significant factor in determining whether excreted urine is concentrated (dark) or dilute (straw color)
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| How does the Adrenal Gland affect fluid & electrolyte balance to regulate homeostasis? | show 🗑
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| show | ↑'s Na+ reabsorption and ↑'s/stimulates K+ excretion; Regulates the amount of electrolytes (Na+/K+ levels) in the body, thus, maintains BP & body fluids
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| What affect does the Parathyroid Gland have on fluid & electrolyte balance to regulate homeostasis? | show 🗑
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| show | Bone reabsorption (when old bone is broken down it sends Ca++ out into the blood stream); Ca++ absorption from the intestines; Ca++ reabsorption from the renal tubules in the kidneys
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| show | The pituitary releases ADH which stimulates water reabsorption and ↓'s U.O. (urinary output); remember...it keeps you from peeing.
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| How does the Renin-Angiotensin-Aldosterone System stimulate thirst? | show 🗑
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| show | Aldosterone in response to renin
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| show | volume
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| show | regulates BP and water balance; a low BP causes the kidneys to secrete renin, renin stimulates Angio I & Aldosterone which ultimately causes the kidneys to hold onto Na+ and water; ↑'s BP (if BP gets too high need to give ACE inhibitors...-sartans)
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| show | sense changes in Na+ concentration in our body
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| show | A cardiac hormone; opposite of renin-angiotensin-aldosterone; ANP ↓'s BP,↑'s U.O. ("ANP makes you Pee"); stimulates vasodilation which ↑'s water excretion/U.O.
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| show | ↑'d risk of F&E disorders b/c experience changes in F&E's quicker r/t decreased renal, pulmonary (lung), and adrenal function
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| What do you need to assess in geriatric clients to evaluate F&E's? | show 🗑
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| show | The end product of muscle metabolism. The most definitive way of measuring kidney function [better than BUN (blood urea nitrogen]; but will use BUN & CC to measure kidney function.
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| show | Oral, IV, SubQ, Enteral (via gut)
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| show | Kidneys and insensible losses
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| show | 1500 mL/day of urine (obligatory [need to lose]U.O. is 400-600mL/day)
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| What are insensible losses of fluid? | show 🗑
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| What is the term for Fluid Volume Deficit (FVD)? | show 🗑
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| What is the definition of hypovolemia? or When does hypovolemia occur? | show 🗑
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| When talking about hypovolemia we talk about a loss of...? | show 🗑
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| show | loss of fluid; but tends to have a high sodium concentration; (thus, the loss of water is not equal to the loss of electrolytes and cannot be called the same thing as hypovolemia.)
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| Which is worse hypovolemia or dehydration? | show 🗑
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| What some causes of hypovolemia/isotonic imbalances from the GI system? | show 🗑
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| What some causes of hypovolemia/isotonic imbalances from the renal system? | show 🗑
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| What are some insensible causes of hypovolemia/isotonic imbalances? | show 🗑
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| As Hypovolemia worsens the signs/symptoms worsen and can lead to...? | show 🗑
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| show | Fluid in the abdomen.
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| show | Administer fluids: Oral route is preferred; may give isotonic IV fluids 0.9% NS or LR (remember they do not cause huge fluid shifts); this will also increase BP
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| show | I&O; Daily wts (most sensitive indicator of fluid changes); VS; Notify the MD of lack of response or worsening of symptoms (SBAR)
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| show | Elderly, renal failure, diarrhea, C.diff (pooping q 5 seconds), vomiting.
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| How would you educate a pt with FVD? | show 🗑
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| How do you best assess the adequacy of FVD replacement in a pt. with hypovolemia by monitoring...? | show 🗑
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| show | Expansion of ECF (outside the cell); isotonic imbalance of fluids and electrolytes; circulatory overload
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| show | ...your body will try to compensate for fluid overload by fine tuning the circulatory or circulating levels of Aldosterone, ADH & ANP; by altering these levels it causes the kidneys to release additional water and sodium
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| What are the primary Signs/Symptoms of hypervolemia (we are expected to know)? | show 🗑
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| How do you manage FVE (fluid volume excess)? | show 🗑
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| What should you monitor for FVE? | show 🗑
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| show | Renal fx, Elderly, Heart & liver failure pts (conditions resulting in impaired circulating volume), any condition that presents with ↓'d serum proteins such as Liver fx, malnutrition, Burns, and Nephrotic syndrome (renal fx)
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| show | via GI tract
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| Where are electrolytes excreted? | show 🗑
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| show | Na+
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| show | controls water distribution; and affects muscle contraction/nerve impulse transmission
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| show | d/t severe neuro side effects; neurovascular SE's;
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| A loss or gain in Na+= | show 🗑
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| show | < 120 mEq/L;
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| What is a CNS symptom of severe HYPONATREMIA of < 120 mEq/L? | show 🗑
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| show | thirst center in the hypothalmus in the pituitary in the brain
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| show | excess water enters the cells; the cell swells/increases
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| show | HYPONATREMIA
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| show | How quickly Na+ falls or how long the levels are low, and the amount of extracellular fluid volume.
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| What are the GI symptoms of hyponatremia? | show 🗑
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| What are the neurological signs and symptoms of hyponatremia? | show 🗑
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