Fluid & Electrolyte Class Notes
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| Water fluid varies due to what? | Gender, Age, and Body Mass
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| 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
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| What % of our body weight is composed of Intracellular fluid (ICF)? | 40%
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| What % of our body weight is composed of Extracellular space (ECF)? | 20%
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| What is ECF primarily composed of? | NaCl and NaHCO3 solutions
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| Describe the ICF? | A non-homogeneous solution of potassium, organic anions, and proteins controlled by cellular membranes and cell metabolism
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| What does the ECF include? | interstitial fluid, intravascular (plasma), and transcellular fluid
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| What are electrolytes? | substances whose molecules split into ions when placed into water.
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| Name prevalent cations in the body? | Na+, K+, CA2+, Mg2+
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| Name prevalent anions | HCO3-, Cl-, PO4-
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| How are concentrations of electrolytes expressed? | as mEq/L
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| What is the most prevalent cation in the ICF? | K+
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| What is the most prevalent anion in the ICF? | HPO4-
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| What is the most prevalent cation in the ECF? | Na+
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| What is the most prevalent anions in the ECF? | Cl-
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| What is osmosis? | Movement through a semi-permeable membrane from area of lessor solute concentration to an area of higher solute concentration.
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| Does osmosis require energy? | No
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| When does osmosis stop? | when equilibrium is reached
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| What does osmolarity mean? | concentration of a solute in a solution
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| 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.
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| What happens when you introduce a hypotonic solution to a body? | fluid moves into cells causing them to enlarge
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| What happens when you introduce a isotonic solution to the body? | expands body's fluid volume without causing a fluid shift
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| What happens when you introduce a hypertonic solution into the body? | fluid is pulled out of the cell causing them to shrink
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| 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
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| What is facilitated diffusion? | Same movement of molecules but requires a carrier molecule to accelerate/facilitate diffusion
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| What does the diffusion rate depend on? | molecule size, concentration, temp of a solution
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| What is filtration? | movement of water and small particles from an area of high pressure to low pressure
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| What is osmotic pressure? | the power of a solution to draw water
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| More concentration equates to what _____ osmotic pressure? | high osmotic pressure
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| What are factors affecting filtration? | size of pores in membrane varies, hydrostatic pressure
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| hydrostatic pressure | Fluid pressure
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| osmotic pressure | power of a solution to draw water (more concentrated, high osmotic pressure)
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| What is the hydrostatic pressure in the atrial capillary? | 40 mm Hg
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| What is the hydrostatic pressure in the venous end? | 10 mm Hg
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| What is the interstitial hydrostatic pressure in the tissue? | 1 mm Hg
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| What is the tissues interstitial oncotic pressure? | 1 mm Hg
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| In active transport where do molecules go? | against there concentration gradient
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| What is required in active transport? | ATP (energy)
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| Do ICF and ECF have the same concentration of Na+ and K+? | Hell no they are very different!
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| What do osmoreceptors monitor? | serum osmolarity
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| 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.
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| Give examples of what osmoreceptors monitor? | decreased fluids or intake of hypertonic fluids, or when hypovolemia occurs
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| What causes hypovolemia? | internal or external bleeding, fluid losses or inadequate fluid intake.
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| Define hypovolemia | A decreased blood volume that may be caused by internal or external bleeding, fluid losses, or inadequate fluid intake.
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| What does the hypothalamus do in response to there is increase osmolarity? | the hypothalamus will stimulate the thirst response
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| When the hypothalamus stimulates the thirst response what is required in the person? | that the individual is in an alert state
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| Who are at risk for dehydration? | infants, cognitively impaired elderly or patients with neurological and or psychological impairments at risk for dehydration.
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| What happens to our sensitivity of thirst as we age? | it decreases
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| How many liters of plasma do the kidneys filter on a daily basis? | 180 L
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| How much do the sensible and insensible water losses through the skin produce? | 500-600 ml daily
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| How much fluid output doe the lungs expire in a day? | 400 ml
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| How much fluid output is moved in the GI tract and returned to the ECF daily? | 3-6 L
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| What gland releases ADH? | pituitary gland
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| What does ADH do? | ADH works directly on the renal tubules to reabsorb water, returning water/fluid to systemic circulation
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| What releases aldosterone? | the adrenal cortex
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| What does aldosterone do? | it works directly on the renal tubules to reabsorb sodium and excrete K+ and H+ leading to water retention
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| What secrets renin? | the Kidney
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| What does renin produce? | angiostensin I which converts to angiotensin II
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| What does renin do? | causes vasoconstriction and improved renal perfusion
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| Define diuresis | elimination of urine
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| Define urinalysis | analysis of a urine sample
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| what could occur if there is damage to the capillary walls such as bruising? | localized edema
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| define edema | the movement of abnormal amts of water from plasma to interstitial fluid
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| What occurs when there is an increase in blood pressure in the pulmonary capillaries? | pulmonary edema
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| What occurs when there is a decrease in blood colloid osmotic pressure? | generalized edema
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| When is aldosterone secreted? | in response to rising K+ or falling Na+ or in response to the activation of renin angiotensin system.
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| 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
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| 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
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| What hormones make u pee and decreases fluids in the body? | natriuretic peptides (ANP, BNP)
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| What hormones causes water retention? | aldosterone, Antidiuretic hormone, renin, angiotensin I/II
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| What illnesses causes fluid and or electrolyte imbalances? | injury, congestive heart failure or burns
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| What is the normal serum Na+ range? | 135 - 145 mEq/L
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| What is the normal serum K+ range? | 3.5 - 5.0 mEq/L
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| What is the normal atertial pH range? | 7.34 - 7.45
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| What is the purpose of regulation of acid base balance? | for optimal functioning of cells
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| What regulates the body's acid base balance? | buffers, respiratory mechanisms, renal mechanisms
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| What therapeutic measures can worsen fluid and electrolyte imbalances? | intravenous fluid administration, diuretic use, surgery
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| 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
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| 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
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| 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
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| 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
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| 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
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| define oliguria | lil amts of piss
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| what causes fluid volume excess? | CHF, renal failure, cirrhosis of the liver, increased serum aldosterone and steroid levels, excessive sodium intake or administration
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| 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
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| 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)
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| 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
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| 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
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| 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
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| 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
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| 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
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| 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
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