Nsg F/E
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| Normal Sodium Level | 135 - 145 mEq/L
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| Normal Potassium Level | 3.5 - 5 mEq/L
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| Normal Calcium Level | 8.5 - 10.5 mg/dL
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| Normal Magnesium Level | 1.8 - 2.7 mEq/L
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| Normal Chloride Level | 96 - 108 mEq/L
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| Normal Phosphorus Level | 2.5 - 4.5 mg/dL
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| Normal Serum Osmolality | 280 - 300 mOsm/kg
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| Normal Urine Specific Gravity | 1.010 - 1.025
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| Normal Glucose (Particle to Water Ratio) | 70 - 110 mg/dL
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| Increased Blood Sugar s/s | Increased thirst, increased hunger & increased urination.
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| Approximately _______ of typical adult weight is water & electrolytes | 60%
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| Factors affecting body fluid balance include: | age - younger > older, gender - males > females & Fat - thin > fat
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| Approximately ______ of body fluids are located in the ICF | 2/3
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| The ECF is further divided into three "compartments" which are: | Intravascular holding 6L of fluid, Interstitial holding 11-12L of fluid and the Transcellular holding 1L of fluid
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| Body fluid moves between the ICF and the ECF to maintain _____________ between spaces | equillibrium
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| Define: Third spacing | The result of fluid shifting out of intravascular spaces but not into intracellular spaces.
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| Cations are | Positively charged ions
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| Anions are | Negatively charged ions
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| Electrolytes are | Substances capable of breaking into electrically charged ions when dissolved in a solution
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| mEq | Milliequivalents - a measure of the combining power of the ion
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| The primary ECF electrolytes | Sodium (Na+) and Chloride (Cl-)
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| The primary ICF electrolytes | Potassium (K+) and Phosphate (HPO4-)
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| Colloid Osmotic Pressure | Pulling force exerted by protein in plasma
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| Hydrostatic Pressure | Pushing force exerted on walls of blood vessels
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| Movements not requiring ATP (energy) | Tonicity, Osmotic, Oncotic, and Diffusion
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| The number of dissolved particles contained in a fluid (concentration) | determines the osmolality
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| Tonicity | The ability of all solutes to cause an osmotic driving force that promotes water movement from one compartment to another.
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| Osmosis | Diffusion through a membrane from and area of lower concentration to an area of higher concentration
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| Osmotic Pressure | The amount of hydrostatic pressure required to stop the flow of water by osmosis
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| Oncotic Pressure | The osmotic pressure exerted by proteins (albumin)
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| Osmotic Diuresis or Particle Induced Diuresis | The increase in urine output caused by excretion of substances such as glucose, mannitol, and contrast agents in the urine
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| Diffusion | The tendency of solutes to move freely (spread) throughout a solvent from an area of high concentration to an area of low concentration. OR The random movement of particles in all directions.
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| Movments which require energy | Filtration and Reabsorbtion
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| Sodium Potassium Pump | requires energy and facilitates movement of molecules across the cell membrane against the concentration gradient (from a lower concentration to a higher concentration)
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| Desireable fluid intake and loss in adults is approximately ____________ | 2600mL/d
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| Sources of fluids | Drink- 1300mL/d, Eat - 1000mL/d, Metabolize 300mL/d
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| Metabolism is | the end product of protein, carbs and fat processing by the body
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| Areas of sensible (measureable) fluid loss: | Kidneys - 1500mL/d, Intestinal Tract 200mL/d, and Skin - sweating - 0-1000mL/d
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| Areas of insensible fluid loss: | Skin - evaporation 600mL/d; lungs - exhalation 300mL/d
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| Normal BUN level | 10 - 20 mg/dL
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| Normal creatinine level | 0.7 - 1.4 md/dL (doesn't vary with diet)
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| Normal Hematocrit level | males 42% - 52%; females 35% - 47% Remember: with increased fluid volume you have decreased Hct and with decreased fluid volume you have increased Hct.
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| The __________ are the primary organs of homeostastis | Kidneys; filtering 180L plasma/d and excreting 1-2L urine/d
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| The ______ and _______ vessels circulate blood through the kidneys under sufficient pressure to allow for urine formation | heart; blood
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| MAP | mean arterial pressure: the difference between the systolic and diastolic blood pressures
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| Should be >70: | MAP
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| _____ will increase coughing and respirations which will assist in increased fluid loss. | Lungs
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| These organs are crucial in maintaining acid-base balance | Lungs
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| Pituitary Gland - hypothalamus manufactures _____ which is stored in the Posterior Pituitary Gland and released as needed to conserve water | Antidiuretic Hormone (ADH)
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| Adrenal Glands | helps the body conserve sodium, save water and chloride and excrete potassium.
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| Cortisol | can cause sodium and water retention in large doses or amounts.
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| Parathyroiid Glands | Four tiny glands embedded in the thyroid gland which secrete parathyroid hormone (PTH) which regulates calcium and phosphate balance
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| Baroreceptor | influences Sodium and Water reabsorbtion as needed
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| Systolic Pressure consists of | ventricular contraction
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| Diastolic Pressure consists of | Ventricular relaxation
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| The Renin-Angiotensin-Aldosterone System | Decreaased BP...renin...angiotensin...angiotensin I...angiotensin II...Aldosterone...Increased BP
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| Before administering these meds always check the BUN, Creatinine, Pulse and BP | Ace Inhibitors (meds ending in PRIL) and ARB Inhibitors (meds ending in SARTIN)
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| Aldactone | is a Potassium sparing Diuretic (always check the K+ level before administration)
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| The presence or absence of ______ is the most significant factor in determining whether urine is concentrated or dilute | ADH
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| Albumin is a protein which | helps pull water into the intravascular space
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| Increased _______ levels may be caused by overhydration | Albumin
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| Decreased glomerular filtration rate is a special consideration for the elderly. The GFR should be | >60
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| The average percentage of body weight in infants which is water: | 70% - 80%
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| The infant is at very high risk for __________ because the ECF is easier to lose than ICF | Fluid Volume Deficit
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| Dehydration is | The loss of water by the body
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| Hypovolemia is | The loss of fluid and electrolytes by the body
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| Causes of Hypovolemia | Vomiting, Diarrhea, GI suctioning, Sweating, and Third Space Fluid shifts
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| S/S of Hypovolemia | Acute weight loss, Decreased skin turgor, Oliguria, Concentrated urine, Orthostatic Hypotension, Weak pulses, Tachycardia, Thirst, Delayed capillary refill, Cool clammy pale skin, anorexia, Nausea, Weakness, Cramps, Dry tounge.
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| ___________ Shock is the most common kind of shock, characterized by a reduction in intravascular volume by 15% - 30% | Hypovolemic
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| Heart Failure, Kidney Failure, Cirrhosis of the liver, Endocrine conditions that affect ADH and aldosterone, Excessive intake of sodium containing fluids, drugs which cause sodium retention and the administration of sodium containing IVF are causes of | Hypervolemia
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| Interstitial Edema, Elevated BP, Tachycardia, Bounding Peripheral Pulses, Increased Respiratory Rate, Dyspnea/Orthopnea, Crackles/Wheezes, Distended neck veins, Weight gain, dependent edema in lower extremities in ambulatory clients. | Hypervolemia
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| Fluid losses due to vomiting diarrhea, sweating, diuretics. | Causes of Hyponatremia
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| Poor skin turgor, hypotension, anorexia, n/v, h/a, exhaustion, muscle cramps/twitching, edema/weight gain, altered mental status. | S/S of Hyponatremia
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| A common cause is fluid deprivaton in an unconscious patient who cannot perceive or respond to or communicate thirst, hypertonic interal feeding without water supplements, diarrhea, hyperventilation r/t fever and burns. | Causes of Hypernatremia
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| Thirst,restlessness or weakness, disorientation or confusion, delusions or hallucinations | S/S Hypernatremia
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| Caused by gastric suction, v/d, fistulas, laxative abuse, Medications, alteration in acid-base balance, Hyperaldosteronism, Poor Dietary intake. | Hypokalemia
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| fatigue, anorexia, n/v, dysrythmias, muscle weakness/cramps, paresthesias, glucose intolerance, decreased muscle strength, decreased DTR's | Hypokalemia
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| Hypokalemia will causes changes to the T wave on an EKG. Will the T wave be extraordinarily high or flat? | Flat
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| Hypokalemia will also create an unsual _____ wave on the EKG | U wave
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| Untreated renal failure, rapid administration of potassium, Hypoaldosteronism (Addison's Disease) and Medications will cause | Hyperkalemia
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| Medications causing hyperkalemia include KCL, Heparin, ACE Inhibitors, _______, beta blockers, and potassium sparing diuretics | NSAIDS
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| ___ of the body's calcium is located in the bones and teeth. | 99%
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| Calcium is controlled by | PTH and calcitonin
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| Hypocalcemia causes include hypoparathyroidism, malabsorbtion, pancreatitis, massive transfusion of citrated blood, renal failure medications which include: | Aluminium containing antacids, corticosteroids, loop diuretics, and caffeine
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| Trousseau's sign and Chvotsky's sign are both signs of: | Hypocalcemia
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| Malignant tumors, hyperparathyroidism, bone loss related immobilization are all causes of | Hypercalcemia
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| Muscle weakness, incoordination, dehydration, anorexia, n/v, constipation, abdominal distention, bone pain, polyuria, nad thirst are all s/s of | Hypercalcemia
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| Dysrhythmias, confusion, impaired memory, slurred speech, lethargy, acute psychotic behavior, coma and cardic arrest | Diagnotic findings of Hypercalcemia
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| Hypomagnesemia is most common in: | chronic alcoholics
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| What is the percentage of Mg found in bones? | 60%
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| What is the second most abundant cation in the ICF after potassium? | Magnesium
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| Magnesium is lost via the: | GI tract
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| NG suction, Diarrhea, Fistulas, Enteral or parenteral feeding deficient in Mg, Rapid administration of citrated blood, diabetic ketoacidosis, sepsis, burns and hypothermia | Causes of Hypomagnesemia
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| Muscle weakness and hyperexcitability, alteraion in mood and changes in LOC | s/s Hypomagnesemia
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| Caused by renal failure, Diabetic Ketoacidosis, Result of catabolism, Excessive administration of Mg, Antacids, and Laxatives | causes of Hypermagnesemia
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