Fluids, electrolytes, and acid-base balances
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| ___% of the average adult's weight is fluid | 60%
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| Intracellular fluids (ICF) | all fluid w/in body cells
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| What % of body weight is ICF? | 40%
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| Extracellular fluid (ECF) | fluid outside of a cell; divided into 3 parts, Interstitial fluid, intravascular fluid, and transcellular fluids
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| What % of ECF makes up body weight? | 20%
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| What is interstitial fluid? | contains lymph, fluid between cells and outside blood vessels
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| What is Intravascular fluid? | blood plasma
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| Electrolytes | minerals or salts; when melted or dissolved in water it separates into ions and is able to carry an electrical current
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| Cation | + charged electrolytes EX: Na+ K+ Ca+
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| Anion | - charged electrolytes EX: Cl- HCO3- SO4-
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| Solute | dissolvable in water
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| Solvent | dissolvable in plasma
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| Osmosis | movement of a pure solvent, through a semipermeable membrane, from an area of lesser solute concentration to an area of greater solute concentration to try to equalize concentrations on both sides of a membrane
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| Osmotic pressure is: | the drawing power for water & depends on the number of molecules in solution
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| A solution with the same osmolarity as blood plasma is called: | isotonic
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| Movement of a solute in a solution across a semipermeable membrane from an area of higher concentration to an area of lower concentration is: | diffusion
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| Filtration | water and diffusable substances move together in response to fluid pressure, moving from an area of higher pressure to an area of lower pressure
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| hydrostatic pressure | mvmt of water from interstitial space into the intravascular space by filtration
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| Increased hydrostatic pressure causes what? | edema, as with CHF
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| Active transport | movement of materials across cell membranes requiring metabolic activity
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| homeostasis | physiological balance
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| Osmoreceptors | continually monitor the serum osmotic pressure, when osmolality increases, hypothalamus is stimulated
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| ADH | Antidiuretic hormone; stored in pituitary gland; works directly on kidney tubules and collecting ducts making them more permeable which returns water to systemic circulation
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| Aldosterone | released by adrenal cortex in response to increased K+ levels; it increases the reabsorption of Na+ and secretion of K+
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| Insensible water loss | continuous and not percieved by person
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| sensible water loss | through excess perspiration
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| The lungs expire____ml of water a day | 400ml
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| What are the major cations? | Na+ K+ Ca+ Ions
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| What are the major anions? | chloride, bicarbonate, phosphate
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| __% of sodium is in the ECF? Function of Na+? | 90%, maintain water balance
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| __% of K+ in ECF. What's it's function? | 2%; regulates metabolic activity
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| 1% of Ca+ is in blood, 99% in bone; what is the function? | blood clotting, bone/teeth formation
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| Magnesium is essential for: | enzyme activities, neurochemical activities, cardiac and skeletal excitability
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| __% of magnesium in ECF. Nl plasma concentration is: | 1%; 1.5-2.5 mEq/L
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| Bicarbonate, a chemical base buffer, is regulated by: | the kidneys
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| Buffer | a substance or group of substances that can absorb or release H+ to correct an acid-base balance
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| What is the largest chemical buffer in ECF? | carbonic acid and bicarbonate buffer system; reacts to change in pH of ECF within seconds
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| Biological regulation | occurs when H= ions are absorbed and released by cells, occurs only after chemiocal buffering and takes 2-4 hrs
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| Fluid volume deficit (FVD) | water & electrolytes lost in equal or isotonic proportions
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| Fluid volume excess (FVE) | water and sodium retained in isotonic proportions
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| Hyperosmolar imbalance = | dehydration
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| hypoosmolar imbalance= | water excess
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| TPN or total parenteral nutrition | nutritionally adequate hypertonic solution of glucose, electrolytes, and other nutrients given through an indwelling or central IV
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| IV fluid and electrolyte therapy | crystalloids
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| colloids | blood and blood component
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| Vascular access devices include: | catheters, cannulas, infusion ports,
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| the breakdown of RBC's is called: | hemolysis
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| Autologous transfusion | collection of clients own blood (pre-op)
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| One of the most common electrolyte imbalances is: | hypokalemia
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| The client most at risk for FVD's is: | an infant
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| One reason older adults experience fluid and electrolyte imbalance and acid-base imbalances is they: | have a decreased thirst sensation
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| Output recorded on an I & O record includes: | urine, diarrhea, vomitus, gastric suction, and drainage from wounds and tubes
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| Health promotion activities in the area of fluid and electrolyte imbalances focuses primarily on: | client teaching
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| TPN is delivered by: | indwelling or central IV catheter
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| As a safety alert the RN is aware the following med is never given directly through IV: | Potassium chloride, it will burn the vein
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| Indications of IV fluid infiltration include: | pallor and coolness
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| CDC recommends replacing peripheral venous catheters and rotating sites should occur at least every: | 72-96 hours
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