Fluids & Electrolytes

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Anonymous
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117367
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Fluids & Electrolytes
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2011-12-01 08:00:36
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Nurse1921 GPC Fluids Electrolytes Exam
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NURS1921 Fluids & Electrolytes
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  1. Active Transport







    ACTIVE TRANSPORT
    movement of solutes accross cell membrane in absence of a favorable chemical or concentration gradient. From an area of higher solute concentration-- against the gradient--Pumping Uphill--REQUIRES ENERGY (ATP) from cell and carrier substances
  2. ELECTROLYTES
    Anions


    Cations
    Anions - electrolyte ions carrying a - elec. Charge

    Cations - electrolyte ions carrying a + elec. Charge
  3. SOLVENTS & SOLUTES
    Solvents - liquids that hold a substance in solution

    Solutes - substances that are dissolved in a solution
  4. COLLOID OSMOTIC PRESSURE
    AKA
    ONCOTTIC PRESSURE
    Plasma proteins, especially ALBUMIN that create a pulling force that brings water back into capilarries
  5. DIFFUSION
    the movement of solutes from an area of higher concentration to an area of lower concentration
  6. EDEMA/Peripherial Edema
    • Excess fluid in interstitial space
    • 1+ pitting edema = 2mm
    • 2+ = 4mm
    • 3+ = 6mm
    • 4+ = 8mm
    • BRAWNEY EDEMA-Fluid cannot be displaced, warm, soft, shiny skin surface
  7. FILTRATION
    passage of fluid through a permeable membrane

    from higher pressure to lower pressure
  8. Hydrostatic Pressure
    the pushing force that moves a fluid through a permeable mebrane

    • 1. venous = 12 mm Hg
    • 2. Colloidal osmotic/oncotic pressure = 22 mm Hg
    • 3. aterial = 32 mm Hg
  9. HYPERTONIC
    • Greater osmolarity than Plasma
    • > 295 mOsm/L
  10. HYPOTONIC
    • Lower osmolarity than plasma
    • < 275 mOsm/L
  11. ISOTONIC SOLUTION
    275-295 mOsm/L = normal plasma
  12. HYPERVOLEMIA
    an excess of isotonic fluid volume in the Extra Cellular Fluid (ECF)
  13. HYPOVOLEMIA
    Loss of equal portions of water and solutes (isotonic) in the Extra Cellular Fluid (ECF)
  14. OSMOSIS
    Passage of a solvent through a semi-permeable membrane from low to high concentration until equilibrium is established
  15. FUNCTIONS of WATER
    • TRANSPORT:
    • nutrients to cells, waste from cells, substances such as hormones, enzymes, WBC & RBC
    • Cellular METABOLISM/CHEMICAL reactions
    • SOLVENT for electrolytes & non electrolytes
    • Maintain nromal BODY TEMP
    • facilitate DIGESTION
    • ELIMINATION
    • TISSUE LUBRICANT
  16. WATER IN:

    Muscle
    Fat
    • + muscle = + water
    • + fat = - water

    • infants have highest water by % (60 =/-)
    • Men more than women
    • adults more than elderly
  17. WHER IS THE WATER HELD IN THE BODY?
    Body is 50-60% water, of that 25 liters

    • ICF - intracellular fluid 40%
    • ECF - extracellular fluid 20%
    • intravascular (Plasma), interstitial (surrounding
    • cells and in lymph)
    • Trancellular - 3rd space - cerebrospinal, pericardal,
    • synovial, intraoccular, pleural fluids
  18. COLLOIDS
    • Large molecules unable to pass through membranes
    • ALBUMIN
    • GLOBULIN
    • FIBRINOGIN
    • Proteins that hold water creating osmotic pull/osmotic presssure that holds water in blood vessels
  19. OSMALARITY/OSMOLALITY
    • Number of dissolved particles in a solution
    • Normal Blood osmolality lab value = 280-300 mOsm/kg of water

    Most of that is Na+ (salt)
  20. Isotonic IV Therapy
    • normal saline, 0.9% NaCl
    • Ringers
    • D5W (changes inside body)

    used to add vascular volume BP goes up
  21. Hypotonic IV Therapy
    lower than norm saline, like 0.45% NaCl

    causes osmosis, increasing water in cells
  22. Hypertonic IV Therapy
    • ie. 3% NaCl
    • addition of 5% Dextrose to 1/2 NS/Isotonic fluid

    • water is pulled from the cells
    • reduces edema, lowers/stabilizes BP, regulates urine output
  23. WATER IN & OUT
    Normal DAILY Fluid Balance
    • IN
    • ingested water 1300 ml
    • ingested food 1000 ml
    • metabolic oxidation + 300 ml
    • 2600 ml
    • OUT
    • kidneys 1500 ml
    • skin 600 ml
    • lungs 300 ml
    • gastrointestinal +200 ml
    • 2600 ml
  24. ALDOSTERONE
    Made in Adrenal Cortex

    Causes Kidneys to re-absorb Na+, and therefore water

    secreted when vascular volume is low-vomiting, blood loss, etc
  25. ADH
    Anti Diurectic Hormone
    • too much ADH = to much water-Soggy Sue:
    • SIADH

    Not enuf ADH= Diabetis Insipidus (DIuresis) loosing water to fast-dehydrating
  26. Fluid Volume Excess FVE
    • distended neck veins
    • distended peripherial veins
    • slow emptying peripherial veins
    • CVP over 11 cm H2O in vena cava
    • moist lungs, SOB, dyspnea
    • Ascites-plueral effusion (severe FVEfluid moves into
    • body cavities
    • Decreased Hematocrit due to plasma dillution
    • Bounding full pulse elevated BP
    • Pulmunary edema, if severe
  27. Causes of Fluid Volume Excess (FVE)
    • renal disease
    • low blood flow to kidneys ie. cardiac insufficiency, liver
    • disease
    • IV fluids infusing to rapidly
    • steroid therapy or Cushing's Syndrome
    • stress
    • Production of ADH

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