Med Surge Ch 13

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caugustine
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165806
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Med Surge Ch 13
Updated:
2012-08-14 22:54:14
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fluid electrolyte med surge
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vocab words for chapter 13 med surge. fluids and Electrolytes
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  1. Homeostatsis
    body conditions close to normal
  2. homeostatic mechanisms
    control actions to prevent dangerous conditions in the body
  3. water is the most common substance in the body
    what % is the total body weight in a healthy young adult and what % is the total body weight in a healthy older adult
    • 55%-60% young adult
    • 50%-55% older adult
  4. ecf (extracellular fluid)
    fluid outside the cells; 1/3 (15 l) of total body water
  5. icf (Intracellular fluid)
    fluid inside the cells; 2/3 (25 l) of total body water
  6. interstitial fluid
    fluid between cells, blood, lymph, bone, connective tissue water and transcellular fluids
  7. transcellular fluids
    includes cerebrospinal fluid, synovial fluid, peritoneal fluid, and pleural fluid
  8. solvent
    water portion of fluids
  9. solutes
    the particles dissolved or suspended in water (solvent)
  10. electolytes
    solutes that have an electrical charge
  11. 3 processes that control fluid and electrolyte balance
    filtration, diffusion, and osmosis. They determine how, when, and where fluids and particles move across the cell membrane
  12. filtration
    movement of fluid thru a cell or blood vessel membrane because of hydrostatic pressure differences on both sides of the memebrane
  13. hydrostatic pressure
    pressing of water molecules. "water-pushing" pressure. Is what pushes water outward from a confined space thru the membrane
  14. viscous
    thick as in blood is thicker than water
  15. permeable
    porous membrane 
  16. equilibrium
    when hydrostatic pressure is the same in both fluid spaces, no difference in hydrostatic pressure
  17. disequilibrium
    hydrostatic pressure is not the same in both spaces
  18. gradient
    graded difference b/w two spaces... one has a high hydrostatic pressure whereas the other has a low
  19. filters
    water moving thru a membrane with nothing stopping it
  20. example of hydrostatic filtering force
    blood pressure
  21. pores
    large spaces
  22. edema
    • tissue swelling with fluid collection... can occur with right sided heart failure 
    • *excess filtration of fluid from the capillaries into the interstitial tissue space occurs, forming visible edema
  23. diffusion
    the free movement of particles (solute) across a permeable membrane from an area of higher concentration to an area of lower concentration (down a concentration gradient)
  24. concentration gradient exists when:
    two fluid spaces have different amounts of the same type of particles
  25. impermeable
    membrane that is not open (no pores) 
  26. facilitated diffusion or facilitated transport
    a form of diffusion across a cell membrane that requires the assistance of a membrane-altering system (for ex insulin)
  27. osmosis
    • the movement of water only thru a selectively permeable (semipermeable) membrane 
    • (usually water can always move thru a cell membrane)
  28. osmolarity
    the number of milliosmoles in a liter of solution
  29. Osmolality
    the number of milliosmoles in a kilogram of solution 
  30. Isosmotic (aka isotonic or normotonic) 
    • when all body fluids have 300 MOSM/L PARTICLE CONCENTRATION THE BODY FUNCTIONS AT ITS BEST
    • NORMAL RANGE IS 270-300 MOSM/L
  31. HYPEROSMOTIC (AKA HYPERTONIC)
    • FLUID OSMOLARITIES ARE GREATER THAN 300 MOSM/L
    • HAVE A GREATER OSMOTIC PRESSURE THAN ISOSMOTIC FLUIDS
    • PULLS WATER FROM THE ISOSMOTIC FLUID SPACE INTO THE HYPEROSMOTIC FLUID SPACE UNTIL BALANCE OCCURS 
  32. HYPO-OSMOTIC (AKA HYPOTONIC)
    • FLUID OSMOLARITIES OF LESS THAN 270 MOSM/L
    • HAVE A LOWER OSMOTIC PRESSURE THAN ISOSMOTIC FLUIDS
    • WATER IS PULLED FROM THE HYPO-OSMOTIC FLUID SPACE INTO THE ISOSMOTIC FLUID SPACE
  33. SOLUBILITY
    • HOW WELL A PARTICLE TYPE WILL DISSOLVE IN WATER
    • THE MORE SOLUBILITY OF A PARTICLE THE HIGHER THE OSMOTIC PRESSURE 
  34. osmoreceptors
    cells sensitive to changes in ECF osmolarity
  35. average fluid intake by an adult of liquids:
    fluid intake from solid foods:
    • Liquids: 1500 ml
    • Solid Foods: 800 ml
  36. obligatory urine output
    minimum amount of urine per day needed to excrete toxic waste products is 400 to 600 ml
  37. Ways fluid loss occurs:
    • Kidney's (most important and sensitive)
    • skin
    • lungs
    • intestinal tract
    • salivation
    • drainage from fistulas and drains
    • Gi suction
  38. In healthy adult insensible water loss is about ____ ml per day
    500-1000 ml/day
  39. aldosterone prevents both ___ and ___ loss
    water and sodium
  40. most important fluids to keep in balance are:
    • blood volume (plasma volume) *most critical in preventing death (keeps blood pressure high enough to ensure perfusion and oxygenation of all organs and tissues)
    • fluid inside the cells (intracellular fluid)
  41. Kidneys monitor 
    blood pressure, blood volume, blood oxygen levels, and blood osmolarity (r/t NA concentration)
  42. impermeable cell membrane 
    not open to certain particles 
  43. facilitated diffusion or facilitated transport:
    diffusion across a cell membrane that requires the assistance of a membrane-altering system (ex: insulin- helps glucose cross cell membrane)
  44. osmosis
    movement of water only thru a selectively permeable (semipermeable) membrane
  45. causes the kidney to reabsorb water and sodium
    aldosterone
  46. renin activates ____
    angiotensin 1
  47. angiotensin 1 activates 
    angiotensin-converting enzyme (ace) which turns angi 1 into angiotensin 2 
  48. angiotensin 2 works to:
    • increase blood volume and blood pressure
    • By:
    • 1.constriction of small arteries and veins
    • 2.constricts the size of the arterioles that feed the kidney nephrons 
    • 3.cause adrenal glands to secrete aldosterone (last and slower action)
  49. dehydration
    • fluid intake or fluid retention is less than what is needed to meet the body's fluid needs
    • condition rather than a disease
  50. relative dehydration 
    when water shifts from the plasma into the interstitial space
  51. isotonic dehydration
    • water and electrolyte loss
    • most common type of fluid loss problem 
  52. hypovolemia
    blood volume is decreased (leads to inadequate tissue perfusion)
  53. "ortho checks" or "Ortho changes"
    measure of blood pressure lying down, sitting, then standing
  54. hemoconcentration
    when more water is lost and other substances remain increasing osmolarity or concentration of the blood
  55. two most important areas to monitor during rehydration are 
    pulse rate and quality and urine output
  56. antimicrobial therapy
    drug therapy used in patients with bacterial diarrhea to stop dehydration
  57. antiemetics
    drug therapy used when vomiting causes dehydration
  58. antipyretics
    drug therapy used to reduce a fever that may cause dehydration to worsen
  59. fluid overload
    • excess of body fluid
    • not a disease; a clinical sign of a problem where fluid intake or retention is greater than the body's fluid needs 
  60. hypervolemia
    most common fluid overload 
  61. hemodilution
    • excessive water in the vascular space causing decreased hemoglobin, hematocrit, and serum protein levels
    • serum electrolyte values usually normal
  62. indicators of increased fluid overload:
    • bounding pulse
    • increasing neck vein distention
    • presence of crackles in the lungs
    • increasing peripheral edema
    • reduced urine output
  63. diuretics
    • drug therapy used for fluid overload as long as kidney failure is not the cause
    • increase kidney water or sodium excretion 
  64. specific gravity below 1.005 may indicate:
    fluid overload
  65. electrolytes (ions)
    substances in body fluids that carry an electrical charge
  66. cations
    positively charged electrolytes
  67. anions
    negatively charged electrolytes

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