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Fluids in the body are found in three basic places: within the cells (intracellular - the largest space), outside the cells (extracellular - AKA intravascular space), and within the tissue spaces (interstitial space or third space).
Edema occurs when too much fluid enters the ______ space.
Peripheral edema usually collects in the __________ areas.
- *interstitial space
- *subcutaneous areas
Normal osmolarity of plasma is ________.
* 270-300 mOsm/L
Hypertonic solutions have a concentration greater than 300 and exert a greater pressure, which pulls water from the <Isotonic Area> to the <Hypertonic Solution> in an attempt to equalize the osmolarity.
Hypotonic solutions have a concetration of less than 270 and exert less pressure, which allows water to be pulled from the <Hypotonic Area> into the <Isotonic Area>.
what are some types of fluid shift?
* Edema (Anasarca- total body, severe edema)
* Increased peritoneal fluid (Ascites)
* Pleural effusion (fluid in space between the lung and chest wall)
how does pleural effusion move?
* filtration - the way fluid moves between the capillaries and tissue space; not everything moves -- live protein don't move.
* Hydrostatic Pressure - pressure of the fluid itself (blood pressure in capillaries and tissues--pressure pushes the fluid out into the tissues)
* Oncotic pressure - (based on protein, large molecules) pulls water back into the capillaries.
What are the 3 groups that cause third space shifts?
1. Hypoalbuminemia- low albumin in blood (from malnutrition or severe liver damage).
2. Inflammation- (most common) damaged cells become leaky. (burns, belly surgery, bowel obstruction, peritonitis, pleural effusion)
3. Increased venous pressure- * heart failure, right side can't keep up with the demand so the blood backs up in the body. * liver disease, the liver becomes hard and blood can't get thru so blood backs up into the belly.
How can you tell if a patient has 3rd spacing?