Fluid and Electrolytes

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NurseNatalie
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52236
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Fluid and Electrolytes
Updated:
2010-11-30 11:40:07
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N200 Drexel
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ch. 41
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  1. Is the body composed of more intracellular or extracellular fluid?
    • Intracellular (42% of body weight)
    • Extracellular (17% of body weight)
  2. What is interstitial fluid?
    Contains lymph; Fluid between cells and outside blood vessels
  3. What is intravascular fluid?
    plasma in vascular system
  4. What is Transcellular fluid?
    Seperated from other fluids by barrier; consists of cerebrospinal, pleural, GI, intraocular, peritoneal, and synovial fluids
  5. Osmosis
    The movement of a pure solvent (water) from area of less concentration to greater; attempts to equal the concentration
  6. Diffusion
    The random movement of Solute in a solution from a high concentration to a low concentration; attempts to even the distribution of solute.
  7. Filtration
    The process by which water and diffusible substances move together in response to fluid pressure
  8. Active transport
    requires metabolic activity and the expenditure of energy to move materials across cell membranes
  9. The thirst mechanism regulates _______ and is located in the ______
    • fluid intake
    • hypothalamus
  10. Hypovolemia can be caused by
    • hemmorhage
    • excessive vomiting
  11. What are the 4 organs of water loss
    skin, lungs, kidneys, GI tract
  12. What is the difference between sensible and insensible water loss?
    • Insensible is continuous and occurs through the skin and lungs. It is not perceived. can increase significantly on pt with fever or burns
    • Sensible occurs through excess perspiration and is percieved
  13. What are the 2 basic types of fluid imbalance?
    • Isotonic: lose gain water and electrolytes in equal parts
    • Osmotic: water is changing. Concentration of electrolytes is not changing
  14. What is the most abundant cation
    sodium about 90% in ECF
  15. What are the sodium levels regulated by?
    dietary intake and adosterone secretion
  16. Sodium ions are responsible for
    maintaining water balance through their effect on serum osmolality, nerve impulse transmission, regulation of acid-base balance, and participation in cellular chemical reactions
  17. Normal Sodium Range
    135-145 meq/L
  18. For a patient with hyponatremia you would
    increase dietary intake, decrease fluid intake, give salt tablets.
  19. For a pt with hypernatremia
    Monitor I &O, increase fluid intake, and beware of frozen and canned foods
  20. Potassium regulates
    • many metabolic activities
    • necessary for glycogen deposits in the liver and skeletal muscle
    • transmission and conduction of nerve impulses
    • normal cardiac conduction
    • skeletal and smooth muscle contraction
  21. Potassium Levels are regulated by
    dietary intake and renal excretion
  22. A normal Potassium Level is
    3.5 to 5 meq/L
  23. Normal serum ionized calcium is _______. Normal total calcium is ____
    • Normal serum ionized calcium is 4 to 5 mEq/L.
    • Normal total calcium is 8.5 to 10.5 mg/100ml.
  24. Calcium is necessary for.....
    • bone and teeth formation
    • blood clotting
    • hormone secretion
    • cell membrane integrity
    • cardiac conduction
    • transmission of nerve impulses
    • muscle contraction.
  25. Magnesium is necessary for....
    • enzyme activities
    • neurochemical activities
    • and cardiac and skeletal muscle excitability
  26. Normal plasma Mg range is
    1.5- 2.5 meq/L
  27. Magnesium is regulated by
    Dietary intake, renal mechanisms, and actions of the parathyroid hormone
  28. What are the three major anions of body fluids?
    • chloride
    • bicarbonate
    • phosphate
  29. Calcium and Phosphate are _______ proportional
    inversely
  30. What is the largest chemical buffer in ECF
    carbonic acid and bicarbonate buffer system
  31. The lungs primarily control the excretion of ________ resulting from metabolism. The kidneys control excretion of _______ and_______.
    • Carbon dioxide
    • Hydrogen and Bicarbonate ions
  32. What is the biological buffering system?
    • when H ions are absorbed or released by cells.
    • occurs after chemical buffering
  33. The Kidneys _______ HCO3 in cases of acid exces
    reabsorb
  34. What could cause Hypokalemia?
    • Vomiting, gastric suctioning, poor intake, diuretic, and alcoholism
    • **Severe Hypokalemia affects cardiac conduction and function
  35. What could cause Hyperkalemia?
    • renal failure
    • hypoaldosteronism
    • ***Causes marked cardiac conduction abnormalities
  36. What kind of treatment could be given for a pt with Hyperkalemia?
    • Kayexalate enema: draws K out of cells and into bowels
    • K wasting diurretic:
    • Monitor Cardiac Activity:
  37. Hypocalcemia is caused by
    abnormalities in thyroid and parathyroid gland
  38. A patient with hypocalcemia will have what kind of symptoms.
    • circumoralparathesias: numbness/tingling around mouth and fingers
    • A positive trousseau sign: tremors in the arm when bp cuff is inflated
    • a positive chvostek: tap on pts facial nerve and they get a twitch
    • decrease in CO, cramps, tremors, and dysarrythmias
  39. What kind of pt usually gets Hypercalcemia?
    The immobile, lethargic pt because calcium is excessivly reabsorbed and and released.
  40. For a pt with hypercalcemia, how would you treat them?
    • Oral phosphate tablets (they work in opposite)
    • water to dilute pt
    • acid ash diet (cran and prunes= doesn't let calcium clump)
  41. What can cause a Hypomagnesemia?
    • Malnutrition
    • alcoholism
    • diarrhea
    • vomiting
    • fistula (abnormal tubelike passage to another cavity)
  42. What are some signs of Hypomagnesemia?
    • neuromuscular irritablility with tremors
    • tachycardia
    • vertigo
    • elevated bp
    • confusion
  43. What can cause Hypermagnesemia?
    • excessive epsom salt intake
    • renal failure
  44. What are some signs of hypermagnesemia?
    • vasodialation
    • nausea and vomiting
    • muscle weakness
    • low BP
    • slow HR
    • respiratory depression and coma
  45. What is the normal chloride level?
    95-108 mEq/L
  46. Hypochloremia can be caused by
    • thiazide diuretics
    • vomiting
    • loss of HCL acid
  47. Hyperchloremia can be caused by...
    • a decrease in bicarbonate
    • an increase in sodium
  48. The normal serum phosphate level is
    2.5-4.5 mg/mL
  49. How is phosphate regulated?
    • dietary intake
    • renal excretion
    • intestinal absorption
    • PTH
  50. Arterial blood gas measures
    pH of blood
  51. The normal paCO2 is
    35-45 mmHg
  52. The normal paO2 is
    80-100 mmHG
  53. What are the signs of Respiratory Acidosis
    • Hypoventilation
    • increased RR
    • confusion
    • warm flush skin
    • **seen in pt with COPD and sedation
  54. Respiratory Alkalosis symptoms are
    • hyperventilation
    • circumoralparethisa
    • change in HR
  55. Metabolic Acidosis is caused by
    • severe diarrhea
    • renal disease
  56. Metabolic alkalosis is caused by
    • overuse of antacids
    • gastric suctioning
    • vomiting
  57. A hypotonic solution is _____ and moves fluids ____ cells.
    • .45% NS
    • into cells= enlargemnt
  58. Isotonic solution is _____ and does what?
    .9% NS and expands body's fluid volume.
  59. A hypertonic solution does what?
    Pulls fluid out of cells

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