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Is the body composed of more intracellular or extracellular fluid?
- Intracellular (42% of body weight)
- Extracellular (17% of body weight)
What is interstitial fluid?
Contains lymph; Fluid between cells and outside blood vessels
What is intravascular fluid?
plasma in vascular system
What is Transcellular fluid?
Seperated from other fluids by barrier; consists of cerebrospinal, pleural, GI, intraocular, peritoneal, and synovial fluids
The movement of a pure solvent (water) from area of less concentration to greater; attempts to equal the concentration
The random movement of Solute in a solution from a high concentration to a low concentration; attempts to even the distribution of solute.
The process by which water and diffusible substances move together in response to fluid pressure
requires metabolic activity and the expenditure of energy to move materials across cell membranes
The thirst mechanism regulates _______ and is located in the ______
Hypovolemia can be caused by
- excessive vomiting
What are the 4 organs of water loss
skin, lungs, kidneys, GI tract
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
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
What is the most abundant cation
sodium about 90% in ECF
What are the sodium levels regulated by?
dietary intake and adosterone secretion
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
Normal Sodium Range
For a patient with hyponatremia you would
increase dietary intake, decrease fluid intake, give salt tablets.
For a pt with hypernatremia
Monitor I &O, increase fluid intake, and beware of frozen and canned foods
- 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
Potassium Levels are regulated by
dietary intake and renal excretion
A normal Potassium Level is
3.5 to 5 meq/L
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.
Calcium is necessary for.....
- bone and teeth formation
- blood clotting
- hormone secretion
- cell membrane integrity
- cardiac conduction
- transmission of nerve impulses
- muscle contraction.
Magnesium is necessary for....
- enzyme activities
- neurochemical activities
- and cardiac and skeletal muscle excitability
Normal plasma Mg range is
1.5- 2.5 meq/L
Magnesium is regulated by
Dietary intake, renal mechanisms, and actions of the parathyroid hormone
What are the three major anions of body fluids?
Calcium and Phosphate are _______ proportional
What is the largest chemical buffer in ECF
carbonic acid and bicarbonate buffer system
The lungs primarily control the excretion of ________ resulting from metabolism. The kidneys control excretion of _______ and_______.
- Carbon dioxide
- Hydrogen and Bicarbonate ions
What is the biological buffering system?
- when H ions are absorbed or released by cells.
- occurs after chemical buffering
The Kidneys _______ HCO3 in cases of acid exces
What could cause Hypokalemia?
- Vomiting, gastric suctioning, poor intake, diuretic, and alcoholism
- **Severe Hypokalemia affects cardiac conduction and function
What could cause Hyperkalemia?
- renal failure
- ***Causes marked cardiac conduction abnormalities
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:
Hypocalcemia is caused by
abnormalities in thyroid and parathyroid gland
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
What kind of pt usually gets Hypercalcemia?
The immobile, lethargic pt because calcium is excessivly reabsorbed and and released.
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)
What can cause a Hypomagnesemia?
- fistula (abnormal tubelike passage to another cavity)
What are some signs of Hypomagnesemia?
- neuromuscular irritablility with tremors
- elevated bp
What can cause Hypermagnesemia?
- excessive epsom salt intake
- renal failure
What are some signs of hypermagnesemia?
- nausea and vomiting
- muscle weakness
- low BP
- slow HR
- respiratory depression and coma
What is the normal chloride level?
Hypochloremia can be caused by
- thiazide diuretics
- loss of HCL acid
Hyperchloremia can be caused by...
- a decrease in bicarbonate
- an increase in sodium
The normal serum phosphate level is
How is phosphate regulated?
- dietary intake
- renal excretion
- intestinal absorption
Arterial blood gas measures
pH of blood
The normal paCO2 is
The normal paO2 is
What are the signs of Respiratory Acidosis
- increased RR
- warm flush skin
- **seen in pt with COPD and sedation
Respiratory Alkalosis symptoms are
- change in HR
Metabolic Acidosis is caused by
- severe diarrhea
- renal disease
Metabolic alkalosis is caused by
- overuse of antacids
- gastric suctioning
A hypotonic solution is _____ and moves fluids ____ cells.
- .45% NS
- into cells= enlargemnt
Isotonic solution is _____ and does what?
.9% NS and expands body's fluid volume.
A hypertonic solution does what?
Pulls fluid out of cells