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Intracellular (ICF)
Within body cells
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Extracellular (ECF)
Outside the cells � Interstitial, Intravascular, & Transcellular
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Intake
Drinking fluids (2700ml per day). 20% from food and metabolism. Thirst is the major regulator of intake.
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Output
Urine-1500mL/day. Feces-100-200 mL/day. Insensible loss � skin (perspiration) and lungs (breath).
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Aldostrone
Increase re-absorption of sodium and water. Secretion of K+ in the kidneys. Increases blood volume & increases BP.
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ADH (Anti-diuretic hormone)
AKA Arginine vasopressin. Nine amino acid peptide secreted from the pituitary.
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Natriuretic Peptide A-type
Secreted largely by the atrial myocardium in response to dilation.
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Natriuretic Peptide B-type
Manufactured mainly by the ventricular myocardium.
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Natriuretic Peptide C-type
Produced by the endothelial cells that line the blood vessels.
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Natriuresis
The excretion of an excessively large amount of sodium in the urine.
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Hypovolemia
Deficient fluid volume (blood) and occurs when there is a proportional loss of fluid and electrolytes form the EFC.
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Dehydration
A state of negative fluid balance in which there is loss of water from the intracellular, extracellular, and intravascular spaces.
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Fluid volume deficits, like hypovolemia or dehydration nursing interventions:
Assess vital signs, capillary refill, neuro status, and daily weight. Monitor electrolytes, CBC, and urine output. Initiate and maintain IV access. Administer isotonic fluid replacement and I&O. Report urine output <30mL/hr to provider. Ensure safety and gait stability. Observe for nausea and vomiting.
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Hypervolemia
The retention of excessive amounts of sodium and water in the EFC.
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Edema
Excess fluid accumulated in the tissues.
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Fluid volume excesses, like hypervolemia nursing interventions:
Monitor vital signs, I&O, & daily weights. Assess lung sounds (dim with crackles) and edema. Monitor for shortness of breath & set in semi-Fowler�s position. Check ABG, CBC, and chest X-ray results. Limit fluid and NA+ intake, administer diuretics, and supplement O2 if prescribed. Reposition every two hours if not mobile.
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Isotonic
Same solute concentration, expands vascular volume.
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Hypertonic
Higher solute concentration, increased vascular volume. Pulls fluid into blood stream and out of cells.
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Hypotonic
Lower solute concentration, decreases vascular volume. Pulls fluid into cells and out of blood stream.
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Sodium
Regulates fluid balance, strengthens skeletal structures, and acts as catalysts for conduction, contraction, and metabolism and are distributed in the ICF and ECF � can be measured in plasma but not in cells.
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Normal Sodium Levels
135-145 mEq/L
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Hyponatremia
Na+<136; Osmol<280
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Hypernatremia
Na+>145; Osmol>300
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Normal Potassium Levels
3.5 � 5.0 mEq/L
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Normal Calcium Levels
9.0-10.5 mg/dL
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Hypercalcemia
Ca>10.5 mg/dL
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Normal Magnesium Levels
1.3 � 2.1 mE/L
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Hypomagnesemia
Mg2+<1.3 mg/dL
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Active transport
Movement of fluid and solutes across the membrane requiring energy.
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Passive transport
Movement of fluid and solutes across the membrane requiring no energy.
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Osmosis
Movement of water across the membrane from less concentration to more concentration.
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Osmolality/Tonicity
Concentration of solutes providing pressure in body fluid.
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Isotonic
A fluid that is the same osmolality as blood.
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Hypotonic
Lower osmolality than blood.
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Hypertonic
Higher osmolality than blood.
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Diffusion
Passive process by which molecules of a solute move through a cell membrane from an area of high concentration to an area of low concentration.
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