renal-exam 1-water homeostasis

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Author:
Ambestul
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8873
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renal-exam 1-water homeostasis
Updated:
2010-03-02 19:36:46
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renal
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exam 1
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  1. ions in intracellular fluid
    k, mg, po4, proteins
  2. extracellular ions
    na, cl, HCO3, includes intravascular(plasma) and interstitial(lymphatic)
  3. TBW for males
    60%, CBW if >130% or ABC
  4. TBW for females
    50%, CBW if >130% or ABW
  5. intracellular fluid amount
    2/3 TBW
  6. extracellular fluid amount
    1/3 of TBW or 20% of weight
  7. intracellular fluid amt
    plasma, 25% of ECF
  8. interstitial fluid amount
    75% of ECF
  9. Blood tonicity governed by:
    thirst(1-2% change needed), arginine vasopressin (AVP) or ADH
  10. blood volume governed by:
    thirst(10-15% drop in blood volume for thirst to be increased) and aldosterone
  11. % body weight lost with mild dehy
    3-5%
  12. % weight lost with moderate dehy
    5-10%
  13. % weight lost with severe dehy
    10-15%
  14. clinical signs of mild dehy
    thirst, decreased sweating, decreased urine volume
  15. clinical signs of mod dehy
    decreased skin turgor, dry mucus membranes, thirst, dizziness, change in mental status, lethargy, increased HR, orthostatic HOTN more than 20 or 10
  16. clinical signs of severe dehy
    hypotension, HR >100, cool skin, poor skin turgor, combativeness, shock, thready pulse
  17. BUN/Cr ratio
    >20:1
  18. normal Hct=Hgb X 3
    more than 3 x's, less is overhydrated
  19. urine osmolality and urine specific gravity-sign of dehy
    >100mOsm and >1.020
  20. when edema becomes clinical
    fluid volume increases 2-2.5 L
  21. fluid requirements
    CBW or ABW, 1500mL + 20mL/kg for each additional kg>20kg, 0.5L of insensible loss
  22. what happens to NS in body
    does not go to ICF, all goes to ECF-2/3 to interstitial and 1/3 to intravascular, isotonic only goes to ECF
  23. what happens to D5W in body
    distibutes like free water, 2/3 ICF, 1/3 ECF
  24. what happens to 0.45% NaCl in body
    half to ICF and half as free water

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