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Composition of fluid
Composition of body fluids
| Question | Answer |
|---|---|
| What are the 2 largest constituents of the body? | Water and electrolytes. |
| What are the 6 functions water serves? | A vehicle for transporting substance to and from cells. Aids in heat regulation. Assists in (H+) balance in the body. Is a medium for enzymatic action of digestion. Gives shape and form to cells. A lubricant and solvent. |
| How long can a person survive without food and water? | You could survive about a week without food, but only 2-3 days without water. |
| What are some facts about water? | more than half of body weight is water. amt varies w/age, sex and health; Males 60%, women 50%; infants and elderly easily affected by changes of fluid balance. |
| Why are infants and elderly easily affected by changes of fluid balance? | Infants' kidneys reabsorb less fluid. Elderly have less antidiuretic hormone and diminshed thirst sensation. Water is critical to maintaing homeostasis. |
| What are electrolytes? | Minerals or salts dissoved in body fluids. In solution, they break up into ions, ions have electrical charges, cations(+) and Anions(-). Each cation must be balanced by an anion. The major source of electrolytes is diet. |
| What are cations? | Electrolytes that carry a positive charge. Sodium, Potassium, Calcium, and Magnesium. |
| What are anions? | Electrolytes that carry a negative charge. Chloride, Bicarbonate, Phosphate and Sulfate. |
| What is the purpose of sodium? | Water regulation and balance. |
| What is the purpose of Potassium? | Nerve impulse transmission, muscle contraction, plasma, acid-base balance. |
| What is the purpose of Calcium? | muscle activity, blood coagulation. |
| What is the purpose of magnesium? | nerve impulse transmission, muscle contraction. |
| What is the purpose of phosphate? | ATP production. |
| What is the purpose of Chloride? | hydrochloric acid production, acid-base balance. |
| What is the purpose of Bicarbonate? | acid-base balance. |
| What is the normal range for Magnesium? | 1.3 - 2.5 mg/dL |
| What is the normal range for Phosphate? | 2.5 - 4.5 mg/dL |
| What is the normal range for Chloride? | 96 - 106 mEq/L |
| What is the normal range for Bicarbonate? | 22 - 26 mEq/L |
| What is the normal range for Sodium? | 135 - 145 mEq/L |
| What is the normal range for Potassium? | 3.5 - 5 mEq/L |
| What is the normal range for Calcium? | 8.4 - 10.6 mg/dL |
| What are some non-electrolytes? | Amino acids (proteins), glucose, and fatty acids. They remain bound together when dissolved in body fluids. |
| Explain the non-electrolyte, blood? | Normal circulating blood volume is 4 - 6L |
| What is blood composed of? | Erythrocytes (red cells) Leukocytes (white cells) Platelets (thrombocytes) is carried in the plasma (liquid porton of blood) |
| What keeps fluid in the vascular compartment? | Plasma proteins and colloids contribute to plasma osmotic pressure, which keeps fluid in the vascular compartment. |
| What alters plasma volume? | Anything that alters body fluid volume also alters plasma volume. |
| What can plasma volume affect? | Blood pressure and circulation. |
| What is the distribution of body fluids? | Intra cellular - (within the cell) Extra cellular - (outside the cell)intravascular(in arteries and veins. Intersitial(between tissues) Transcellular(saliva,GI secretions) |
| What is extracellular fluids? | Fluid outside of the cells. 1/3 of total body water. Transports nutrients, oxygen and waste products to and from cells. Regulated by renal, metabolic and neurologic factors. High in sodium content. |
| What is intravascular fluids? | (outside the cell)Fluid within the blood vessels, consists of plasma and fluid within blood cell. Contains large amts of protein and electrolytes, which help maintain intravascular volume. |
| What is transcellular fluids | aqueous humor (in the eyes), saliva, cerebrospinal fluid, pleural, peritoneal, synovial (joints), and percarial fluids(layers of heart), gastro secretions, fluid in the urinary tract and lymphatic system fluids. |
| What is osmotic pressure? | Pull that draws solvent through membrane to more concentrated side (or side with solvent). Determined by relative number of particles of solute on side of greater concentration. Proportional to # of particles per unit volume solvent. |
| What is colloid(protein) osmotic pressure or oncotic pressure? | Special kind of osmotic pressure. Created by substances with a high molecular weight (like albumin) |
| What does isotonic mean? | Iso - Means like Tonicity - refers to osmotic activity of body fluids; tells the extent that fluid will allow movement of water in & out cell. |
| What is Isotonic? | Means that solutions on both sides of selectively permeable membrane have established equilibrium. Any solution put into body with the same osmolality as blood plasma (normal saline - 0.9%) (Sodium chloride or 5% glucose) |
| What is Hypertonic? | Solution of higher osmotic pressure. 3% sodium chloride is example. If infused into blood, water moves out of cells and into solution (cells wrinkle or shrivel) Solutions pull fluid from cells. |
| What is Hypotonic? | Solution of lower osmotic pressure. Less salt or more water than isotonic. If infused into blood, RBCs draw water into cells (can swell and burst) Solutions move into cells causing them to enlarge. |
| What is Osmolality | Measure of solution's ability to create osmotic pressure & thus affect movement of water. Number of osmotically active particles per kilogram of water. ECF osmolality is determined by sodium. Measure used in clinical practice to evaluate serum and urine. |
| What is Osmosis? (Passive transport) | Movement of pure solvent (liquid) across membrane. Water moves from area of less solute concentration to area of greater concentration until the solutions in the compartments are of equal concentration. Takes place via a semipermeable membrane. |
| What is Diffusion? (Passive transport) | Substances move back and forth across the membrane until evenly distributed throughout available space. Substances move from high to low concentration until concentration on both sides are equal. Glucose, oxygen, carbon dioxide, water move by diffusion. |
| What is Facilitated diffusion? | Involves carrier system that moves substance across a membrane faster than it would with simple diffusion. Substance can only move from area of higher concentration to one of lower concentration. (ex. movement of glucose w/help from insulin.) |
| What is filtration-passive transport? | Movement of fluid through a selectively permeable membrane from an area of higher hydrostatic pressure to an area of lower hydrostatic pressure. |
| What is hydrostatic pressure? | Force of the fluid pressing outward against vessel wall with blood not only refers to weight of fluid against capillary wall but to force with which blood is propelled w/heartbeat "fluid-pushing pressure inside a capillary" |
| What is Active Transport System? | Moves molecules or ions uphill against concentration & osmotic pressure. Req cellular energy from hydolysis of ATP. Req specific "carrier" molecule as well as specific enzyme (ATPase). Sodium, potassium, calcium, magnesium, sugars & amino acids use it. |
| What is the movement of fluids and electrolytes? | Water taken in by ingesting fluids and food and through metabolism. Thirst mechanism in the hypothalamus regulates thirst based on conentration of electrolytes and solutes in circulation. |
| What is thirst? | Conscious desire for water. Major factor that determines fluid intake. Initiated by the osmoreceptors in hypothalamus that are stimulated by increse in osmotic pressure of body fluids to initiate thirst. Also stimulated by a decrease in the ECF volume. |
| What is the main organ of water secretion? | Kidneys, with some loss in feces, perspiration, and breathing. |
| How can you use urine as a sign of hydration? | Should be light yellow or straw colored. 40-80mL/hr if not excessive losses by other routes. Obligatory excretion 400-600 mL/day. Should be no less than 30 mL/hr urinary output, below that call dr. Could be going into renal failure. |
| Describe gastrointestinal secretions. | Above pylorus(bottom valve) - acidic losses, risk of alkalosis (vomiting) Below pylorus - alkaline losses, risk of acidosis (diarrhea) |
| What is third spacing? | Large quantities of fluid from the intravascular compartment shift into the intersitital space; is inaccessible to the body. (edema) |
| What are plasma proteins(albumin)? | Affects serum osmolarity. Create colloid osmotic pressure which pulls in and holds water in the vascular bed as well as pulling water from intersitial space into vascular bed "water magnet" |
| What is dehydration? | When too little water in the plasma, water drawn out of the cells by osmosis to equalize concentration, and the cells shrivel. Treated by fluid administration, either orally or intravenously. |
| Who is at risk for fluid volume deficit? | Pts unable to take in enough fluid, impaired swallowing, extreme weakness, disorientation or coma, or unavailability of water. Pts who lose excessive amts of fluid, vomiting or diarrhea. |
| What are the signs and symptoms of dehydration? | thirst, weakness, dizziness, postural hyptension, decreased urine production, dry mucous membranes, thick saliva, dry scaly skin, poor tissue turgor, flat neck veins, increased pulse, weak, elevated temp, concentrated urine, dry cracked lips. |
| What is fluid excess? | Healthy people do not ordinarily drink too much water. Receive IV fluids too quickly, given tap water enemas, drink more fluids than they can eliminate (renal patients) |
| What are the signs of over hydration? | weight gain, crackles in the lungs(wet lungs), slow bounding pulse, elevated blood pressure, possible edema. |
| What is hyponatremia? | Sodium deficit; can be from decreased sodium or increased water intake and retention(may be caused by excessive vomiting or diarrhea) |
| What is hypernatremia? | Sodium excess: most ocmmonly from water loss from fever or respiratory infection. |
| What is hypokalemia? | Pottassium deficit: Occurs w/excessive loss of potassium or loss of body water; may be from poor diet, vomiting, diarrhea, excessive sweating, or diuretic therapy(lasix). |
| What is hyperkalemia? | Potassium excess: Occurs with burns, crush injuries, uncontrolled diabetes mellitus, and renal failure. |
| What is hypercalcemia? | Calcium excess: Usually cancer. Most cases related to hyperparathyroidism or malignancy such a multiple myeloma. |
| What is hypocalcemia? | Calcium deficit: Occurs with nutritional deficiency of calcium or vit D or in bone disorders such as metastatic cancer of the bone. |
| What is hypomagnesemia? | Magnesium deficit: Results from malabsorption, malnutrition, renal tubular dysfunction, thiazide diuretic use, extensive gastric suction, or diarrhea. |
| What is Hypermagnesemia? | Magnesium excess: Occurs only in presence of renal failure. |
| What is hypochloremia? | Chloride deficit: Chloride level below 96 mEq/L is associated with hyponatremia. (Sodium and chloride work together) |
| What is hyperchloremia? | Chloride excess: Chloride level above 106 mEq/L. Occurs along with hypernatremia and a form of metabolic acidosis. |
| What is hypophosphatemia? | Phosphate deficit: May result from use of aluminum-containing antacids, from vit D deficiency, or from hyperparathyroidism. |
| What is hyperphosphatemia? | Phosphate excess: Commonly occurs in renal failure. |
| What is acid-base balance? | Important in maintaining homeostasis. Balance between bicarbonate and carbonic acid. |
| What is pH? | measures of the degree of acidity or alkalinity. Normal serum pH is 7.35 - 7.45. Death may occur if pH is less than 6.8 or greater than 7.8 |
| What is the normal serum pH? | 7.35-7.45. Death may occur if pH is less than 6.8 or greater than 7.8 |
| How does a balance remain between cibarbonate and carbonic acid? | Carbonic acid retained or removed by respiratory system and bicarbonate retained or removed by kidneys. |
| What is the most general effect changes on pH? | Enzyme functions, also effects excitability of nerve and muscle cells. |
| What are the 2 ions acid-base balance is primarily concerned with? | Hydrogen (H+) and Bicarbonate (HCO3-) Imbalances of hydrogen and bicarbonate concentrations in body fluids are common in disease processes. |
| Why does the H+ ion have special significance? | Because of the narrow ranges that it must be maintained in order to be compatible with living systems. |
| Maintenance of an acceptable pH range in the extraacellular fluids is accomplished by what 3 mechanisms? | Chemical buffers~reacts very rapidly. Respiratory regulation~reacts rapidly(seconds to minutes)#1 Renal regulation~reacts slowly(minutes to hours) |
| How does the chemical buffer work? | The body uses pH buffers in the blood to guard against sudden changes in acidity. A pH buffer works checically to minimize changes in the pH of a solution. |
| How does the respiratory regulation work? | breathing is increased, blood CO2 level decreases, the blood becomes more Base. Breathing is decreased, blood CO2 level increases, blood becomes more acidic. Adj speed & depth of breathing, resp control centers & lungs able to reg the blood pH min by min. |
| Explain pH. | Water is neutral pH=7. pH=4 is more acidic than pH=6. pH=4 has 10 times more free H+ than pH=5 and 100 times more free H+ than pH=6. |
| How do the kidneys compensate the acid-base balance? | By retaining hydrogen ions and increasing bicarbonate excretion. |
| Review Arterial Blood Gas (ABG) | (pCo2) 35-45mm/Hg. (HCo3) 22-26 mEq/L Respiratory the pH and PCo2 move opposite directions. Metabolic disorders, the pH and HCO3- values move in same direction from norm. pH abv 7.45 alkalotic/pH below 7.35 acidotic. |
Created by:
krislynn
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