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Fluids/electrolytes
nurs 111
| Question | Answer |
|---|---|
| % of healthy adult's weight that is water | 60% |
| water is vital to health and normal cellular function, serving as | a medium for metabolic reactions within cells, transporter for nutrients, a lubricant, an insulator and shock absorber,one means of regulating and maintaining body temp |
| factors that affect total body water | age, gender, sex, body fat, lifestyle, environmental temperature |
| The body's fluid is divided into two types | intracellular (ICF) and extracellular (ECF) fluid compartments |
| Fluid can move between compartments by a variety of methods which are: | Diffussion, active transport, filtration, and osmosis |
| Assessment of fluid and electrolyte balance includes: | Nursing history, physical assessment (mental status and behavior, skin and mucous membranes, breath and heart sounds, neurological status, I&O, daily weight, specific laboratory values |
| Define Osmosis | Movement of water across cell membranes from area of less *concentration* to greater concentration |
| Define Diffusion | The continual intermingaling of molecules in liquids, gases, or solids brought about by the random movement of the molecules. |
| Define Filtration | Process where fluids and solutes move together across a membrane from one compartment to another; from an area of higher *pressure* to lower |
| Define Active Transport sodium potassium pump | Substances can move cell membranes from a less concentrated solution to a more concentrated one. Differs from osmosis and diffusion in that metabolic energy is expended. Maintains higher sodium levels in ECF, higher potassium levels in ICF |
| Soultes | substances that dissolve in liquid |
| Solvent | is the component of a solution that can dissolve a solute |
| solvent, solute example | sugar added to coffee... Sugar is the solute, Coffee is the solvent In the body, water is the solvent, solutes include electrolytes, oxygen, carbon dioxide, glucose, urea, amino acids and proteins. |
| What is the greatest determinant of osmolality? | Sodium. With glucose and urea contributing. |
| Cations | positivly charged ions; sodium (Na+) Potassium (K+) Calcium (Ca2+) Magnesium (Mg2+) |
| Anions | Negatively charged ions; Chloride (Cl-) Bicorbonate (HCO3-) phosphate (HPO42-) |
| soultes may be | Crystalloids (salts that dissolve readily into true solutions) or Colloids (substances such as large protein molecules that do not readily dissolve into true solutions) |
| Osmolality | the concentration of solutes in the body fluids. Determined by total solute concentration within a fluid compartment and measured as parts of soulte per kilogram of water. |
| tonicity | used to refer to the osmolality of a solution. Solutions may be termed isotonic, saline, hypertonic, or hypotonic |
| Isotonic solution | same osmolality as body fluids |
| Saline Solution | normal saline 0.9% sodium chloride is a saline solution |
| Hypertonic Solution | have higher osmolality than body fluids |
| hypotonic solution | such as one half normal saline (0.45% sodium chloride) have a lower osmolality than body fluids. |
| Osmotic pressure | power of a solution to draw water across a semi permiable membrane; 2 solutions of different solute concentrations are separated by semipermiable membrane. Solution of higher solute concentration exerts higher osmotic pressure, drawing water across membra |
| Rate of diffusion varies according to | size of molecules, concentration of solution, temperature of solution |
| Colloid osmotic pressure/ oncotic pressure | pulling water from the interstitial space into the vascular compartment. this is an important mechanism in maintaining vascular volume (plasma proteins exert this pressure/ draw) |
| hydrostatic pressure | pressure a fluid exerts within a closed system on the walls of its container (force of blood against the artery walls) |
| pressure in the compartment that results in the movement of the fluid and substances dissolved in fluid out of the compartment | filtration pressure difference between hydrostatic pressure and osmotic pressure |
| Thirst regulator is located in the | hypothalamus |
| average adult drinks approx ____ mL per day but needs ____ mL | drinks 1500mL needs 2500mL (addition 1000mL) this added volume is acquired from foods and the oxidation of these foods during metabolic processes. |
| Foods contributes approx _____ mL per of h2o | 750mL water content of fresh vegtables approx 90%, fruits 85%, lean meats 60% |
| water as a by-product of food metabolism accounts for approx. ____ mL | 200 mL |
| four routes of fluid loss: | Urine, insensible loss through skin as perspiration and through the lungs as water vapor in the expired air, noticable loss through the skin, loss through intestines in the feces |
| how much fluid does the average person lose by urinating every day? | 1400-1500mL urine insensible losses 350-400 lungs 350-400 skin 100 sweat 100-200 feces total 2300-2600 |
| Diagnostic tests | serum electrolytes, CBC, osmolality (serum, urine), urine specific gravity, urine sodium and chloride excretion |
| Caring intervetions to maintain fluid and electrolyte balance | initiate IV therapy, IV management, monitor fluid balance, medication administration, blood transfusion |
| Pharmacologic therapies to correct electrolyte and fluid imbalance and restore balance | Electrolyte supplements, colloids, crystalloids, diuretics |
| Hyperkalemia | elevated potassium levels, corrected by dialysis. Treatments such as admin. of glucose and insulin can help drive potassium back into cells |
| Hypokalemia | Defecit in potassium, side effect of diuretics |
| hypernatremia | sodium excess, often seen in clients with reduced production of ADH (antidiuretic hormone) |
| Hyponatremia | sodium defeciency (less than 135mEq/L), treated with oral supplementation or if severe, IV supplementation. |
| Sodium facts, levels | 135-145mEq/L Cation contributes to serum osmolality regulating ECF volume and distribution |
| Potassium facts, levels | 3.5-5.0mEq/L Cation Maintains ICF osmolality Transmits nerve and other electrical impulses skeletal and smooth muscle function Regulates acid base bal. |
| Calcium Facts, levels | 8.5-10.5mg/dL or 4.5-5.5mEq/L skeletal maintanence, regulates muscle contractions (cardiac), neuromuscular function, blood clotting, activates enzymes |
| Magnesium facts, levels | 1.56-2.5mEq/L Intracellular metabolism, operates sodium potassium pump, regulates cardiac and nueromuscular function, relaxes muscle contractions. |
| Chloride facts, levels | 95-108mEq/L regulates serum osmolality, regulates ECF balance, regulates acid base balance, major component of stomach fluids, buffer in oxygen-cabon dioxide exchange |
| Phosphate facts, levels | 2.4- 4.5mg/dL forms bones and teeth, metabolism of protein, fat, carbohydrates, cellular metabolism, muscle nerve and RBC function, regulates acid-base balance, regulates calcium levels |
| Bicarbonate | major body buffer, regulates acid base balance, produced through metabolic processes |
| Serum osmolality | 280-300mOsm/kg water (measure of solute concentration of the blood) |
| systems used by the bosy to maintain homeostatis | antidiuretic hormone AKA argine vasopressin, renin angiotension-aldosterone system (to restore blood volume and renal perfusion through sodium and water retention) and the atrial natriuretic factor(inhibits thirst, reducing fluid intake, potent diuretic) |
| what is the role of the kidneys in fluid and electrolyte balance? | primary regulator of body fluids and electrolyte balance. Regulate the volume and osmolality of extracellular fluids by regulating water and electrolyte excretion |
| Anti diuretic hormone responsible for | reduction of urine prodution |
| Renin is released in response to: | decreased blood flow or decreased renal pressure (sensed by receptors in the nephrons) |
| Aldosterone is produced by the: | Adrenal cortex, in response to stimulation by angiotensin II, causing the tubules to excrete K+ while retaining Na2+. Adding to the reabsorption of water back into the vascular system. |
| hypovolemia | body loses both water and electrolytes from the ECF |
| dehydration | water is lost from the body, no loss of electrolytes |
| hypovolemia can lead to | hypovolemic shock |
| hypervolemia | both water and sodium are retained in abnormally high levels |
| overhydration | when more water is gained than electrolytes |
Created by:
lnzjean
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