Body Fluids Chp17

Front 1

Body fluids and electrolytes play an important role in:

Back 1

homeostasis

Front 2

What has the ability to affect fluid and electrolyte balance?

Back 2

Many diseases and their treatments

Front 3

Water is the primary component of the body, accounting for approximately _____ of the body weight in the adult.

Back 3

60%

Front 4

The two major fluid compartments in the body are:

Back 4

intracellular and extracellular

Front 5

The measurement of electrolytes is important to the nurse in evaluating electrolyte balance, as well as:

Back 5

in determining the composition of electrolyte preparations

Front 6

Indicates the water balance of the body

Back 6

Osmolality

Front 7

In the metabolically active cell, there is a constant exchange of substances between_(2)_but no net gain or loss of water occurs.

Back 7

between the cell and the interstitium

Front 8

The major colloid in the vascular system contributing to the total osmotic pressure is:

Back 8

protein

Front 9

The amount and direction of movement between the interstitium and the capillary are determined by the interaction of:
(4)

Back 9

(1) capillary hydrostatic pressure,
(2) plasma oncotic pressure
(3) interstitial hydrostatic pressure
(4) interstitial oncotic pressure.

Front 10

If capillary or interstitial pressures are altered, fluid may abnormally shift from one compartment to another, resulting in: (2)

Back 10

edema or dehydration.

Front 11

Fluid is drawn into the plasma space whenever there is an increase in the plasma osmotic or oncotic pressure. Causes: (4)

Back 11

administration of colloids, dextran, mannitol, or hypertonic solutions.

Front 12

_________ describes the normal distribution of fluid in the intracellular fluid (ICF) and extracellular fluid (ECF) compartments.

Back 12

First spacing

Front 13

___________ refers to an abnormal accumulation of interstitial fluid (i.e., edema)

Back 13

Second spacing

Front 14

_________occurs when fluid accumulates in a portion of the body from which it is not easily exchanged with the rest of the ECF.

Back 14

Third spacing

Front 15

Water balance is maintained via :

Back 15

the finely tuned balance of water intake and excretion.

Front 16

An intact thirst mechanism is important for fluid balance. The patient who cannot recognize or act on the sensation of thirst is at risk for:

Back 16

fluid deficit & hyperosmolality

Front 17

An increase in plasma osmolality or a decrease in circulating blood volume will stimulate:

Back 17

antidiuretic hormone (ADH) secretion

Front 18

Reduction in the release or action of ADH produces:

Back 18

diabetes insipidus

Front 19

Mineralocorticoid with potent sodium-retaining and potassium-excreting capability:

Back 19

Aldosterone

Front 20

The primary organs for regulating fluid and electrolyte balance:

Back 20

kidneys, lungs, & gastrointestinal tract.

Front 21

Invisible vaporization from the lungs and skin, assists in regulating body temperature:

Back 21

Insensible water loss

Front 22

With severely impaired renal function, the kidneys cannot maintain fluid and electrolyte balance. This condition results in : (4)

Back 22

1)edema retention
2)potassium retention
3)phosphorus retention
4) acidosis & other electrolyte imbalances.

Front 23

Structural changes to the kidney and a decrease in the renal blood flow lead to: (4)

Back 23

1)decrease in the glomerular filtration rate
2)decreased creatinine clearance
3) the loss of the ability to concentrate urine and conserve water
4)narrowed limits for the excretion of water, sodium, potassium, and hydrogen ions.

Front 24

Fluid and electrolyte imbalances are commonly classified as:

Back 24

deficits or excesses

Front 25

Fluid volume deficit can occur with:

Back 25

1)abnormal loss of body fluids
2)inadequate intake
3)plasma-to-interstitial fluid shift

Front 26

Examples of abnormal loss of body fluids:

Back 26

diarrhea, fistula drainage, hemorrhage, polyuria

Front 27

How do we record information regarding fluid electrolyte problems:

Back 27

24–hour intake and output records

Front 28

What changes do we monitor to prevent or detect complications from fluid and electrolyte imbalances? (2)

Back 28

cardiovascular and neurologic changes

Front 29

What provides the easiest measurement of volume status?

Back 29

Accurate daily weights.
Weight changes must be obtained under standardized conditions.

Front 30

Edema is assessed by:

Back 30

pressing with a thumb or forefinger over the edematous area

Front 31

The __________ of IV fluid solutions should be carefully monitored.

Back 31

rates of infusion

Front 32

The goal of treatment in fluid and electrolyte imbalances is to:

Back 32

treat the underlying cause

Front 33

Major ECF cation:

Back 33

SODIUM

Front 34

An elevated serum sodium may occur with: (2)

Back 34

water loss or sodium gain.

Front 35

Common causes of Hyponatremia are:

Back 35

Water excess from inappropriate use of sodium-free or hypotonic IV fluids.

Front 36

Symptoms of hyponatremia:

Back 36

Cellular swelling
It is first manifested in the central nervous system (CNS).

Front 37

Major ICF cation:

Back 37

POTASSIUM

Front 38

Factors that cause potassium to move from the ICF to the ECF include: (3)

Back 38

1)acidosis
2)trauma to cells (as in massive soft tissue damage or in tumor lysis)
3)exercise.

Front 39

The most common cause of Hyperkalemia is: (4)

Back 39

1)RENAL FAILURE
2) massive cell destruction (e.g., burn or crush injury, tumor lysis)
3)rapid transfusion of stored, hemolyzed blood
4)catabolic states (e.g., severe infections).

Front 40

Symptoms of hyperkalemia:

Back 40

Cramping leg pain, followed by weakness or paralysis of skeletal muscles. Ventricular fibrillation or cardiac standstill

Front 41

All patients with clinically significant hyperkalemia should be monitored

Back 41

Electrocardiographically to detect dysrhythmias and to monitor the effects of therapy

Front 42

Hyperkalemia effects on heart:
Cardiac depolarization is ___________________.

Back 42

DECREASED
leading to flattening of the P wave and widening of the QRS wave

Front 43

With hyperkalemia,
Cardiac repolarization occurs ________.

Back 43

Repolarization occurs MORE RAPIDLY, resulting in shortening of the QT interval and causing the T wave to be narrower and more peaked.

Front 44

Hyperkalemia:
The patient experiencing dangerous cardiac dysrhythmias should receive what IV?

Back 44

IV calcium gluconate immediately while the potassium is being eliminated and forced into cells.

Front 45

Hypokalemia
The most common causes:

Back 45

Abnormal losses via either the kidneys, the GI tract or when the patient is diuresing (particularly in the patient with an elevated aldosterone level).

Front 46

Hypokalemia cardiac changes include:

Back 46

Impaired repolarization, resulting in a flattening of the T wave and eventually in emergence of a U wave.

Front 47

The incidence of potentially lethal ventricular dysrhythmias is _____ in hypokalemia.

Back 47

increased

Front 48

Patients taking digoxin experience increased digoxin toxicity if their serum potassium level is _____.

Back 48

low

Front 49

Hypokalemia symptoms:
Severe hypokalemia can cause :

Back 49

Skeletal muscle weakness & paralysis.
Severe - respiratory muscle weakness or paralysis to shallow respirations & respiratory arrest.

Front 50

How is hypokalemia treated?

Back 50

By giving potassium chloride supplements and increasing dietary intake of potassium.

Front 51

Hypercalcemia causes:

Back 51

Hyperparathyroidism 2/3 cases.
Malignancy 1/3 cases:
(breast cancer, lung cancer,& multiple myeloma.)

Front 52

Manifestations of hypercalcemia include: (8)

Back 52

1)decreased memory
2)confusion
3)disorientation
4) fatigue
5)muscle weakness
6)constipation
7)cardiac dysrhythmias
8)renal calculi.

Front 53

Treatment of hypercalcemia: (2)

Back 53

1)promotion of excretion of calcium in urine by admin of a loop diuretic
2)hydration of the patient w/ isotonic saline infusions.

Front 54

Hypocalcemia
Is caused by :

Back 54

Decrease in the production of parathyroid hormone.

Front 55

Hypocalcemia is characterized by:

Back 55

Increased muscle excitability resulting in tetany.

Front 56

Following which surgeries should a PT be monitored for hypocalcemia?

Back 56

Neck surgeries including thyroidectomy

Front 57

The major condition that can leads to hyperphosphatemia:

Back 57

Acute or chronic renal failure.

Front 58

Hypophosphatemia (low serum phosphate) is seen in the patient who is:

Back 58

Malnourished or has a malabsorption syndrome.

Front 59

Hypomagnesemia (low serum magnesium level) produces:

Back 59

Neuromuscular and CNS hyperirritability.

Front 60

Hypermagnesemia usually occurs only with:

Back 60

Increase in magnesium intake accompanied by renal insufficiency or failure.

Front 61

Pts with which illnesses frequently develop acid-base balances? (4)

Back 61

1)Diabetes mellitus
2)chronic obstructive pulmonary disease
3)kidney disease
4)Vomiting and diarrhea may cause loss of acids and bases.

Front 62

What is the fastest acting system and the primary regulator of acid-base balance.

Back 62

The buffer system.

Front 63

The lungs help maintain a normal pH by:

Back 63

Excreting CO2 and water, which are by-products of cellular metabolism.

Front 64

The three renal mechanisms of acid elimination are:

Back 64

1)secretion of small amounts of free hydrogen into the renal tubule
2)combination of H+ with ammonia (NH3) to form ammonium(NH4+)
3)excretion of weak acids.

Front 65

Acid-base imbalances are classified as: (2)

Back 65

respiratory or metabolic

Front 66

Occurs whenever there is hypoventilation:

Back 66

Respiratory acidosis (carbonic acid excess)

Front 67

Occurs whenever there is hyperventilation:

Back 67

Respiratory alkalosis (carbonic acid deficit)

Front 68

Occurs when an acid other than carbonic acid accumulates in the body or when bicarbonate is lost from body fluids.

Back 68

Metabolic acidosis (base bicarbonate deficit)

Front 69

Occurs when a loss of acid (prolonged vomiting or gastric suction) or a gain in bicarbonate occurs:

Back 69

Metabolic alkalosis (base bicarbonate excess)

Front 70

Arterial blood gas (ABG) values provide valuable information about:

Back 70

1)Acid-base status
2)underlying cause of the imbalance
3)body’s ability to regulate pH
4)overall oxygen status.

Front 71

In cases of acid-base imbalances, the treatment is directed toward:

Back 71

Correction of the underlying cause.

Front 72

What is used to correct fluid and electrolyte imbalances?

Back 72

Fluid replacement therapy

Front 73

A hypotonic solution provides:

Back 73

A hypotonic solution provides MORE WATER than electrolytes, diluting the ECF.

Front 74

What do plasma expanders do?

Back 74

Plasma expanders stay in the vascular space and increase the osmotic pressure.

Front 75

What does a hypertonic solution do?

Back 75

A hypotonic solution provides more water than electrolytes, diluting the ECF.
Plasma expanders stay in the vascular space and increase the osmotic pressure.
A hypertonic solution initially raises the osmolality by the ECF and expands it.

Front 76

(vocab)

ACIDOSIS

Back 76

process that adds acid or eliminates base from body fluids.

Front 77

(vocab)

ACTIVE TRANSPORT

Back 77

process in which molecules move across a membrane against a concentration gradient.

Front 78

(vocab)

ALKALOSIS

Back 78

process that adds base or eliminates acid from body fluids.

Front 79

(vocab)

ANIONS

Back 79

negatively charged ions.

Front 80

(vocab)

BUFFER

Back 80

a substance that acts chemically to change strong acids into weaker acids or to bind acids to neutralize their effect.

Front 81

(vocab)

CATIONS

Back 81

positively charged ions

Front 82

(vocab)

DIFFUSION

Back 82

the process in which particles in a fluid move from an area of higher concentration to an area of lower concentration.

Front 83

(vocab)

ELECTROLYTE

Back 83

an element or compound that, when melted or dissolved in water or another solvent, dissociates into ions and is able to conduct an electric current.

Front 84

(vocab)

FACILITATED DIFFUSION

Back 84

the movement of molecules from an area of high concentration to one of low concentration at an accelerated rate with the assistance of a specific carrier molecule.

Front 85

(vocab)

FLUID SPACING

Back 85

the distribution of water in the body.

Front 86

(vocab)

HOMEOSTASIS

Back 86

the state of equilibrium in the internal environment of the body, naturally maintained by adaptive responses that promote healthy survival.

Front 87

(vocab)

HYDROSTATIC PRESSURE

Back 87

the force that fluid exerts within a compartment.

Front 88

(vocab)

HYPERTONIC

Back 88

solutions that increase the degree of osmotic pressure on a semipermeable membrane.

Front 89

(vocab)

HYPOTONIC

Back 89

solutions that have a lower concentration of solute than another solution, thus exerting less osmotic pressure on a semipermeable membrane.

Front 90

(vocab)

ION

Back 90

an atom or group of atoms that has acquired an electrical charge through the gain or loss of an electron or electrons.

Front 91

(vocab)

ISOTONIC

Back 91

fluids having the same concentration of solute particles as another solution, thus exerting the same osmotic pressure on a semipermeable membrane.

Front 92

(vocab)

ONCOTIC PRESSURE

Back 92

the osmotic pressure of a colloid in solution, such as when there is a higher concentration of a protein in the plasma on one side of a cell membrane than in the neighboring interstitial fluid.

Front 93

(vocab)

OSMOLALITY

Back 93

the measure of the osmotic force of solute per unit of weight of solvent (mOsm/kg or mmol/kg).

Front 94

(vocab)

OSMOSIS

Back 94

the movement of water between two compartments separated by a membrane permeable to water but not to a solute.

Front 95

(vocab)

OSMOTIC PRESSURE

Back 95

amount of pressure required to stop the osmotic flow of water.

Front 96

(vocab)

pH

Back 96

abbreviation for potential hydrogen, a scale representing the relative acidity (or alkalinity) of a solution. Neutral 7

Front 97

(vocab)

TETANY

Back 97

increased nerve excitability and sustained muscle contraction that results from low calcium levels that allow sodium to move into excitable cells, increasing depolarization; low calcium levels affect the membrane potential.

Front 98

(vocab)

VALENCE

Back 98

the electrical charge of an ion that is a numeric expression of the capability of an element to combine chemically with other elements.

Front 99

(lab values)

pH NEUTRAL

Back 99

7.35 - 7.45

Front 100

(lab values)

RESPIRATORY ACIDOSIS

Back 100

pH ↓ <7.35

CO2 ↑ >45

Front 101

(lab values)

RESPIRATORY ALKALOSIS

Back 101

pH ↑ >7.45

CO2 ↓ <35

Front 102

(lab values)

METABOLIC ACIDOSIS

Back 102

pH ↓ <7.35

HCO3- ↓ <22

Front 103

(lab values)

METABOLIC ALKALOSIS

Back 103

pH ↑ >7.45

HCO3- ↑ >26

Front 104

(lab values)

serum SODIUM

Back 104

135 - 145 mEq/L

Front 105

(lab values)

serum POTASSIUM

Back 105

3.5 - 5 mEq/L

Front 106

(lab values)

total serum CALCIUM

Back 106

8.9 - 10.1 mEq/L

Front 107

(lab values)

Ionized CALCIUM

Back 107

4.4 - 5.3 mg/dL

Front 108

(lab values)

serum PHOSPHATES

Back 108

2.5 - 4.5 mg/dL

1.8 - 2.6 mEq/L

Front 109

(lab values)

serum MAGNESIUM

Back 109

1.5 - 2.5 mEq/L

Front 110

(lab values)

serum CHLORIDE

Back 110

98 - 108 mEq/L