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70 Cards in this Set
- Front
- Back
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A state of equilibrium in the internal environment of the body is called ( to keep conditions as close to normal as posable)
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Homeostatis
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What disease or illness can affeCt fluid aND electrolyle balance?
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Dehydration is the # one cause
CHF Renal disorders DKA HHNK |
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What treatments and medications can cause F/E balance
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Diuretics laxatives
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What environmental conditions can affect F/E balance
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extream heat.
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Why is it important for the nurse to know about fluid and electrolyte and acid bace balance
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to be able to know life saving interventions that will come up.
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what is the most abundant fluid in the body?
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Water.
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what is the fuction of water in the body?
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it IS a solvent that transports dissolved nutrients,electrolytes ,gases, and waste. it also helps to maintain body temp, and cell shape.
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Does water content of the body change with gender,body mass or age?
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yes
infant 70-80% adult 50-60% older adult 45-55% |
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why do men have a higher water content then women?
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women have a higher fat content then men, and men have more muscle then women, fat has little to no water,and muscle has high content of water.
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what age group has a greater risk of water disturbance?
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the older adult and the child
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What are some age related changes in the older adult that Will change fluid and electrolyte balance?
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skin- decrease in elasticity, turgor & oils.
Renal-decrease concentration & filteration. Muscular-decrease muscle mass Neuro- decrease trirst, medications adrenal atrophy |
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What are some of the considerations in a pediatric pt and fluid and electrolyte balance?
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they have a higher BSA and loose more water from skin.
they can not concentrate UA to 3months and kidney not efficient till 2years higher metabolism and they are totaly dependant on adult to provide fluids. |
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what is the fluid found inside of the cell?
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ICF intracellular fluid
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what is the most prevalent cation in the ICF,and the most prevalent anion in the ICF
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K+ is the cation
PO4- is the anion(phosphate) |
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What is the % of body wt found in the ICF
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40% of the body wt.
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Body fluid that is present outside of the cell; and includes plasma,interstitial fluid and transcellular fluid is called?
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ECF extracellular fluid. the fluid spaces betweenthe cells. it exspands adn contracts.
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What is the prevalent cation and anion inthe ECF?
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the anion is CL-
the cation is Na+ |
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this is a small and important compartment and hold appoximatly 1L if fluid ?
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Transcellular fluid.
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What does the Transcellular fluid contain
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Cerebrospinal fluif
Gi fluid pleural spaces synoveal spaces peritoneal spaces eyeballs |
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What are the mechanisms that control fluid and elctrolyte movemant?
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Filtration& hydrostatic pressure
diffusion osmosis active transport |
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define how hydrostatice pressure works?
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It is a major force that pushes water into the capillary level from the vascular system(interstitial space)
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What is an example of Hydrostatic pressure
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Blood pressure
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after hydrstatic pressure pushes water into the capillary level, what happens to the extra fluid fluid?
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THe lymph system picks up and transports fluid back to systemic circulation towards the heart.(no pump is needed it depends on muscle concration & body processes)
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WHEN WOULD YOU FIND FLUID SHIFTS IN THE CAPILLARIES?
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WHEN PLASMA ENTERS THE INTERSTITIAL SPACE AND CAUSE EDEMA.
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WHAT ARE SOME CLINICAL EXAMPLES OF FLUID SHIFT INTO THE CAPILLARIES?
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FLUID OVERLOAD
CHF PEDAL EDEMA PROTEIN LOSS |
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WHAT IS THE CALCULATION FOR A STANDARD FLUID RESTRICTION?
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7-3 SHIFT 50% OF ORDERED FLUID
3-7 SHIFT 40%" " 7-11 SHIFT 10%" " |
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WHAT ARE SOME NURSEING INTERVENTIONS FOR PT. WITH FLUID RESTRICTIONS?
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TEACH REASON FOR RESTRICTION
MOUTH CARE HARD CANDY/GUM ICE CHIPS |
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HOW DO YOU CALCULATE GAINS AND LOSSES IN A PT BEING MONITERED CLOSE FOR I&O?
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1LITER=1kg(2.2LBS)
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if pt recieving diuretics loses 3.3LBS in a 24HR HOW MUCH FLUID LOSS WAS THEIR.
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3.3/2.2=1.5kg=1500ML
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DOES A NURSE NEED AN ORDER TO DO I&O ON A PT?
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NO
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WHAT ARE SOME CARDIOVASCULAR SIGNS YOU WILL SEE WHEN ASSESSING A PT WITH OVERHYDRATION?
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INCREASE BP
INCREASE HR(BOUNDING PULSE) DISTENDED NECK VEINS WT GAIN |
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WHAT ARE SOME RESP CLINICAL SIGNS IN A PT WITH OVERHYDRATION?
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INCREASE RESP RATE,AND SHALLOW
CRACKELS |
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WHT ARE SOME NEUR SIGNS INA PT WITH OVERHYDRATION?
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HEADACHE
ALTERED LOC |
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WHEN ASSESSING A PT WITH OVERHYDRATION WHAT RENAL ASSESSMENT WHOUD YOU LOOK AT?
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INCREASE URINE OUTPUT
DECREASE SPECIFIC GRAVITY |
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WAHT ARE SOME NURING ASSESSMENTS OF THE INTEGUMENTARY when overhyrated GOING TO FIND?
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PITTING EDEMA IN DEPENDANT AREAS
(ECEPT HYPOTONIC) SHIN PALE AND COOL |
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WHAT HAPPENS TO GI MOTILITY WHEN A PT IS OVERHYDRATED?
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IT INCREASES
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WHT ARE TTHE NURSING INTERVENTIONS FOR A PT TAHT IS OVERHYDRATED?
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MONITER ABC's
SAFTY DIURETICS FLUID RESTRICTION DAILY WTS STRICT I&O MONITER LAB ORAL CARE |
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NURSING INTERVENTIONS FOR THE PT THAT IS DRHYDRATED?
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ABC
SAFTY FLUID MANAGEMENT ORAL CARE. |
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WHEN A PT IS IN ISOTONIC DEHYDRATION WHAT IV FLUID SHOULD YOU GIVE?
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ISOTONIC FLUID REPLACEMENT
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WHAN A PT IS IN HYPOTONIC DEHYDRATION WAHT FLUID REPLACEMENT SHOULD THE PT HAVE?
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HYPERTONIC FLUID
MONITER PULSE RATE AND QUALITY URINE OUTPUT. |
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WHAT IS THE TREATMENT OF CHOICE IF A PT IS IN HYPERTONIC DEHYDRATION?
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HYPOTONIC FLUID
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ACTS AS A MAGNET TO HOLD WATER INSIDE THE BLOOD VESSEL
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PROTEIN(ALBUMIN)
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WHAT SYMTOMS WOULD BE SEEN IN A PROTEIN DEFICIT?
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EDEMA, SLOW HEALING TIME
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WHAT ILLNESSES OR DIESESES WOUD HAVE A PROTEIN DEFICIT?
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STARVATION
MALNUTRITION LIVER DISEASE RENAL DISEASE |
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WHAT IS THE DEFINITION OF DIFFUSION?
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MOVEMENT OF A MOLECULES FROM AN AREA OF HIGHER CONCENTRATION TO A LOWER CONCENTRATION.
EXAMPLE:O2 DIFUSSING THROUGH CELL. IT DOES NOT NEED ENERGY |
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WHAT IS THE DEFINITION OF OSMOSIS?
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WATER ONLY, FROM A LOWER CONCENTRATION TO A HIGHER CONCENTRATION.
EXAMPLE: OSMOTIC DIURETIC, MANNITOL.(NO CHEMICAL) |
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WHAT IS ACTIVE TRANSPORT?
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PROCESS IN WHITCH MOLECULES MOVE AGAINST CONCENTRATION GRADIENT.
EXAMPLE SODIUM POTASSIUM PUMP. ATP ENERGY NEEDED. |
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WHAT TYPE OF SOLUTION IS THE SAME OSMOLARITY AS BLOOD?
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ISOTONIC
EXAMPLES: NS NaCl LR |
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what lab vlues would you see in a pt with isotonic overhydration?
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electrolytes will be normal,decrease hemoglobin,hematocrit,protein
excessive water |
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what lab values will you see in a pt with hyertonic overhydration?
(caused by renal failure) |
increase in electrolyte,bun,blood urea,creatine
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what lab values will you see ina pt with hypotonic overhydration
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decrease in blood count protiens and electrolytes.
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WHAT INDICATES ECF EXPANDING AND ICF STAYING NORMAL.
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ISOTONIC OVERHYDRATION
also known as hypervolemia or fluid overload. |
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Common cause of isotonic overhydration is?
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iv therapy, not watching fluid flow.
renal failure steriod use(fluid and Na retension) |
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what indicates water excess,diluted electrolytes ICF cells swell..
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Hypotonic overhydration
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Common causes of hypotonic overhydration?
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CHF
early renal failure SIADH hypotonic iv fluids(1/2 NS) |
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ICF cells dehydrate and shrink and is a very rare overhydration?
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hypertonic overhydration
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what causes hypertonic overhydration?
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excessive Na ingestion
hypertonic IV saline excessive sodium bicarb |
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WHAT ARE HYPOTONIC SOLUTIONS?
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LOWER OSMOLALITY OR LOWER OSMOTIC PRESSURE THAN BLOOD.
1/2 NS 1/2NaCl WATER /PO |
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WHAT IS A HYPERTONIC SOLUTION?
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HIGHER OSMOLALITY OR HIGHER OSMOTIC PRESSURE THAN BLOOD.
3%NS 3%NaCl 10% DEXTROSE |
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IN FLUID SPACING WHAT IS FIRST SPACING CONSIDERED
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IT IS A NORMAL DISTRABUTION OF ICF AND ECF FLUIDS.
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IN FLUID SPACING WHAT DOES SECOND SPACING MEAN?
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ABNORMAL ACCUMULATION OF INTERSTITIAL FLUID(EDEMA)
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IN FLUID SPACING WHAT DOES THIRD SPACING MEAN?
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FLUID ACCUMULATION IN PARTS OF THE BODY WHERE IT IS NOT EASILY EXCHANGED WITH ECF.
EXAMPLE: BURNS,ASCITES(THE FLUID IS COMPOSED OF PROTEIN ADN ELECTROLYTES),PERITONITIS. |
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WHAT DO THE KIDNEYS DO IN THE REGULATION OF FLUID BALANCE?
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SELECTIVLY MAINTAIN AND EXCRETE FLUIDS
REGULATE PH *HYDROGEN IONS *BICARBONATE |
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WAHT DO THE ADRENAL GLANDS DO TO HELP IN THE REGULATION OF FLUIDS?
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SECREATE ALDOSTERONETHAT RETAINS Na
WATER RETENTION K+EXCREATION |
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WHAT ROLE DOES THE PITUATARY GLAND PLAY ON FLUID REGULATION?
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SECRETES ADH(AND CAUSE WATER RETETION)
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THE HYPOTHALMUS SENSE FLUID DEFICIT OR INCREASE IN PLASMA OSMOLALITY AND DOES WHAT?
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STIMULATES THIRST AND ADHRELEASE FROM PITUATARY
OR RESULTS IN INCREASE FREE WATER AND DECREASE PLASMA |
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WHERE ARE NATRIURETIC PEPTIDE HORMONES SECREATED, AND WHEN ARE THEY RELEASED?
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SECREATED IN THE ATRIA AND VENTRICLES(ANP&BNP)
RELEASED WHEN HEART TISSUE STRETCH, INDICATER OF HEART FAILURE. |
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WHAT ARE AVERAGE TOTAL FLUID LOSSES IN A DAY, AND THE ROUT IT IS LOST?
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KIDNEY-1500ML/DAY
SKIN AND LUNGS-900M (INSENSIBLE LOSS) GI TRACT-100 ML/DAY |
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WHAT IS THE DIFFERENCE IN SENSIBLE FLUID LOSS AND INSENSIBLE FLUID LOSS?
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SENSIBLE IS VISABLE,OR MEASURABLE
INSENSIBLE IS WHENYOUCAN NOT SEE IT OR IT IS UNMEASURABLE. |
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WHAT IS INDICATED WHEN WATER ADN ELECTROLYTE LOSS IS EQUAL IN PROPORTIONS, ADN ICF REMAINS NORMAL?
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ISOTONIC DEHYDRATION.
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