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50 Cards in this Set

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What is the fluid that is inside of cells called?
intracellular fluid (ICF)
What is the water outside of the cells called?
extracellular fluid (ECF)
The EXF contains about 15L of total body water. This space includes _________, which is fluid between the cells.
interstitial fluid
The movement of FLUID through a cell or blood vessel membrane beause of hydrostatic pressure differences on both sides of the membrane is called what?
filtration

F.Y.I...filtration depends on differences in water volume pressing against confining walls.
Water molecules in a confined space constantly press outward against the confining walls. What is the force of the weight of WATER molecules pressing against the confining walls of a space?
hydrostatic pressure

F.Y.I...hydrostatic pressure is a "water-pushing" pressure, because it is the force that pushes water outward from a confined space through a membrane.
In most instances, substances will move from the ________ amount of pressure or concentration to the _________ amount.
greater, lesser

F.Y.I...filtration continues only as long as the hydrostatic pressure gradient exists.
The assisted movement of a substance through a permeable membrane between two fluid compartments
active transport
The movement of fluid through a biologic membrane as a result of hydrostatic pressure differences on both sides of the membrane - usually occurs from capillaries to the interstitial fluid
filtration
The free movement of substances across a permeable membrane and down a concentration gradient - is not pressure dependent and occurs in both directions across capillary and cell membranes
diffusion
The process by which only the solvent diffuses through a selectively permeable membrane - it involves movement of water only and depends on hydrostatic and osmotic pressures.
osmosis
The movement of a substance across a selectively permeable membrane and against a concentration, electical, or pressure gradient - helps to maintain a special intracellular environment.
active transport
Hormones secreted by special cells that lkine the atria of the heart and the ventricles of the heart - they are secreted in response to increased blood volume and blood pressue, which stretch the heart tissue.
natriuretic peptides (NPs)
Preferred range for Sodium (Na+)
136-145 mmOl/L
Preferred range for Potassium (K+)
3.5-5.0 mmOl/L
______ is the major cation in the ECF and is responsible for maintaining ECF osmolarity.
Sodium

F.Y.I...the ECF sodium level determines whether water is retained, excreted, or moved from one fluid space to another.
______ is the major cation of the ICF.
Potassium
Normal urine specific gravity range
1.015-1.025
Dehydration, SIADH, diabetes mellitus, and toxemia of pregnancy will _______ urine specific gravity levels.
increase
Chronic renal insufficiency, diabetis insipidus, lithium toxicity, and early renal disease will _______ urine specific gravity levels.
decrease
The three types of fluid volume deficit are:
1. Isotonic dehydration
2. Hypertonic dehydration
3. Hypotonic dehydration
Dehydration in which water and dissolved electrolytes are lost in equal proportions.
isotonic dehydration
Dehydration in which water loss is greater than electrolyte loss.
hypertonic dehydration
Dehydration in which electrolyte loss is greater than water loss.
hypotonic dehydration
1 L of water = ____lbs, or ___kg
2.2 lbs, 1 kg
The best indicator of fluid loss or gain
daily weight
A sudden decrease in the tightness of a patient's shoe or ring size may indicate ______, whereas a sudden increase may indicate ______.
dehydration, edema
Some risk factors for dehydration:
vomiting; diarrhea; burns; large, draining wounds; DM; DI; renal disease; hemorrhage; major venous obstruction; prolonged febrile state; surgery; diuretics; NPO; enemas; NG suctioning
Key features of dehydration:
increased pulse rate; thready pulse; decreased BP; orthostatic hypotension; flat neck and hand veins in dependent positions; diminished peripheral pulses; weight loss; increased RR; increased depth of respirations; fever; decreased CNS activity; decreased UO; increased urine specific gravity; dry, scaly skin; poor turger; dry mouth; thirst; diminished bowel sounds; constipation
BUN levels in the dehydrated patient will be _____.
normal or increased
Creatinine levels in the dehydrated patient will be _____.
normal or increased
Sodium levels in the dehydrated patient will be _____.
normal
Osmolarity in the urine of a dehydrated patient will be _____.
increased
H&H in the dehydrated patient will be _____.
increased
Urine specific gravity in the dehydrated patient will be _____.
>1.010
0.9% NS is _____.
isotonic solution
0.45% NS is _____.
hypotonic
D5W is _____.
isotonic

F.Y.I...within a short time after administration, the dextrose is metabolized, and the tonicity of the infused solution decreases in proportion to the osmolarity of the electrolytes in within the water.
5% Dextrose in 0.45% Saline is _____.
hypertonic

F.Y.I...within a short time after administration, the dextrose is metabolized, and the tonicity of the infused solution decreases in proportion to the osmolarity of the electrolytes in within the water.
LR is _____.
isotonic

F.Y.I...within a short time after administration, the dextrose is metabolized, and the tonicity of the infused solution decreases in proportion to the osmolarity of the electrolytes in within the water.
D5LR is _____.
hypertonic

F.Y.I...within a short time after administration, the dextrose is metabolized, and the tonicity of the infused solution decreases in proportion to the osmolarity of the electrolytes in within the water.
Most problems caused by overhydration are related to fluid volume excess in the _____ or to dilution of specific electrolytes and blood components.
vascular space
In _____ overhydration, isotonic fluids are ingested or retained, so that osmolarity remains normal. Only the ECF compartment expands, and the fluid does not shift between the spaces. The problems caused by severe _____ overhydration are circulatory overload and edema.
isotonic
_____ overhydration, also called water intoxication, is when the osmolarity of the ECF decreases, and hydrostatic pressure increases. Fluid moves into the intracellular space because of the decreased plasma osmotic pressure, and all the fluid spaces expand.
hypotonic
_____ overhydration is rare, and it is caused by an excessive sodium intake. The hyperosmolarity of the plasma and interstitial compartments draws fluid from the ICF compartment. Thus, the ECF volume expands, and the ICF volume contracts.
hypertonic
Some key features of overhydration are:
increased pulse rate; bounding pulse; peripheral pulses full; elevated BP; decreased pulse pressure; distended neck and hand veins; weight gain; increased RR; increased dyspnea with exertion or in the supine position; moist cracles heard on auscultation; shallow respirations; pitting edema in dependent areas; pale, cool skin; altered LOC; headache; visual disturbances; muscle weakness; increased motility
Some features specific to isotonic overhydration are:
liver enlargement; ascites formation
Some features specific to hypotonic overhydration are:
polyuria; diarrhea; nonpitting edema; cardiac dysrhythmias associated with electrolyte dilution; projectile vomiting
Common causes of isotonic overhydration:
poorly controlled IV therapy; renal failure; long-term corticosteriod therapy
Common causes of hypotonic overhydration:
early renal failure; CHF; syndrome of inappropriate antidiuretic hormone; poorly controlled IV therapy; replacement of isotonic fluid loss with hypotonic fluids; psychogenic polydipsia; irrigation of wounds and body cavities with hypotonic fluids
Common causes of hypertonic overhydration:
excessive sodium ingestion; rapid infusion of hypertonic saline; excessive sodium bicarbonate therapy