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95 Cards in this Set
- Front
- Back
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What usually leads to imbalances and can cause death?
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Illness
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What is the MOST ACCURATE method of determining fluid balances?
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Daily Weight
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Imbalances of fluids, electrolytes, and pH affect the ability to do what three activities?
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maintain ADLs, think clearly, and engage in self-care
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What should nurses do to prevent fluid imbalances?
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Identify and assess clients who are likely to develop imbalances, monitor them for early manifestations, and implement collaborative and nursing interventions to prevent and correct imbalances.
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Who are high-risk patients for fluid imbalances?
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Infants, older adults, and people w/cardiac and renal disorders
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What are body fluids made up of?
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Primarily WATER with other dissolved substances (solutes)
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What are two nonelectrolytes?
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Nonelectrolytes are molecules that remain intact-> glucose and urea
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What two gases can dissolve readily in body fluids?
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CO2 and O2
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What constitutes about 60% of total body weight?
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Water/body fluids
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Obese people and elderly have ______ percentage of body fluids for total weight?
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a smaller
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Where are the 60% of body fluids contained? What percentages in each place?
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40% Intracellular, 5% plasma, 15% Interstitial (Extracellular=20%)
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Fluid I & O should be ________.
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Equal in a healthy person (about 2500 mL/day)
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What are the functions of body fluids?
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*Maintain blood volume
*Assist w/digestion *Regulate body temp (lack fluids- can’t cool down)*Serve as medium for metabolism *Transport materials to & from cells *Waste excretion *Serve as aqueous medium for cellular metabolism *Solvent for non-electrolytes & electrolytes |
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Intracellular fluid contains what cations and anions?
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cations K, Mg & anions phosphate and sulfate
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Extracellular fluid contains what cations and anions?
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cation Na, & anions Cl, Bicarbonate
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What are the fluids that make up Extracellular fluids?
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Interstitial fluid (includes lymph)-Between body cells, edema
Intravascular fluid- plasma Transcellular-cerebrospinal, pleural, peritoneal and synovial, and digestive juices Third Spacing- ascites, pericardial effusion |
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What are the main cations and anions in the body?
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Cations are Na, K, Ca, Mg Anions are Cl, HCO3, HPO4, SO4
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What are electrolytes measured in?
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Measured in milliequivalents per liter of water (mEq/L)- measure of chemical-combining power
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What are the three types of passive transport?
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Osmosis, diffusion, filtration
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What is osmosis?
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Movement of water from lower concentration of solvent to higher concentration
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What is the "pulling power" of a solution referred to as?
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Osmolarity
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What tonicity does a solution have that has more pulling power (osmolarity) than plasma (>295 mOsm/L) have?
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Hypertonic
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What tonicity does a solution that has less pulling power (<275 mOsm/L)than plasma have?
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Hypotonic
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If there is a hypotonic solution in the plasma, does the fluid go into the cells or out of the cells?
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It goes into the cells because the cells have more pulling power and the cells may burst when this happens.
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What type of tonicity does a solution have if it is equal to the plasma osmolarity?
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Isotonic
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Crystalloids are _________absorbed whereas colloids are ________ absorbed.
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readily; not readily
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What is diffusion?
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The tendency of solutes to move freely throughout a solute from higher concentration to lower
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What can also move by diffusion?
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CO2 and O2 in the alveoli
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The rate of diffusion is determined by what 3 factors?
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size of molecule, concentration of solution and temp
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What is filtration?
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Movement of both water and smaller particles from high pressure to low pressure
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What is hydrostatic pressure?
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Force created by fluid within a closed system (“pushing force”)
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What is the (colloid) osmotic pressure
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power of a solution to draw water
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What is the filtration pressure?
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Difference between Osmotic and Hydrostatic pressures
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What is the process that requires energy for the movement of substances through a cell membrane from lower solute concentration to higher solute concentration?
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Active transport
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What pump requires active transport? What type of energy is used?
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Sodium/ Potassium pump; ATP
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What is the major regulator of fluid intake?
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Thirst
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What causes an increase in thirst?
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situations that increase plasma osmolarity include excessive fluid loss, excessive Na intake, and decrease fluid intake
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What causes a decrease in thirst?
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situations that increase plasma osmolarity include excessive fluid loss, excessive Na intake, and decrease fluid intake
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What are the fluid intake values that men and women need?
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Women need 2700 mL/day, Men need 3700 mL/day
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Most people get ___% water from food and ___% water from fluids.
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20; 80
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In a healthy person fluid intake _________ output.
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equals
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What are three ways in which a person loses considerable amounts of water (other than urine)?
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skin, lungs, and feces
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What does the Antidiuretic hormone (ADH) do?
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Helps the body to retain fluid **manufactured in hypothalamus and stored in posterior lobe of pituitary gland
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What does the Renin-Angiotensin System do?
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Retain sodium and water (angiotensin 2 tells adrenal cortex to release aldosterone which promotes reabsorption of sodium and excretion of potassium in distal tubules)
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What does aldosterone do?
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It helps body conserve sodium and save chloride and water, also causes potassium to be excreted
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What does the thyroid gland release and what does it do?
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releases Thyroxine which increases blood flow which leads to increased renal circulation and increased glomerular filtration and urinary output
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What is the Atrial natriuretic factor (ANF) and what does it do?
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Released from atrium when stretched (excess fluid) and promotes excretion of Na and water
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Hyperthyroidism causes ________ in cardiac and urine output.
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increase
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Hypothyroidism causes _________ in cardiac and urine output.
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decrease
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Diarrhea and vomiting causes a loss in ___________ & ______________.
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Potassium and other electrolytes
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What is the major cation in ECF?
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Sodium
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What is Na's primary function?
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regulate fluid volume
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What other functions does Na have?
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Maintain blood volume, interact w/calcium to maintain muscle contraction, stimulates nerve impulses
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What is an acid?
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Any compound that contains hydrogen ions that can be released
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What is a base?
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Any compound that combines with hydrogen ions in solution (aka cation acceptors)
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What is normal blood pH?
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7.35-7.45
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What is the pH range that alters enzymatic activity and creates myocardial irritability?
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<7.3 and >7.52
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What pH ranges are fatal?
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<6.9 and >7.8
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What do buffers do?
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Prevent wide swings in pH by absorbing or releasing free hydrogen ions
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What are the two main buffers of pH?
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Bicarbonate (base) and Carbonic acid
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What does the thyroid gland release and what does it do?
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releases Thyroxine which increases blood flow which leads to increased renal circulation and increased glomerular filtration and urinary output
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What is the Atrial natriuretic factor (ANF) and what does it do?
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Released from atrium when stretched (excess fluid) and promotes excretion of Na and water
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Hyperthyroidism causes ________ in cardiac and urine output.
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increase
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Hypothyroidism causes _________ in cardiac and urine output.
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decrease
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Diarrhea and vomiting causes a loss in ___________ & ______________.
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Potassium and other electrolytes
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What is the major cation in ECF?
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Sodium
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What is Na's primary function?
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regulate fluid volume
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What other functions does Na have?
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Maintain blood volume, interact w/calcium to maintain muscle contraction, stimulates nerve impulses
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What is an acid?
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Any compound that contains hydrogen ions that can be released
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What is a base?
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Any compound that combines with hydrogen ions in solution (aka cation acceptors)
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What is normal blood pH?
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7.35-7.45
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What is the pH range that alters enzymatic activity and creates myocardial irritability?
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<7.3 and >7.52
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What pH ranges are fatal?
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<6.9 and >7.8
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What do buffers do?
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Prevent wide swings in pH by absorbing or releasing free hydrogen ions
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What are the two main buffers of pH?
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Bicarbonate (base) and Carbonic acid
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What organ regulates formation of carbonic acid?
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Lungs
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What organ regulates production of bicarbonate?
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Kidneys
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What is the normal ratio of bicarbonate to carbonic acid in the ECF?
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20:1
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What is metabolic acidosis?
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Condition in which excess of hydrogen ions or loss of bicarbonate in ECF cause the pH to fall below 7.35
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What is metabolic alkalosis?
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Condition in which there is a lack of hydrogen ions or a gain of bicarbonate which causes the pH to rise above 7.45
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What does the Phosphate buffer system do?
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Active in the ICF, especially the renal tubules, it converts alkaline sodium phosphate to acid-sodium phosphate in the kidneys
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What does the Protein buffer system do?
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It is a mix of plasma proteins and globin in RBCs that can combine with or liberate hydrogen ions both inside and outside the cells
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The lungs are the primary controller of the body's _______ ______ supply.
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carbonic acid
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Are the lungs fast or slow when changes in hydrogen are needed?
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fast
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The lung's response is _____________ whereas the kidney's response is _____________.
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short-term; long-term
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What is hypovolemia?
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Isotonic fluid loss... (low blood volume) Osmotic and hydrostatic pressure force interstitial fluid into the plasma to try and compensate.
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What is the third-space shift?
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It is a distributional shift of body fluids into spaces such as the pleural, peritoneal, or pericardial areas, joint cavities, bowel, or interstitial spaces
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What is hypervolemia?
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Excess of isotonic solution usually caused by kidney malfunction and failure of the heart to pump adequately
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What is normal PaCO2?
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35-45 mmHg
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What is normal bicarbonate levels?
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22-26 mEq/L
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What is the body's first, second and third line of regulation for acid-base imbalances?
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1) Buffers carbonic acid and bicarbonate, 2) Lungs, and
3) Kidneys |
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Are the kidneys fast or slow at fixing acid-base problems?
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slow but effective
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What are the symptoms of Hypovolemia and which is first?
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Thirst is first... later rapid, weak pulse and low BP, dry skin and mucous membranes, decreased turgor, decreased UO, fatigue, temp increase
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What are the symptoms of Hypervolemia?
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BP elevated, bounding pulse, resp. increased and shallow, neck veins distended, dependent edema, pale and cool skin, urine dilute, rapid wt gain
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What are some more sever signs of hypervolemia?
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Moist crackles in lungs, dyspnea and ascites, decreased BUN, hct, and urine specific gravity
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