Fluid, Electrolyte, And Acid-Base. Klor9

Front 1

What are two aspects of fluid balance

Back 1

1. Water concentration of all body fluids

2. Volume of fluid in extracellular space

Front 2

What is the function of water

Back 2

It is a transport system that facilitates elimination and helps to control temperature regulation

Front 3

What percentage of water is in an adult and child

Back 3

Adult 60%

Child 70% - 80%

Women have lower fluid content

Front 4

Define active transport

Back 4

Movement of substances across a cell membrane against an electrochemical gradient

Front 5

Define anions

Back 5

Negatively charged ion

Front 6

Define baroreceptors

Back 6

Stretch receptors located in major arteries and veins that monitor vascular volume

Front 7

Define base (alkali)

Back 7

Any substance that can combine with and decrease hydrogen ions in solution

Front 8

Define cations

Back 8

Positively charged ions

Front 9

Define diffusion

Back 9

Movement of molecules from an area of higher concentration to one of lower concentration: High concentration to low concentration

Front 10

Define electrolytes

Back 10

Chemical compound that dissociates into ions when in solution: Ex. sodium, potassium, chloride

Front 11

Define filtration

Back 11

Passage of solution through a semi-permeable membrane from a region of high pressure to a region of low pressure: high pressure to low pressure

Front 12

Define hyperosmolar

Back 12

One compartment contains a greater concentration of dissolved substance (hyperosmolar) than the other compartment (hypoosmolar)

Front 13

Define hypoosmolar

Back 13

One compartment contains a lesser concentration of dissolved substance (hypoosmolar) than the other compartment (hyperosmolar)

Front 14

Define interstitial fluid

Back 14

Fluid between the cells

Front 15

Define extracellular fluid

Back 15

Body fluid outside the cells; mainly interstitial fluid and plasma

Front 16

Define intracellular fluid

Back 16

Portion of body fluid contained within the cells

Front 17

Define osmolality and how is it expressed in units

Back 17

Concentration of solutes in a solution: Express = milliosmols per kilogram (mOsm/kg), norm 280-300

Front 18

Define osmolarity and what is it expressed in units

Back 18

Concentration of solute in a solution Express = milliosmols per liter (mOsm/L) norm 280 - 300

Front 19

Define osmosis

Back 19

Movement of fluid through a semi-permeable membrane from a region of lower to higher solute concentration

Front 20

Define osmotic pressure

Back 20

Pressure that would have to be applied to Pure solvent to prevent from passing into a solution by osmosis; tends to hold fluid within its container and is opposed to a hydrostatic pressure

Front 21

What is renin-angiotensin-aldosterone

Back 21

A hormone that regulates blood pressure, vasoconstriction, arterial perfusion, thirst

Front 22

How does the renin-angiotensin-aldosterone system work

Back 22

Renin converts inactive angiotensin into Angiotensin 1, which happens in the liver. Angiotensin converting enzyme (ACE) then converts Angiotensin 1 to Angiotensin 2, which happens in the lungs.

Front 23

What is Angiotensin

Back 23

Family of peptides with vasoconstrictive activity produced by enzymatic actions of renin on angiotensinogen

Front 24

What is the effect of natriuretic peptide hormone

Back 24

Affects fluid volume and cardiovascular function through excretion of sodium (natriuretic)

Front 25

What is antidiuretic hormone (ADH)

Back 25

A hormone determining urine concentration or dilution by controlling water excretion with sodium

Front 26

What is most abundant and regulated by renin Angiotensin aldosterone, that if changed can influence water balance

Back 26

Sodium (Na+)

Front 27

What is mainly used for normal cardiac and muscle function and regulated by aldosterone and insulin

Back 27

Potassium (K+)

Front 28

What determines physiologic function and can cause signs and symptoms associated with calcium imbalance

Back 28

Calcium (Ca++)

Front 29

Where is calcium found and which two states is it present

Back 29

Approximately 99% of body's calcium is found in bones and teeth. The remainder is in serum. It is primarily present in blood of the ionized and protein (albumin) bound state with a percentage of 50% to 50%

Front 30

Similar to potassium, what is important in regulating neuromuscular function and cardiac activity and is regulated by the kidneys

Back 30

Magnesium (Mg+)

Front 31

What happens to potassium and calcium in deficiency of magnesium

Back 31

Low magnesium causes hypocalcemia. Alterations in potassium run parallel to changes in magnesium

Front 32

What is found higher in children and is important in energy metabolism, bones and membrane structures, and synthesis of nucleic acid (RNA and DNA) that is regulated by kidneys

Back 32

Phosphorus (HPO4)

Front 33

Define hydrostatic pressure

Back 33

The pressure present within a fluid when it is at rest that acts equally in all directions due to increase weight of fluid exerted downward from above. The deeper the fluid the higher the pressure

Front 34

Define filtration pressure

Back 34

Pressure that helps move filtrate through a membrane. The measure hydrostatic and osmotic pressure

Front 35

Define buffers

Back 35

Compound that helps stabilize the pH of a solution for neutralizing added acid or base

Front 36

What are the four ways fluid and electrolytes can be lost

Back 36

1. Urine

2. Perspiration

3. Stool or vomit from GI tract

4. Water loss through lungs

Front 37

What is the normal urine output per day and hour

Back 37

1500ml/day and 30cc/hr

Front 38

What is lost through vomiting

Back 38

1. Gastric juice

2. Sodium

3. Chloride

4. Potassium

5. Hydrogen

Front 39

What is lost through diarrhea

Back 39

Loss of bicarbonate causing metabolic acidosis. Loss of sodium, chloride, water, and potassium causing extracellular fluid volume deficiency

Front 40

What is lost through diaphoresis

Back 40

Hypotonic fluid: sodium, potassium, chloride

Front 41

Define hypertonic

Back 41

Of Greater concentration than in body fluids

Front 42

Define hypotonic

Back 42

Of lower concentration than in body fluids

Front 43

What is lost with the use of diuretics and what can happen if lost is high

Back 43

Sodium, chloride, water. If too much is lost a decrease in extracellular fluid and magnesium will happen

Front 44

How does stress influence fluid and electrolyte loss or gains

Back 44

It increases aldosterone causing extracellular fluid retention. Increases antidiuretic hormone causing decrease renal excretion of water. Total fluid retention

Front 45

What is the result of extracellular fluid volume deficit

Back 45

Sodium, chloride, bicarbonate, water, and plasma causing decrease volume of extracellular fluid: hypovolemia, saline deficit, isotonic dehydration

Front 46

What is the result of extracellular fluid excess

Back 46

Increase interstitial and Vascular volume causing renal failure and liver disease

Front 47

What is the result of water deficit or hyperosmolarity

Back 47

Fluid are pulled from cells and brain resulting in confusion, agitation, convulsion, coma, and possible death

Front 48

What general reasons can cause water deficit or hyperosmolarity

Back 48

1. Decreased intake of fluid

2. Increase loss of fluid

3. Increased intake of salt

Front 49

How do one treat water deficit or hyperosmolarity

Back 49

Give water orally or IV dextrose 5%

Front 50

What is the result of water excess or hypoosmolarity

Back 50

Water moves into cells resulting in letharg, irritability, confusion, personality change, seizure, and possible death

Front 51

What general reasons can cause water excess or hypoosmolarity

Back 51

1. Increased intake of fluid

2. Decrease output

3. Abnormal secretion of antidiuretic hormone

Front 52

How is sodium used in the body

Back 52

Maintains blood pressure, attracts and holds water, is an electrolyte

Front 53

How is potassium used in the body

Back 53

Used to maintain heart function in muscle contraction

Front 54

How is potassium used in the body

Back 54

Used to maintain heart function and muscle contraction. Is an electrolyte

Front 55

How is calcium used in the body

Back 55

Muscle contraction, clotting blood, bone and teeth strength, conduct nerve impulse, and normal heart rate

Front 56

How is magnesium used in the body

Back 56

To regulate biochemical reactions: protein synthesis, muscle and nerve function, glucose control, blood pressure regulation

Front 57

How is phosphorus used in the body

Back 57

The mineral, which is found in bone and teeth, is used for growth and repair body cells and tissues

Front 58

What causes respiratory acidosis and how does it occur

Back 58

Cause by lung disease, depressed neural or muscular function that compromises breathing ability. This results in Carbon dioxide accumulating in the blood. As carbonic acid level increase free hydrogen increases causing pH to drop becoming more acidic

Front 59

How and what mechanism is used to compensate for respiratory acidosis

Back 59

The kidneys compensate for the acid build-up by increasing the excretion of hydrogen ion into the urine and return bicarbonate (HCO3) into blood. Normal pH level can only be reestablished if original problem can be reversed. Damaged lungs may have chronic respiratory acidosis

Front 60

What causes metabolic acidosis and how does it occur

Back 60

Occurs when excess acid is ingested, created (diabetic ketoacidosis), severe diarrhea, acid accumulation, or when kidneys are unable to retain enough bicarbonate ions to buffer free hydrogen ions in the blood

Front 61

How and what is used to compensate for metabolic acidosis

Back 61

1. Respiratory system compensates by increasing ventilation resulting in increase rate of carbonic acid excretion causing a drop in partial pressure of CO2 (PaCO2) in blood.

2. Renal compensates by excreting hydrogen ion and retaining bicarbonate. This can occur simultaneously with respiratory compensation to return pH within normal limits

3. Respiratory compensation alone cannot return acid-base balance to normal limits

Front 62

What causes respiratory alkalosis and how does it occur

Back 62

Caused by anything that results in hyperventilation: anxiety, fear, pain high altitude, asthma. This leads to decrease PaCo2 and increased pH blood

Front 63

How and what is used to compensate for Respiratory alkalosis

Back 63

Kidneys compensate by increasing the excretion of bicarbonate through urine and pH returns to normal

Front 64

What causes metabolic alkalosis and how does it occur

Back 64

Caused by loss of gastric juices (NG Tube, vomiting), high intake of antacids, endocrine disorders, hypokalemia. When excessive loss of body acids or unusual intake of alkaline substance, hydrogen ion's shift in blood causing pH to increase

Front 65

How and what is used to compensate for metabolic alkalosis

Back 65

1. Lungs compensate by decrease ventilation that allows blood carbon dioxide concentration to rise

2. Kidneys respond by retaining acid and excreting bicarbonate. However this is impaired if person has extracellular fluid deficit or hypokalemia

Front 66

What are General signs and symptoms of fluid, electrolyte, and acid-base imbalances

Back 66

1. Imbalance intake and output and body weight

2. Change in mental status

3. Change in vital signs

4. Abnormal tissue hydration

5. Abnormal muscle tone or sensation

Front 67

How much water is gained in a patient with an increase of one kilogram of weight

Back 67

One kilogram equals one liter of water gained

Front 68

What are the millimeters of depth in the levels of pitting edema

Back 68

1+ = 2 mm

2+ = 4 mm

3+ = 6 mm

4+ = 8+ mm

Front 69

In a Laboratory test what does serum osmolarity tests

Back 69

Obtained by venous blood sample. Plasma osmolarity decreases in water excess and increases in water deficit

Front 70

In laboratory tests what is urine osmolarity

Back 70

Measures urine solute concentration. When nitrogenous waste (urea, creatinine, uric acid) increases, urine osmolarity increases

Front 71

In laboratory tests what is urine specific gravity

Back 71

Measures the weight of a substance compared with an equal part of water. Concentrated urine equals higher specific gravity results. Diluted urine equals lower specific gravity results.

Front 72

In laboratory tests what is arterial blood gases

Back 72

A test that measures pH, partial pressure of carbon dioxid, partial pressure of oxyge, bicarbonate, and oxygen saturation hemoglobin: pH, PaCO2, PaO2, HCO3, O2 sat. Used to evaluate acid-base balance and pulmonary function

Front 73

What is the normal range of pH and the names of the extremes

Back 73

Normal = 7.35 - 7.45

Acidosis = < 7.35

Alkalosis = > 7.45

Front 74

What is a normal range of partial pressure of carbon dioxide (PaCO2) and the names of its extremes

Back 74

Normal = 35 - 45 mmHg

Hypocapnia = < 35 mmHg

Hypercapnia = > 45 mmHg

Front 75

What is a normal range of partial pressure of oxygen (PaO2)and the names of its extremes

Back 75

Normal = 80-100 mmHg

Hypoxemia = <80 mmHg

Front 76

What is the normal range for bicarbonate (HCO3)

Back 76

22 - 26 mEq/L

Front 77

What is base excess and it's normal range

Back 77

A measure of buffering capacity

Normal = -2 to +2

Front 78

What are the cations electrolytes

Back 78

Sodium

Potassium

Calcium

Magnesium

Front 79

What are the anions of electrolytes

Back 79

Chloride

Bicarbonate

Phosphorus

Front 80

What is a normal serum value of sodium

Back 80

135 - 145 mEq/L

Front 81

What is a normal serum value of potassium

Back 81

3.5 - 5.3 mEq/L

Front 82

What is a normal serum value of calcium in Total serum and ionized

Back 82

Total serum = 8.2 - 10.2 mg/dL

Ionized = 4.12 - 4.92 mg/dL

Front 83

What is a normal serum value of magnesium

Back 83

1.6 - 2.6 mg/dL

Front 84

What is the normal serum value for chloride

Back 84

97 - 107 mEq/L

Front 85

What is the normal serum value for bicarbonate

Back 85

22 - 26 mEq/L

Front 86

What is the normal serum value for phosphorus

Back 86

2.5 - 4.5 mg/dL

Front 87

What is the ABG of respiratory acidosis

Back 87

Decrease pH

Increase PaCO2

Increase HCO3

Front 88

What is the ABG of respiratory alkalosis

Back 88

Increase pH

Decrease PaCO2

Decrease HCO3

Front 89

What is the ABG of metabolic acidosis

Back 89

Decrease pH

Decrease PaCO2

Decrease HCO3

Front 90

What is the ABG of metabolic alkalosis

Back 90

Increase pH

Increase PaCO2

Increase HCO3

Front 91

What organ is the problem in respiratory acid balance and what organ is it fixed by

Back 91

Lungs are the problem and fixed by kidneys

Front 92

What organ is the problem in metabolic acid balance and what is it fixed by

Back 92

Kidneys are the problem and fixed by lungs

Front 93

What treatment is used for hyponatremia

Back 93

Sodium replacement

Water restriction

Hypertonic sodium solution

Front 94

What treatment is used for hypernatremia

Back 94

Hypotonic electrolyte solution

Isotonic non saline solution

Front 95

What is the treatment for hypokalemia

Back 95

Increase diet of potassium: fruit, veggies, whole grain, milk, meat

: fruit, veggies, whole grain, milk, meat

Potassium IV therapy

Front 96

Is the treatment for hyperkalemia

Back 96

Potassium restriction in diet and medication

Front 97

What is the treatment for hypocalcemia

Back 97

IV calcium salt

Vitamin D to increase calcium

Increase calcium diet: milk products, green, sardines, canned salmon, oysters

Front 98

What is the treatment for hypercalcemia

Back 98

1. IV 0.9% saline to dilute serum calcium

2. Diuretics

3. Calcitonin to decrease serum calcium for heart failure and renal failure

4. Corticosteroids with cancer patients

Front 99

What is the treatment for hypomagnesemia

Back 99

Diet: greens, nuts, Seafood, greens, peanut butter, cocoa

Magnesium salt oral or IV in bolus dose

Front 100

What is the treatment for hypermagnesemia

Back 100

1. Discontinue magnesium meds

2. Ventilation support and calcium gluconate

3. Loop diuretics

4. Sodium chloride IV

5. Lactated Ringer's IV

Front 101

What is the treatment for hypophosphatemia

Back 101

1. IV phosphorus

2. IV sodium or potassium phosphorus

Front 102

What is the treatment for hyperphosphatemia

Back 102

1. Treat underlying cause

2. Vitamin D to decrease binding phosphorus in GI

3. Calcitriol

4. Loop diuretic

5. Volume replacement Saline

Front 103

What is first spacing in fluid shifting

Back 103

Normal distribution of fluid in intracellular fluid and extracellular fluid

Front 104

What is second spacing in fluid shifting

Back 104

Abnormal accumulation of fluid in interstitial space: edema

Front 105

What is third spacing and fluid shifting

Back 105

Abnormal accumulation of fluid in interstitial space; the non-functioning area between cells: fluid in abdomen cavity, edema with Burns, ascites

Front 106

What are crystalloids

Back 106

Clear fluid classified as osmolality, normal osmotic pressure within cell

Front 107

What are the types of crystalloid solutions

Back 107

1. Isotonic

2. Hypotonic

3. Hypertonic

Front 108

What is an isotonic crystalloid solution and what is it used for

Back 108

Having same osmotic pressure as intracellular fluid and extracellular fluid. Expands extracellular fluid without pull on cells in the intracellular fluid

Used for expanding intravascular compartment resulting in increased circulatory volume. This is the only solution for blood

Front 109

What is hypotonic crystalloid solution and what is it used for

Back 109

The osmotic pressure of hypotonic is lower than osmotic pressure of ICF and ECF. It provides more water than electrolytes and dilute ECF

Used to correct cellular dehydration (cell enlargest or swells)

Front 110

What is a hypertonic crystalloid solution and what is it used for

Back 110

Osmotic pressure of hypertonic are greater than osmotic pressure of ICF and ECF. Increases osmotic pressure in the ECF causing fluid shift from cell

It is used to decrease cell edema (monitor overload)

Front 111

What are solutions of isotonic crystalloids

Back 111

1. Normal saline

2. Lactated ringers

Front 112

What are solutions of hypotonic crystalloids

Back 112

1. 0.45% normal saline

2. 5% dextrose

Front 113

What are solutions of hypertonic crystalloids

Back 113

1. 5% dextrose with normal saline

2. 5% dextrose with 0.45% normal saline

3. 3% saline solution

Front 114

What are colloid Solutions

Back 114

Cloudy fluids containing starch or protein for maintaining circulatory volume and replacing components

White blood cells, whole blood, plasma, albumin, platelets, Total parenteral Nutrition