Fluids And Electrolytes

Front 1

Fluid movement throughout the body helps... (3)

Back 1

1. Maintain temp
2. Maintain cell shape
3. Transports nutrients, gases, and wastes.

Front 2

What are insensible losses?

Back 2

Immeasurable losses.

Front 3

Examples of insensible losses.

Back 3

Through the skin and lungs.

Front 4

What are sensible losses?

Back 4

Measurable losses.

Front 5

What are examples of sensible losses?

Back 5

Urination, defication and wounds.

Front 6

Intracellular fluid

Back 6

Fluid inside the cell. Must be balances with extracellular fluid.

Front 7

Extracellular fluid

Back 7

Fluid outside of the cell, must be balanced with intracellular fluid.

Front 8

Transcellular fluid

Back 8

Cerebrospinal column, pleural cavity, lymph system, joints and eyes. Remains mostly constant.

Front 9

Isotonic

Back 9

Equally concentrated with other solutions

Front 10

Hypotonic

Back 10

Less concentrated than other solutions.

Front 11

Hypertonic

Back 11

more concentrated than other solutions.

Front 12

Diffusion

Back 12

Form of passive transport that moves solutes from areas of higher concentraion to areas of lower concentration, resulting in equality.

Front 13

Active transport

Back 13

Uses ATP to move solutes from one area of low concentration to an area of higher concentration. Ex. Na K pump.

Front 14

Osmosis

Back 14

Passive movement of fluid across a membrane from an area of lower solute concentration to and area of higher solute concentration until equal.

Front 15

Capillary filtration

Back 15

Movement of fluid through capillary walls through hydrostatic pressure balanced by plasma colloid osmotic pressure from albumin that causes reabsorption of fluid and solutes.

Front 16

Nephrons form urine by

Back 16

Filtering blood

Front 17

What does aldosterone do?

Back 17

Regulates sodium and water reabsorption by the kidneys.

Front 18

Aldosterone is secreted from

Back 18

The adrenal cortex

Front 19

ADH/Vasopressin

Back 19

Produced by hypothalamus to reduce diuresis and increase water retention if serum osmolality increases or blood volume decreases.

Front 20

Renin-Angiotensin- Aldosterone system

Back 20

Increase in blood flow causes juxtaglomerular cells to secrete renin.Leads to production of angiotensin II, which stimulates aldosterone to regulate absorption of H2O and Na.

Front 21

Atrial Natiuretic Peptide

Back 21

Produced and stored in the atria of the heart. Stops action of RAA system. Decreases BP by causing vasodilation and redices fluid volume by increasing excretion of Na and H2O.

Front 22

Thirst is regulated by

Back 22

The hypothalamus

Front 23

Ions

Back 23

Electrically charged particles created when electrolytes separate in a solution. Pos or neg charged.

Front 24

Anions

Back 24

Neg charged electrolytes. Cl, P, and bicarbonate

Front 25

Cations

Back 25

Positively charged electrolytes. Na, K, Ca, and Mg

Front 26

Electroneutrality

Back 26

Positive and negative ions balance each other out, achieving a neutral electric charge.

Front 27

Sodium

Back 27

Helps nerve cells and muscle cells interact.

Front 28

Chloride

Back 28

Maintains osmotic pressure and helps gastric and mucosal cells produce HCl.

Front 29

Calcium

Back 29

Stabilizes cell membrane, reducing premeability, transmits nerve impulses, contracts muscels, coagulates blood and forms bones and teeth.

Front 30

Bicarbonate

Back 30

Regulates acid base balance.

Front 31

Potassium

Back 31

Regulates cell exciteability, nerve impulse conduction, resting membrane potential, muscle contraction, myocardial membrane responsiveness and intracellular osmolality.

Front 32

Phosphate

Back 32

Controls energy metabolism

Front 33

Magnesium

Back 33

Influences enzyme reactions, neuromuscular contractions, normal functioning of nervous and cardiovascular system, protein synthesis, and Na and K ion transportation.

Front 34

What influences electrolyte imbalances?

Back 34

1. Normal cell fx
2. Fluid intake and output
3. Acid base balance
4. Hormone secretion

Front 35

Role of kidney in maintaining electrolyte balance.

Back 35

Regulates Na and K balance (Excretes K in exchange for Na retention)

Front 36

Lung and liver role in elecrolyte balance.

Back 36

Regulates Na, H2O and blood pressure.

Front 37

Hreat role in electrolyte balance

Back 37

Secretes ANP, causing Na excretion.

Front 38

Sweat glands role in elecrolyte balance.

Back 38

Excrete Na, K, Cl, and H2O in sweat.

Front 39

GI tract role in electrolyte balance.

Back 39

Absorbs and excretes fluids and electrolytes.

Front 40

Parathyroid glands role in electrolyte balance.

Back 40

Secrete Parathyroid hormone, which draws Ca into blood and helps move Phosphorous to the kidneys for excretion.

Front 41

Thyroid role in balance of electrolytes.

Back 41

Secretes calcitonen, which prevents Ca release from the bone.

Front 42

What do diuretics treat?

Back 42

Hypertension, heart failure, electrolyte imbalances and kidney disease.

Front 43

What do diuretics do?

Back 43

Increase urine production. Cause loss of electrolytes, particularly potassium.

Front 44

When a burn damages cells you would expect the cells to release what major electrolyte?

Back 44

Potassium.

Front 45

Acids

Back 45

Molecules that can give H molecules to other molecules. Solutions with a pH below 7.

Front 46

Bases

Back 46

Molecules that can accept H ions. Solutions with a pH above 7

Front 47

Acid base inbalanaces can be caused by?

Back 47

Infection, trauma, and medications.

Front 48

pH

Back 48

Calculation based on the % of H ions in a solution and the amount of acids and bases in the solution.

Front 49

Normal blood pH.

Back 49

7.35-7.45
Balance between H ions and bicarbonate ions.

Front 50

Acidosis

Back 50

Blood pH below 7.35 and either the H ion concentration has increased or bicarb level has decreased.

Front 51

Alkalosis

Back 51

Blood pH is above 7.45 and either the H ion concentration is decreased or the bicarb level has increased.

Front 52

What pH is fatal?

Back 52

Above 7.8 or below 6.8

Front 53

What three systems regulate acids and bases?

Back 53

1. Chemical buffers
2. Respiratory system
3. Kidneys

Front 54

Chemical buffers

Back 54

Neutralize the offending acid or base

Front 55

Respiratory system

Back 55

Regulates retention and excretion of acids.

Front 56

Kidneys

Back 56

Excrete or retain acids or bases

Front 57

What are the different chemical buffer systems?

Back 57

Bicarb buffer system
Phosphate buffer system
Protein buffer system

Front 58

Bicarb buffer system

Back 58

Buffers blood and interstitial fluid.

Front 59

Phosphate buffer system

Back 59

Reacts with acids and bases to form compounds that alter pH, especially effective in renal tubules.

Front 60

Protein buffer system

Back 60

Acts inside and outside the cell, binds with acids and bases to neutralize them.

Front 61

Anion gap

Back 61

Represents the level of unmeasured anions in extracellular fluid.

Front 62

What is the normal range of an anion gap?

Back 62

8-14 mEq/L

Front 63

Arterial lines (A lines)

Back 63

Inserted into radial or brachial artery. Used to continuously monitor BP. Can also be used to run ABG's.

Front 64

Pulmonary artery (PA) catheters

Back 64

Are inserted into the subclavian or the internal jugular vein. Measure PAP, PAWP, CVP and cardiac output.

Front 65

Hypovolemia

Back 65

Hypotonic fluid loss from extracellular space. May progress to shock if not detected and treated. Caused by excessive fluid loss.

Front 66

Signs of mild fluid loss

Back 66

Orthostatic hypotension
Restlessness
Anxiety
Wt loss
Increased HR
q

Front 67

Signs of moderate fluid loss

Back 67

Confusion, irritability, extreme thirst, cool clammy skin, rapid pulse, and decreased urine output.

Front 68

Signs of severe fluid loss

Back 68

Decreased cardiac output, unconsciousness, tachycardia, hypotension, weak or absent peripheral pulses,cool mottled skin, decrease in urine output.

Front 69

Hypervolemia

Back 69

Excess fluid in interstitial spaces. Leads to heart failure and pulmonary edema. May gain 5-10% of weight.

Front 70

Causes of hypervolemia

Back 70

Excessive sodium or fluid intake. Fluid or Na retention. Shift in fluid from the interstitial space to the intravascular space.

Front 71

Thyroid role in balance of electrolytes.

Back 71

Secretes calcitonen, which prevents Ca release from the bone.

Front 72

What do diuretics treat?

Back 72

Hypertension, heart failure, electrolyte imbalances and kidney disease.

Front 73

What do diuretics do?

Back 73

Increase urine production. Cause loss of electrolytes, particularly potassium.

Front 74

When a burn damages cells you would expect the cells to release what major electrolyte?

Back 74

Potassium.

Front 75

Acids

Back 75

Molecules that can give H molecules to other molecules. Solutions with a pH below 7.

Front 76

Bases

Back 76

Molecules that can accept H ions. Solutions with a pH above 7

Front 77

Acid base inbalanaces can be caused by?

Back 77

Infection, trauma, and medications.

Front 78

pH

Back 78

Calculation based on the % of H ions in a solution and the amount of acids and bases in the solution.

Front 79

Normal blood pH.

Back 79

7.35-7.45
Balance between H ions and bicarbonate ions.

Front 80

Acidosis

Back 80

Blood pH below 7.35 and either the H ion concentration has increased or bicarb level has decreased.

Front 81

Assessment findings in someone with hypervolemia.

Back 81

Tachypnea, dyspnea, crackles, rapid or bounding pulse, hypertension, increased CVP, PAP, PAWP, distended neck and hand veins, acute wt gain, edema, S3 gallop.

Front 82

Sodium is a major _______.

Back 82

Cation in extracellular fluid.

Front 83

What does sodium do?

Back 83

It helps transmit impulses in nerve and muscle fibers.

Front 84

Normal serum levels of sodium

Back 84

135-145 mEq/L

Front 85

What happens if sodium level drops below 110mEq/L?

Back 85

May cause stupor or coma

Front 86

Hyponatremia is caused by

Back 86

Inadequate Na intake, excessive water loss, or water gain.

Front 87

Hypovolemic

Back 87

Both Na and H2O are decreased in extracellular area but Na loss is > H2O loss.

Front 88

Hypervolemic

Back 88

Both Na and H2O are increased in extracellular area but H2O gain is > Na gain.

Front 89

Isovolemic

Back 89

Water increases, but total Na level remains stable.

Front 90

Hypernatremia

Back 90

Caused by water loss, inadequate water intake or Na gain or diabetes insipidus.

Front 91

Why must hypernatremia be corrected slowly?

Back 91

To prevent rapid shift of water back into the cells resulting in cerebral edema.

Front 92

S/S of hypernatremia

Back 92

Agitation, confusion, flushed skin, lethargy, low grade fever, thirst, restlessness, muscle twitching and weakness.

Front 93

What does magnesium do?

Back 93

Enzyme reactions, ATP, vasodilation, protein synthesis, neurotransmission, produces parathyroid hormone.

Front 94

Normal serum levels for magnesium?

Back 94

1.8-2.5 mEq/L

Front 95

What does magnesium bond to?

Back 95

Albumin

Front 96

What are serum levels when the PT has hypomagnesia?

Back 96

< 1.8 mEq/L

Front 97

S/S of hypomagnesia?

Back 97

Altered LOC, Ataxia, Confusion, depression, seizures, vertigo, weakness, tetany, arhhythmias, rapid HR and vomiting.

Front 98

Hypermagnesemia is caused by?

Back 98

Addisons disease, adrenocortical insufficiency and untreated DKA.