Iggy Ch 14: Fluid & Electrolyte Balance

Front 1

What is the process where body conditions remain as normal as possible?

Back 1

homeostasis

Front 2

What two homeostatic mechanisms prevent body temperatures from rising much more than 1 degree F?

Back 2

1)sweating
2)dilation of blood vessels

Front 3

What percentage of the adult body weight consists of water?

Back 3

55-60%

Front 4

The fluid INSIDE the cells is called _______.

Back 4

intracellular fluid (ICF)

Front 5

The fluid OUTSIDE the cells is called _______.
It consists of what 6 components?

Back 5

extracellular fluid (ECF)

interstitial fluid, blood, lymph, bone, connective tissue water, and the transcellular fluids.

Front 6

The ECF / ICF contains about 1/3 of the body's total water (approx 15 L). The ECF / ICF contains the remaining 2/3 of total body water (approx 25 L).

Back 6

ECF

ICF

Front 7

The fluid BETWEEN cells is called ________.

Back 7

interstitial fluid

Front 8

The fluids in special body spaces, including cerebrospinal fluid, synovial fluid, peritoneal fluid, and pleural fluid is called ________.

Back 8

transcellular fluids

Front 9

_______ is needed to deliver dissolved nutrients, electrolytes, and other substances to all organs, tissues, and cells.

Back 9

water

Front 10

The ______ is the water portion of fluids.

Back 10

solvent

Front 11

The ______ are the particles dissolved or suspended in the water.

Back 11

solutes

Front 12

The movement of fluid through a cell or blood vessel membrane because of hydrostatic pressure differences on both sides of the membrane is called ______. This does not require energy.

Back 12

filtration

Front 13

_______ is the force of the weight of water molecules pressing against the confining walls of a space.

Back 13

hydrostatic pressure

Front 14

The amount of water in a fluid is inversely related to the _______ of that fluid.

Back 14

viscosity (thickness)

Front 15

Blood is thicker / thinner than water.

Back 15

thicker

Front 16

In most instances, substances move from a lesser / greater amount of pressure or concentration to a lesser / greater amount.

Back 16

greater
lesser

Front 17

Intercellular spaces, also called ______, help water filter freely through capillary membranes.

Back 17

pores

Front 18

tissue swelling with fluid collection, called ________, occurs with changes in normal hydrostatic pressure differences.

Back 18

edema

Front 19

The free movement of particles (solute) unrelated to pressure gradients across a permeable membrane down a concentration gradient is called ___________

Back 19

diffusion

Front 20

________________ is the vibration of single molecules caused by eletrons orbiting at the core of each molecule. This causes totally random movement of molecules, which collide or bump into each other.

Back 20

brownian motion

Front 21

As a result of brownian motion, molecules in a solution do what?

Back 21

spread out evenly through the available space, moving from an area of high concentration to an area of lower concentration

Front 22

When does a concentration gradient exist between two fluid spaces?

Back 22

When they have different amounts of the same type of molecules

Front 23

The degree of concentration difference is known as the ________ of the gradient.

Back 23

steepness

Front 24

When the concentration of a solute is the same on both sides of the membrane, does diffusion still occur?

Back 24

yes, without a net movement of solute (equal exchange)

Front 25

Why is there 10 times more sodium ions in the ECF than in the ICF?

Back 25

Because of the cell membrane impermeability of sodium, and from the "sodium pump" moving it uphill across the gradient and back into the ECF.

Front 26

Why is the amount of glucose higher in the ECF than in the ICF?

Back 26

glucose cannot cross most cell membranes without the help of insulin

Front 27

Diffusion across a cell membrane that requires assistance of a transport system or membrane-altering system is called _________.

Back 27

facilitated diffusion (or facilitated transport)

Front 28

_________ is the movement of water only (solvent) through selectively permeable membrane with a concentration gradient between both sides.

Back 28

Osmosis

Front 29

What 3 factors determine whether and how fast osmosis occurs?

Back 29

1) the overall concentration of particles in solution
2) how easily the solute dissolves in water (solubility)
3) the amount of membrane available for osmosis

Front 30

_____ is the number of milliosmoles in a liter of solution.

Back 30

osmolarity

Front 31

______ is the number of milliosmoles in a kilogram of solution.

Back 31

osmolality

Front 32

The normal osmolarity value for plasma and other body fluids ranges from __ to __.

Back 32

270-300 mOsm/L

Front 33

When the body fluids are at normal osmolarity, there is no net water movement occurs. In this situation, the body fluids are ______.

Back 33

Isotonic or isosmotic

Front 34

Give two examples of isotonic IV solutions.

Back 34

0.9% sodium chloride in water
Ringers lactate in water

Front 35

______ fluids (> 300 mOsm/L)tend to pull water from the isosmotic fluid space into this fluid space.

Back 35

hypertonic or hyperosmotic

Front 36

______ fluids (< 300 mOsm/L) tend to be pulled into the isosmotic space.

Back 36

hypotonic

Front 37

The degree to which a solute dissolves in water is called ______.

Back 37

solubility

Front 38

The greater the amount of membrane available for osmosis, the slower / faster the rate of osmosis.

Back 38

faster

Front 39

Give an example of how osmosis helps maintain homeostasis in relation to fluid intake.

Back 39

the thirst mechanism

Front 40

_____ transport is the movement of substance across the cell membrane against a concentration gradient (uphill).

Back 40

active

Front 41

The ________ pump is an example of a comon active transport system that moves two substances at the same time in opposite directions.

Back 41

sodium-potassium pump

Front 42

Describe the sodium-potassium pump.

Back 42

It moves the extra sodium out of the cell and returns the lost potassium back into the cell. It recquires the use of cellular energy: when the P is split off of the ATP.

Front 43

Describe what happens in the cell when there is insufficient ATP available due to a lack of oxygen.

Back 43

Extra sodium ions cannot be pumped out, causing increased osmotic pressure. When water moves into the cell in response to the pressure, the cell will swell and break open (lyse) and die.

Front 44

Extra fluid leaking out of the capillaries is returned to the systemic circulation as ________.

Back 44

lymph

Front 45

Lymph fluid is similar to __________, but contains far less proteins.

Back 45

blood plasma

Front 46

_____ is a hormone secreted by the adrenal cortex which protects sodium balance by preventing sodium loss.

Back 46

aldosterone

Front 47

_______ constricts many blood vessels and stimulates aldosterone secretion.

Back 47

angiotensin II

Front 48

Aldosterone works on the _____________ triggering these areas to reabsorb sodium from the urine back into the blood.

Back 48

distal tubules of the nephrons

Front 49

________ is produced in the brain and stored in the posterior pituitary gland. When blood plasma osmolarity increases, this is released to act directly on the kidney tubules, making them more permeable to water to decrease osmolarity.

Back 49

antidiuretic hormone (ADH)

Front 50

________ are hormones secreted by the atria and ventricles of the heart that respond to the stretch of heart tissue. It works the opposite of angiotensin II by inhibiting the reabsorption of sodium.

Back 50

natriuretic peptides (NPs)

Front 51

An older adult has more / less total body water than a young adult.

Back 51

less

Front 52

An obese person has more / less total body water than a lean person of the same body weight.

Back 52

less

Front 53

A woman of any age usually has more / less total body water than does a man of similar size and age.

Back 53

less

Front 54

Fluid intake is regulated by the ________.

Back 54

thirst drive

Front 55

Metabolic water accounts for about _____ mL of the daily water requirement.

Back 55

300

Front 56

An adult drinks an average of ______ mL of fluid per day and ingests an additional _____mL of fluid from food.

Back 56

1500

800

Front 57

Of all the water loss pathways, the ______ is the most important and the most sensitive.

Back 57

kidney

Front 58

The minimum amount of urine per day needed to dissolve and excrete toxic waste products is ____ to _____ mL, called the ___________________.

Back 58

400-600

obligatory urine output

Front 59

Water loss from the skin, lungs, and stool is called _________ because it cannot be controlled.

Name 3 hypermetabolic states which can increase this water loss.

Back 59

insensible water loss

1. thyroid crisis
2. trauma
3. burns
4. states of extreme stress
5. fever

Front 60

Name two clients who are at risk for increased insensible water loss.

Back 60

mechanically ventilated pts
pts with rapid respirations

Front 61

Excessive insensible water loss can lead to _________. Explain

Back 61

hypernatremia: insensible water loss does not contain electrolytes, which causes the ECF to be more hypertonic.

Front 62

Sweat is slightly hypertonic / hypotonic compared to blood.

Back 62

hypotonic

Front 63

_____ are substances in body fluids that carry an electrical charge.

Back 63

electrolytes (ions)

Front 64

Cations / anions have a positive charge.

Cations / anions have a negative charge.

Back 64

cations

anions

Front 65

Body fluids are chemically positive / negative / neutral.

Back 65

neutral

Front 66

How do most electrolytes enter the body?

Back 66

by the ingestion of food

Front 67

_____ is the major cation in the ECF and is responsible for maintaining ECF osmolarity.

Back 67

Sodium

Front 68

The activity of the ________ keeps the sodium level of the ICF low while maintaining high sodium levels in the blood and ECF.

Back 68

sodium-potassium pump

Front 69

Name three functions that normal sodium levels are vital for.

Back 69

skeletal muscle contraction
cardiac contractions
nerve impulse transmission
normal ECF osmolarity
normal ECF volume

Front 70

The average dietary intake of sodium is about _____ g/day. It is stored in the ________.

Back 70

6-14

kidneys

Front 71

Low / high serum levels of sodium inhibit the secretion of ADH and NP and trigger aldosterone secretion.

Back 71

low

Front 72

Low / high serum levels of sodium inhibit aldosterone secretion and directly stimulate secretion of ADH and NP.

Back 72

high

Front 73

_______ is the major anion in the ICF.

Back 73

potassium

Front 74

Name three functions of potassium.

Back 74

1. regulation of protein synthesis
2. regulation of glucose use and storage
3. maintenance of action potentials in excitable membranes

Front 75

Potassium does / does not take energy to cross the cellular membrane down the concentration gradient into the ECF.

Back 75

does not; drifts into the ECF

Front 76

The sodium potassium pump removes ___ sodium ions from the fluid inside the cell for every ___ potassium ions that it returns to the cell.

Back 76

three
two

Front 77

_____ is a divalent cation that exists in tow forms: bound and ionized.

Back 77

calcium

Front 78

Bound calcium is usually attached to __________, especially ________ (specific type).

Back 78

serum proteins
albumin

Front 79

Ionized (free) calcium is present in the _______ and the ______. This is the active form.

Back 79

blood
ECF

Front 80

The calcium level in the ICF is low / high as compared to the ECF.

Back 80

low

Front 81

Name 3 functions that calcium is important for.

Back 81

1. bone strength and density
2. activation of enzymes or reactions
3. skeletal muscle contraction
4. cardiac muscle contraction
5. nerve impulse transmission
6. blood clotting

Front 82

When more calcium is needed, the parathyroid glands will release ____________.

Back 82

parathyroid hormone (PTH)

Front 83

Name the 3 ways PTH causes serum calcium levels to increase.

Back 83

1. releasing free calcium from bone storage sites directly into the ECF (resorption)
2. stimulating vit D activation, thus increasing intestinal absorption of dietary calcium
3. inhibiting kidney excretion of calcium and stimulating kidney reabsorption of calcium

Front 84

When excess calcium is present in plasma, PTH secretion is inhibited and the secretion of ________ is increased.

Back 84

thyrocalcitonin (TCT)

Front 85

Name the 3 ways PTH decreases serum calcium levels to decrease.

Back 85

1. inhibiting bone resorption of calcium
2. inhibiting activation of vit D, casing decreased GI uptake of calcium
3. increasing kidney excretion of calcium in the urine

Front 86

_____ % of phosphorus can be found in the bones.

Back 86

80

Front 87

Phosphorus is the major anion / cation in the ICF and its concentration inside cells is much lower / higher than in ECF.

Back 87

anion
higher

Front 88

Give 3 cellular activities that phosphorus is needed for.

Back 88

1. activating B complex vitamins
2. forming and activating ATP
3. assisting in cell division
4. cooperating in CHO metabolism
5. cooperating in protein metabolism
6. cooperating in fat metabolism
7. acid-base buffering
8. calcium homeostasis

Front 89

The regulation of ECF phosphorus occurs throught he activity of the _________. Increased levels of this cause a net loss of phosphorus.

Back 89

parathyroid hormone (PTH)

Front 90

_______ is a mineral that forms a cation when dissolved in water.

Back 90

magnesium

Front 91

_____% of magnesium is stored in bones and cartilage.

Back 91

60

Front 92

More magnesium is present in the ECF /ICF and has more functions in the cells than in the blood.

Back 92

ICF

Front 93

Name 4 functions of magnesium in cell reactions or activities.

Back 93

1. skeletal muscle contraction
2. CHO metabolism
3. ATP formation
4. B complex vitamin activation
5. DNA synthesis
6. Protein synthesis

Front 94

What two things does ECF magnesium regulate?

Back 94

blood coagulation
skeletal muscle contractility

Front 95

Magnesium regulation occurs through the ______ and the _______.

Back 95

kidney
GI tract

Front 96

_______ is the major anion of the ECF and works with sodium to maintain ECF osmotic pressure.

Back 96

chloride

Front 97

Chloride is important in the formation of ______ in the stomach.

Back 97

hydrochloric acid

Front 98

_______ is the most commonly exchanged anion for chloride in a chloride shift into the ICF.

Back 98

bicarbonate (HCO3-)

Front 99

Describe 5 age-related changes on fluid and electrolyte balance in the older adult.

Back 99

Loss of elasticity of skin & decreased skin turgor make skin an unreliable indicator of fluid status.

Decreased glomerular filtration and decreased concentration capacity make for poor excretion of waste products and increased water loss.
Decreased muscle mass for decreased total body water, increased risk of dehydration.
Diminished thirst reflext.
Adrenal atrophy resulting in poor regulation of potassium and sodium.

Front 100

Give an example of an assessment tool for fluid and electrolyte status.

Back 100

Gordon's Functional Health Patterns

Front 101

Give three sites where skin turgor is best assessed.

Back 101

over the sternum
on the forehead
the back of the hand* (not best for older adults)
(sites with little fat)