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52 Cards in this Set

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rule out Myocardial infarction
Body's Fluid Make-up
2/3 (of TBW = total body water) Intracellular Fluid ICF which we cannot measure
1/3 Extracellular Fluid ECF made of 75% interstitial fluid ISF (Btw tissues) and 25% intervacsular fluid IVF (BLOOD!!) which is THE ONLY FLUID WE CAN MEASURE!!
Intervascular Fluid Make-up
Mostly Salt Water
-45% RBCs
-Plus Plasma (yellow color) = Salt Water + K + glucose + vitamins + protein
How many RBCs are in 100cc of H2O
What percentage H2O are we?
Premature Babies 83%
Infants 77%
Elderly 50%

Obese and women have generally more fat cells which do not contain significant amounts of H2O so less % H2O.
electrically neutral
elements or compounds that when dissolved in H2O dissasociate into parts knows and ions

For Homeostasis the body must maintain a balance BTW THE POSITIVE AND NEG electrolytes

You cannot prepare fluid solns for therapeutic use that contain only cations or only anions. THE SOLUTIONS MUST ALWAYS BE BALANCED!! so if patient needs an anion it will be given in a soln of that anion with a cation and that compound will disassociate in the body to become the necessary agents the body needs BUT you have to consider the dog that will bite you: the effect of the other electrolyte on the body!!
HCO3- given with what?
K+ given with what?
pounds to kilograms?
2.2 lbs to 1 kg

Edematous = swollen
Percent total body weigh of IVF
25% ECF or approx 5% of total body weight or approx 5L
Only fluid compartment that can be measured directly
What is blood made of
H2O + molecules + electrolytes + RBCs + WBCs + platelets + proteins

-water with lots of materials floating in H2O
-plasma is the water and the molecules,elecs, proteins, MINUS the blood cells and platelets.
a fragment of a cell
3 forms of blood proteins
responsible for immune function
responsible for blood clotting
Maintains Colloid Osmotic Pressure in the ECS
-a colloid osmotic agent
-BIG peanut M&M
Colloid Osmotic Pressure
In the blood stream there are diff size molecules: small and big M&Ms. Since Albumin is BIG it cannot cross the capillary membrane so IT STAYS WITHIN THE BV AND EXERTS A GREATER PULL SO WATER WILL FOLLOW IT!
Sequence of Blood Flow?
blood flows from the heart to the arteries to the arterioles to the capillaries to the venules to the veins and back to the heart.
What happens at the capillary level in the sequence of blood flow?
At the capillary level = diffusion of oxygen and nutrients from the blood into the tissues occurs. AND diffusion of waste products of metabolism from the tissues into the blood occurs.
Describe Fluid leaking from wounds:
clear fluid without pus or debris
refers to bloody, or red drainage
a combo of serous and sanguinous and is thin, watery pale red to pink fluid
thick, cloudy, yellow, or tan
How many times per hour does all blood go to the liver?
Why dont we pee blood?
Bowman's capsule = KIDNEY = the system doesnt allow BIG molecules to pass through SO if there is ALBUMIN (AKA PROTEIN) in the URINE = ALERT!!!
Albumin aka protein in the urine and could be a sign that the patient is developing TOXEMIA
What cation is given for the lethal injection and why?
K+ because a potassium overload causes the cells to die. HYPERKALEMIA. K+ spills into the extracellular space to cause HYPERKALEMIA.
Normal K+ level intracellularly?
150 mEq
Normal K+ level extracellularly?
3.5 - 5 mEq (and this is the level we pay attention to! It is the level that is impt to keep us alive!)
Normal Na+ level extracellularly?
135-145 mEq (note that the levels of Na+ plus K+ extracellularly EQUAL the level of K+ intracellularly)
A first sign of Hyperkalemia?
Semi-permeable membrane
forms a separation btw the intracellular space and the extracellular space. Cellophane with pores. No protein (Big M&M is allowed under any NORMAL circumstances to fit through and leave the BV (RBCs and plasma, protein). FOR THIS REASON THE IVS CAN DRAW FLUID BACK FROM THE ISS.

Visualize Blood stream as water with lots of small and big M&Ms. water and small ones are allowed to pass through into the ISS but not the big M&Ms which are too large to get through the little pores so they stay in.
Osmosis is?
the movement of H2O across a semi-permeable membrane from an area of lesser conc to an area of higher conc. Consider that in the end we want everything to be equal!
Diffusion is?
the movement of molecules (aka M&Ms) from an area of higher concentration of molecules to an area of lower conc of molecules. The movement of SOLUTES!!
Role of the Kidneys in the regulation of the body's fluid composition and volume?
All of our blood goes to our kidneys every hour and normally no blood cells or plasma proteins are allowed to filter into the tubular system, hence we do not have blood or protein in our urine under normal circumstances. Albumin is the smallest and the first sign of a problem! An infection would cause the pores at the cap level to get so large that the plasma proteins get out. So plasma proteins are decreased and osmotic pressure in the IVS is dec.
Hypotonic is?
Note that plain WATER is HYPOTONIC!
less conc of molecules outside the cell
250 or less
Hypertonic is?
more conc of molecules outside the cell
over 375
Isotonic is?
same conc inside and outside the cell
Low plasma proteins are a sign of problems with?
Liver bc protein gets metabolized and sent to the liver where it is broken down into plasma proteins.
Also an overwhelming infection (gram neg organism) causes the pores at the capillary level to get so large that plasma proteins can leak out and when plasma proteins are decreased, the OSMOTIC PRESSURE in the IVS is dec.
Active Transport
pushing of substances across concentration gradients.
EX: Na+/K+ pump actively pushes the Na+ out of the intracellular space and into the ECF so that higher K+ levels are maintained intracellularly.
Hormones that control ECF balance?
Aldosterone=major regulator of sodium balance
ADH=controls the excretion of water in urine
Atrial Natriuretic Peptide=ANP=in response to stress causes diuresis and decreases cardiac workload.
Mean Arterial Pressure is the Average Perfusion Pressure and is normally 70-105 and is measured by
Systalic + Diastalic(2) and all divided by 3.
In physiology, perfusion is the process of nutritive delivery of arterial blood to a capillary bed in the biological tissue.
Factors that precipitate Aldosterone release
dec Na+
inc K+
What happens to the Kidney with GI bleeding (loss of vol) Cardiogenic Shock (loss of pump) and Trauma (loss of Vol)
dec in renal perfusion sensed by JG cells which secrete Renin, Angiotension I and II causing Vasoconstriction and and inc in Aldosterone secretion and Na+ reabsorption and H2O excretion in the Distal Tubule and Collecting Duct
To heart with same conditions?
dec in stroke vol which stimulates baroreceptors and inc SNS stimulation and inc HR and force of contraction causing peripheral vasoconstriction and the shunting of blood to the heart and the brain. there is an inc in venous return.