N517 Fluid And Electrolyte Balance

Front 1

ROMI

Back 1

rule out Myocardial infarction

Front 2

Body's Fluid Make-up

Back 2

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!!

Front 3

Intervascular Fluid Make-up

Back 3

Mostly Salt Water
-45% RBCs
-Plus Plasma (yellow color) = Salt Water + K + glucose + vitamins + protein

Front 4

Hematocrit

Back 4

How many RBCs are in 100cc of H2O

Front 5

What percentage H2O are we?

Back 5

Premature Babies 83%
Infants 77%
ADLUTS 60%
Elderly 50%

Obese and women have generally more fat cells which do not contain significant amounts of H2O so less % H2O.

Front 6

Molecules

Back 6

electrically neutral

Front 7

Electrolytes

Back 7

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!!

Front 8

Cation

Back 8

POSITIVE

Front 9

Anion

Back 9

NEGATIVE

Front 10

HCO3- given with what?

Back 10

Na+

Front 11

K+ given with what?

Back 11

Cl-

Front 12

pounds to kilograms?

Back 12

2.2 lbs to 1 kg

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Edema

Back 13

Swelling

Edematous = swollen

Front 14

Percent total body weigh of IVF

Back 14

25% ECF or approx 5% of total body weight or approx 5L

Front 15

Only fluid compartment that can be measured directly

Back 15

IVF

Front 16

What is blood made of

Back 16

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.

Front 17

Platelets

Back 17

a fragment of a cell

Front 18

3 forms of blood proteins

Back 18

Globulins
Fibrinogen
Albumin

Front 19

Globulins

Back 19

responsible for immune function

Front 20

Fibrinogen

Back 20

responsible for blood clotting

Front 21

Albumin*****

Back 21

Maintains Colloid Osmotic Pressure in the ECS
-a colloid osmotic agent
-BIG peanut M&M

Front 22

Colloid Osmotic Pressure

Back 22

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!

Front 23

Sequence of Blood Flow?

Back 23

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.

Front 24

What happens at the capillary level in the sequence of blood flow?

Back 24

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.
DIFFUSION OF OXYGEN AND NUTRIENTS AND WASTE PRODUCTS

Front 25

Describe Fluid leaking from wounds:

Back 25

Serous
Sanguinous
Serosanguinous
Purulent

Front 26

Serous

Back 26

clear fluid without pus or debris

Front 27

Sanguinous

Back 27

refers to bloody, or red drainage

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Serosanguinous

Back 28

a combo of serous and sanguinous and is thin, watery pale red to pink fluid

Front 29

Purulent

Back 29

thick, cloudy, yellow, or tan

Front 30

How many times per hour does all blood go to the liver?

Back 30

SIX

Front 31

Why dont we pee blood?

Back 31

Bowman's capsule = KIDNEY = the system doesnt allow BIG molecules to pass through SO if there is ALBUMIN (AKA PROTEIN) in the URINE = ALERT!!!

Front 32

Albuminurea

Back 32

Albumin aka protein in the urine and could be a sign that the patient is developing TOXEMIA

Front 33

What cation is given for the lethal injection and why?

Back 33

K+ because a potassium overload causes the cells to die. HYPERKALEMIA. K+ spills into the extracellular space to cause HYPERKALEMIA.

Front 34

Normal K+ level intracellularly?

Back 34

150 mEq

Front 35

Normal K+ level extracellularly?

Back 35

3.5 - 5 mEq (and this is the level we pay attention to! It is the level that is impt to keep us alive!)

Front 36

Normal Na+ level extracellularly?

Back 36

135-145 mEq (note that the levels of Na+ plus K+ extracellularly EQUAL the level of K+ intracellularly)

Front 37

A first sign of Hyperkalemia?

Back 37

MUSCLE ACHE

Front 38

Semi-permeable membrane

Back 38

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.

Front 39

Osmosis is?

Back 39

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!

Front 40

Diffusion is?

Back 40

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!!

Front 41

Role of the Kidneys in the regulation of the body's fluid composition and volume?

Back 41

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.

Front 42

Hypotonic is?

Back 42

Note that plain WATER is HYPOTONIC!
less conc of molecules outside the cell
250 or less

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Hypertonic is?

Back 43

more conc of molecules outside the cell
over 375

Front 44

Isotonic is?

Back 44

same conc inside and outside the cell
270-300

Front 45

Low plasma proteins are a sign of problems with?

Back 45

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.

Front 46

Active Transport

Back 46

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.

Front 47

Hormones that control ECF balance?

Back 47

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.

Front 48

MAP?

Back 48

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.

Front 49

Perfusion

Back 49

In physiology, perfusion is the process of nutritive delivery of arterial blood to a capillary bed in the biological tissue.

Front 50

Factors that precipitate Aldosterone release

Back 50

dec Na+
inc K+
Hypovolemia
Stress

Front 51

What happens to the Kidney with GI bleeding (loss of vol) Cardiogenic Shock (loss of pump) and Trauma (loss of Vol)

Back 51

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

Front 52

To heart with same conditions?

Back 52

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.