Spring Selected Topics Unit 2/2

Front 1

normal intake and output per day

Back 1

2600 ml

Front 2

TBW of physiologic person
amt in ECF
amt in ICF

Back 2

49 L- total
14 L- ECF (20%)
35 L- ICF (50%)

Front 3

what happens if the concentrations are not equal in each compartment

Back 3

water rapidly moves to equilibrate by osmosis

Front 4

of the ecf what percent is plasma, and ISF

Back 4

plasma - 25%
ISF- 75%

Front 5

what is the amt of elements within each compartment

Back 5

composition

Front 6

Normal composition of ECF for Na, K, HCO3, and CL

Back 6

Na - 140-145
K 4.0-4.5
HCO3 - 27
Cl - 103

Front 7

amt of water in each compartment

Back 7

distribution

Front 8

what does excess fluid in a compartment cause

Back 8

edema
either ICF or ECF

Front 9

What are the abnormalities in water balance (5)

Back 9

simple water excess
simple water deficit
Isotonic salt water deficit
Isotonic salt water excess
salt water intoxication

Front 10

What is hyponatremia or milliosmolar dilution syndrome

Back 10

simple water excess- SIADH
the kidney reabsorbs huge amts of water with decrease urine flow- ECF expands- decrease concentration- water moves into ICF and decreases its concentration= dilution in both compartments

Front 11

when is simple water excess most common and why

Back 11

post op surgery pts.- end up secreting too much ADH

Front 12

symptoms of simple water excess

Back 12

headache (Increased ICP from cells swelling, can cause seizures)
increase BP
papilla edema
intracellular (fingerprint) edema

Front 13

Lab findings in simple water excess

Back 13

Scant amt of urine
Electrolytes in plasma are reduced (dilution)
can have acidosis from diluting bicarb

Front 14

Treatment of simple water excess

Back 14

stop fluid intake
treat with hypertonic solutions (.2 or .3 % NS)
draw fluid from ICF to ECF to decrease cell volume

Front 15

What is hypernatremia or milliosmolar conc. syndrome

Back 15

simple water deficit- occurs when loss of water exceeds loss of salt

Front 16

what are common causes of simple water deficit

Back 16

profuse sweating (sweat is hypotonic)
alcoholism (inhibits ADH, loose lots of water and dont take in much)
Hyperalimentation (causes fluid shift from ECF to intestines- diarrhea)
Diabetics (increased glucose- loose lots of water)

Front 17

mechanism for simple water deficit

Back 17

water lost first from ECF which increases concentration- then from ICF to equilibrate. causes intracellular dehydration

Front 18

symptoms of simple water deficit

Back 18

Thirst - if concious
if not dry and red membranes
failure to regulate body temp (will have fever from failure of internal thermostat malfunction)

Front 19

lab findings in simple water deficit

Back 19

UOP is decreased
Urine conc is increased
(S.G. > thant 1.025)
electrolytes increased in plasma

Front 20

Treatment of simple water deficit

Back 20

replenish water PO if possible
Treat with D5W

Front 21

why do we use D5W when we want hypotonic fluid

Back 21

liver will take up extra glucose and free water is what is left in the ECF
plain water will hemolyze RBCs

Front 22

what is isotonic salt water deficit

Back 22

loss of isotonic body fluids

Front 23

causes of isotonic salt water deficit

Back 23

vomiting
diarrhea
fistula (liver or pancreatic)

Front 24

what is third space syndrome

Back 24

ascites

Front 25

mechanism of isotonic salt water deficit

Back 25

isotonic volume loss from ECF
osmolar conc. remains the same in both ECF and ICF so no water moves

Front 26

symptoms of isotonic salt water deficit

Back 26

depression of CNS function (apathy, listless)
Hypothermia (malfunction of therm regulatory center
decrease in skin turgor
hypotension (decreased plasma volume)

Front 27

lab findings in isotonic salt water deficit

Back 27

nothing significant
may see slight decrease in K if vomiting

Front 28

treatment of isotonic salt water deficit

Back 28

Fluid is replaced with isotonic solutions (NS, LR, Ringers)

Front 29

what does self treating with tea, sprite, ect... cause when you have fluid loss

Back 29

worsen the problem - they are hypotonic and can lead to simple water excess on top of salt water deficit and cause HA from intracellular edema

Front 30

What is isotonic salt water excess

Back 30

gain of isotonic fluid

Front 31

cause of isotonic salt water excess

Back 31

CHF
renal failure
heart fails so GFR decreases causing salt and water retention- or kidney fails and dont filter right

Front 32

mechanism of isotonic salt water excess

Back 32

isotonic fluid accumulates in the ECF- no fluid shifts since conc are the same

Front 33

symptoms of isotonic salt water excess

Back 33

increased BP
Interstitial edema (pitting)
normal electrolytes

Front 34

treatment of isotonic salt water excess

Back 34

correct problem
diuretics to rid excess salt and water
cardiotonic agents (glycosides)

Front 35

what is salt water intoxication

Back 35

hyperosmotic intoxification (seawater)

Front 36

mechanism of salt water intoxication

Back 36

Expands ECF and superconsentrates it
Water moves from ICF to ECF to equilibrate so ECF volume becomes even more expanded but ICF becomes drastically reduced causing intracellular dehydration

Front 37

Symptoms of salt water intoxication

Back 37

Increased BP
Hyperthermia (main problem)
internal thermostat in hypothalamus fails causing irreversible hyperpyrexia and the proteins in the brain starts to coagulate

Front 38

Treatment of salt water intoxication

Back 38

lots of fluid- D5W

Front 39

when will you most often see orthostatic hypotension

Back 39

isotonic fluid loss

Front 40

when is K loss at its greatest

Back 40

with diarrhea and vomiting

Front 41

urine output should be atleast what to excrete adequate amt of K- what happens if it drops below this

Back 41

600 ml/day
less than 600 ml/day K will accumulate rapidly- esp in renal failure

Front 42

symptoms of hypokalemia

Back 42

muscle weakness
paralysis
some ECG changes

Front 43

symptoms of hyperkalemia

Back 43

increased T wave (6-8)
v-fib (9-10)

Front 44

causes of hyperkalemia

Back 44

renal failure
addisons disease (decrease aldosterone)
administering KCl

Front 45

causes of hypokalemia

Back 45

diuretics
vomiting
diarrhea
iv therapy with saline

Front 46

where does K move during acidosis.......alkalosis

Back 46

to ECF- acidosis (fluid excess)
to ICF- alkalosis (fluid deficit)