Term
| How much water (in L) is the total amount of water in the body? What % of body weight is this? |
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Definition
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Term
| What is water important in doing? |
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Definition
|
o metabolic process
o Breaks down things (hydrolysis)
o Transport system
o Protective: tears; cerebrospinal fluid; synovial fluid; bursa fluid in bursa sack; amniotic fluid
o Lubricant: GI, reproductive track
o Maintaining temperature
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Term
Who has the most water in their body? An infant or an 80 year old?
How much fluid do each of them have? |
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Definition
infant at 80%
elderly have 50% water |
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Term
| What is the Starling Hypothesis |
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Definition
| Net Filtration = forces favoring filtration - forces opposing filtration |
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Term
| What forces favor filtration? Oppose filtration? |
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Definition
Favor: Hydrostatic Pressure; Interstitial Oncotic (osmotic r/t colloid) pressure (the ability of interstitial to draw water)
Oppose: Plasma oncotic pressure; interstitial hydrostatic pressure |
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Term
| What are four functions of water? |
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Definition
Metabolism
Transport
Protection
Lubricant |
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Term
| Fluid shifts within the body to maintain _____? |
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Definition
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Term
What are insensible fluids and how much per day does a person have?
How much sweat?
What is the normal range of urine per day?
How much water is there in feces per day? |
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Definition
Insensible Fluids: those lost that we aren't aware of (700 ml/day)
100 ml/day
0.5-20 L/day
100 ml/day |
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Term
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Definition
Osmoles (particles) per liter of solution
OsM/L = mOsM/L |
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Term
What is Osmolality?
Decreased means...?
Increased...? |
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Definition
Osmoles of solute per kilogram of water (mOsm/kg)
Decreased: less solute/more water
Increased: Less water/more solute |
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Term
| What to Prostaglandins do? |
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Definition
| Vasodilators that increase the GFR |
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Term
| What is the "conscous desire for water" and where does it come from? |
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Definition
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Term
| What 5 things does thirst respond to? |
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Definition
- increased osmolality (dehydration/less water)
- decreased fluid volume
- decreased arterial pressure
- angiotensin II
- dry mouth or mucous membrane |
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Term
| Plasma osmolarity = ___ x _____. |
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Definition
| Plasma Osmolarity = 2.1 x plasma sodium concentration |
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Term
Normal sodium = ___ - ___ mEq/L
What is released when Na concentration is increased? |
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Definition
140-145 mEq/L
ADH is released |
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Term
| The Hypothalamus keeps the plasma osmolarity _____ mOsM |
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Definition
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Term
| Someone that is thirsty, exreting large amounts of urine, is dehydrated and suffering from Hypernatremia most likely has: |
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Definition
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Term
| A patient with DI would exibit what symptoms? Why |
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Definition
Symptoms: lg amounts of urine, thirsty, dehydrated, hypernatremia
Because ADH not working |
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Term
| Someone who is retaining water (and therefore exibiting dilutional hyponatremia), has a low UO and a High urine osmolality is most likely suffering from...? |
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Definition
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Term
| A pt with SIADH would exibit what symptoms? |
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Definition
Water Retention
Dilutional Hyponatremia
Low UO
High Urine Osmolality |
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Term
| The capillary filtration pressure is a direct result of _____. |
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Definition
| capillary hydrostatic pressure |
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Term
| The capillary colloidal osmotic pressure is a force that _____. |
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Definition
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Term
| The Interstitial hydrostatic pressure is a force that _____. |
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Definition
| opposes moving fluids out of the capillaries |
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Term
| The Tissue Colloidal Osmotic Pressure is a force that _____. |
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Definition
| favors fluid moving out of the capillaries |
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Term
| The Hydrostatic Pressure is an _____ force that is ___ mmHg at the arteriolar end and ___ mmHg at the venous end. |
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Definition
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Term
| The Colloid Osmotic Pressure is an _____ force that is ___ mmHg. |
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Definition
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Term
Na is the major extracellular _____.
A hypertonic problem would be when Na is _____ or water is _____.
A hypotonic probelem with Na is _____ or water is _____. |
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Definition
Cation
Hypertonic: Na gained, water lost
Hypotonic: Na lost, water gained |
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Term
| An isotonic fluid volume deficit would simply be a problem of _____ and proportionally, Sodium and water would be _____ as normal. |
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Definition
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Term
| What S/S would be associated with Isotonic Fluid Volume Deficit? |
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Definition
o Thirst
o Low UO
o Dry skin
o Decreased turgor
o Dry mucous membranes
o Depressed fontanel (in forehead)
o Weak, rapid pulse
§ Compensation for low fluids
o Postural hypotension
§ Not enough fluid!
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Term
| Losing blood, sweating or excessive drainage, GI loss, or a lack of fluid intake could lead to: |
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Definition
| Isotonic Fluid Volume Deficit |
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Term
| What is the best way to treat Isotonic Fluid Volume Deficit? |
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Definition
Replace with isotonic fluids
- D5W
- 0.9% NS
- Lactating Ringers |
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Term
| Isotonic Fluid Volume Excess is a problem of _____ due to _____, increased _____ intake, or renal ______ retention. |
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Definition
Hypervolemia
IV fluides
Na
Na |
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Term
| S/S of Isotonic Fluid Volume Excess include |
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Definition
o Weight gain
o Edema
o JVD
o Worst case: Pulmonary edema
§ HF
o Ascites: fluid in peritoneal spaces
o Pleural Effusion can develop in lungs
o Dilutional Alterations
§ Protein in plasma, amount of hemoglobin, hematocrit
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Term
| What is the worst complication of Isotonic Fluid Volume Excess? |
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Definition
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Term
What is the best treatment for Isotonic Fluid Volume Excess?
What do you need to restrict?
What do you need to monitor for? |
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Definition
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Term
| Hypertonic Fluid Volume Alterations is when the osmolality is _____ and there is _____ Na. Intracellular fluid is _____ and cells will ____ in hypertonic solutions. |
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Definition
| Hypertonic Fluid Volume Alterations is when the osmolality is above normal and there is increased Na. Intracellular fluid is lost and cells will shrink in hypertonic solutions. |
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Term
Hyponatremia = _____.
Hypernatremia = _____. |
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Definition
Hyponatremia = < 135 mEq/L.
Hypernatremia = > 147 mEq/L. |
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Term
| Treatment for hypernatremia is: |
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Definition
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Term
| Seizures, coma, pulmonary edema, thirst, fever, hypotension, tachycardia, and respiratory infections are all S/S of...? |
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Definition
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Term
| Hyperchloremia is when the serum chloride is _____ mEq/L. This occurs in conjunction with _____ and urine output will _____. |
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Definition
| Hyperchloremia is when the serum chloride is > 97-105 mEq/L. This occurs in conjunction with hypernatremia and urine output will increase. |
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Term
| Hypotonic Fluid Volume Alterations is when the serum osmolality is _____ than normal. Cells will swell/shrink? due to _____ and water will move from _____ to _____. |
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Definition
| Hypotonic Fluid Volume Alterations is when the serum osmolality is less than normal. Cells will SWELL due to hypovolemia and water will move from ECF to ICF. |
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Term
| If a person is lethargic and hypotensive, they may be experiencing _____. This is when the serum Na is _____ mEq/L and cells with swell/shrink? |
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Definition
| If a person is lethargic and hypotensive, they may be experiencing Hyponatremia. This is when the serum Na is <135 mEq/L and cells with SWELL? |
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Term
| Hypochloremia is due to decreased _____ and increased _____. The most common symptom is ______. |
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Definition
| Hypochloremia is due to decreased Na and increased bicarbonate. The most common symptom is vomiting. |
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Term
| Psychogenic Polydypsia is the: |
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Definition
| Excessive need to drink too much water |
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Term
| If acute water excess, treat with a _____ and monitor levels of _____. |
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Definition
hypertonic solution (3% NaCl)
Na |
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Term
| ______ is when the interstitial fluid volume expands or accumulates. What are the four types of this? |
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Definition
EDEMA
Localized, Generalized, Pitting, non-pitting |
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Term
| Name 5 reasons for Edema: |
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Definition
Decreased Colloid Osmotic Pressure (malnutrition, cancer, burns, liver failure, kidney failure, GI problems, all r/t not adequate PROTEIN)
Increased Capillary Hydrostatic pressure causing water retention (CHF, L sided HF, Renal failure, impaired venous flow, hepatic obstruction)
Increased permeability of capillary membrane (burns, trauma, allergic reactions, inflammation)
Lymphatic Obstruction (removal problems, cancer, inflammation, trauma, parasites, MASECTOMY)
Sodium/Water excess (aldosterone, CHF, Kidney Failure) |
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Term
| Edema can be life threatening if it is in the _____, _____, or _____. |
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Definition
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Term
What is the major intracellular cation?
What is the major extracellular cation? |
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Definition
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Term
ICF K+ = _____ mEq/L
ECF K+ = _____ mEq/L |
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Definition
ICF K+ = 150-160 mEq/L
ECF K+ = 3.5-5.0 mEq/L |
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Term
| How much K+ should be in your diet per day? |
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Definition
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Term
| ___% of K that is filtered out into Bowman's capsule is reabsorbed to keep _____. |
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Definition
| 90% of K that is filtered out into Bowman's capsule is reabsorbed to keep intra/extracellular balance |
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Term
| What is released with increased K+ levels? Does the UO increase or decrease? |
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Definition
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Term
| Insulin stimulates the action of the ______ which ______ that moves into cells. |
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Definition
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Term
| Beta-1 adrenergic stimulates _____ in/out? of the cells whereas alph-adrenergec shift _____ in/out? of the cells. |
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Definition
| Beta-1 adrenergic stimulates K+ INTO the cells whereas alph-adrenergec shift K+ OUT of the cells. |
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Term
| K+ is important for _____, _____, and ______/ |
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Definition
| growth, metabolism, action potentials |
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Term
An action potential is dependent on the ratio of __:__.
In a hypokalmic state, a _____ stimulus is needed and in a hyperkalemic state, a _____ stimulus is needed. |
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Definition
IC K+ : EC K+
In a hypokalmic state, a stronger stimulus is needed and in a hyperkalemic state, a lesser stimulus is needed. |
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Term
| With severe hyperkalemia, the resting membrane is _____ and the cells can not _____. |
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Definition
| With severe hyperkalemia, the resting membrane is close to the threshold and the cells can not repolarize. |
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Term
| K levels are ____ mEq/L during Hypokalemia and is caused by: |
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Definition
| K levels are < 3.5 mEq/L during Hypokalemia and is caused by Low intake, High loss of K, ICF-ECF shift (acidotic state moves K out and alkalosis shifts K in) |
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Term
| ______ yeilds S/S of decreased neuromuscular excitability, muscle cramping, fatigue, weakness, dysrhythmias, and dealys the ventricular repolarization. |
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Definition
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Term
| Hyperkalemia is when K levels are _____ mEq/L and caused by _____, _____, and _____. |
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Definition
| Hyperkalemia is when K levels are > 5.5 mEq/L and caused by renal problems, rapid infusion, and IC-EC shifts. |
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Term
| Increased neuromuscular excitability initially, but with time decreased, in conjunction with paresthsias, GI cramps, and decreased cardiac conductivity are all signs of _____. |
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Definition
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Term
| Sodiuma is the major EC _____ and should be _____ mOsM/L. |
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Definition
| Sodiuma is the major EC cation and should be 135-145 mOsM/L. |
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Term
Hyponatremia is when Na levels are _____ and caused by _____ or _____. Do cells shrink or swell?
How is this treated?
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Definition
Hyponatremia is when Na levels are < 135 mEq/L and caused by Na loss or water gain.
Swell
Fluid restriction |
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Term
Hypernatremia is when Na levels are _____ and caused by _____ or _____. Do swells shrink or swell?
How is this treated? |
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Definition
Hypernatremia is when Na levels are > 145 mEq/L and caused by excess Na or decreased water.
Shrink
treat cause, replace fluids with D5W |
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Term
| Calcium should be _____ mg/dl or _____ mEq/L and functions to: |
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Definition
Calcium should be 8.5-10.5 mg/dl or 4.5-5.5 mEq/L and functions to:
o Muscle contraction
o Stored in bones and teeth
o Blood clotting
§ Clotting cascade
o Cardiac contraction
o Nerve Impulses
o Contributes to stability of cell membrane
§ Has + charged and inserts itself in between – charges to keep Na and keep cell stable
o 2nd messanger; metabolic processes
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Term
| Phosphate is normally _____ mg/dl and functions as: |
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Definition
Phosphate is normally 2.5-4.5 mg/dl and functions as:
o Bone
o Phospholipids
o Inorganic phosphate
o ATP
o Anion buffer
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Term
| Chvostek's Sign and Trousseau's sign show signs of...? |
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Definition
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|
Term
| Tetany, seizures, and laryngospasm are s/s of...? |
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Definition
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Term
| Ca and PO4 have a _____ relationship. |
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Definition
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Term
Mg sits at _____ mEq/L and is the 2nd most abundant IC _____.
Almost everything that uses _____ has Mg to help.
Additional functions include: |
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Definition
Mg sits at 1.8-2.4 mEq/L and is the 2nd most abundant IC cation.
ATP
Additional functions include:
o Enzyme activation
o All activity using ATP
o DNA replication and synthesis
o RNA translation
o Binds to Ca receptors
o Competitive
o Inhibits actions of Ca
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Term
| Alcohol ingestion can cause...? |
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Definition
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Term
| Hypomagnesemia usually occurs with _____ and _____. |
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Definition
| Hypocalcemia and hypokalemia |
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Term
Hypermagnesia is caused by _____
and results in: |
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Definition
Hypermagnesia is caused by:
o ↓/slowed neuromuscular activity
o Lethargy
o Drowsy
o Respiratory depression
o Bradycardia (↓HR)
o Hypotension (↓BP)
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