Term
| What is intracellular fluid? |
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Definition
| The fluid that is inside of cells. |
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Term
| What is extracellular fluid? |
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Definition
| The fluid outside of the cell - this can include vascular fluid (blood and lymph) and interstitial fluid (the fluid between cells) |
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Term
| How much of the extracellular fluid vascular, and how much is interstitial? |
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Definition
Vascular - 2/3
Interstitial - 1/3 |
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Term
| What is the normal % range of body fluids for premature infants? Newborn (full term) infants? |
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Definition
Premature - up to 90%
Newborn - 70-80% |
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Term
| What is the normal % body fluid for a child (1-12)? |
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Definition
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Term
| What is the normal % body fluid for some from puberty to 39 years of age? |
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Definition
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Term
| What is the normal % body fluid for 40-60 year olds? |
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Definition
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Term
| What is the normal % body fluid in someone over the age of 60 years of age? |
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Definition
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Term
| Who (males or females, young or old) have higher % of body fluids and why? |
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Definition
1) Men, because women tend to have more adipose (fat) tissue, and water isn't store in fat.
2)Newborns have more ECF than ICF, whereas anyone over the age of 1 has the inverse. |
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Term
| Define the difference between: Solute and solvent. |
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Definition
Solute - The substance that is dissolved (sodium, electrolytes etc)
Solvent - Water, the thing that the solutes are dissolved into |
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Term
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Definition
| The proportion of dissolved particles (solutes) in a volume of fluid. |
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Term
| What is the range of normal osmolarity? |
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Definition
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Term
| What is the normal range of sodium? Where is it primarily located? |
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Definition
135-145 mEq/L
Extracellular space |
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Term
| What is the normal range of Potassium? Where is it primarily located? |
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Definition
3.5-5 mEq/L
Intracellular space |
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Term
| What is the normal range of Calcium? Where is it primarily located? |
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Definition
8.9-10.1 mg/dL
Intracellular space |
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Term
| What is the normal range of magnesium? Where is it primarily located? |
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Definition
1.5-1.9 mEq/L
Intracellular space |
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Term
| Put simply, what does Antidiuretic Hormone (ADH) do? |
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Definition
| Retains water, increases fluid volume |
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Term
| Put simply, what does aldosterone do? |
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Definition
| Retains salt, increases fluid volume |
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Term
| Put simply, what does Natriuretic do? |
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Definition
| excretes salt, decreases volume |
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Term
| Name the 4 possible ways fluid and electrolytes move across membranes. |
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Definition
| Diffusion, Osmosis, Active Transport, Filtration |
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Term
| What are some lifespan considerations for an infants fluid and electrolytes balance? |
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Definition
1) Immature kidneys.
2) They can lose proportionally more fluid through the skin vs an adult.
3) They also have proportionally larger fluid requirements. |
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Term
| What are some lifespan considerations for a Toddler/Preschoolers fluid and electrolytes balance? |
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Definition
| Water loss through the skin, respiration, urine and stools is proportionally greater for young children. |
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Term
| What are some lifespan considerations for a child/adolescents fluid and electrolytes balance? |
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Definition
1) Poor fluid selection - soda, fruit juice, water w/o electrolyte replacement.
2) Fad Diets or Food disorders
3) Alcohol and Drug use |
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Term
| What are some lifespan considerations for an adult/older adults fluid and electrolytes balance? |
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Definition
1) Adipose tissue increases, resulting in a continual decline in the % of body weight that is water after 40.
2) After an illness or surgery, more likely to experience an imbalance.
3) Lifestyle choices - may choose to restrict water intake near bedtime to avoid accidents in the night. |
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Term
| What is one of the first signs of fluid and electrolyte imbalances? |
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Definition
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Term
| Name 4 major contributors to acute fluid deficits. |
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Definition
Vomiting – massive losses, sensible losses
Diarrhea – massive losses, sensible losses
Diaphoresis – insensible losses
Use of Diuretics – insensible losses |
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Term
| What is the normal daily intake and output total? |
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Definition
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Term
| When you are low on extracellular fluid that is called - what? |
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Definition
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Term
| When you have excess extracellular fluid you have - what? |
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Definition
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Term
| When you have excess sodium in the body you have - what (also known as what?) |
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Definition
| Hyperosmolarity aka Hypernatremia |
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Term
| When you have low levels of sodium in the body you have - what (also known as what)? |
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Definition
| Hypoosmolarity aka Hyponatremia |
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Term
| There are 8 common manifestation areas in Fluid Imbalances - what are they? |
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Definition
| Intake and output/weight, mental status, vital signs, skin turgor (abnormal tissue hydration), Muscle tone or sensation, GI function, Numbness and Tingling, Impact on ADL's. |
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Term
| What are the 4 possible nursing diagnosis relating to fluid imbalances? |
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Definition
Extracellular fluid volume deficit
Extracellular fluid volume excess
Water excess
Water deficit |
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Term
| What is the basic function of sodium regarding fluid/electrolyte balance? |
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Definition
| body water balance, maintains osmolarity |
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Term
| As an electrolyte, what does potassium do? |
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Definition
| Cardiac, Neuromuscular, muscle function and contractility. |
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Term
| As an electrolyte, what does Calcium do? |
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Definition
| Membrane structure and excitability, wound healing, muscle contractility, bone and teeth, glycolysis. |
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Term
| As an electrolyte, what does magnesium do? |
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Definition
| Neuromuscular function, cardiac function |
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Term
| What major symptoms are present in a potassium imbalance (hypo or hyperkalemia)? |
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Definition
Both have cardiac and neuromuscular disturbances -
Hypo - decreased bowel sounds and constipation
Hyper - increased bowel sounds and diarrhea |
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Term
| What major symptoms are present in a calcium imbalance (hypo or hypercalcemia)? |
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Definition
Affects directly neuromuscular, cardiac and GI tract.
Hypo - muscle cramping, hypotension, tetany, diarrhea, arrythmia, poor clotting
Hyper - anorexia, vomiting, constipation, bradycardia, bounding pulse |
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Term
| What major symptoms are present in a magnesium imbalance? |
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Definition
| They are almost exactly the same thing as in hypo/hyperkalemia. These are paralleled by changes in potassium. |
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Term
| How does stress affect fluid balance? |
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Definition
| When stress increases, aldosterone production is increased, causing ECF retention. Stress also increases ADH production. |
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Term
| How does Chronic Illness affect fluid balance? |
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Definition
Renal Failure - unable to function properly, kidneys can either accumulate or dump sodium and fluid in the body. Hyperkalemia and Hypocalcemia are common.
Cardiac Failure - As heart fails to pump properly, BP drops. Secretion of aldosterone and ADH is stimulated resulting in ECF volume and water excesses.
Liver Failure - People with liver failure often present with water excess due to an increase in ADH. |
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Term
| How does Surgery affect fluid balance? |
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Definition
| During surery, increased insensible losses occur as the internal body structures are exposed to air. Blood is also lost. Due to cellular tramua, potassium levels frequently fall. Some clients are also NPO for a length of time leading up to surgery. |
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Term
| How does Pregnancy affect fluid balances? |
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Definition
| ECF volume increases by around 40% during pregnancy, but due to vasodilation, blood pressure is typically the same or lower than usual. This is due to increased aldosterone levels, which are approximately 10x normal levels of a non-pregnant female. |
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Term
| How does hypovolemia affect ABC? (Airway, Blood pressure and Cardiac) |
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Definition
Airway - bradypnea
Blood Pressure - hypotension (specifically orthostatic hypotension, and can end up in hypovolemic shock)
Cardiac - tachycardia |
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Term
| How does hypervolemia affect ABC? (Airway, Blood pressure and Cardiac) |
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Definition
Airway - tachypnea
Blood Pressure - hypertension
Cardiac - tachycardia (note - both hypo and hyper are tachycardia.) |
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Term
| What are some dietary sources of sodium? |
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Definition
| salt, soy sauce, dairy products, processed food, canned soup, pickles |
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Term
| What are some dietary sources of potassium? |
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Definition
| Bananas, melons, apricots, avocado, carrots, oranges, tomatoes and potatoes |
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Term
| What are some dietary sources of calcium? |
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Definition
| Dairy products, dark green vegetables, oysters and tofu |
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Term
| What are some dietary sources of magnesium? |
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Definition
| Nuts and peanut butter, milk, whole grains, chocolate, citrus fruits |
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Term
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Definition
| chemical compounds that partially dissolve in solution, divided between cations (positiviely charged ions) and anions (negatively charged ions). |
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Term
| Name some possible symptoms of the nursing diagnosis ECF Volume Deficit (hint: there are 9): |
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Definition
1) decreased urine output/increased urine concentration
2) weight loss
3) tachycardia and hypotension
4) decreased skin turgor
5) weak pulse/decreased pulse pressure
6) changes in mental status
7) increased body temperature
8) dry skin/mucous membranes
9) thirst |
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Term
| Name some possible symptoms of the nursing diagnosis ECF Volume Excess (hint: there are 7): |
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Definition
1) Edema
2) weight gain
3) shortness of breath
4) intake greater than output
5) breath sounds (crackles)
6) change in mental status
7) Jugular vein distension |
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Term
| Name some possible symptoms of the nursing diagnosis Water excess (hint: there are 6): |
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Definition
1) serum osmolarity of less than 275 mOsm/L
2) confusion and headache
3) nausea or vomiting
4) weight gain
5) Cramps
6) Convulsions or Coma |
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Term
| Name some possible symptoms of the nursing diagnosis Water deficit (hint: there are 7): |
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Definition
1) serum osmolarity over 300 mOsm/L
2) disorientation
3) irritability
4) thirst
5) anuria
7) tachycardia |
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Term
| What are the four normal ways that water and electrolytes are lost from the body? |
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Definition
1) kidneys - as urine
2) skin - as perspiration
3) GI tract - as stool or vomit
4) lungs - as insensible water loss |
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Term
| How is insensible water loss different from perspiration? |
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Definition
| With perspiration, sweat glands actively expel water through the skin. With insensible losses, water loss occurs when water molecules move from an area of high concentration (the body) to an area of lower concentration (the atmosphere). |
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Term
| What conditions can have a dramatic effect on water loss and how(hint: there are 4)? |
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Definition
Vomiting - ECF is lost in high amounts during vomiting, and the ability to maintain adequate intake is greatly hindered.
Diarrhea - Very similair to vomiting.
Diaphoresis - (excessive sweating) sweat is a hypotonic fluid that contains sodium, chloride and potassium. With a fever, this can bring about large quantities of insensible loss.
Diuretics - prescribed to increase the exretion of sodium (for example, cardiac patients, renal and liver problems, and blood pressure disorders). |
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