Term
| Body Fluids havea number of critical functions which are |
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Definition
Transport nurtrient and wastes
Regulate the temp of the body
aid in digestion
help lubricate the joints |
|
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Term
| What is the main body fluid? |
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Definition
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Term
| What are the two main areas of body fluid? |
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Definition
Intracellular compartment
Extracellular compartment |
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Term
| What compartment is within the cells? |
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Definition
| Intracellular compartment |
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Term
| What fluid compartment is outside the cells? |
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Definition
| extracellular compartments |
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Term
| Two-thirds of the body's fluid is |
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Definition
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Term
| What fluid type is the least vuneralbe to major fluid shifts? |
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Definition
| Intracellular fluid (ICF) |
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Term
| What fluid type comprises one-third of the body's water? |
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Definition
| Extracellular fluid (ECF) |
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Term
| What are the two main components of ECF? |
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Definition
interstitial fluid (fluid between the cells) and
plasma |
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Term
| What is interstitial fluid? |
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Definition
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Term
| One third of the ECF is in the... |
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Definition
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Term
| What body fluid is the least stable? |
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Definition
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Term
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Definition
| a balance within the body maintained by balancing intake and output |
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Term
| Osmosis occurs when there are two compartments separated by a __________ that large particles cannot cross. |
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Definition
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Term
| A shift of fluid occurs from areas of ___concentrationof particles to an area of _____concentration of particles until the concentrations in the two areas are equal. |
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Definition
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Term
| How does the water shift in cells by osmosis? |
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Definition
| Water shifts from inside the cells to outside the cells |
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Term
| The shift of fluid in and out of the vessels occurs by__ |
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Definition
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Term
| Hypertonic sodium IV will draw fluid into where from where? |
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Definition
| Into the vascular space from the tissues |
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Term
| How do the body fluids shift when given a hypotonic solution? |
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Definition
| Fluid will shift fro mthe intracascular spaces into the tissues |
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Term
| Accumulation of fluid in the cellular space may cause |
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Definition
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Term
| What type of solution does not cause fluid shifts? |
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Definition
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Term
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Definition
| The concentration of particles per kilogram of water |
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Term
| In the human body, the major solvent is |
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Definition
|
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Term
| What is osmotic pressure? |
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Definition
| the amount of power that a solution has to draw fluid across a semipermeable membrane |
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Term
| The higher the osmolality of a solution, the ___ its power to pull water or fluid across a membrane |
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Definition
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Term
| _________ is the major particle in plasma that contributes to plasma osmolality |
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Definition
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Term
| What should the nurse monitor for when giving a hypertonic solution? |
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Definition
| fluid overload and pulmonary edema |
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Term
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Definition
The force of a solution against the walls of a container
Ex: blood against the walls of blood vessels |
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Term
| What is it called when fluid moves into an area of lower pressure carrying some particles with it? |
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Definition
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Term
| _________ Pressure is a key element in understanding the movement of fluid through capillaries. |
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Definition
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Term
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Definition
| the force of colloids pulling fuids from the tissues into the vessels |
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Term
| Antidiuretic hormone (ADH) is |
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Definition
| a water conserving hormone |
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Term
| ADH is produced where and stored where? |
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Definition
| produced in the hypothalamus and stored in the posterior pituitary. |
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Term
| A fluid deficit causes the posterior pituitary to release |
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Definition
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Term
| When there is too much water in the body, ____secretion is inhibited and a greater volume of water is excreted from the kidneys |
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Definition
|
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Term
| What are some factors that can stimulate the release of ADH? |
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Definition
| Stress, nausea, morphine, nicotine, drop in blood pressure |
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Term
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Definition
| when ADH is released abnormally. |
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Term
| What occurs as a result of SIADH? |
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Definition
| water retention and decreased urinary output |
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Term
| Aldosterone is secreted by the |
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Definition
|
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Term
| Aldosterone causes sodium to do what? |
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Definition
| Retained by the kidneys and potassium to be secreted in its place |
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Term
| ________ is secreted when there is a drop in blood pressure, a decreased in the serum sodium level, or an increased in serum potassium level. |
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Definition
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Term
| ________ is a glucocorticoid hormone secreted bythe adrenal glands when a person is stressed. |
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Definition
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Term
| Cortisol causes the kidneys to do what? |
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Definition
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Term
| When a patient is stressed, cortisol levels may rise, resulting in |
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Definition
| decreased urine output and increased fluid volume within the body. |
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Term
| _________ is released from the atria of the heart when the atria are distended from high blood volume or pressure. |
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Definition
| Atrial natriuretic peptide (ANP) |
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Term
|
Definition
| vasodilation, which results in reduced BP and reduced pressure on the atria |
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Term
| ANP inhibits what two hormones? |
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Definition
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Term
| Lack of a thirst mechanism increases the risk of______ |
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Definition
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Term
| Thirst is often diminished in ______, resulting in increased problems with fluid balance. |
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Definition
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Term
| Insensible water loss consists of |
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Definition
| vaporizaton of fluid fro mthe lungs and skin |
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Term
| The two main types of fluid volume deficit are.... |
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Definition
| isotonic dehydration and hypertonic dehydration |
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Term
| Why cant fluid in third spacing be useful? |
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Definition
| It cannot be mobilized for homeostasis as needed |
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Term
| What is the most common type of fluid volume deficit? |
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Definition
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Term
| _________ occurs when fluids and solutes are lost in proportion, so there is no change is osmolality. |
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Definition
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Term
| Usually, isotonic fluid loss is from the ____, leaving ICF intact |
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Definition
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Term
| Treatment of isotonic fluid loss involves |
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Definition
| Replacement of vascular fluuid |
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Term
| What types of fluids are used to treat isotonic fluid losses? |
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Definition
|
|
Term
| What kind of dehydration is when more fluid than solute is lost? |
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Definition
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Term
| What type of dehydration is caused by inadequate fluid intake, severe or long-term isotonic fluid losses, watery diarrhea and increased salt intake? |
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Definition
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Term
| What is the treatment for hypertonic dehydration? |
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Definition
| Replace vascular and cellular fluid |
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Term
| cellular dehydration may be treated with |
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Definition
|
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Term
| What should the nurse monitor the patient being treated with hypotonic solutions for? |
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Definition
| cerebral edema and brain injury caused by swelling of brain tissues |
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Term
| What type of dehydration occurs when there are losses of solute that are greater in comparison to losses to fluid |
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Definition
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Term
| Thirst is an unreliable symptom in what age groups? |
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Definition
| Elderly and young children |
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Term
| If the mildly dehydrated patient can drink, ______ is the usual form of treatment |
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Definition
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Term
| What types of drinks should be avoided during dehydration? |
|
Definition
1. sports drinks
2. sodas
3. Caffeine |
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Term
| What methods of hydration are used for patients with moderate to severe dehydration? |
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Definition
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Term
| If third spacing has occured with fluid accumulation in the tissue, _______solutions may be administered with diuretics to draw the fluid from the tissues back into the vessels and promote elimination by the kidneys. |
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Definition
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Term
| What type of solution may be used to correct cellular dehydration? |
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Definition
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Term
| What can form when there is an increase in capillary hydrostatic pressure, which moves more fluid out of the vessels than is returned into the vessels? |
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Definition
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Term
| Hypotonic fluid volume excess is also known as |
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Definition
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Term
| Particles move from areas of __concentration to areas of ____concentration until the concentration of both areas are ___. |
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Definition
|
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Term
|
Definition
| Particles moving from an area of high concentration to an area of low concentration until the concentration of the two areas are equalized. |
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Term
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Definition
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Term
|
Definition
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Term
| Isotonic IV solutions have the same osmolality in the body as |
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Definition
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Term
| Isotonic IV solutions do not create osmotic pressure therefore do not cause____ |
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Definition
|
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Term
| Name 5 Isotonic fluid solutions |
|
Definition
Normal Saline
Ringer's solution
Lactated Ringers Solution
Dextrose
NaCl |
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Term
| ____Solutions have lower osmolality than normal plasma and are composed of more water than electrolytes |
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Definition
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Term
| Fluid loss in patients is usually |
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Definition
|
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Term
| Hypotonic solutions are used to treat_______dehydration |
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Definition
|
|
Term
| _______ solutions have a higher osmality than plasma |
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Definition
|
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Term
| Hypertonic solutions are used to treat _____ and _______. |
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Definition
| hypovolemia and hyponatremia |
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Term
| Hypertonic dextrose solutions are usually given by ___ or ____. |
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Definition
|
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Term
| _______ are large particles that normally do not pass through cell and capillary membranes |
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Definition
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|
Term
| Normal serum level of sodium is |
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Definition
|
|
Term
| Most of the sodium in our bodies comes from____ |
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Definition
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Term
| Regulation of sodium levles is carried out primarily by the ____ |
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Definition
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Term
| Fluid shift that occur with hyponatremia can be very dangerous because the cells swell, causing________ |
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Definition
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Term
| Severe hyponatremia can cause ______ and ________ |
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Definition
| seizures and and neurological damage |
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Term
| Hypernatremia occurs when serum levels rise above |
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Definition
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Term
| High sodium levels cause an increase in ___activity and stimulate the________mechanism |
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Definition
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Term
| Symptoms of hypernatremia are mostly due to |
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Definition
| fluid shift into the vessels and the effects of high sodium levels on the brain |
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Term
| The normal serum level of potassium is |
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Definition
|
|
Term
| What is the function of potassium? |
|
Definition
| Maintain action potentials in cells of muscles, nerves and other tissues |
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Term
| When the patient has acidosis, hydrogen ions move into the cells and ____ moves outof the cells |
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Definition
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Term
| Potassium's role in cellular metabolism is to |
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Definition
| Regulate the production of protein and glycogen |
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Term
| Potassium is mainly excreted by the |
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Definition
|
|
Term
|
Definition
| Serum level of potassium drops below 3.5 |
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Term
| What is the most important clinical manifestation of hypokalemia? |
|
Definition
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|
Term
| Always use a ___ to administer IV potassium |
|
Definition
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|
Term
| Never give potassium by what method? |
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Definition
|
|
Term
| What is a concern if giving potassium too fast? |
|
Definition
| Cardiac arrhythmias and arrest |
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Term
| What do you want to monitor the IV site for when giving potassium and why? |
|
Definition
| Infiltration and phlebitis because potassium is extremely irritation to the tissues |
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Term
|
Definition
| Serum potassium level exceeds 5.0 |
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Term
| Acidosis causes potassium to move out of the cells in exchange for hydrogen ions, resulting in what? |
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Definition
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Term
| Muscle twitching is a ______ sign of hyperkalemia |
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Definition
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Term
| Muscle cramps, muscle weakness and flaccid paralysis are _____ signs of hyperkalemia |
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Definition
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|
Term
| Respiratory failure is a ________ sign of hyperkalemia |
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Definition
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Term
| Kayexalate is used for serious cases of what electrolyte imbalance? |
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Definition
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Term
| In serious cases of hyperkalemia, ____ may be administered to decrease the effects of potassium on the cardiac muscles. |
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Definition
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|
Term
| The normal level of total calcium in the serum is |
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Definition
|
|
Term
| Some calcium is bout to plasma proteins, especially |
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Definition
|
|
Term
| How much calcium do adults need daily? |
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Definition
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Term
| When levels of calcium are low, ______ causes calcium to move out of the bones and into the serum. |
|
Definition
| PTH (Parathyroid hormone) |
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Term
| Parathyroid hormone causes increased calcium absorbtion in what two areas of the body? |
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Definition
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|
Term
| When Ca is too high, ____ is released from the thyroid gland. |
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Definition
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|
Term
| Calcitonin reduces the serum level of |
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Definition
|
|
Term
| What vitamin causes increased Ca reabsorption in the kidneys and absorption through the GI tract? |
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Definition
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|
Term
| When levels of calcium rise, the level of phosphorus does what? |
|
Definition
|
|
Term
| Hypocalcemia occurs when serum levels of calcium drop below _____ |
|
Definition
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|
Term
| Clinical signa and symptoms of hypocalcemia result from the effects of calcium on what? |
|
Definition
| nerve transmission, muscle function, and cardiac function |
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|
Term
| PTH causes calcium to have what effect on the bones? |
|
Definition
| Causes calcium to be removed from the bone |
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Term
| Conditions that cause decreased production of PTH result in ____ calcium levels |
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Definition
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|
Term
| Low magnesium also lowers the threshold for ____, the neurologicla disorder that results in spasms of the extremeties |
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Definition
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|
Term
| Why does neck surgery put a patient at risk for hypocalcemia? |
|
Definition
| due to possible accidental removal of parathyroid glands |
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Term
|
Definition
| contraction of facial muscles when facial nerve is tapped |
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Term
| What are carpal spasms that occur when a blood pressure cuff is inflated above the systolic pressure? |
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Definition
|
|
Term
| Tetany is major clinical manifestation of what electrolyte deficiency? |
|
Definition
|
|
Term
| What may be early signs of tetany? |
|
Definition
| parathesias: Numbness and tingling in limbs |
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Term
|
Definition
| When serum calcium levels rise over 10.5 |
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|
Term
| Most causes of hypercalcemia result from the movement of calcium... |
|
Definition
| out of the bones into the serum |
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Term
| Clinical signs and symptoms of hypercalcemia result from what? |
|
Definition
| decreased neuromuscular irritability |
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Term
| The most common cause of hyperparathyroidism is what? |
|
Definition
| adenoma of the parathyroid gland |
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Term
| Decreased memory, confusion, psychosis, coma and stupor are signs of what electrolyte disorder? |
|
Definition
|
|
Term
| What are substances that produce hydrogen ions when dissolved in water? |
|
Definition
|
|
Term
| _______ are substances that accept hydrogen ions when dissolved in water |
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Definition
|
|
Term
| Blood has a normal pH range of |
|
Definition
| 7.35-7.45 slightly akaline |
|
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Term
| If a person's ph drops below 7.35, the person has what? |
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Definition
|
|
Term
| A blood ph above 7.45 is considered |
|
Definition
|
|
Term
| Regulation of the acid-base balance is carried out by the ___, ____, and ___ system |
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Definition
| respiratory, renal, and chemical buffer system |
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Term
| If acidosis develops, the lungs will do what? |
|
Definition
| increase respiratory rate to blow off CO2 and thus rid the body of a source of acid |
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Term
| If alkalosis develops, the respiratory rate will do what |
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Definition
|
|
Term
| The renal system is especially good for regulating acid-base imbalances in what situations? |
|
Definition
| Slow developing rather than rapidly developing imbalances (chronic lung disease) |
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Term
| The chemical buffer system acts ___ to regulate acid base imbalances |
|
Definition
| very fast (within seconds) |
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Term
| Respiratory acidosis primarily occurs with what type of breathing? |
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Definition
|
|
Term
| COPD and CHF may cause what type of acid-base balance? |
|
Definition
|
|
Term
| Compensation for respiratory acidosis begins where? |
|
Definition
|
|
Term
| How do the lungs compensate for respiratory acidosis? |
|
Definition
|
|
Term
| How do the kidneys compensate for respiratory acidosis? |
|
Definition
| the kidneys conserve bicarbonate (HCO3) and secrete increased amounts of hydrogen ions into the urine |
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Term
|
Definition
| when there is a loss of acid through hyperventilation and elevation of pH and a low PaCO2 |
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Term
| What two deficiencies are associated with respiratory akalosis? |
|
Definition
| hypokalemia and hypocalcemia |
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Term
| Hyperventilation of respiratory alkalosis can be caused by stimulation of the CNS through what? |
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Definition
| Drugs (asa toxicity), fever, CNS lesions, anxiety, pain, excessive mechanical ventilation, and as a response to respiratory acidosis (compensation) |
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Term
|
Definition
| When acids accumulate in the extracellular fluid, ph drop below 7.35 and HCO3 decreases |
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Term
| What are some conditions that can lead to metabolic acidosis |
|
Definition
| diabetic acidosis (accumulation of ketones), fever, excessive exercise, starvation and malnutrition, and renal failure |
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Term
| Diarrhea puts a patient at risk for what metabolic disorder |
|
Definition
|
|
Term
| How does the body compensate for metabolic acidosis? |
|
Definition
| Increased RR and depth (to excrete C02) and retention of bicarbonate (HCO3) by the kidneys |
|
|
Term
|
Definition
| when there is a gaoin of bicarbonate and loss of acid. Ph rises above 7.45 and there is an increase in HCO3. |
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Term
| Vomiting or NG suctin can cause what type of acid-base irregularity |
|
Definition
|
|
Term
| How does the body compensate for metabolic alkalosis? |
|
Definition
| lungs decrease the RR and depth in attempt to retain CO2. The kidneys conserve hydrogen ions and excrete bicarbonate. |
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Term
| Diagnosis of acid-base imbalances relies on what test? |
|
Definition
| Arterial blood gas (ABG) analysis |
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|
Term
| How can a ABG test sample be taken |
|
Definition
| Radial, brachial or femoral artery with heparinized syringe |
|
|
Term
| What effect does ADH have on fluid levels within the body? |
|
Definition
| Raises the level of fluid in the body. It acts on the kidneys to promote fluid retention. |
|
|
Term
| What effect does fluid volume deficit have on a patient's vital signs? |
|
Definition
| The patient may develop hypotension, increased heart rate, weak and thready pulse, and low-grade fever |
|
|
Term
| What is the normal level of sodium in the serum? |
|
Definition
|
|
Term
| Neurological signs and symptoms such as headache, tremors, and coma can occur with hyponatremia. What causes these symptoms? |
|
Definition
| Fluids shifts from the vessels into the cells, including the brain cells. This swelling of brain cells results in the neurological symptoms described. |
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|
Term
| What effect does potassium have on muscle and nerve cells? |
|
Definition
| Potassium maintains the action potential of nerves and muscles. Decreased potassium leads to decreased excitability of muscles and nerves. |
|
|
Term
| The nurse should never give potassium IV Push. Why? |
|
Definition
| Cardiac arrythmias and arrest can occur |
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|
Term
| Which electrolyte imbalance is most likely to cause tetany? |
|
Definition
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