Body Fluids

Question 1

Adult female

Answer 1

50% body fluid, less due to adipose tissue

Question 2

Intracellular compartment

Answer 2

-holds 2/3 of body fluids

Question 3

Extra cellular compartment

Answer 3

• interstitial fluid(fluid around the cells)

- intravascular fluid(fluid in bloodstream 5 liters)

Question 4

Age considerations in fluid distributions

Answer 4

• as we age we lose muscle mass=less water/fluids
• elderly increase in fat=decrease fluids
• infants hold more fluid in interstitial spaces than adults

Question 5

Osmosis

Answer 5

Movement of water from areas of high concentration of water to lower concentrations of water

Question 6

Capillary filtration and reabsorption

Answer 6

-Movement of fluid through capillary membranes(via hydrostatic pressure) in order to carry water and nutrition into cells, water outside is reabsorption through blood stream

Question 7

Normal serum osmolarity

Answer 7

270-300 mOs/L

Question 8

Obligatory urine output

Answer 8

Minimal amount of urine needing to be excreted per 24 hours to avoid accumulation of waste products and possibly causing lethal electrolyte imbalances

400-600ml/24hours

Question 9

ADH

Answer 9

• released from hypothalamus, and pituitary gland
• ADH is released and causes kidneys to hold water
• released when brain doesn’t sense enough volume in body

Question 10

Renin angiotensin aldosterone

Answer 10

• aldosterone causes the kidneys to retain sodium(retention in water)
• responds to volume not osmolarity

Question 11

Atrial natriuretic peptide

Answer 11

• responds to volume

- released when there is too much volume!(stops ADH and aldosterone release)

Question 12

Thirst

Answer 12

• major driver for controlling osmolarity

- depends on the brain to function

Question 13

Insensible water loss

Answer 13

Water loss from skin,lungs, and stool

Question 14

Fluid volume deficit hypovolemia

Answer 14

Hypovolemia is an extra cellular problem caused by decrease of fluid in extra cellular space

-your concentration of electrolytes stays the same just a loss of volume

Question 15

Third spacing

Answer 15

When fluid moves from the intravascular space to interstitial space.

• response to injury
• ex:bowels, pleural cavity, pericardium
• may occur as a result of increased permeability of the capillary membrane, that allows fluid into interstitial spaces

Question 16

May lead to hypovolemia shock

Answer 16

Third spacing or Hemorrhage

Question 17

Ascites

Answer 17

Accumulation of fluid in the peritoneal cavity

Question 18

Finding with hypovolemia

Answer 18

• changes in LOC
• increased HR,decreased BP
• oliguria(less than 30ml/Hr)

Question 19

Fluid volume deficit dehydration

Answer 19

• fluid leaving the cells by osmosis to high concentrated areas
• Intracellular problem

Question 20

Dehydration may be caused by

Answer 20

-npo,tube feeding, inability to obtain water,prolonged diarrhea,prolonged fever, hyperglycemia

Question 21

Diabetes insipidis

Answer 21

Patient does not make enough ADH, may have output up to 30 liters

Question 22

S/S of dehydration

Answer 22

• weight loss
• increased HR,decreased BP
• weak thready pulse
• poor skin turgor
• decreased LOC
• dry mucous membranes
• elevated labs (osmolarity>300)(BUN>25)(USG>1.030)(elevated sodium>145)

Question 23

Palpation BP

Answer 23

• feel for artery
• systolic only
• chart as 80/P

Question 24

Doppler BP

Answer 24

• only systolic reading

- chart as 80/D

Question 25

Crystalloids

Answer 25

Solutions that have small particles that pass into the cells quite easily

Question 26

Isotonic solution

Answer 26

- same as plasma(most friendly solution with osmolarity of 240-340) - EX: 0.9 NaCL: only solution that can be used in blood transfusion - ringers solution: largely NaCL but does have same Ca added - elaborated ringers: isotonic solution with majority of NaCL, has lactate in it for the body to create bicarbonate(good for patients with acidosis)

Question 27

Dextrose 5% in water... Special case

Answer 27

- considered isotonic while in bag - when infused in body, the body uses the sugar leaving you with just water and a little glucose(not much of a replacement)

Question 28

Fluid bolus

Answer 28

- large amount of IV fluid in a short period of time - purpose: stabilize BP, restore blood volume, maintain kidney function by dumping water into vascular system forcing excretion

Question 29

Nursing considerations while giving a bolus

Answer 29

- monitor vitals every 15-30 minutes | - monitor IV Site

Question 30

After we deliver a bolus

Answer 30

- monitor output | - assess heart and lungs for fluid volume excess

Question 31

Colloids

Answer 31

- aka plasma expanded - have large molecules that cannot get to interstitial fluid space - good for hypovolemia

Question 32

Colloid examples

Answer 32

- Albumin:fluid magnet | - albumin comes in different strengths

Question 33

Hypotonic crystalloids

Answer 33

- solution contains less than 240 mOs/L | - quickly move through vascular system

Question 34

Fluid volume excess hypervolemia

Answer 34

An excess of isotonic fluid(water and sodium) in the extra cellular compartment

Question 35

Causes of hypervolemia

Answer 35

- excessive fluid intake via po/IV - heart failire(poor cardiac function) - limited output - increased sodium intake

Question 36

Finding present in hypervolemia

Answer 36

- dependent edema(sacrum,butt,legs,feet) - pulmonary edema - tachycardia with bounding pulse - distended hand and neck veins - BUN & hematocrit below normal

Question 37

What to do for hypervolemia

Answer 37

- restrict fluids as ordered - restrict NA - give diuretics - give cardio tonics(Digoxin,betablockers) - digoxin strengthens cardiac contractions and slows the HR - monitor lungs sounds - daily weight - O2 saturation - fatigue

Question 38

Fluid volume excess: water intoxication

Answer 38

- a hypotonic extra cellular problem | - too much fluid shifting into cells

Question 39

Water intoxications causes

Answer 39

- overuse of hypotonic IV solutions - too may tap water enemas - too much tap water NG irrigation - overly dilute baby formula

Question 40

Syndrome of increased and dangerous hydration SIADH

Answer 40

- opposite of diabetes insipides - pituitary gland is releasing too much ADH - cancer releases a substance in blood stream that mimics ADH

Question 41

Findings with water intoxication

Answer 41

- ICF more hypertonic than ECF - pronounced neurological changes with increased ICP - increased BP,decreased HR - lab results(osmolarity

Question 42

How can we help with water intoxication

Answer 42

- restrict water intake - monitor neurological status - monitor labs - daily weights - provide safe environment

Question 43

Hypertonic crystalloids

Answer 43

- greater osmolarity than plasma - greater than 340 -D5/lactated ringers 3-5%NaCL draws fluid from cells

Question 44

Adult male

Answer 44

60 % body fluid(40 liters)