Fluids

Question 1

Factors

Answer 1

1. Age
2. Gender
3. Fats: fat doesn’t hold water well

More fat = the lesser water held

Older people have less water than young

females: menopause (less adipose tissue)

Men have less water than women

Question 2

Samples of cations

Answer 2

sodium and potassium (positive charges)

Question 3

Anions

Answer 3

Chlorine and Bicarbonate Phosphate (negatively charged)

Question 4

Nonelectrolytes

Answer 4

glucose (no charges)

Question 5

Fluid found in blood vessel

Answer 5

Intracellular

Question 6

Fluid outside blood vessels

Answer 6

Extracellular

Question 7

Interstitial

Answer 7

Extracellular

Question 8

joint fluids (synovial fluids) and cerebrospinal fluid

Answer 8

Transcellular

Question 9

Separates intracellular and extracellular fluid

Answer 9

Cell membrane (main)

Question 10

Separates interstitial fluid from the plasma (at extravascular fluid)
Separates intravascular to extravascular

Answer 10

Capillary endothelium (sub)

Question 11

Movement of molecules from a higher concentration to a lower concentration

Answer 11

Diffusion

Question 12

From high to low: natural

From low to high: needs push (needs ATP)

Answer 12

Active transport

Question 13

Process where small particle and water will be filtered through a barrier where large particle will be filtered (like coffee grounds making coffee yah)

Answer 13

Filtration

Question 14

Movement from Low to high solute concentration

Filtered through a semi-permeable membrane

Ex: raisins absorbing water (Right balance of water)

Answer 14

Osmosis

Question 15

Factor that increase diffusion

Answer 15

Temperature: higher temp, diffuses faster

Surface area: larger surface, diffuses faster

Concentration gradient: higher gradient (larger concentration and lower concentration, diffuses faster)

Size of Particles: Small particles, diffuses faster

Diffusion Medium: solid - slowest, liquid - faster, gas - fastest

Question 16

Maintain blood pressure and good tissue perfusion

Sympathetic Nervous System: Fight and flight system activated can raise blood pressure circulation of blood (secretion of epinephrine) (increased heart rate, vasoconstriction)

Answer 16

Regulation of vascular volume

Question 17

Regulates blood volume an pressure

Answer 17

RAAS (Renin Angiotensin Aldosterone System)

Question 18

Release in Kidneys when there is low blood pressure or low blood volume

Answer 18

Renin

Question 19

Process of renin to angiotensin II

Answer 19

Renin converts angiotensinogen then converted to Angiotensin ii (vasoconstriction, aldosterone release, ADH release-antidiuretic hormone) converted by ACE

Question 20

are hormones that help lower blood pressure and reduce blood volume by promoting sodium and water excretion

Answer 20

Natriuretic peptides

Question 21

released by the atria of the heart (relaxes blood vessels once released)

Answer 21

Type A (Atrial natriuretic peptides)

Question 22

released by the ventricles of the heart especially during heart failure (increased pressure of the heart) cause vasodilation when released an increases renal sodium excretion

Answer 22

Type B (Brain natriuretic peptides)

Question 23

Produce by endothelial cells lining the blood vessels (vasodilator)

Answer 23

Type C

Question 24

posterior pituitary gland (water retention and vasoconstriction)

Answer 24

ADH Antidiuretic hormone (Vasopressin)

Question 25

Medications that alter ADH

Answer 25

- **Lithium (suppresses):** treat bipolar, interferes with kidneys ability to ADH which lead to impaired water absorption, promote diabetes insipidius (condition where kidneys cant concentrate urine=excessive urination) - **Demeclocycline (suppresses):** Antibiotic used in SIADH (syndrome of inappropriate amount of diuretic hormone) reduce kidneys ability to respond to ADH which impairs water absorption - **Methoxyflurane (suppresses):** Anesthetic agent, interferes ADH function, increases urine - **Chloropropramide (enhances):** used to treat type 2 diabetes, reduces urine output - **Indomethacin (Enhances):** for pain (NSAID) increases release of ADH = more water retention

Question 26

Serum Osmolality range

Answer 26

280 to 300 mOsm/kg

Question 27

Hematocrit

Answer 27

40% to 50% (males) 37% to 47% (females)

Question 28

BUN

Answer 28

6 to 20 mg/dL

Question 29

Urine Osmolality

Answer 29

300 to 900 mOsm/kg (24 hr speimen) 50 to 1200 (random urine osmolality)

Question 30

Urine Specific Gravity

Answer 30

1.010 to 1.025

Question 31

Urine Sodium

Answer 31

50-130 mEq/L

Question 32

when there is greater water loss than electrolyte loss causes cell to shrink DM (Diabetic Keto Acidosis) Fever, Kidney Disease

Answer 32

Hypertonic dehydration:

Question 33

cells swells loss of electrolyte i greater than loss of water, malnutrition, excessive ingestion of hypotonic fluid

Answer 33

Hypotonic dehydration

Question 34

excessive fluid in the ECF compartment but with normal osmolality

Answer 34

Isotonic Overhydration (hypervolemia)

Question 35

excess fluid is hypotonic to body fluids with decreased serum osmolality (hemodilution)

Answer 35

Hypotonic Overhydration (water intoxication)

Question 36

due to excessive Na intake which causes ECF volume to expand while the ICF volume contracts

Answer 36

Hypertonic Overhydration

Question 37

are substances that release hydrogen ions (H⁺) in a solution (e.g., hydrochloric acid).

Answer 37

Acids

Question 38

are substances that accept hydrogen ions (e.g., sodium bicarbonate).

Answer 38

Bases

Question 39

is a measure of how acidic or basic a solution is, with a scale from 0 (acidic) to 14 (basic), and a pH of 7 being neutral

Answer 39

pH

Question 40

What is the Body’s pH regulation

Answer 40

• Respiratory system: The lungs regulate pH by controlling the amount of carbon dioxide (CO₂) in the blood. More CO₂ increases acidity (lower pH), and less CO₂ makes the blood more alkaline (higher pH). • Renal system: The kidneys regulate pH by excreting hydrogen ions and reabsorbing bicarbonate (HCO₃⁻). This is a slower process compared to respiratory regulation

Question 41

ABG Components

Answer 41

• pH: A measure of blood acidity or alkalinity. • PaCO₂: The partial pressure of carbon dioxide in the blood, which is regulated by the lungs. • HCO₃⁻: Bicarbonate, which is regulated by the kidneys

Question 42

Normal pH levels

Answer 42

pCO2: 35-45 mmHg HCO3: 22-26 mEq/L O2: 95 up PaO2: partial arterial oxygen 80-100

Question 43

pH value

Answer 43

7.35-7.45 Acidic: below 7.35 Alkaline/basic: above 7.45

Question 44

paCO2 value

Answer 44

35-45 mmHg Respiratory Acidosis: High 45 Respiratory Alkalosis: Lower 35

Question 45

HCO3 range

Answer 45

22-26 mEq/L Metabolic Alkalosis: Higher than 26 Metabolic Acidosis: Lower 22

Question 46

What is step 3 in identifying pH balance?

Answer 46

Determine if the disorder is compensated or uncompensated. Compensated: pH is within normal range (7.35-7.45), but PaCO₂ or HCO₃⁻ is still abnormal. Uncompensated: pH is abnormal, PaCO₂ or HCO₃⁻ is abnormal

Question 47

Compensation mechanism

Answer 47

• Respiratory compensation: If metabolic acidosis occurs (low HCO₃⁻), the body may increase breathing to blow off CO₂ and raise the pH. • Renal compensation: If respiratory acidosis occurs (high PaCO₂), the kidneys may retain bicarbonate to balance the pH

Question 48

two primary mechanisms that help restore balance when body is acidic (Acidosis pH < 7.35)

Answer 48

Respiratory Compensation: •The lungs respond by increasing the rate and depth of breathing (hyperventilation). •This increases the exhalation of carbon dioxide (CO2), which reduces CO2 levels in the blood, helping to raise the pH. Renal Compensation: •The kidneys excrete more hydrogen ions (H⁺) and retain more bicarbonate (HCO₃⁻). •This helps to neutralize the excess acid in the blood and raise the pH

Question 49

When the body becomes alkaline (Alkalosis pH > 7.45), it uses similar but opposite mechanisms to restore balance:

Answer 49

Respiratory Compensation: •The lungs slow down the rate and depth of breathing (hypoventilation). •This reduces the amount of CO2 exhaled, raising CO2 levels in the blood, which helps lower the pH. Renal Compensation: •The kidneys retain hydrogen ions (H⁺) and excrete more bicarbonate (HCO₃⁻). •This helps to increase the acidity of the blood and lower the pH

Question 50

HYPOXIA LEVELS Hypoxia Classification by PaO2

Answer 50

• PaO₂ 80-100 mmHg → Normal • PaO₂ 60-79 mmHg → Mild hypoxia (may indicate early-stage respiratory failure). • PaO₂ 40-59 mmHg → Moderate hypoxia (require supplemental O₂). • PaO₂ < 40 mmHg → Severe hypoxia (potentially life-threatening, need urgent intervention)

Question 51

Quick Compensation Rule for Respiratory

Answer 51

Respiratory Acidosis: Kidneys retain bicarbonate (HCO₃⁻) to increase pH. Respiratory Alkalosis: Kidneys excrete bicarbonate (HCO₃⁻) to decrease pH.

Question 52

Quick Compensation Rule for metabolic

Answer 52

Metabolic Acidosis: Lungs increase ventilation toblow off CO2. Metabolic Alkalosis: Lungs decrease ventilation tomretain CO2.

Question 53

Signs and Symptoms of fluid Overload

Answer 53

➢ Weight gain of (>2 lbs. in 24 hrs) ➢Elevated BP ➢Bounding pulse ➢Large-volume pale urine ➢Crackles in lungs ➢Dyspnea ➢Moist labored respirations ➢edema ➢distended neck veins ➢Tachycardia ➢↑ pulse pressure and ↑ CVP ➢↑ Urine Output ➢shortness of breath ➢wheezing

Question 54

Nursing management for fluid volume overload

Answer 54

➢Take I&O and daily weights ➢Assess for lung sounds, edema, and other symptoms ➢Monitor responses to medications such as diuretics ➢Promote adherence to fluid restrictions and provide patient teaching related to sodium and fluid restrictions ➢Monitor and avoid sources of excessive sodium ➢Provide medications as ordered ➢Promote rest ➢Use semi-Fowler’s position for orthopnea ➢Provide skin care and positioning/turning