Module 2

Question 1

What are the three main compartments where water is found in the body, and what is the role of each?

Answer 1

Intracellular Fluid- inside the cells
Interstitial Fluid (ISF)- b/w the cells and vessels
Extracellular Fluid (ECF)- in the blood vessels

Question 2

How does Hydrostatic pressure contribute to fluid movement between compartments?

Answer 2

• Physical pushing force that is exerted by fluid in the bloodstream, water gets pushed from extracellular compartments to IS compartments then into IC compartments

Question 3

How does oncotic pressure contribute to fluid movement between compartments?

Answer 3

• Specific type of osmotic pressure exerted only by the protein albumin in the bloodstream that pulls water back from the IC and IS compartments into the EC compartment

Question 4

How does Osmotic pressure contribute to fluid movement between compartments?

Answer 4

• Chemical pressure exerted by all the solutes in the blood stream that pulls water back from the intracellular and interstitial compartments into the EC compartment

Question 5

What is Starling’s Law of Capillary Forces, and how does it explain fluid balance?

Answer 5

Osmotic Pressure=Hydrostatic pressure
Meaning pressure going out but equal the pressure going in

Question 6

Define osmolarity and explain how it affects cell hydration.

Answer 6

Osmolarity: Measurement of the concentration of solutes in 1kg of solvent
- This evaluates the bodys hydration status
- Low osmolarity= fewer solutes- over hydrated

-High osmolarity=too many solutes=dehydration

Question 7

Define tonicity

Answer 7

Tonicity: Concentration of solutes in a solution compared to the concentration of solutes in the bloodstream

Question 8

Define Hypotonic

Answer 8

A solution that has fewer particles than blood, causes water to shit from ECF to ICF when infused
- good for dehydrated cells

Question 9

What is the role of intake/output measurements in assessing fluid volume status?

Answer 9

Record everything a person eats and drinks (IVs, jello, ice cream)
- Record all parenteral administrations

Question 10

What is the minimum output for the kidneys in an hour

Answer 10

30ml/hr

Question 11

Define Hypertonic

Answer 11

Relatively stable equilibrium b/w interdependent elements, esp as maintained by physiological processes
- Helps with edema

Question 12

What mechanisms maintain fluid homeostasis, and how do osmoreceptors and the RAAS system contribute?

Answer 12

Thirst receptors (Osmoreceptors) ma

Question 13

What are the causes and symptoms of edema

Answer 13

Causes: increased hydrostatic pressure and decreased osmotic force
heavy limbs, ankle swelling

Question 14

How does edema differ from third-spacing/effusion?

Answer 14

Third-spacing is a specific type of edema where fluid enters cavities in the body that are normally free of fluid (Pericardial sac, peritoneal cavity, pleural space)

Question 15

How does dehydration alter hydrostatic and osmotic pressures, and what are its key clinical signs?

Answer 15

Alters do to it being caused by a decreased hydrostatic pressure and an increased osmotic force

Clinical Signs: dark urine with high specific gravity, depressed fontanelles, dry mucus mems, low urine output, thirst, weight loss

Question 16

What is the role of daily weight measurements in assessing fluid volume status?

Answer 16

to know if a client is loosing too much too quick
- report a change of more then 2lbs in a day or 5lbs in a week

Question 17

what is dependent edema

Answer 17

edema in lower extermities that results from poor circulation and blood pooling from gravitational forced and poor venus return

Question 18

what is anasarca edema

Answer 18

generalized edema that is all over the body, usually due to osmotic pressure problem

Question 19

what is pleural effusion

Answer 19

fluid in the pleural space around the lung–> causes partial collapse of lung

Question 20

what is pericardial effusion

Answer 20

the build up of too much fluid in the double-layered sac like structure around the heart

Question 21

What are the main roles of sodium (Na) in maintaining cellular function?

Answer 21

• Main extracellular electrolyte
• Contributes to osmotic pressure and is the primary determinant of osmolarity and blood volume

Question 22

What is the main role of potassium (K) in maintaining cellular function?

Answer 22

• The main intracellular electrolyte
• Always being pumped into the cells
• High functioning in muscle cells
• K follows insulin but goes opposite hydrogen

Question 23

What is the main role of calcium (Ca) in maintaining cellular function?

Answer 23

• One of the main contents of bone
• An electrolyte that helps with clotting and neuromuscular irritability

Question 24

What are the causes and symptoms of hyperkalemia, and how can they affect cardiac function?

Answer 24

• Serum potassium level over 5.2
• Causes: renal failure, major myo trauma
• Symptoms:
  Early- myo cramping, numbness/tingling of extremities, diarrhea, apathy, confusion, EKG changes
  Late: bradycardia, cardiac arrhythmias, cardiac arrest

Question 25

What are the causes/symptoms of hypokalemia how can they affect cardiac function?

Answer 25

- Serum Potassium level less then 3.5mEq/L - Cause: Diuretic therapy, inadequate intake, vomiting and diarrhea - Symptoms: anorexia, nausea, vomiting, cardiac arrthymias, leg cramps, myo fatigue, weakness, decreased/absent deep tendon reflexes - Digitalis toxicity can occur

Question 26

Describe the causes, symptoms, and potential complications of hyponatremia

Answer 26

Cause: loss of both sodium and fluid together (due to losses from GI tract and kidneys) Symptoms:

Question 27

Describe the causes, symptoms, and potential complications of hypernatremia.

Answer 27

Cause: from excess Na/ a decrease in body water Symptoms: thirst irritability, restlessness, confusion, myo weakness, seizures, lethargic Complication: Fluid overload (watch for edema)

Question 28

How does calcium balance relate to conditions like hypocalcemia, what are the clinical presentations?

Answer 28

Cause: lack of intake, vitamin D deficiency, renal disease, hypoparathyroidism CP: Acute and Chronic symptoms

Question 29

What are the acute symptoms of hypocalcemia

Answer 29

Neuromuscular excitability, pareathesias, Chvostek's sign, Trousseau's sign, seizures, hypotension, arrhythmias

Question 30

What are the chronic symptoms of hypocalcemia

Answer 30

bone pain and fragility, dry skin and hair, cataracts, depressed, dementia, hypophophetemia

Question 31

How does calcium balance relate to hypercalcemia, and what is the clinical presentation?

Answer 31

- Serum calcium level higher then 10mEq/L - Causes: Hyperparathyroidism, cancer, prolonged immobility, excess vitamin D or calcium intake - Symptoms: decreased neuromuscular activity, bone tenderness, renal stones, increased cardiac contractility, ventricular arrhythmias

Question 32

What does bones, stones, groans and psychiatric overtones go with

Answer 32

hypercalcemia

Question 33

Explain the carbonic acid-bicarbonate buffer system and its role in pH regulation.

Answer 33

- Acid plus a base creates a balance (pH) - The body controls the amounts of acid and base in our system

Question 34

What is the cause compensatory mechanism of metabolic acidosis

Answer 34

Cause: - increased production of fixed metabolic acids or ingestion of fixed acids like salicylic acid Compensatory Mech: - increase in respirations (Kussmaul breathing)

Question 35

What is the cause and compensatory mechanism in respiratory acidosis

Answer 35

Cause: - Chronic disorders of ventilation (CODP, pneumonia) Compensatory Mech: - increased renal excretion of H+ into the urine and increased production of bicarb

Question 36

What is the cause and compensatory mechanism metabolic alkalosis

Answer 36

cause: a gain of a base, loss of acids from the stomach CM: depressed breathing

Question 37

What is the cause and compensatory mechanism respiratory alkalosis

Answer 37

Cause: hyperventilation CM: decreased renal excretion of H+ into the urine and decreased production of bicarb

Question 38

What is the anion gap, and how does it help diagnose the cause of metabolic acidosis?

Answer 38

Anion gap: the difference between the plasma concentration of major measured cations and the sum of the measured cations Helps with MA because the AG tells if the MA is due to an addition or loss of a base

Question 39

What are crystalloids, and what are their mechanisms of action and uses?

Answer 39

IV solution that contains electrolytes and other substances in conceptrations that closely resemble the bodys ECF - Mech of action: moves water in/out/ fills volume of the cells

Question 40

What are colloids, what are their mechanisms of action and uses?

Answer 40

Proteins, starches/other large molecules that remain in the blood for a long time as they are too large to cross plasma mem. MoA: Act like a hypertonic solution (draws water out of the ICF and ISF)

Question 41

What are the indications, actions, and precautions associated with potassium chloride administration?

Answer 41

Indicator: - treatment of hypokalemia Actions: - replaces lost potassium Precaution: - Do not crush/chew tablets and give with lots of water. - You can melt it in water or add to apple juice but do not crush

Question 42

What are the indications, actions, and precautions associated with sodium bicarbonate administration?

Answer 42

Indicator: - to correct metabolic acidosis Actions: - after dissociation, the bicarb ion directly raises pH Precautions: - My be give PO or IV but watch for metabolic alkalosis

Question 43

How do isotonic, hypotonic, and hypertonic solutions differ, and when are they typically used in fluid therapy?

Answer 43

- iso: Expands ECF without causing shits in other compartments - Hypo: causes water to move out of the ECF into the ISF and ICF - Hyper: expands ECF by drawing out fluid from ICF and ISF

Question 44

What happens when nerve cells and muscles don't function correctly

Answer 44

you die, brain stops and heart stops beating