Module 2: Fluids And Electrolytes Flashcards by Sofia Francheska Rosas

Bean shaped organ located on either side of the vertebra to the 3rd lumbar vertebra

Regulate by selectively excreting or conserving bicarbonate and hydrogen ions

Kidney

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Is to precess blood plasma and excrete urine

Kidney function

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Also known as the fibrous tunic of the kidney

Renal capsule

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Surrounds the renal capsule

Adipose capsule

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Which is a dense outer layer

Renal fascia

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The basic functional unit of the kidney

Nephrons

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Where plasma is filtered

Renal corpuscle

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Into which the filtered fluid passes which form urine

Renal tubules

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Movement of water and solute from the plasma in the glomerulus, across the glomerular capsular membrane.

Filtration

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Movement of molecules out of the tubule and into the peri-tubular blood

Reabsorption

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Movement of molecules out of the peritubular blood and into the tubule excretion

Secretion

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Two tubes that drain urine from the kidneys to the bladder, approx. 28cm long tube which conveys urine from the kidney to the urinary bladder

Ureter

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It is collapsible bag located behind the symphysis pubis; made up of detrusor muscles

Urinary bladder

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Small tube lined with mucus membrane from the floor of the bladder to the exterior of the body.

Urethra

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Universal solvent

Provides an aqueous medium for cellular metabolism and proper cellular chemical functioning

Water

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Fluid in the cells, 2/3

Intracellular

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Fluid outside the cells, 1/3

Extracellular

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Within blood vessels, contains plasma

Intravascular

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Fluid that surrounds the cells

Interstitial

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Smallest division and contains approximately 1L

Transcelluar

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Loss of ECF into a space that does not contribute to equilibrium between the ICF and ECF

Third spacing / Fluid shift

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Are active chemicals (cations and anions)

Electrolytes

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Major Cations

Sodium
Potassium
Calcium
Magnesium

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Major anions

Chloride
Phosphate
Sulfate

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Diffusion of water caused by fluid and solute concentration gradient

Osmosis

Number of solute per KG of solvent

Osmolality

Number of solute per LITER of solution

Osmolarity

Pressure exerted by the fluid on the walls of blood vessels

Hydrostatic pressure

Pressure exerted by the solutes within the plasma

Osmotic pressure

Fluid consisting of non-soluble substances that are evenly distributed within a solvent

Colloid

Commonly used as temporary blood replacement

Colloid solution

Mineral ions dissolved in water

Crystalloid solutions

Natural tendency of a substance to move from an area of higher concentration to one of lower concentration

Diffusion

Hydrostatic pressure in the capillaries tends to filter fluid out of the intravascular compartment into the interstitial fluid

Filtration

To maintain cellular function, more potassium needs to be inside the cell and more sodium needs to be outside the cell

Sodium-Potassium Pump

Sodium-potassium pump performs which actively moves sodium from the ECF to the ICF

Active-Passive transport

Ability of the solutes causes an osmotic driving force that promotes water movement from one compartment to another

Tonicity

The same sodium and chloride concentration as the bloodstream

Isotonic solutions

Less solutes but more water than the bloodstream

Hypotonic Solutions

Composed of greater concentrations of NaCl compared to blood

Hypertonic Solutions

Nonreabsorbable sugar alcohol, in water is an IV solution that can be used to move water from ICF to ECF rapidly

Mannitol

Reflects the concentration of Sodium, although BUN and glucose also play a major role in deter.

Serum osmolality

Determine by urea, creatinine, and uric acid

Urine osmolality

Measures the destiny of urine compared to water

Urine specific gravity (1.005 - 1.030)

Measures the amount of urea in the bloodstream

BUN (10 - 20 mg/dl)

Breakdown product of muscle metabolism that is almost cleared from the bloodstream and excreted by the kidney (0.7 - 1.4)

Creatinine

Measures the percentage of red blood cells in a volume of whole blood

Hematocrit (men = 42 - 52%) (Women = 35 - 47%)

Change with sodium intake and the status of fluid volume

Urine Sodium

Hypoosmolarity, ECF water excess

Hypoosmolar imbalance

Signs and symptoms of hypoosmolarity

Swelling of cerebral cells Oliguria Increased urine output Sudden weight gain Pulmonary edema

Management of hypoosmolar

Water restriction Eliminate the cause Decrease sodium intake diet

Results from either a water deficit or an extracellular solute overload

Hyperosmolar Imbalance

Causes of hyperosmolarity

Decreased water intake Increased loss of water Injudicious use of hypertonic solutions

Signs/symptoms of hyperosmolarity

Thirst Poor skin turgor Dry tongue Sunken fontanels Increased temperature CV symptoms

Fluid volume deficit, occurs when loss of ECF volume exceeds the intake of fluids

Hypovolemia

Causes of hypovolemia

Abnormal fluid losses, such as those resulting from vomiting, diarrhea, GI suctioning, and sweating

Decreased ability to concentrate urine due to either a deficit of ADH or nephrons resistance to ADH

Diabetes Insipidus

Signs/symptoms of Diabetes Insipidus

Acute weight loss Low skin turgor Oliguria Concentrated urine Low blood pressure

Labs of diabetes insipidus

Increased hemoglobin and hematocrit Increased serum and urine osmolality and specific gravity Increased BUN and creatinine Decreased Urine sodium

Medical management for diabetes insipidus

Oral route - deficit is not serve IV - fluid losses are acute or severe Isotonic solutions - first line choise to treat

Nursing management for diabetes insipidus

Assess turgor Monitor VS signs and CVP Palpate peripheral pulses

Fluid volume excess, expansion of the ECF caused by the abnormal retention of water and sodium in approximately the same proportions in which they normally exist in the ECF

Hypervolemia (Edema is most evident in the ankles)

Signs/symptoms of hypervolemia

Acute weight gain Increased urine output Peripheral edema

Medical management for hypervolemia

Diuretics (loop diuretics)

Nursing management for hypervolemia

Monitor weight and VS Assess for edema Auscultate lungs and heart sounds, assess breath sounds Monitor I&O

Charged ions that are capable of conducting electricity, are present in all body fluids and fluid compartments

Electrolytes

Major contributor to serum osmolality Most abundant cation in extracellular fluid, maintains ECF volume Functions largely in controlling and regulating water balance

Sodium (Na+) (135-145 mEq/L)

Functions of sodium

Maintains ECF volume Maintains plasma volume and regulates size os vascular space

Sodium requirement per day

4.5 gms/day (6.0 sa NCLEX)

Sodium deficit, <135 mEq/L

Hyponatremia

Causes of hyponatremia

Water intoxication Diuretics Vomiting, diarrhea

Signs/symptoms of hyponatremia

Poor skin turgor Dry mucosa Headache Decreased saliva production Nausea and vomiting Stupor Malaise Anorexia

Result of a fluid overload in a surgical patient

Acute hyponatremia

Patients outside the hospital settings, has longer duration and has less serious neurological sequelae

Chronic hyponatremia

Nursing interventions for hyponatremia

Monitor I&O Assess level of consciousness Maintain quiet environment Encourage foods high in sodium

Sodium excess in the blood, >145 mEq/L Gain of sodium in excess of water or by a loss of water in excess of sodium

Hypernatremia

Causes of hypernatremia

Diarrhea and vomiting Renal losses Osmotic diuretics

Signs and symptoms of hypernatremia

Thirst Elevated body tempt. Swollen dry tongue Lethargy Pulmonary edema Vomiting

Nursing interventions for hypernatremia

Monitor BP Monitor I&O Encourage avoidance of foods high in sodium

Major intracellular electrolyte, 98% is in inside the cell Influences both skeletal and cardiac muscle activity

Potassium (3.5-5 mEq/L)

Potassium deficit, <3.5 mEq/L

Hypokalemia

Signs and symptoms of hypokalemia

Fatigue nausea and vomiting Muscle weakness Polyuria Leg cramp Decreased bowel motility ECG: Flattened T waves, Prominent U wave, ST depression, Prolonged PR interval

Management for hypokalemia

IV (no more than 1mEq/10ml) Kalium durule High potassium diet Correct K loss daily Monitor heart rate/rhythm Monitor RR Assess LOC Auscultate bowel sounds

Potassium excess, >5.0mEq/L

Hyperkalemia

Module 2: Fluids And Electrolytes Flashcards

(85 cards)