objective 4 (1)

Question 1

what are the principles of fluid and electrolyte balance?

Answer 1

• Necessary for life and homeostasis
• Nursing role is to help prevent and treat fluid and electrolyte
  disturbances

Question 2

• State of equilibrium in body
• Naturally maintained by adaptive responses
• Body fluids and electrolytes are maintained within narrow limits

Answer 2

homeostasis

Question 3

what is the % of water content of the body?

Answer 3

• 50% to 60% of body weight in adult
• 45% to 55% in older adults
• 70% to 80% in infants

Question 4

inside the cell

Answer 4

intracellular fluid

Question 5

outside a cell

Answer 5

extracellular fluid

Question 6

Normal distribution of fluid in ICF and ECF

Answer 6

first spacing

Question 7

Abnormal accumulation of interstitial fluid

Answer 7

second spacing

Question 8

loss of ECF into a space that does not contribute to
equilibrium

Answer 8

third spacing

Question 9

cations that carry a positive charge and anions
that carry a negative charge

Answer 9

active chemicals

Question 10

what are the major cations?

Answer 10

sodium, potassium, calcium, magnesium and
hydrogen ions

Question 11

what are the major anions>

Answer 11

chloride, bicarbonate, phosphate, sulfate and
proteinate ions

Question 12

what is the major cation in ECF?

Answer 12

sodium (Na+)

Question 13

what is the normal for sodium?

Answer 13

134-145 mmol/L

Question 14

what is the major cation in ICF?

Answer 14

potassium K+

Question 15

what does the movement of fluid through capillary walls depend on?

Answer 15

• Hydrostatic pressure
   Pressure exerted on the walls of blood vessels
• Osmotic pressure
   Pressure exerted by the protein in the plasma

Question 16

movement of water between 2 compartments

Answer 16

osmosis

Question 17

movement of a substance from an area of higher concentration to
one lower concentration (ions and molecules - eg O2 and CO2)

Answer 17

diffusion

Question 18

movement of water and solutes from high hydrostatic pressure to
low hydrostatic pressure (eg kidney filtering lymph)

Answer 18

filtration

Question 19

energy is expended for the movement to occur against a
concentration gradient
12

Answer 19

active transport

Question 20

what is the average fluid intake?

Answer 20

2500mL/day

Question 21

what is the average fluid output?

Answer 21

1500mL/day Urine
100mL/day bowels

Question 22

• Dietary intake of fluid and food or enteral feeding
• Parenteral fluids (IV)

Answer 22

fluid gain

Question 23

• Kidney: urine output
• Lungs / skin loss - insensible losses
• GI tract

Answer 23

fluid loss

Question 24

what are the homeostatic mechanisms?

Answer 24

• Kidney – regulates F & E balance
• Heart and Blood Vessel – renal perfusion and water and electrolyte
  regulation
• Lung – exhalation
• Pituitary – ADH conserves water as needed
• Adrenal – fluid retention or water loss
• Parathyroid –regulates calcium and phosphate balance

Question 25

pinched skin with slow rebound

Answer 25

tenting

Question 26

* loss of water alone with increased serum sodium (Na+) level * Most common in older adults

Answer 26

dehydration

Question 27

* low volume of extracellular fluid (blood ) * accompanied by low e- level

Answer 27

hypovolemia

Question 28

what are the causes of hypovolemia?

Answer 28

* Prolonged vomiting, Diarrhea * GI suctioning * profuse urination or sweating * decreased intake * wound loss (burn injury) * inability to gain access to fluid

Question 29

what are the risk factors of hypovolemia?

Answer 29

diabetes insipidus, hemorrhage, coma, and third space shifts

Question 30

Greater due to decreased plasma volume

Answer 30

hematocrit

Question 31

hyponatremia and hypernatremia

Answer 31

sodium imbalances

Question 32

hypokalemia and hyperkalemia

Answer 32

potassium imbalances

Question 33

hypocalcemia and hypercalcemia

Answer 33

calcium imbalances

Question 34

hypomagnesemia and hypermagnesemia

Answer 34

magnesium imbalance

Question 35

hypophosphatemia and hyperphosphatemia

Answer 35

phosphorus imbalance

Question 36

hypochloremia and hyperchloremia

Answer 36

chloride imbalances

Question 37

what are the causes of hyponatremia?

Answer 37

adrenal insufficiency, water intoxication, SIADH, & losses by vomiting, diarrhea, sweating, & diuretics

Question 38

what are causes of hypernatremia?

Answer 38

excess water loss, excess Na+ administration, diabetes insipidus, heat stroke, & hypertonic (3% NACL) IV solutions

Question 39

what is potassium for?

Answer 39

* Transmission and conduction of nerve and muscle impulses * Cellular growth * Maintenance of cardiac rhythms * Acid–base balance* Transmission and conduction of nerve and muscle impulses * Cellular growth * Maintenance of cardiac rhythms * Acid–base balance

Question 40

what is the causes of hypokalemia?

Answer 40

* Abnormal losses of K+ via the kidneys or gastrointestinal tract * Magnesium deficiency * Metabolic alkalosis

Question 41

what are the causes of hyperkalemia?

Answer 41

* Massive intake * Impaired renal excretion * Shift from ICF to ECF * Most common in renal failure * tissue trauma (severe burns)

Question 42

what are the normal calcium values?

Answer 42

2.25-2.75 mmol/L

Question 43

what are the causes of hypocalcemia?

Answer 43

* Decreased production of PTH (hypoparathyroidism) * Acute pancreatitis * Multiple blood transfusions * Alkalosis * Vitamin D deficiency

Question 44

* Inflate a B/P cuff 20 mmHg above systolic * Adducted thumb, flexed wrist and metacarpophalangeal joints, extended interphalangeal joints

Answer 44

trousseau's sign

Question 45

Twitching of the facial muscles in response to tapping over the area of the facial nerve.

Answer 45

chovstek's sign

Question 46

what are the causes of hypercalcemia?

Answer 46

* Hyperparathyroidism (two-thirds of cases) * Malignancy * Vitamin D overdose * Prolonged immobilization

Question 47

what the normal magnesium values?

Answer 47

0.74-1.07 mmol/L

Question 48

what are the causes of hypomagnesemia?

Answer 48

* Prolonged fasting or starvation * Chronic alcoholism * Fluid loss from gastrointestinal tract * Prolonged parenteral nutrition without supplementation * Diuretics

Question 49

what are the causes of hypermagnesemia?

Answer 49

Increased intake or ingestion of products containing magnesium when renal insufficiency or failure is present

Question 50

what are the normal phosphorus values?

Answer 50

0.97-1.45 mmol/L

Question 51

what are the causes of hypophosphatemia?

Answer 51

*Malnourishment/malabsorption * Alcohol withdrawal * Use of phosphate-binding antacids * During parenteral nutrition with inadequate replacement

Question 52

what are the causes of hyperphosphatemia?

Answer 52

* Acute or chronic renal failure * Chemotherapy * Excessive ingestion of phosphate or vitamin D

Question 53

what are the normal protein values?

Answer 53

64 – 83 g/l

Question 54

what are the causes of hypoproteinemia?

Answer 54

Anorexia - Malnutrition - Starvation - Fad dieting - Poorly balanced vegetarian diets

Question 55

Rare, but can occur with dehydration induced hemoconcentration

Answer 55

hyperproteinemia