Fluid and Electrolytes made easy

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1. 
A liquid such as water that can hold another substance in a solution.
 
Solvent
 
2. 
A substance that is either dissolved or suspended in a solution.
 
Solute
 
3. 
A solution that has the same concentration of solutes as another solution.
 
Isotonic Solution
 
4. 
A solution that has MORE solutes than another solution.
 
Hypertonic Solution
 
5. 
A solution that has FEWER solutes than another solution.
 
Hypotonic Solution
 
6. 
0.9 Sodium Chloride or NS is an example of ______ used in a hospital setting.
 
Isotonic Solution
 
7. 
Elements or compounds that dissolve in water and separate into ions that carry an electric current.
 
Electrolytes
 
8. 
What is the percentage of body water in a young adult, the elderly, and infants. (3 answers)
 

Young Adult: 60%

Elderly: 45%

Infants: 80%

 
9. 
An infants BSA is greater than that of an adult relative to his/her weight, with that and a high metabolism and Immature kidneys, these factors puts the infant at a risk for:
 
Fluid Volume Defecit
 
10. 
This is triggered by the hypothalamus. As we age it becomes diminished, putting the elderly at risk for fluid volume defecit.
 
Thirst Mechanism
 
11. 
What electrolyte mainy controls the distribution of water throughout the body?
 
Sodium
 
12. 
What is the dominant Cation in ICF?
 
Pottasium (K+)
 
13. 
What is the dominant Anion in ICF?
 
Phosphorous (PO4-)
 
14. 
What is the dominant Cation in ECF?
 
Sodium (Na+)
 
15. 
What is the dominant Anion in ECF?
 
Chloride (Cl-)
 
16. 
What amount of body water is intracellular fluid?
 
2/3
 
17. 
What amount of body water is extracellular?
 
1/3
 
18. 
Estracellular fluid consists of two compartments. What are they?
 

Interstitial Fluid

Intravascular Fluid

 
19. 
What four processes do solutes and solvents move across the membranes?
 

Diffusion

Osmosis

Filtration (Hydrostatic Pressure)

Active Transport (requires energy)

 
20. 
The MOVEMENT OF WATER through a semipermiable membrane from a solution with a lower solute concentration to one with a higher solute concentration.
 
Osmosis
 
21. 
What is the pulling power of a solution for water?
 
Osmotic Pressure
 
22. 
Term used to express osmotic pressure?
 

Osmolality*

*The higher the osmolality the greater the pulling power of water

 
23. 
What is the Normal Serum Olsmolality Level?
 
280-300 mOsm/kg
 
24. 
The process by which large particles, such as protien, that can pull fluid from tissues into the vessels by osmosis?
 
Colloidal Osmotic Pressure
 
25. 
The movement of a solute in a solution across a semipermable membrane from an area of higher solute concentration to a area of lower solute concentration until both sides are equal.
 
Diffusion
 
26. 
This requires energy to move substances across cell membranes. It allows larger molecules to enter the cell moving thise particles uphisl from areas of lower concentration to areas of higher concenteration.
 
Active Transport
 
27. 
This hormone is manufactured in the hypothalamus and is stored in the posterior pituitary gland . It makes the kidneys more permable to water.
 
ADH
 
28. 
This hormone is realesed by the Adrenal Cortex it causes the kidneys to reabsorb Na+ and water while exreting K+.
 
Aldosterone
 
29. 
Because Sodium retention leads to water retention, Aldosteron acts as a _______.
 
Volume Expander
 
30. 

The production of Aldosterone is stimulated by:

Decreased _____ _____ _____ _____ and

increased _____

 

Decreased: B/P, Blood Volume, Sodium (Na+)

Increased: Potassium (K+)

 
31. 

Aldosterone is NOT produced with

Increased _____ _____ _____ _____ and decreased _____

 

Increased: B/P, Blood Volume, Sodium (Na+)

Decreased : Potassium (K+)

 
32. 
The average adult releases ____-____ ml of fluid output daily
 
2600-3600 ml
 
33. 
With what four organs does fluid ouput occur?
 

Kidneys 1500 ml/day (Sensible)

Skin 600ml/day (Insensible

lungs 400ml/day (Insensible)

GI tract 100 ml/day (Sensible)

 
34. 
When fluid loss is not perceived b the individual, it is called _________
 
Insensible Fluid Loss
 
35. 
When fluid loss is perceived by the individual, it is called ________
 
Sensible Fluid Loss
 
36. 
What is the functioning unit of the kidney?
 
Nephron
 
37. 
The nephron filters blood at a rate of _______/min
 
125ml
 
38. 
What amounf of uring/kg of body weight/hour is produced by all ages.
 
1 ml/hr
 
39. 
Name two common fluid imbalances in the body.
 

Edema and

Dehydration

 
40. 
When water and electrolytes gained or lost in equal proportion
 
Isotonic fluid imbalances
 
41. 
When only water is gained or lost
 
Osmolar fluid imbalances
 
42. 
What occurs when water and electrolytes are lost in equal proportions?
 
Isotonic Dehydration
 
43. 
Fluid losses are primarily in the ____ (the least stable fluid compartment)
 
Extra Cellular Fluid (ECF)
 
44. 
This occurs when more water is lost than electolytes
 
Osmolar Dehydration
 
45. 
A lower Serum Osmolality suggests...
 
Fluid Overload
 
46. 
A higher Serum Osmolality suggests...
 
Fluid Dehydration
 
47. 
These two values are often high due to Hemoconcentration.
 
Hct and BUN
 
48. 
Normal Serum Soduim Level
 
135-145 mEq/L
 
49. 
Normal Serum Potassium Level
 
3.5-5.0 mEq/L
 
50. 
Normal Serum Calcium Level
 
8.5-10.5mg/dl
 
51. 
Normal Serum Chloride Level
 
95-108 mEq/L
 
52. 
Normal Serum Phosphate Level
 
2.5-4.5 mg/dL
 
53. 
Normal Serum Magnesium Level
 
1.4-2.1 mEq/dL
 
54. 
Normal Serum Bicarbonate Level
 
22-26 mEq/dL
 
55. 
Name the 3 types of IV Solutions
 

Isotonic (NS 0.9)

Hypotonic (1/2 NS 0.45)

Hypertonic (D5NS)

 
56. 
What is the main role of Na+
 
To control water distribution and maintian normal fluid balance
 
57. 
Sodium dilution from increased volume states
 
Dilutinal Hyponatremia
 
58. 
This is caused by excessive administration of hypotonic fluids, diseases that add increased volume, an increase in ADH, drining excessive amounts of water, excessive Na+ losses from profuse perspiration , GI losses, and Diuresis
 
Hyponatremia
 
59. 
Signs and symptoms of Hyponatremia
 

Water shifts from vascular space into the cells causeing headache and altered mental status

Abdominal cramps, anorexia, nausea, and diarrhea.

 
60. 
This is caused by Excess sodium intake, or excessive infusion of sodium fluids, decreased sodium loss, excessive water loss, Renal failure, increased aldosterone
 
Hypernatremia
 
61. 
Signs and symptoms of Hypernatremia
 
Whater shifts from Cells (cellular dehydration) into the vascular space. Dry mucous membranes, thirst, decreased urin ouput, agitation , dosorentation , seizures
 
62. 
What is the main role of K+
 
maintain cell membrane electric potential. Neuromuscular function
 
63. 
Duretics, excessive loss of GI fliuds, increase secretion of Asldosterone, and high glucose levels leading to diuresis leads to
 
Hypokalemia
 
64. 
Signs and symptoms of Hypokalemia
 
Weak thready pulse, EKG changes, Paralytic ileus and Muscle weakness: leg cramps
 
65. 
This is caused by excessive intake from foods, salt substitues, IV infusion of KCL, decreased secretion due to renal failure, adrenal insufficiency, ACE inhibitors, decreased Aldosterone, massive Tissue trauma and it is rare in those individuals with normally functioning kidneys
 
Hyperkalemia
 
66. 
Signs and symptoms of Hyperkalemia
 
EKG changes, Irregular slow heart rate, Increased peristalsis, causeing nausea, vomiting or diarrhea
 
67. 
Principle functions of this elecrolyte include enhanced bone strength, normal clotting of the blood and regulation of neuromuscular irritability
 
Calcium
 
68. 
Hypoparathyroidism , decreased magnesium leves inadequate Vitamin D, increased Phosphorus levels cause this
 
Hypocalcemia
 
69. 
Signs and Symptoms of Hypocalcemia
 
Decreased blood pressure and decreased myocardial contractility, increased bleeding, nubness of fingers and toes, Tetany, positive Chvostek's sign and Positive Trousseau's sign
 
70. 
Positive Chvostek's sign is described as
 
Tapping on the face at the point just anterior to the ear and just below the cheek bone. Positive if twitching of the facial muscles occurs
 
71. 
Positive Trousseau's sign is described as
 
inflating a B/P cuff above systolic blood pressue for several minutes. Positive if flexion of the wrist and metacarpophalageal joints and hyperesxtension of the fingers and flexion of the thumb on palm occurs
 
72. 
Bones stones and grones, hyperparathyroidism, metastic cancer and decreased phosphourus levels are significant in patients with
 
Hypercalcemia
 
73. 
this is clossaly associated with serum sodum levels, principle functions include serum osmolality and water balance, regulation of pH of stomach
 
Chloride (Cl-)
 
74. 
Caused by decreased intake or absorption, prolonged vomiting , sweating, diarrhea, or GI drainage, Na+ and K+ deficiency
 
Hypochloremia
 
75. 
Caused by certain drugs that lead to retention, usually associated with increased Na+ levels
 
Hyperchloremia
 
76. 
Thees two elecrolytes have an inverse relationship when one is up the other is down
 
Calcium and Phosphorus
 
77. 

This causes Increased Serum Calcium Levels (hypercalcemia)

and Decresed Serum Phosphorus Levels(hypophosphatemia)

 
Hyperparathyroidism
 
78. 
This causes Decreased Serum Calcium Levels (hypocalcemia) and Increased Serum Phosphorus Levels (hyperphosphatemia)
 
Hypoparathyroidism
 
79. 
Name the common complications with IV therapy
 

Infiltration

Phlebitis/Thrombophlebitis

Infection (local or systemic)

Fluid Overload

Bleeding

 
80. 
the
 
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