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Alterations in Fluid and Electrolyte Balance
Terms in this set (58)
Located inside the cell. This fluid accounts for about 40% of our total body weight; 2/3 of all body fluid.
Located outside the cell. This fluid accounts for about 20 % of our total body weight and 1/3 of all body fluid. Easier to lose this fluid than the other.
Type of extracellular fluid. 5% of total body weight. Liquid portion of the blood inside the vessels. When serum tests are ordered, they come from here.
Type of extracellular fluid. 14% of total body weight. Fluid that bathes the cells, located between cells, this also includes lymphatic fluid.
Type of extracellular fluid. 1% of total body weight. Found in synovial cavities and pericardial or pleural spaces.
Water is more prominent in lean muscle mass. _______ has very little water.
elderly and infants
Who is at risk for fluid imbalances?
When a person has lost too much body water they are said to be...
decreased organ perfusion
When more than 1/3 of the body's fluid is lost, life threatening things can happen such as...
What is fluid intake regulated by?
Urine, sweat, feces
What are the sensible fluid losses?
What are insensible losses?
How do we measure loss?
Abnormal fluid losses
Vomiting, burns, hemorrhage, wound drainage, heart problems, fever, increased room temps.
About what % of an infants weight is fluids?
Most of an infants fluids are what?
The solutes move from a crowded area to a less crowded area until the concentration is equal.
This is a compensatory mechanism. When the ICF space is either dehydrated or overhydrated, fluid will move from the area with less solutes to the area with more solutes.
The concentration of solutes in a L of solution. Used for describing fluids outside the body.
The concentration of solutes in a kg of water. Used for describing fluids inside the body.
Normal osmolality value:
The change in movement of water (osmotic pull) causes cells to shrink or swell.
Have no effect on the cell size. The fluid in the ICF and the ECF are equal. These fluids have about the same osmolality as the blood.
Think intracellular dehydration. The IV solution will rehydrate the cells and make them swell. Risk is that cells will burst.
Think intracellular over hydration. The IV solution will help move fluid from the intracellular spaces to the extracellular spaces and make them shrink. Cells might shrivel.
0.9% Normal Saline, Lactated ringers
0.45% normal saline (half strength saline), 0.22% NS (quater strength).
D5LR (Dextrose 5% and lactated ringers, 3% NS)
Capillary filtration pressure
Pushes water from the capillary into the interstitial space, can cause edema.
Interstitial hydrostatic pressure
Opposes the movement of water from the capillary.
Capillary colloidal osmotic pressure
Pulls water back into the capillary. Generated by plasma proteins that are too large to pass through the pores of the capillary. (since concentrations of proteins are so great in capillary it will pull water back in.)
Tissue colloidal osmotic pressure
Pulls water out of the capillary into the interstitial space. (reflects fact that some proteins escape.)
Increase in interstitial volume. Tissues can hold up to 10-30 L of fluid. Edema is evident when > 2-3 L of l fluid.
Increased capillary filtration pressure
Too much fluid which results in dependent edema.
Decreased capillary colloidal osmotic pressure
Decreased plasma proteins which result in both dependent and independent edema.
Increased capillary permeability
When skin integrity or pores are impaired as with burns inflammation etc.
Obstruction of the lymph flow
Cancer of the lymphatic system, Lymphademia.
Non visible edema
Impaired oxygen delivery, increased risk of tissue damage, and may compress blood vessels.
Occurs when the fluid moves into serous cavities (such as the pericardial sac or pleural cavity). THIRD SPACE ACCUMULATION.
Occurs when the fluid moves into the peritoneal cavity. THIRD SPACE ACCUMULATION
SNS, RAAS, diameter of blood vessel, amount of fluid in blood vessel, blood flow resistance
In order to move blood from the heart to the tissues, we need pressure and this pressure is dependent on:
Sympathetic nervous system
Branch of the autonomic nervous system that produces rapid physical arousal in response to perceived emergencies or threats. Activated by baroreceptors. Results in constriction of blood vessels and increased heart rate.
Rennin angiotensin aldosterone system
As blood flow to the kidney decreases, this is activated and through a sequence causes potent vasoconstriction and retention of sodium and water.
helps to create Angiotensin II which acts as a vasoconstrictor, elevating blood pressure
In response to a drop in overall blood pressure, _________ stimulates constriction of the glomerular inlet and even greater constriction of the outlet
"salt-retaining hormone" which promotes the retention of Na+ by the kidneys. na+ retention promotes water retention, which promotes a higher blood volume and pressure
Posterior pituitary stores this. Activated by increased osmolality and decreased ECF volume. Reabsorbs water from the kidneys.
Sense pressure changes in arteries and activates the SNS and ADH response.
If the atria of the heart receive too much blood flow, the body senses the stretch and will release ______. This will cause vasodilation of the blood vessels and excretion of the excess fluid by the kidneys.
Fluid deficit, decreased blood pressure and weight loss.
Fluid excess, increased blood pressure, weight gain.
Isotonic fluid deficit (hypovolemia) causes
Poor fluid intake, excess renal loss, excess GI loss, excess skin loss, third space accumulation.
Isotonic fluid deficit (hypovolemia) manifestations
Weight loss, increased serum osmolality, decreased ECF, compensatory mechanisms (thirst, SNS, RAAS, ADH), concentration of blood, skin alterations, hyperthermia, decreased urine output.
Isotonic fluid excess (hypervolemia) causes
medications and fluid retention, decreased elimination of sodium and water, excess intake.
Isotonic fluid excess (hypervolemia) manifestations
Decreased serum osmolality, increase in ECF, compensatory mechanism (ANP), S3 heart sound, dilution of blood, increased capillary filtration.
Greatly increased urination and dehydration due to high levels of glucose that cannot be reabsorbed into the blood from the kidney tubules, causing a loss of water into the urine.
Abnormally rapid heartbeat
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