Chapter 17 Fluid & Electrolyte Balance

For healthy people, water intake should ______ water output.

Approximately Equal

Extracellular fluid is located in _______ and _______.

Blood Vessels (plasma); Tissues (Interstitial Fluid)

Smaller amounts of water are also lost in _______ and _______.

Breathing; Feces

______ are substances that dissociate in water into ions, electrically charged particles that circulate in the body fluids and take part in the body's chemical reactions.

Electrolytes

Homeostasis is a state of dynamic _______; the body constantly adjusts to external and internal stimuli to maintain homeostasis.

Equilibrium, Balance

All the water found outside cells is called _______fluid.

Extracellular (ECF)

If Sweating increases, what must be done to compensate?

Drink More Fluids Drinks with electrolyte are better than plain water for heavy water loss.

(see 34) How does this affect the reabsorption of water by the kidneys? (increases or decreases)

Increases

When the body is dehydrated, the osmolarity of body fluids _______ (increases or decreases), because there is more dissolved material in proportion to water.

Increases

A secondary pathway of water loss is by way of the ______ system in the form of ________.

Integumentary (skin); Sweat

The water found within the cells is called_______ fluid is about _________ (fraction) of the total body water.

Intracellular (ICF); 2/3

_____ is an excess of water in the body.

Overhydration

ECF

Extracellular Fluid One of the two main compartments body fluids are divided into which is fluid outside the cells. Constitutes abotu 1/3 of the total body fluid in an adult.

True or False Oxygen is the main component of the pH system of the body.

False p stands for potential or power and H stands for Hydrogen

Fluids and other substances are transported into and out of cells ________ (without ATP energy) or _____ (with ATP energy).

Passively; Actively

With a decrease in blood volume, _____ is released by the kidneys.

RAA

Feedback

The relaying of information about a given condition to the appropriate organ or system.

The ability of a membrane to allow molecules to pass through is known as _____.

permeability

______ feedback occurs when the body reverses an original stimulus to regain physiological homeostasis.

Negative Feedback

The specialized cells in the hypothalamus that detect changes in the osmolarity of body fluids are called _____.

Osmoreceptors

The two processes by which WATER moves from one compartment to another with in the body are _____ and ______.

Osmosis & Filtration

What are the features of extracellular fluid (ECF)?

The body fluid outside the cell composed of blood plasma, interstitial fluid, lymph and transcellular fluid.

The nurse is caring for a group of elderly clients. a. What are the effects of aging on fluid and electrolyte balance that the nurse should be aware of?

a. As people age their thirst sensation decreases; therefore, older people may become dehydrated. Many medications also cause fluid loss. Chronic diseases, such as renal failure, heart failure, or COPD, contribute to alterations in fluid and electrolyte and acid-base balance.

Which of the following causes increased capillary pressure and results in edema? a. Neoplastic Disease b. Extensive Burns c. Liver Disease d. Arteriolar Dilatation

a. Neoplastic Disease (cancers) b. Extensive Burns (see box 17-1)

A nurse is monitoring a client who has elevated levels of extracellular fluid (ECF). Which of the following conditions should the nurse monitor? a. High Blood Pressure b. Vomiting c. Hypovolemic Shock d. Diarrhea

a. high blood pressure

The nurse is caring for a group of elderly clients. b. What are the nursing interventions for elderly clients who are at high risk of fluid and electrolyte imbalance?

b. Encourage intake of foods and fluids; regulate tempature control.

Intravascular fluid is the watery fluid of the blood known as _______.

blood plasma

When is ADH released from th eposterior pituitary gland?

in response to changes in blood osmolality.( If the blood gets thicker (higher osmolality), ADH is released to tell the body to hold water), (If the blood gets thinner (lower osmolality), ADH is suppressed)

Match each of these specialized fluids with its proper location: 1. Cerebrospinal Fluid 2. Aqueous Humor 3. Synovial Fluid 4. Serous Fluid A. Within the eyeball B. Between membranes such as the pleural membranes C. Around and within the CNS D. Within joint cavities

1. C 2. A 3. D 4. B

This fluid (ECF) may be given more specific names when found in specific locations. Name each of these fluids: 1. _________ in tissue spaces between cells 2. _________ in blood vessels 3. _________ in lymph vessels

1. Interstital Fluid 2. Intravascular Fluid (plasma) 3. lymph

Match the terms with definations: 1. Isotonic 2. Hypertonic 3. Hypotonic 4. Edema a. The excess accumulation of fluid in the interstitial spaces b. A solution that exerts equal pressure on opposite sides of a membrane. c. A solution that is stronger compared to that on the opposite side of a membrane. d. A solution that is weaker compared to that on the opposite side of a membrane.

1. b 2. c 3. d 4. a

Match the conditions in column A with their characteristics in column B: Column A: 1. Ascites 2. Anasarca 3. Diarrhea 4. Hemorrhage Column B: a. Causes frequent and watery bowel movements. b. Causes abnormal severe internal or external discharge of blood. c. Causes accumulation of serous fluid in the abdominal cavity. d. Causes accumulation of fluid in cellular tissues of the body.

1. c 2. d 3. a 4. b

Hypovolemic Shock

A significant loss of ECF volume can drop in blood pressure to a life-threatening point where cells can no longer function, due to a lack of oxygen and nutrients. This results in a condition known as Hypovolemic Shock.

The hormone _____ is produced by the hypothalamus and stored in the ____ pituitary gland.

ADH; Posterior "The hypothalamus is able to detect the increased blood concentration caused by the loss of water. To correct the situation, it uses the posterior pituitary to release anti-diuretic hormone (ADH) into the circulatory system. When ADH reaches the kidneys, it causes more water to be reabsorbed into the bloodstream, diluting the blood. When the hypothalamus detects the return to a normal blood concentration, it stops the release of ADH from the pituitary gland, and the kidneys return to normal functioning." http://education-portal.com/academy/lesson/what-is-the-pituitary-gland-functions-hormones-hypothalamus.html#lesson

If blood volume or BP increases, the heart will produce the hormone _____, which will _______ (increase or decrease) the excretion of sodium ions and water.

ANP; increase Atrial Natriuretic Peptide An additional mechanism involved in the regulation of Na+ levels involves the hormone atrial natriuretic peptide (ANP). This hormone is synthesized by cells in the atrium of the heart, and is released in response to distension of the atria, in other words, when plasma volume increases. The effect of ANP is to increase natriuresis, that is the excretion of Na+ in the urine. ANP increases natriuresis by increasing GFR and decreasing Na+ reabsorption. ANP works to oppose the effects of the renin-angiotensin-aldosterone system, preventing plasma overload by preventing excessive Na+ levels in the body. http://courses.washington.edu/conj/bess/sodium/sodium.htm

The hormone _____ is produced by the adrenal cortex and increases the reabsorption of sodium ions by the kidney tubules.

Aldosterone

CSF

Cerebral Spinal Fluid Found in brain & spinal cord.

The term osmolarity means ______________.

Concentration of dissolved material in a solution

If there is too much water in the body, the secretion of ADH will _____ (increase or decrease), and the urinary output will _____ (increase or decrease).

Decrease; Increase

As water is absorbed by the digestive tract, the osmolarity of the body fluid ______ (increases or decreases) toward normal.

Decreases

True or False Diffusion is the random movement of molecules from an area of lower concentration to an area of higher concentration.

False Diffusion, or the process of "being widely spread," is the random movement of molecules from an area of higher concentration to an area of lower concentration.

_______ is the relayng of information to and from organ systems (especially nervous and endocrine systems) and keeps the body's functioning capacity within normal boundries.

Feedback

ECF in the fluid that is most important in _______.

Fluid Balance

A person's intake and output must be balanced to avoid a ________ or a ________.

Fluid Deficit (dehydration); Fluid Excess (edema)

Intravascular Fluid

Fluid is the watery fluid in blood known as plasma.

A secondary source of water is the water in ______.

Foods

Interstitial Fluid

Found between cells

GI Tract

Gastrointestinal tract.

_____ is the dynamic process through which the body maintains balance by constantly adjusting to internal and external stimuli.

Homeostasis

_______ mechanisms involved in regulation of eCF include actions of the thirst center, ADH, RAA and ANP.

Homeostatic

Stronger (more concentrated) solutions are _______; weaker solutions are _______.

Hypertonic; Hypotonic

The part of the brain that regulates the water content of the body is the __________.

Hypothalmus

ICF

Intracellular Fluid One of the two main compartments body fluids are divided into, which is fluid inside the cells. Constitutes about 1/2 to 2/3 of the total body fluid in an adult.

What are the two main compartments of body fluid?

Intracellular Fluid (ICF) & Extracellular Fluid (ECF)

The body has two main fluid compartments: _________ (within the cells) and _______.

Intracellular; Extracellular

The process of _____ involves the dissociation of compounds into their respective ions.

Ionization

Normal saline (0.9% NaCl) is an _______ solution.

Isotonic

State two types of situations that stimulate secretion of aldosterone.

Low Blood Pressure Low Salt

A small amount of water is produced within the body as a product of the process of ________.

Metabolism or cell respiration

What causes renin to be released by the kidneys?

Renin is secreted when sensing cells in the DCT (called the macula densa) sense changes in blood volume and pressure. The macula densa lies next to the renin-producing cells. Renin is produced when the macula densa cells sense that blood volume, blood pressure, or blood sodium levels is low. Renin then converts renin substrate (angiotensinogen) into angiotensin I.

A _____ is the substance dissovled in a solvent.

Solute

Water acts as a _______ and _____ agent. It helps regulate body temperature, pH, and fluid pressures inside and outside a cell. It assists and participates in chemical reactions.

Solvent; Suspension

Transcellular Fluids

Specialized ECFs, are usually within epithelial-lined spaces; these include synovial fluid in joint cavities, CSF, & Aqueous (ocular) fluid in the eyes.

A nurse is caring for a client with severe dehydration. What are some of the causes of dehydration that the nurse should educate the client about?

Sweating too much, for example, from exercising in hot weather Fever Vomiting or diarrhea Urinating too much (uncontrolled diabetes or some medications, like diuretics, can cause you to urinate a lot)

In a state of dehydration, a person experiences the sensation of ________ and will _______.

Thirst; Drink

True or False A salt is created when the negative ions of a base replace the positive oxygen ions of an acid.

True

True or False An atom that has gained or lost one or more electrons is called an ion.

True

True or False Electrolytes are substances that dissociate in water into ions.

True

True or False: A positively charged ion is known as a cation.

True

True or False A vesicle transports large molecules or whole cells across the plasama membrane.

True see page 167

The major pathway of water loss from the body is by the way of the ______ system in the form of ______.

Urinary; Urine

If Fluid intake is excessive, however; ______ will increase to return the body's water content to normal.

Urine Output "In edema, the body attempts to restore homeostasis by increased secretion of natriuretic ("salt-losing") peptides, decreased ADH, increased urine output, & reduced thirst."

The function of ADH is to _______ by the kidneys.

d. increase the reabsorption of water

(see 32) In this situation is ADH effects will cause urinary output to _________.

decrease

In what type of situation os ADH secreted?

dehydration increased plasma osmolarity in plasma

The body's major source of water is ________.

drinking fluids

The body has buffer systems that help to maintain the _____ in the narrow range between approximately 7.35 and 7.45. Acids and bases are important components of this system.

serum pH