Fundamentals: Chapter 28: Fluid, Electrolyte, and Acid-base Balance

60

12 yr old thru adults usually have a __ % water to body weight ratio.

fluid

A ___ imbalance can occur if too much or too little fluid is in any fluid compartment.

hypotonic

A ___ solution has a concentration of solute that is less than that of blood plasma

hypertonic

A ___ solution is where the effective concentration of solute is greater than that of the blood plasma

paresthesias

Abnormal sensations ranging from burning to tingling

3

African Americans' risk for kidney disease is almost __ times higher than that of whites.

4, moderate

An edema measurement of 2+ indicates edema that is ___ mm or ___.

6, deeper

An edema measurement of 3+ indicates edema that is __ mm or ___.

8, severe

An edema measurement of 4+ indicates edema that is ___mm or ___ edema.

base

Any substance that can decrease H⁺ in a solution is a ___.

acid

Any substance that can donate free H⁺ ions to a solution is called an ___.

62

Approximately ___ % of a toddler's weight is water.

chloride, bicarbonate, phosphate, sulfate

Biologically important anions are:

sodium, potassium, calcium, magnesium

Biologically important cations are:

phosphorus

Calcium usually has a reciprocal relationship with ___.

volume excess

ECF ___ ___ often occurs in persons with cardiac failure, renal failure, or liver disease.

sodium, chloride, water

ECF is a 0.9% solution of ___, ___, and ___.

inadequate intake, abnormal losses

ECF volume deficit can occur because of ___ ___, ___ ___, or both.

2.5, 3.0

Edema is not observable in most patients until ___ to ___ L of fluid has been retained.

high, water

If the sodium is ___, this means that there is not enough water to follow. If the sodium is ___, this means that there is too much water.

70, 80

Infants have a large percentage of total body weight as water: ___-___ %

equal

Intake and output should be approximately ___ for a 24-hour period.

K, Ca, Mg

Irregular heart rhythms are common with ___, ___, and ___.

heart failure

Neck vein distention occurs in ___ ___ because of fluid retention.

1000 mL

Normal fluid in food intake

200 mL

Normal fluid output through feces:

300 mL

Normal fluid output through insensible loss: respiration:

300-400 mL

Normal fluid output through insensible loss: skin:

100-200 mL

Normal fluid output through perspiration:

1500 mL

Normal fluid output through urine:

1300 mL

Normal oral fluid intake:

280, 300

Normal osmolality is ___ - ___ mOsm/kg and is measure with a venous blood sample

300 mL

Normal oxidation of food intake:

osmolality

Osmotic pressure depends on the solution's ___.

15, 30

Pitting edema occurs when an when an indentation remains int eh skin, often for ___ to ___ seconds after a finger presses into edematous tissue.

nausea, vomiting, diarrhea, severe diaphoresis

Risk factors for a fluid, electrolyte, or Acid-base imbalance include resent illnesses that included these symptoms:

ECF volume excess

Symptoms of ___ ___ ___ include increased blood pressure, bounding pulse, and fullness of neck veins.

water excess

Symptoms of ___ ___ includes lethargy, irritability, confusion, personality changes, seizures, coma, and eventually death if there is no treatment or treatment is ineffective.

kidneys

The ___ regulate magnesium levels by reabsorbing the ion when serum levels are low and excreting it when serum levels are high.

volume, concentration

The body monitors and controls two aspects of the body fluid balance: the ___ of fluid in the extracellular space; particularly vascular volume and the ___ of solutes of all body fluids; which influences the volume of ECF and ICF.

acid-base balance

The maintenance of H⁺ concentrations is called:

7.35, 7.45

The pH of blood is normally between ___ and ___.

sodium, chloride, bicarbonate

The primary extracellular fluid electrolytes are:

potassium, phosphate, sulfate

The primary intracellular electrolytes are:

vascular volume

The signs and symptoms of a decrease in ___ ___ include orthostatic or postural changes in pulse rate and blood pressure; weak rapid pulse; decreased urine output; and slow-filling peripheral veins.

interstitial volume

The signs and symptoms of decreased ___ ___ include dry mucous membranes and poor skin turgor.

volume deficit

Treatment for ECF ___ ___ includes either oral or IV replacement of sodium, chloride, and water in the same concentrations found in body fluid. Use oral rehydration fluids, salty liquids such as broth and tomato juice.

volume excess

Treatment for ECF ___ ___ includes restriction of sodium and saline intake and administration of diuretics; the underlying pathology is identified and treated.

deficit

Treatment of a water ___ involves giving water either orally or intravenously in the form of 5% dextrose in water.

excess

Treatment of water ___ typically involves free water restriction.

insulin, aldosterone

Two hormones exert major control over the extracellular concentration of potassium: ___ and ___.

milliequivalent

Unit used to give concentration of an electrolyte in solution; the ability of cations to combine with anions

kidneys, skin, GI tract, lungs

Water and electrolytes can be lost from the body in four ways:

water deficit

When a ___ deficit occurs fluid is pulled from the cells of the brain and causes confusion, agitation, convulsions, coma and even death may occur. Other symptoms may include: decreased urine output, urine concentration, thirst, and dry mucous membranes.

48

When evaluating trends in intake, output, and weight, consider at least the last ___ hours or longer for some chronic health problems. Look for a pattern.

compensation

With ___, the body either excretes or retains acids or bases to compensate for loses.

postural pulse

___ ___ and blood pressure reading are a useful assessment tool with all patients at risk for ECF volume depletion. increase in pulse of more than 20 bpm, drop of more than 15 mm Hg systolic or 10 mm Hg diastolic

hydrostatic pressure

___ ___ causes filtration of fluid from an area of higher pressure to an area of lower pressure.

filtration pressure

___ ___ is hydrostatic pressure minus osmotic pressure

active transport

___ ___ is the process by which ions and other molecules are moved across membranes from an area of lesser concentration to an area of greater concentration; energy is required to move ions against a concentration gradient.

parathyroid hormone, vitamin D, calcitonin

___ ___, ___ ___, and ____ regulate the calcium and phosphate balance.

buffers

___ allow acids or bases to be transported from where they are produced to where they are excreted without causing large swings in pH.

buffers

___ are substances that help to prevent large changes in pH by absorbing or releasing H⁺ions.

PTH

___ causes serum calcium levels to increase.

filtration

___ involves the transfer of water and dissolved substances through a permeable membrane from a region of high pressure to a region of low pressure.

Potassium

___ is essential for normal cardiac, neural, and muscle function and contractility of all muscles.

calcium

___ is important in cell-to-cell adhesion, wound healing, synaptic transmission in nervous tissue, membrane excitability, muscle contractility, and teeth and bone structure.

phosphorus

___ is important in energy metabolism, structure of bones and membranes, and synthesis of nucleic acids.

magnesium

___ is important in regulating neuromuscular function and cardiac activity.

sodium

___ is the most abundant cation in the ECF; water follows sodium

diffusion

___ is the movement of a solvent or solutes from an area of higher solvent or solute concentration to an area of lower solvent or solute concentration.

metabolic acidosis

___ occurs either when excess acid is ingested or created (diabetic ketoacidosis) or when the kidneys are unable to retain enough bicarbonate ions to buffer free hydrogen ions in the blood. pH lower than 7.35 and a plasma HCO₃⁻ concentration lower than 22mEq/L.

osmosis

___ refers to the movement of a fluid through a semipermeable membrane.

respiratory alkalosis

a high pH is acccompanied by a blood carbon dioxide concentration lower than 35 mm Hg.j; Hyperventilation

isotonic solution

a solution whose solute concentration is equal to the solute concentration inside a cell

no edema

an edema measurement of 0 indicates:

2, perceptible

an edema measurement of 1+ indicates edema that is ___mm or just ___.

hypophosphatemia

below-normal serum concentration of inorganic phosphorus

electrolytes

chemical compounds that partially separate in solution; these particles carry electrical charges and are known as ions.

hypokalemia

deficient level of potassium in the blood

respiratory acidosis

elevation of pCO2 as a result of ventilation depression; hypoventilation

hyperkalemia

excessive potassium in the blood

tonicity

fluid's effect on cell size

manifestations of fluid, electrolyte, or acid-base imbalances

imbalance of intake and output and body weight; changes in mental status; changes in vital signs; abnormal tissue hydration; abnormal muscle tone or sensation;

anions

negatively charged ions

metabolic alkalosis

occurs when there is excessive loss of body acids or with unusual intake of alkaline substances; can occure with an ECF deficit or K deficit; often caused by vomiting

cations

positively charged ions

alcoholism, diabetes mellitus, renal phosphate wasting

some causes of Hypophosphatemia

renal failure, cell damage, insulin deficiency, adrenal deficiency,

some causes of hyperkalemia

abnormal loss of K, inadequate replacement, increased movement into cells

some causes of hypokalemia

osmolarity

the concentration of dissolved substances in a given volume of fluid

osmotic pressure

the force of attraction for water by undissolved particles, helps to keep fluid within blood vessels, opposing net flow outward.

osmolality

the proportion of dissolved particles, in a given weight of fluid