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