Pathophysiology Chapter 7 Fluid and Fluid Imbalances
In conditions of fluid volume deficit, which of the following would you expect to be elevated? Select all that apply. antidiuretic hormone renin plasma osmolarity natriuretic peptide risk for edema
ADH Renin Plasma Osmolarity
Increases sodium and water retention by the kidneys
ALDOSTERONE Aldosterone is released by the adrenal glands, and the target for aldosterone is the kidneys. Aldosterone stimulates sodium and water reabsorption by the kidneys, increasing fluid volume.
Because of poor preparation and planning, two individuals are transported to the emergency department with severe dehydration following a hike in a mountainous desert area. Which of the following do you expect to be elevated in these individuals? Body weight Antidiuretic hormone levels Blood pressure Natriuretic peptide Parasympathetic activation
Antidiuretic hormone levels
Diminished water volume in intracellular fluid and extracellular fluid
DEHYDRATION Loss of fluid volume from the intracellular and extracellular compartments is known as dehydration. Cell shrinkage, tachycardia, and hypotension may accompany dehydration.
Type of edema in the lower extremities
DEPENDENT Dependent edema is fluid accumulation underneath the skin. Most commonly, dependent edema develops in the lower extremities when a person is standing due to hydrostatic pressure in the capillaries.
Which of the following responses would you expect to see when fluid volume is too low? Select all that apply. Decreased antidiuretic hormone levels Increased renin release Increased natriuretic levels Increased aldosterone Decreased plasma concentration
Decreased antidiuretic hormone levels Decreased plasma concentration
Which of the following increase the likelihood for edema? Select all that apply. Increased capillary permeability Decreased hydrostatic pressure Decreased oncotic pressure Hypoalbuminemia Decreased plasma volume
Decreased oncotic pressure Decreased hydrostatic pressure
Characterized by excess fluid in interstitial and intracellular fluid compartments
EDEMA Edema is fluid accumulation, most commonly in the interstitial space between cells. Edema may be due to increased fluid loss by the vascular system or lymph blockage preventing removal of fluid from the interstitial space.
Type of IV given to reduce cellular swelling (Mannitol IV solution is an example)
HYPERTONIC Tonicity refers to the concentration difference across a semi-permeable membrane. A hypertonic solution is more concentrated than blood, thus hypertonic solutions pull water from the cells, reducing cell swelling.
Standard IV solution used as a blood volume expander (0.9% NaCl is commonly used)
ISOTONIC Tonicity is the difference in particle concentration across a membrane. An isotonic IV solution has the same concentration as intracellular fluid. With isotonic IV solutions, cells do not gain or lose fluid, but use of this IV solution adds to the total fluid volume of the body.
Excreted in response to fluid volume overload
NATRIURETIC PEPTIDES Natriuretic peptides are hormonal signals released by the brain and heart in response to excess fluid in the body. These signals increase urine output and reduce fluid volume.
Which hormone is released when a fluid volume excess is present? Select all that apply. Natriuretic peptide Anti-diuretic hormone Renin Aldosterone Cortisol
Natriuretic peptide
Pressure that is due to albumin in the bloodstream
ONCOTIC Oncotic pressure is a form of osmotic pressure exerted by proteins. In the blood, albumin is the most common plasma protein and is, therefore, a primary determinant of oncotic pressure.
The pressure exerted by solutes in solution
OSMOTIC Osmotic pressure is defined as the pressure exerted by solutes in solution.
Occurs when application of pressure over a bony area leaves an indentation
PITTING EDEMA When fluid accumulates under the skin due to edema and pressure is applied to this area, a "pit" or indentation may remain for a few moments after the pressure is removed. The formation of this indentation is known as "pitting edema" and is due to displacement of the fluids by the pressure applied.
The main intracellular cation
POTASSIUM Due the action of the sodium-potassium ATP pump, which transports potassium into the cell, the main intracellular cation is potassium.
The main determinant of plasma osmolarity
SODIUM Sodium is the most abundant ion in the extracellular fluid. Therefore, the concentration of sodium is the primary determinant of plasma concentration.
Fluid sequestration in the body cavities
THIRD SPACE ACCUMULATION Third space accumulation results from loss of fluid from the vascular space that becomes trapped in body compartments, such as the peritoneum.
A client has fluid volume excess and has gained 2 kg of weight. Which are the symptoms the client might exhibit due to fluid volume excess? Select all that apply. Hypotension Third space accumulation Edema Thirst Elevated heart rate
Third space accumulation Edema
Which of the following statements is correct? Water in the body can only move from intracellular fluid (ICF) to extracellular fluid (ECF), not ECF to ICF. Water is repelled by albumin. Water is attracted to sodium. Water cannot cross the plasma membrane. Water movement is unaffected by solute concentration.
Water is attracted to sodium.
Which of the following exerts oncotic pressure? Select all that apply. Sodium Potassium Glucose Albumin Cortisol
albumin Sodium Potassium
An isotonic IV solution ______________________. Select all that apply. has a higher solute concentration than the blood. has the same solute concentration as the blood. causes cell swelling. is used to counteract cellular swelling. causes no fluid gain or loss by cells.
has the same solute concentration as the blood. causes no fluid gain or loss by cells.
A young male arrives at the emergency department having suffered a severe traumatic brain injury. To reduce swelling of the brain's cells, a __________________ IV solution is administered. hypotonic isotonic hypertonic
hypertonic