Nursing exam 3 2
Terms
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- what is a delicate balance of fluids maintained in the body?
- homeostasis
- What fluid is located within cells? This is the most stable fluid.
- Intracellular fluid (ICF)
- What fluid is located outside the cells; such as intravascular fluid (plasma), interstitial fluid (surrounds cells), and transcellular fluid (lymph fluids, cerebrospinal fluid, percardial, etc? IV'S can change this
- Extracellular fluid (ECF)
- What three ways does movement of fluid and ions occur?
- Osmosis, filtration, and active transport.
- What is movement through a semipermeable membrance from lower to higher concentration?
- Osmosis
- What two terms refer to concentration of a solution?
- Osmolality and osmolarity
- What is the pulling power of a solution for water, it forces the solution through the membrane?
- Osmotic (Oncotic) Pressure
- What is the term for the same osmolality as normal plasma; example solutions are NS and LR.
- Isotonic
- What is the term for lower osmolality; solution would be like 1/2 normal saline
- hypotonic
- What term if for higher osmolality; solution would be like 3% NS? These shrink cells by pulling water out. The higher the dryer
- hypertonic
- What is the substance dissolved in liquid; such as crystalloids-salts that dissolve readily; Colloids- substances that do not dissolve readily; and electrolytes- glucose, oxygen, proteins?
- Solute
- What is the solution that can dissolve a solute such a water?
- solvent
- What is the process where fluids and solutes move together across a membrane from one compartment to another. Movement is from higher pressure to lower pressure.
- Filtration
- What is movement from less concentration to more concentrated; takes metabolic energy; combines with a carrier to cross the cell membrane; example would be sodium-potassium pump?
- Active Transport
- What are the four routes of output?
- Urine, insensible loss, feces, and obligatory losses.
- What is the major fluid output? 30 cc/hr; 1400-1500 cc/24 hours
- Urine
- What is the term for perspiration loss; it cannot be measured?
- Insensible loss
- What output is through chyme, all but 100 ml is reabsorbed?
- Feces
- What loss runs the body, 500 ml through kidneys just to run the body?
- Obligatory loss
- What part of the brain controls thirst?
- hypothalamus
- What are steroid is released by adrenals, causing body to retain sodium and water, causing generalized edema?
- Glucocorticoids
- This is released to regulate water excretion from the kidney with the goal to conserve water?
- Antidiuretic hormone
- This is released from the heart; it is sodium wasting and sends sodium out to decrease ECF fluid?
- Atrial Natriuretic factor
- This system releases aldosterone and promotes sodium and water retention.
- Renin-angiotensin-aldosterone system
- These are an example of _____ fluid loss: hemorrhage, GI losses, Burns, diuretics, Third space shifting. Must give NS to bring to homeostasis.
- Isotonic
- Hypertonic fluid loss would result in what?
- Third spacing- ascites
- What is the term for edema in the peripherals?
- third spacing
- These lab finding would be associated with what? Normal or high hematocrit; BUN: normal or high; high urine specific gravity (>1.030)dark and concentrated; if hypertonic dehydration- elevated serum osmolality, elevated serum sodium (N 135-145), elevat
- Fluid volume deficit
- Medications used to helps with fluid volume deficit: Antiemetics- phenergen; antidiarrheals-imodium (not give if bacterial); ADH (vasopressin) if diabetes insipidus; antipyretics- tylenol and motrin
- No answer
- ____ fluid excess could be from: renal failure, cardiac failure, high cortisol levels (puffy look), high aldosterone levels(caused by liver damage)
- Isotonic
- _____ fluid excess can be a result from repeated plain water enemas, NG irrigation, inappropriate prepared formula and existing disease states.
- hypotonic
- Risk factors for Fluid volume excess: extremes in age, acute or chronic illness- cardiovascular disease, renal disease, surgery, and IV therapy. and can be from long term glucocorticoid therapy.
- No answer
- Things found on the FHP related to Fluid volume excess: edema, JVD, bulging fontanel, resp. distress (tachypnea), flaring nostrils, intercostal retractions, S3 gallop, distended abdomen and full veings.
- No answer
- lab finding related to Fluid volume _____. Hemodilution- HCT decreased, Bun decreased, Serum osmolality is low, Serum sodium is low. Chest x-ray may show pneumonia and arterial blood gases show hypoxemia (low oxygen)
- Excess
- What two diet restriction would there be for someone in fluid volume overload?
- sodium and protein restricted diets
- What medication is commonly used for someone in fluid volume overload?
- Lasix
- What would you assess for neurological changes in someone with fluid volume overload?
- Becaue cells in the brain are swollen
- One is one consideration whe giving Lasix?
- Must watch potassium levels, the drug may need to be switched to a potassium sparing drug.