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Nursing exam 3 2


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what is a delicate balance of fluids maintained in the body?
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?
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.
What is the term for lower osmolality; solution would be like 1/2 normal saline
What term if for higher osmolality; solution would be like 3% NS? These shrink cells by pulling water out. The higher the dryer
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?
What is the solution that can dissolve a solute such a water?
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.
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
What is the term for perspiration loss; it cannot be measured?
Insensible loss
What output is through chyme, all but 100 ml is reabsorbed?
What loss runs the body, 500 ml through kidneys just to run the body?
Obligatory loss
What part of the brain controls thirst?
What are steroid is released by adrenals, causing body to retain sodium and water, causing generalized edema?
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.
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)
_____ fluid excess can be a result from repeated plain water enemas, NG irrigation, inappropriate prepared formula and existing disease states.
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)
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?
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.

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