Med Surge Ch 13

body conditions close to normal

control actions to prevent dangerous conditions in the body

• 55%-60% young adult
• 50%-55% older adult

fluid outside the cells; 1/3 (15 l) of total body water

fluid inside the cells; 2/3 (25 l) of total body water

fluid between cells, blood, lymph, bone, connective tissue water and transcellular fluids

includes cerebrospinal fluid, synovial fluid, peritoneal fluid, and pleural fluid

water portion of fluids

the particles dissolved or suspended in water (solvent)

solutes that have an electrical charge

filtration, diffusion, and osmosis. They determine how, when, and where fluids and particles move across the cell membrane

movement of fluid thru a cell or blood vessel membrane because of hydrostatic pressure differences on both sides of the memebrane

pressing of water molecules. "water-pushing" pressure. Is what pushes water outward from a confined space thru the membrane

thick as in blood is thicker than water

porous membrane 

when hydrostatic pressure is the same in both fluid spaces, no difference in hydrostatic pressure

hydrostatic pressure is not the same in both spaces

graded difference b/w two spaces... one has a high hydrostatic pressure whereas the other has a low

water moving thru a membrane with nothing stopping it

blood pressure

large spaces

• tissue swelling with fluid collection... can occur with right sided heart failure 
• *excess filtration of fluid from the capillaries into the interstitial tissue space occurs, forming visible edema

the free movement of particles (solute) across a permeable membrane from an area of higher concentration to an area of lower concentration (down a concentration gradient)

two fluid spaces have different amounts of the same type of particles

membrane that is not open (no pores) 

a form of diffusion across a cell membrane that requires the assistance of a membrane-altering system (for ex insulin)

• the movement of water only thru a selectively permeable (semipermeable) membrane 
• (usually water can always move thru a cell membrane)

the number of milliosmoles in a liter of solution

the number of milliosmoles in a kilogram of solution 

• when all body fluids have 300 MOSM/L PARTICLE CONCENTRATION THE BODY FUNCTIONS AT ITS BEST
• NORMAL RANGE IS 270-300 MOSM/L

• FLUID OSMOLARITIES ARE GREATER THAN 300 MOSM/L
• HAVE A GREATER OSMOTIC PRESSURE THAN ISOSMOTIC FLUIDS
• PULLS WATER FROM THE ISOSMOTIC FLUID SPACE INTO THE HYPEROSMOTIC FLUID SPACE UNTIL BALANCE OCCURS 

• FLUID OSMOLARITIES OF LESS THAN 270 MOSM/L
• HAVE A LOWER OSMOTIC PRESSURE THAN ISOSMOTIC FLUIDS
• WATER IS PULLED FROM THE HYPO-OSMOTIC FLUID SPACE INTO THE ISOSMOTIC FLUID SPACE

• HOW WELL A PARTICLE TYPE WILL DISSOLVE IN WATER
• THE MORE SOLUBILITY OF A PARTICLE THE HIGHER THE OSMOTIC PRESSURE 

cells sensitive to changes in ECF osmolarity

• Liquids: 1500 ml
• Solid Foods: 800 ml

minimum amount of urine per day needed to excrete toxic waste products is 400 to 600 ml

• Kidney's (most important and sensitive)
• skin
• lungs
• intestinal tract
• salivation
• drainage from fistulas and drains
• Gi suction

500-1000 ml/day

water and sodium

• blood volume (plasma volume) *most critical in preventing death (keeps blood pressure high enough to ensure perfusion and oxygenation of all organs and tissues)
• fluid inside the cells (intracellular fluid)

blood pressure, blood volume, blood oxygen levels, and blood osmolarity (r/t NA concentration)

not open to certain particles 

diffusion across a cell membrane that requires the assistance of a membrane-altering system (ex: insulin- helps glucose cross cell membrane)

movement of water only thru a selectively permeable (semipermeable) membrane

aldosterone

angiotensin 1

angiotensin-converting enzyme (ace) which turns angi 1 into angiotensin 2 

• increase blood volume and blood pressure
• By:
• 1.constriction of small arteries and veins
• 2.constricts the size of the arterioles that feed the kidney nephrons 
• 3.cause adrenal glands to secrete aldosterone (last and slower action)

• fluid intake or fluid retention is less than what is needed to meet the body's fluid needs
• condition rather than a disease

when water shifts from the plasma into the interstitial space

• water and electrolyte loss
• most common type of fluid loss problem 

blood volume is decreased (leads to inadequate tissue perfusion)

measure of blood pressure lying down, sitting, then standing

when more water is lost and other substances remain increasing osmolarity or concentration of the blood

pulse rate and quality and urine output

drug therapy used in patients with bacterial diarrhea to stop dehydration

drug therapy used when vomiting causes dehydration

drug therapy used to reduce a fever that may cause dehydration to worsen

• excess of body fluid
• not a disease; a clinical sign of a problem where fluid intake or retention is greater than the body's fluid needs 

most common fluid overload 

• excessive water in the vascular space causing decreased hemoglobin, hematocrit, and serum protein levels
• serum electrolyte values usually normal

• bounding pulse
• increasing neck vein distention
• presence of crackles in the lungs
• increasing peripheral edema
• reduced urine output

• drug therapy used for fluid overload as long as kidney failure is not the cause
• increase kidney water or sodium excretion 

fluid overload

substances in body fluids that carry an electrical charge

positively charged electrolytes

negatively charged electrolytes