fluid and electrolyte & acid-base homeostasis and imbalances

  1. intracellular fluid? extracellular fluid? types?
    • Intra:   inside the cell
    • Extra: intravascular and interstitial.
    • Intravascular (plasma): its what in the vesicles.
    • Interstitial: fluid that is around the cell.
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  2. What is fluid volume deficit? etiology? CM?
    • Caused by removal of sodium-containing fluid from the body (decrease in salt and water- bc H2O goes where sodium goes)
    • There is a decrease vascular volume, and interstitial volume. However, the is normal osmolality (concentration) .
    • Etiologies: vomiting, diarrhea or gastric suction, polyuria, scessive sweating, decrease intake, ascites (third space).
    • CM: sudden weight loss, and many other in adults. In infants: Fontanels may be sunken, neck veins are not reliably assessed in infants.
  3. What is fluid Volume Excess? Etiologies? CM?
    • amt of extracellular fluid is abnormally increased. Increased in the vascular and interstitial volume.
    • Etiology: Renal dailure, CHF, Cirrhosis, dietary sodium.
    • CM: gain weight, decreased BUN, HCT, in infants= bulging fontanel, neck vein sticks out.
  4. Hyponatremia? etiologies? CM?
    • A serum sodium concentration below the lower limit of normal (sodium is more in the extracellular fluid)
    • It is the most common electrolyte abnormally.
    • The cell swells-up.
    • Etiology: 2 primary reasons.
    • A gain of relative more water than salt (due to the use of diuretics)
    • a loss of relatively more salt tahn water (loos of GI fluids -- vomiting, diarrhea, etc -- or GI suctioning)
    • CM: mild CNS dysfuctions (malaise, nausea, vomiting, headache, etc) or severe CNS dysfunctions (confusion, lethargy, seizures when drop is fast, etc)
  5. hypernatremia? Etiology? CM?
    • Serum sodium concentration above upper limit of normal. there is more sodium than water in the extracellular space causing the cell to shrink.
    • etiologies: dehydration, watery diarrhea (colitis), heat stroke, diabetes insipidus (a prob w ADH)
    • CM: Mild (thirst, oliguria (decrease in urine output), confusion, lethargy, dry sticky membranes.
    • Severe (disorientation, seizures, coma, death)
  6. What is clinical dehydration? Etiologies? CM?
    • It is the combination of 2 fluid disorders: usually extracellular volume deficit, and hypernatremia.
    • Etiologies: Vomiting, diarrhea, gain of more salt than water (ppl w renal disease), Loss of more water than salt).
    • CM: Common symptoms of dehydration, plus hypovolemis shick (dehydration trauma, could cause death-- associated w hemorrhaging.
  7. What is edema?
    • It is the excess fluid in interstitial compartments.
    • Could also be caused by blockage of the lymphatic drainage.
    • Decreased capillary osmotic pressure: plasma proteins decreased; extensive edema.
    • increased in fluid osmotic pressure: inflammation causes proteins to leak out from vascular permeability/
  8. What is potassium's functions?
    • It is the major intracellular electrolyte, cation.
    • It is essential for transmission and conduction of nerve impulses, normal cardiac rhythms, and skeletal and smooth muscle contraction.
    • Pts w potassium issues are usually hospitalized bc of 2 reasons: K is usually intake by mouth, and they need to be monitor for dysrhythmias.
  9. Hypokalemia? etiologies? CM?
    • Decreased k ion concentration in extracellular fluid.
    • Etiology: Decreased intake, GI loss (vomiting/diarrhea)
    • Renal losses, Diuretics.
    • CM: Paralytic ileus (decrease paralisis), dysrhythmias, bilateral muscle weakness (pts who are falling all of the sudden).
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fluid and electrolyte & acid-base homeostasis and imbalances