The average infant has_______________of body weight in water
80%
Tell me three ways a health adult loses fluids
kidneys 60%, intestines 4%, skin 8% insensible loss 28%
Name the fluid compartments
intercellular extracellurlar-intravascular, interstitial, transcellular
The average older adult has ______ of body weight in water
40%
What percent of fluid is in the ICF?
2/3
T/f renal failure and long term steriod use may result in FVETrue False
True
T/F isotonic FVE is the result of excessive ECF?True False
TRUE
List 3 patients who are at risk for FVD resulting from a lack of intake
chemically or physically restrained dementia, depressed anorexia eating disorders elderly (decreased thirst center activation, inabliity to get up)
when does the nurse need to provide oral care?
as needed. May be a much as every hour for a fluid deficit patient
what does the nurse need to record as output?
NG suction, chest tubes, emesis, urine, hemovac, JP drain, wound vac
What does the nurse need to record as input?
PO-ice, popsicles, tube feeding, tube flushes, IV irrigations
T/F the hematocrit will be elevated with a fluid volume deficitTrue False
true
What are important factors about obtaining weights?
Same time, same scale, same attire
What is one of the most valuable pieces of assessment information concerning fluid volume?
Weight
The average adult has _____ of body weight in water
60%
Describe diffusion
free passage of solutes throughout a solvent making the solutes evenly distributed
an isotonic solution ______
has the same concentration of particles as plasma
Describe osmosis
water passes from an area of lesser solute concentration to an area of greater concentration
a hypertonic solution is a ______________
greater concentration of particles than to plasma
Describe the action of ADH
increases permeability of distal tubules of kidneys resulting in more water being reabsorbed and less urine output
How is the thirst mechanism activated?
Decreases in volume or increase in osmolality stimulate osmoreceptors in hypothalamus
Name 4 organs systems that play a role in fluid homeostasis
Kidneys, CV, lungs, adrenal glands, thyroid, parathyroid, GI, CNS
What does sodium do?
Regulates osmolality balances water volume in the body promotes transmission of nerve impulses to muscles and tissues helps with acid base balance
What assessment would you expect with fluid deficits
CV-thready pulse, tachy, hypotension, flat neck veins resp--tachypnea renal decreased urine output, increased sp.gravity neuro restless, head ache, lethargy, coma skin dry poor turgor, tenting, dry mucous membranes, Gi constipation, thirst, weight loss
T/f water facilitates metabolism and chemical functioningTrue False
true
list three nursing diagnosis for PT with fluid volume excess
what nursing assessment can the nurse expect to find in a FVE patient?
CV-tachy, NVD hypertension? Boudning pulse resp crackles, dyspnea, tachypnea neuro altered LOC, h/a visual disturbances, paresthesis skin pale, coll, pitting edema GU decrease sp gravity pale urine
what is colloid osmotic pressure?
opposes hydrostatic pressure. Holds the fluids in the vascular compartments to maintain vascular volume. Many time referred to as the pulling pressure. Proteins are need to maintain
what is hydrostatic pressure?
Pressure a fluid exerts in a closed system. many times referred to as the "pushing" pressure
Filtration is _____
the movement of fluids and solutes throught a membrane from higher to lower pressure
What is active transport?
Movement of substances in and out of cells that requires energy ie. sodium potassium pump
what are anions? what charge do they carry?
chloride, bicarbonate, phosphorus negative
What are the cations/ What charge do they carry?
Sodium, potassium, calcium, magnesium Positive
What are the goals in dehydration treatment?
Restore fluid volume replace electrolytes eliminate the cause
What is the action of aldosterone?
Promotes Na retention resulting in retained Na and water will increase the ECF volume and increase blood pressure
What is example of hypertonic fluid volume deficit?
Ketacidosis, diabetes insipidus, excessive perspiration
what people are prone to isotonic fluid volume deficit?
NVD Ng tube to suction, inability to access fluids, npo
List 3 cause of isontoic fluid volume deficit
increase GI output increase GU output decreased intake
T/f water facilitates metabolism and chemical functioningTrue False
true
Renin is secreted from _____
juxatoglomerular in the kidneys
What is hypertonic flud volume deficit?
Amount of fluids lost is greater than the amount of electrolyte loss
From where is ADH secreted?
Posterior pituitary
What role do proteins play in fluid balance?
proteins maintain colloid osmotic pressure
What are the 2 actions of ACE
allows conversion of angiotensin I to angiotensin II inactivates bradykinens
Renin stimulates
angiotensin I
What is needed to convert angiotensin I to angiotensin II?
angiotensin coverting enzyme ACE
what is meant by third spacing fluid shift?
shift of body fluids into the potential body spaces
Electrolytes are generally measured in _______?
milliequivalents
what are ions?
a substance than when dissolved in water carry an electric charge or current
what is hypovolemia?
decrease in ECF-portion of water to electrolytes is near normal
what is hypervolemia?
excessive retion of water and Na in the ECF
edema is -------
excessive ECF accumulates in the interstitial spaces
a hypotonic solution is_______--
lesser concentration of particles than that of plasma
why are electrolytes important?
regulate fluid balance assist with acid base balance facilitate enzyme reactions balance neuromuscular functioning
tell me three sources of fluids for the body
food 30% liquids 60% metabolism 10%
what percent of fluid is in the ECF?
1/3
