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Is the body composed of more intracellular or extracellular fluid?
- Intracellular (42% of body weight)
- Extracellular (17% of body weight)
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What is interstitial fluid?
Contains lymph; Fluid between cells and outside blood vessels
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What is intravascular fluid?
plasma in vascular system
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What is Transcellular fluid?
Seperated from other fluids by barrier; consists of cerebrospinal, pleural, GI, intraocular, peritoneal, and synovial fluids
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Osmosis
The movement of a pure solvent (water) from area of less concentration to greater; attempts to equal the concentration
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Diffusion
The random movement of Solute in a solution from a high concentration to a low concentration; attempts to even the distribution of solute.
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Filtration
The process by which water and diffusible substances move together in response to fluid pressure
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Active transport
requires metabolic activity and the expenditure of energy to move materials across cell membranes
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The thirst mechanism regulates _______ and is located in the ______
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Hypovolemia can be caused by
- hemmorhage
- excessive vomiting
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What are the 4 organs of water loss
skin, lungs, kidneys, GI tract
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What is the difference between sensible and insensible water loss?
- Insensible is continuous and occurs through the skin and lungs. It is not perceived. can increase significantly on pt with fever or burns
- Sensible occurs through excess perspiration and is percieved
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What are the 2 basic types of fluid imbalance?
- Isotonic: lose gain water and electrolytes in equal parts
- Osmotic: water is changing. Concentration of electrolytes is not changing
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What is the most abundant cation
sodium about 90% in ECF
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What are the sodium levels regulated by?
dietary intake and adosterone secretion
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Sodium ions are responsible for
maintaining water balance through their effect on serum osmolality, nerve impulse transmission, regulation of acid-base balance, and participation in cellular chemical reactions
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Normal Sodium Range
135-145 meq/L
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For a patient with hyponatremia you would
increase dietary intake, decrease fluid intake, give salt tablets.
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For a pt with hypernatremia
Monitor I &O, increase fluid intake, and beware of frozen and canned foods
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Potassium regulates
- many metabolic activities
- necessary for glycogen deposits in the liver and skeletal muscle
- transmission and conduction of nerve impulses
- normal cardiac conduction
- skeletal and smooth muscle contraction
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Potassium Levels are regulated by
dietary intake and renal excretion
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A normal Potassium Level is
3.5 to 5 meq/L
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Normal serum ionized calcium is _______. Normal total calcium is ____
- Normal serum ionized calcium is 4 to 5 mEq/L.
- Normal total calcium is 8.5 to 10.5 mg/100ml.
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Calcium is necessary for.....
- bone and teeth formation
- blood clotting
- hormone secretion
- cell membrane integrity
- cardiac conduction
- transmission of nerve impulses
- muscle contraction.
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Magnesium is necessary for....
- enzyme activities
- neurochemical activities
- and cardiac and skeletal muscle excitability
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Normal plasma Mg range is
1.5- 2.5 meq/L
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Magnesium is regulated by
Dietary intake, renal mechanisms, and actions of the parathyroid hormone
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What are the three major anions of body fluids?
- chloride
- bicarbonate
- phosphate
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Calcium and Phosphate are _______ proportional
inversely
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What is the largest chemical buffer in ECF
carbonic acid and bicarbonate buffer system
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The lungs primarily control the excretion of ________ resulting from metabolism. The kidneys control excretion of _______ and_______.
- Carbon dioxide
- Hydrogen and Bicarbonate ions
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What is the biological buffering system?
- when H ions are absorbed or released by cells.
- occurs after chemical buffering
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The Kidneys _______ HCO3 in cases of acid exces
reabsorb
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What could cause Hypokalemia?
- Vomiting, gastric suctioning, poor intake, diuretic, and alcoholism
- **Severe Hypokalemia affects cardiac conduction and function
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What could cause Hyperkalemia?
- renal failure
- hypoaldosteronism
- ***Causes marked cardiac conduction abnormalities
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What kind of treatment could be given for a pt with Hyperkalemia?
- Kayexalate enema: draws K out of cells and into bowels
- K wasting diurretic:
- Monitor Cardiac Activity:
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Hypocalcemia is caused by
abnormalities in thyroid and parathyroid gland
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A patient with hypocalcemia will have what kind of symptoms.
- circumoralparathesias: numbness/tingling around mouth and fingers
- A positive trousseau sign: tremors in the arm when bp cuff is inflated
- a positive chvostek: tap on pts facial nerve and they get a twitch
- decrease in CO, cramps, tremors, and dysarrythmias
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What kind of pt usually gets Hypercalcemia?
The immobile, lethargic pt because calcium is excessivly reabsorbed and and released.
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For a pt with hypercalcemia, how would you treat them?
- Oral phosphate tablets (they work in opposite)
- water to dilute pt
- acid ash diet (cran and prunes= doesn't let calcium clump)
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What can cause a Hypomagnesemia?
- Malnutrition
- alcoholism
- diarrhea
- vomiting
- fistula (abnormal tubelike passage to another cavity)
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What are some signs of Hypomagnesemia?
- neuromuscular irritablility with tremors
- tachycardia
- vertigo
- elevated bp
- confusion
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What can cause Hypermagnesemia?
- excessive epsom salt intake
- renal failure
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What are some signs of hypermagnesemia?
- vasodialation
- nausea and vomiting
- muscle weakness
- low BP
- slow HR
- respiratory depression and coma
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What is the normal chloride level?
95-108 mEq/L
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Hypochloremia can be caused by
- thiazide diuretics
- vomiting
- loss of HCL acid
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Hyperchloremia can be caused by...
- a decrease in bicarbonate
- an increase in sodium
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The normal serum phosphate level is
2.5-4.5 mg/mL
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How is phosphate regulated?
- dietary intake
- renal excretion
- intestinal absorption
- PTH
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Arterial blood gas measures
pH of blood
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The normal paCO2 is
35-45 mmHg
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The normal paO2 is
80-100 mmHG
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What are the signs of Respiratory Acidosis
- Hypoventilation
- increased RR
- confusion
- warm flush skin
- **seen in pt with COPD and sedation
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Respiratory Alkalosis symptoms are
- hyperventilation
- circumoralparethisa
- change in HR
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Metabolic Acidosis is caused by
- severe diarrhea
- renal disease
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Metabolic alkalosis is caused by
- overuse of antacids
- gastric suctioning
- vomiting
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A hypotonic solution is _____ and moves fluids ____ cells.
- .45% NS
- into cells= enlargemnt
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Isotonic solution is _____ and does what?
.9% NS and expands body's fluid volume.
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A hypertonic solution does what?
Pulls fluid out of cells
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