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3 facts about Body Fluid:
- Water is the primary body fluid
- Varies between: Age, sex, adipose tissue
- Contains solutes: electrolytes and nonelectrolytes.
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Extracellular fluids consists of:
- Interstitial
- Intravascular
- Transcellular
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Movement of fluids and electrolytes: (name 4)
- Osmosis
- diffusion
- Filtration
- active transport
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Fluid intake is composed of?
IOM recommendation.
% from food?
Regulation
- drinking fluids.
- 2700 mL/day
- 20% from food
- Fluid intake is regulated by thirst: changes in plasma osmolality and hypothalamus.
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Fluid output for urine, skin, lungs, feces.
- Urine:1500 mL/day
- Skin and lungs: Perspiration
- Feces: 100-200 mL/day
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Hormonal regulation (name 4)
- Antidiuretic hormone (ADH)
- Renin-angiotensin system
- Aldosterone
- Thyroid hormone; atrial natriuretic factor
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Fluid volume deficits include:
- Hypovolemia
- Dehydration: dry skin, mucous membranes, nonelastic skin turgor, decreased urine output and blood pressure; rise in temperature
- weight loss
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Fluid volume excess include:
- Hyerpvolemia
- Overhydration: elevated blood pressure, bounding pulse, pale, cool skin, edema/ascites, crackles
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As a major electrolyte, Sodium..
- is a extracellular fluid that regulates fluid volume
- kidney reabsorbs
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As a major electrolyte, Potassium:
- is an intracellular fluid that regulates muscle contraction
- kidneys eliminate.
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Calcium regulation and insufficiencies
- Bone health, neuromuscular function, cardiac function
- Insufficiency leads to osteoporosis
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Magnesium regulations and what can cause low levels?
- ICF; bone
- Alcoholism leads to low levels
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Where is chloride found?
ECF; bound to other ions
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What is Phosphate, who is it bound to, and where is it found?
- ICF anion
- bound with calcium in teeth and bones; inverse relationship
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Bicarbonate regulation, purpose, and location
- regulated by kidneys
- Produced by body to act as buffer
- ICF and ECF
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Acid-Base Balance: Define acid and base. What does acid base balance do?
What is the acceptable range and how is it measured?
- Acid: compound that contains hydrogen ions
- Base: compounds that accept hydrogen ions
- Acid-base balance amounts in solution reflected by pH
- Acceptable range for serum is 7.35-7.45 pH
- Measured by arterial blood gases.
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Acid-Base regulation has 3 types:
- Buffer systems
- respiratory mechanisms
- renal mechanisms
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Acid base imbalance: Define acidosis.
- Serum pH below 7.35
- Respiratory cause: retention of CO2
- Metabolic cause: alteration in bicarbonate.
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Alkalosis
- Serum pH above 7.45
- Respiratory cause: blowing off CO2
- Metabolic cause: alteration in bicarbonate.
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A nursing assessment of fluid, electrolyte and acid-base imbalance include:
- Head-to-toe physical assessment
- vital signs : temp, pulse, respiration, blood pressure
- daily weight
- fluid intake/output
- laboratory studies
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Nursing interventions for fluid, electrolyte, and acid-base imbalances include:
- dietary teaching
- oral electrolyte supplements
- limiting or facilitation oral fluid intake
- parenteral replacement of fluids and/or electrolytes
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