homeostasis and hydration

electrolytes

more essential for body to function

two solutes water contains

electrolytes and nonelectrolytes

body fluid compartments

intracellular and extracellular

extracellular body compartments

interstitial, intravascular, transcellular

interstitial

lies spaces between body cells

intravascular

plasma within the blood

transcellular

specialized fluids (cerebral spinal fluid)

third body compartment

where 3rd spacing happens; fluid has escaped to this compartment

what happens if fluid has escaped to third body compartment

swelling and edema

movements of fluids and electrolytes

osmosis, diffusion, filtration, active transport

osmosis

movement of water from less concentration to more concentration

diffusion

passive process of moving molecules from an area of higher concentration to area of lower concentration

filtration

movement of both water and smaller particles from area of high to low concentration; also filters blood

active transport

bigger molecules (electrolytes) move from area of low to high concentration, produces atp (source of energy)

fluid intake recommendation for women

2700 ml/ day

fluid intake recommendation for men

3700 ml/ day

why do men have more fluid intake

because men have more muscle and water content

where does 20% of your fluid intake come from

food/ metabolism of food

fluid intake is regulated by what

thirst

thirst is regulated by

the hypothalamus

what is the amount of fluid output a day

1500ml a day

what is adequate range of urine output an hour

25-30 ml

what is the recommended range per hour for urine output

50-60ml

UOP

urine output

ways you can output urine

perspiration, exhaling, feces

range of feces output

100-200 ml/day

range of sweating output

300-600ml/ day

lungs/exhalation output

300 ml per day

hormonal regulation

-Antidiuretic hormone (ADH)

-Renin-Angiotensin aldostrone System

-Thyroid hormone

-Brain natriuretic peptide

antidiuretic hormone

hold on to fluid

what holds on to ADH

the kidneys

too much ADH

swollen and edema

too little ADH

dehydrated

renin-angiotensin-aldosterone system

regulation of fluid, renin, angiotensin (1 and2)

what is responsible for converting angiotensin 1 to 2

renin

releasee of angiotensin 2

-tells kidneys to hold on to more water and sodium

- produces aldosterone

wherever water goes

sodium flows

aldosterone (RASS)

tells kidneys to reabsorb sodium but release potassium

RASS can have an effect on what

blood pressure

thyroid hormone

affects fluid volume by influencing cardiac output (pumping more blood so more urine excretes)

BNP

brain natriuretic peptide

BNP releases

sodium through the urine

what is BNP a sign of

Heart failure

PT with kidney failure wont be able to absorb

sodium or excrete potassium

normal sodium range

135-145

what type of fluid is sodium

extracellular and a cation (positive charge)

what reabsorbs sodium

kidneys

really high sodium or really low sodium can affect

brain function

hypo- hyper natremia

low or high sodium

whatever sodium does

chloride does

normal range for potassium

3.5- 5

what type of electrolyte is potassium

intracellular, and involves the movement of muscle and cardiac contraction

what do you never do with potassium

push it through a iv

what does kidneys do to potassium

eliminates

hypo or hyper kalemia

low or high potassium

calcium normal range

8.5- 10.5

what does calcium do

bone health and nerve conduction

where is 99% of calcium found

bones and teeth

insufficiency of calcium leads to

osteoporosis

hypo or hyper calcemia

low or high calcium

normal range for magnesium

1.7- 2.2

magnesium is

intracellular- bones, and helps with cell functions

what mainly leads to low levels of magnesium

alcoholism

hypo or hyper magnesmia

low or high magnesium

normal range for phosphurus

2.5- 4.5

what type of electrolyte is phosphurus

intracellular and a anion

if your phosphate is high, what is low?

calcium

hypo or hyper phosphatemia

low or high phosphurus

biocarbonate

icf and ecf, acid base balance

What is bicarbonate regulated by

kidneys

bicarbonate acts as

buffer to neutralize acids in the body

acids

contains hydrogen h+

basde

compound that accepts hydrogen

amounts of acid and base give us

PH

ph can be

acidotic or alkalotic

if your ph is alkalotic you

need more hydrogen

if your ph is acidotic

you have too much hydrogen

normal ph

7.35-7.45

acidotic pH

is under 7.35

alkalotic ph

is over 7.45

how is ph measured

ABGs

acid base regulations

buffer systems

respiratory mechanisms lungs

renal mechanisms kidneys

deficit fluid volume

hypovolemia

what does hypovolemia lead to

dry skin, dry mucous membranes

skin turgor

decreased urine, blood pressure

increased heart rate, and temperature

Fluid Volume Excess

hypervolemia

signs of hypervolemia

elevated blood pressure, bounding pulse

pale, cool skin

edema, ascites

crackles

s3 sound of heart is indication of

fluid overload

On the assessment of a patient with acute renal failure, the nurse finds the following: distended neck veins, cool and pale skin, and crackles in the lungs. The nurse should suspect the patient is experiencing

hypervolemia

isotonic

equal balance

hypotonic

less stuff

hypertonic

more stuff