Fluid, Electrolyte, and Acid-Base Balance Lecture Review

Flashcards covering laboratory values, fluid and electrolyte physiology, acid-base regulation, cardiovascular conditions (HTN, PVD, DVT, PE), and nursing professional standards/safety based on the provided lecture transcript.

Basal Metabolic Panel (BMP)

A set of laboratory tests that measure various chemicals in the blood, including electrolytes, glucose, BUN, and creatinine.

Normal Sodium (Na+) Range

$$135-145\,mEq/L$$

Normal Potassium (K+) Range

$$3.5-5.0\,mEq/L$$

Normal Phosphorus Range

$$2.5-4.5\,mg/dL$$

Normal Calcium (Ca2+) Range

$9-11\,mg/dL$ (transcribed as "Call 911") or $9.0-10.5\,mg/dL$ according to the Lab Value summary on page 40.

Normal Magnesium (Mg2+) Range

$1.5-2.5\,mg/dL$ (Page 1) or $1.3-2.1\,mEq/L$ (Page 40).

Normal Chloride (Cl-) Range

$95-105\,mEq/L$ or $98-106\,mEq/L$ per page 40.

Normal Hemoglobin (Hgb) - Male

$13-18\,g/dL$ or $14-18\,g/dL$ (page 2).

Normal Hemoglobin (Hgb) - Female

$$12-16\,g/dL$$

Normal Hematocrit (HCT) Estimation

Calculated by multiplying the Hgb value by 3 (e.g., $12 \times 3 = 36\%$).

Normal BUN Range

$7-20\,mg/dL$ (page 1) or $10-20\,mg/dL$ (page 45).

Normal Creatinine (Cr) Range

$0.6-1.2\,mg/dL$ (same as Lithium's therapeutic range).

Normal WBC Count

$4,500-11,000$ per mcL ("Wanna Buy a Car for $4,500-$11,000").

Normal Glucose Range

$$70-100\,mg/dL$$

HbA1c

A measurement of blood sugar over time that should be between $4-5.6\%$ and is typically tested every 3 months for diabetics.

Extracellular Fluid (ECF)

Fluid outside the cells, making up about one-third (approx. $15\,L$) of total body water, including interstitial fluid, blood, lymph, and transcellular fluids.

Intracellular Fluid (ICF)

Fluid inside the cells, making up about two-thirds (approx. $25\,L$) of total body water.

Filtration

The movement of fluid (water) through a cell or blood vessel membrane because of hydrostatic pressure differences on both sides of the membrane.

Hydrostatic Pressure

The "water-pushing" pressure exerted by water molecules against the surfaces of a confining space.

Diffusion

The movement of particles (solute) across a permeable membrane from an area of higher particle concentration to an area of lower particle concentration.

Facilitated Diffusion

Diffusion across a cell membrane that requires a membrane-altering system or carrier protein (like insulin for glucose) but does not require extra energy.

Osmosis

The movement of water only through a selectively permeable (semipermeable) membrane to achieve equilibrium of osmolarity.

Osmolarity

The number of milliosmoles in a liter of solution.

Isotonic (Isosmotic)

Fluids with a solute concentration close to $300\,mOsm/L$, the normal value for plasma.

Hypertonic (Hyperosmotic)

Fluids with osmolarities greater than $300\,mOsm/L$ that pull water from the isosmotic fluid space.

Hypotonic (Hypo-osmotic)

Fluids with osmolarities less than $270\,mOsm/L$ where water is pulled from them into isosmotic spaces.

Insensible Water Loss

Water loss through the skin and lungs that occurs without mechanisms to control it.

Aldosterone

A hormone secreted by the adrenal cortex that prevents water and sodium loss by triggering the kidneys to reabsorb them, while promoting potassium excretion.

Antidiuretic Hormone (ADH)

A hormone released from the posterior pituitary that causes the retention of only water by making kidney nephrons more permeable to water.

Natriuretic Peptides (NP)

Hormones like ANP and BNP secreted by the heart in response to stretching; they decrease blood volume and osmolarity by inhibiting sodium reabsorption.

Renin-Angiotensin-Aldosterone System (RAAS)

A major regulator of fluid balance and blood pressure triggered by low blood pressure, low blood volume, low blood oxygen, or low blood sodium.

Cations

Positively charged ions, such as $Na^+$, $K^+$, $Ca^{2+}$, and $Mg^{2+}$.

Anions

Negatively charged ions, such as $Cl^-$ and $PO_4^{3-}$.

Acid-Base Balance pH Range

$$7.35-7.45$$

Acid

A substance that releases hydrogen ions ($H^+$); more $H^+$ leads to a lower pH.

Base

A substance that accepts hydrogen ions, such as Bicarbonate ($HCO_3^-$).

Chemical Buffering Systems

The first line of defense for pH regulation, acting immediately (e.g., carbonic acid-bicarbonate system).

Respiratory System (pH Defense)

The second line of pH defense, responding within minutes by changing the rate and depth of respirations to control $CO_2$ levels.

Renal System (pH Defense)

The third line of pH defense; a slow response (hours to days) that eliminates $H^+$ and reabsorbs $HCO_3^-$ or vice versa.

Hypovolemia

A condition where the circulating blood volume is decreased.

Hypervolemia

An excess of body fluid in the extracellular space (interstitial or intravascular).

Nonelectrolytes

Substances dissolved in fluid that do not carry an electrical charge, such as urea, protein, glucose, creatinine, and bilirubin.

Intermittent Claudication

Cramping or burning muscular pain in PVD/PAD that occurs with walking and stops with rest.

Virchow’s Triad

The three factors contributing to DVT: blood flow stasis, endothelial injury, and hypercoagulability.

Sentinel Event

A significant patient safety event that signals a need for immediate investigation and response.

Root Cause Analysis

A process of digging deeper to find the underlying cause of a clinical problem rather than just treating symptoms.

Dash Diet

Dietary Approaches to Stop HTN; emphasizes vegetables, fruits, whole grains, and low-fat dairy while limiting sweets and red meats.

Primary (Essential) Hypertension

High blood pressure not caused by an underlying disease; the most common type which can lead to organ damage.

ACE Inhibitors (ACEIs)

Antihypertensive drugs (e.g., Lisinopril) that may cause a common side effect of a dry nagging cough.

Arteriosclerosis

A condition involving the thickening or hardening of the arterial wall, often associated with aging.

Atherosclerosis

A type of arteriosclerosis involving the formation of plaque within the arterial wall; a leading risk factor for cardiovascular disease.

D-dimer Test

A global marker of coagulation activation used as an adjunct test to exclude DVT.

National Performance Goals (NPGs)

Formerly National Patient Safety Goals; 14 high-priority measurable hospital topics established by The Joint Commission for 2026.

Novice to Expert Theory

Patricia Benner's model describing the stages of nursing clinical competence: Novice, Advanced Beginner, Competent, Proficient, and Expert.

Nurse Practice Act (NPA)

State-specific laws that set standards, issue licenses, and define the scope of nursing practice.