HLTH 201: Ch. 8 - Disorders of Fluid and Electrolyte (exam 1)

What is intracellular fluid?

fluid inside the cell

What is extracellular fluid?

fluid outside the cell

is the majority of the fluid in our body intracellular or extracellular?

intracellular (67%)

extracellular fluid is \___ in sodium and \___ in potassium (retype sentence with answers)

extracellular fluid is high is sodium and low in potassium

intracellular fluid is \___ in sodium and \___ in potassium (retype sentence with answer)

intracellular fluid is low in sodium and high in potassium

What is hydrostatic pressure?

pressure due to fluid volume

what is osmotic pressure?

number of dissolved particles in a solution

What is colloid osmotic pressure?

pressure associated with proteins

if there is a higher osmotic pressure inside of the cell, where will the water move?

inside the cell

where does water always move to?

area with a higher osmotic pressure (more solutes)

if the osmotic pressure of the solution is greater than inside the cell, where will the water move to?

out of the cell into solution

What is an isotonic solution?

Contains equal concentrations of solutes on both sides.

What is hypotonic solution?

concentration of solution has a lower osmotic pressure than the cell, causing water to move inside the cell

what is a hypertonic solution?

the concentration of solution has a higher osmotic pressure than the cell, causing water to move out of the cell

What is edema?

accumulation of fluid in body tissue

what are they types of edema?

transudative edema, exudative edema

what is transudative edema?

high in fluid, low in protein

what is exudative edema?

high in fluid, high in protein

what are the causes of edema?

increased capillary pressure, decreased osmotic pressure, lymphatic obstruction, increased capillary permeability

will increasing capillary pressure cause transudative or exudative edema?

transudative

will decreasing osmotic pressure cause transudative or exudative edema?

transudative

will lymphatic obstruction cause transudative or exudative edema?

transudative

will increased capillary permeability cause transudative or exudative edema?

exudative

What is anasarca?

generalized edema of the whole body due to low plasma proteins

what is the best way to tell if someone is retaining fluid?

weighing them

how does having liver failure cause edema?

plasma proteins are produced in the liver and help keep fluid in blood vessels. Low plasma proteins will cause fluids to leak out of the blood vessels.

what does water balance mean?

water input is equal to water output

which hormones regulate water balance?

ADH, aldosterone, ANP, renin-angiotensin system

What does ADH do?

causes kidneys to reabsorb water

What does aldosterone do?

causes kidneys to reabsorb sodium and excrete potassium

What does ANP do?

causes kidneys to excrete sodium and water

What does the renin-angiotensin system do?

helps maintain sodium and water balance to maintain a healthy blood pressure and blood volume

What is hypodipsia?

decreased thirst

what is hyperdipsia?

excessive thirst

What is diabetes insipidus?

a disorder caused by inadequate amounts of ADH which causes excessive water loss

what is neurogenic diabetes insipidus?

Insufficient amounts of ADH

What is nephrogenic diabetes insipidus?

lacking ADH receptors

What is dipsogenic diabetes insipidus?

excessive water consumption

what is gestational diabetes insipidus?

placenta produces vasopressin which breaks down the ADH

What is Syndrome of Inappropriate ADH (SIADH)?

too much ADH is causing a decrease in urine production

which ADH disorder causes hyponatremia?

syndrome of inappropriate ADH

why does syndrome of inappropriate ADH cause hyponatremia?

reabsorbed water goes into bloodstream causing it to become diluted

What is hypovolemia?

isotonic fluid volume deficit

what is hypovolemia caused by?

fluid output is greater than fluid intake

what are causes of isotonic fluid volume deficit? (hypovolemia)

diarrhea, vomiting, excessive sweating, excessive urination, GI suction

what are signs and symptoms of isotonic fluid volume deficit?

increased thirst, weak pulse, increased heart rate, decreased blood pressure, constriction of cutaneous blood vessels, decreased urine output, decreased skin turgor, decreased hematocrit, dry mucous membranes

why does isotonic fluid volume deficit cause an increased heart rate?

low blood volume increases heart rate to maintain cardiac output

why does isotonic fluid volume deficit cause cutaneous blood vessels to constrict?

blood is being shunted to the internal organs to maintain function

why does isotonic fluid volume deficit cause increased hematocrit?

low blood volume causes the percentage of RBCs to increase

does isotonic fluid volume deficit increase or decrease ECF volume?

decrease (less fluid in blood)

what is a way to treat isotonic fluid volume deficit?

fluid replacement (drinking water, saline)

What is hypervolemia?

fluid volume excess

does hypervolemia increase or decrease vascular volumes?

increase

does hypervolemia increase or decrease sodium and water?

increase (sodium follows water)

what is fluid volume excess caused by?

increased sodium consumption, decreased sodium excretion, decreased water excretion

what are some diseases that can cause a decrease excretion of sodium and water?

renal failure, heart failure, liver failure, corticosteroid hormone excess

what are signs and symptoms of fluid volume excess (hypervolemia)?

weight gain, edema, distended neck veins, bounding pulse, decreased hematocrit

why does hypervolemia cause a stronger pulse?

increased fluid volume in blood causes increase blood pressure

why does hypervolemia cause a decrease in hematocrit?

increased fluid in blood causes the percentage of RBCS will be lower (dilutes the blood)

what are treatments for a patient with fluid volume excess (hypervolemia)?

diuretics: potassium wasting diuretics, potassium sparing diuretics, osmotic diuretics

What are the potassium-wasting diuretics that would be used on a patient with fluid volume excess?

lasix, hydrochlorothiazide

What are the potassium sparing diuretics that would be used on a patient with fluid volume excess?

Aldactone, spironolactone

What are osmotic diuretics administered?

Intravenous (IV)

how do osmotic diuretics treat excess fluid volume (hypervolemia)?

circulates around the bloodstream and draws water into urine

what are normal sodium levels?

135 to 145 mEq/L

which element regulates extracellular fluid volume and osmolarity?

sodium

if a patient is retaining sodium, will their blood volume increase or decrease?

increase

what are the types of sodium imbalances?

hyponatremia, hypernatremia

What is hyponatremia?

serum sodium level below 135 mEq/L.

what is hyponatremia caused by?

excessive sweating, diarrhea, diuretics, insufficient aldosterone, decreased renal function, excessive ADH secretion, excessive water intake, diluting baby formula

how does insufficient aldosterone cause hyponatremia?

aldosterone reabsorbs Na, low aldosterone causes low reabsorption of Na

how does decreased renal function cause hyponatremia?

kidneys can't produce urine, causing body fluids to dilute the blood, decreasing Na levels

how does excessive ADH secretion cause hyponatremia?

water retention dilutes blood, decreasing Na levels

what are the signs/symptoms of hyponatremia?

muscle cramps, fatigue, nausea, decreased osmotic pressure, headaches

for a patient with hyponatremia, where will the fluid shift to?

into the cell

what are the treatments for hyponatremia?

limiting water intake, saline, hypertonic saline

What is hypernatremia?

serum sodium level above 145 mEq/dL.

in a patient with hypernatremia, does their extracellular osmotic pressure increase or decrease?

increase (water moves out of cell: cellular dehydration)

what are the causes of hypernatremia?

insufficient ADH, watery diarrhea, excessive aldosterone, kidney unable to conserve water, high osmotic food

how does insufficient ADH cause hypernatremia?

ADH causes fluid retention, low ADH will cause less fluid retention causing blood to be more concentrated

how does excess aldosterone cause hypernatremia?

aldosterone causes kidneys to hold onto Na, excess aldosterone causes Na levels to increase

what are the signs and symptoms of hypernatremia?

increased thirst, increased ADH secretion, dry skin, decreased skin turgor, decreased salivation, confusion

why does hypernatremia cause confusion?

water is exiting the cell to balance high extracellular sodium levels, causing cells to shrink

what are treatments for hypernatremia?

treating underlying cause, fluid replacement

what are normal potassium levels?

3.5 to 5.0 mEq/L

what element maintains intracellular molarity and controls the cells resting potential?

potassium

what are the types of potassium imbalances?

hypokalemia, hyperkalemia

what is hypokalemia?

potassium level below 3.5 mEq/L

what is hypokalemia caused by?

low potassium intake, potassium wasting diuretics (Lasix's, hydrochlorothiazide), excessive aldosterone, treating diabetic ketoacidosis with insulin, beta adrenergic agonists, metabolic alkalosis

how does excessive aldosterone cause hypokalemia?

aldosterone causes K excretion, high aldosterone will excrete too much K

how does metabolic alkalosis cause hypokalemia?

causes kidneys to excrete K

what are signs and symptoms of hypokalemia?

muscle weakness, fatigue, paresthesia, cardiac arrhythmias

what is a tell-tale sign that a patient has hypokalemia?

their EKG will show a very prominent U Wave

What is hyperkalemia?

potassium level above 5.0 mEq/L

What are the causes of hyperkalemia?

renal failure, decreased aldosterone, potassium sparing diuretics (aldactone/spironolactone), prolonged acidosis, tissue injury, rapid potassium administration

how does decreased aldosterone cause hyperkalemia?

aldosterone causes excretion of K. without aldosterone, K will not be excreted (accumulates in body)

how does tissue injury cause hyperkalemia?

K is released when cells are dead/damaged

how does prolonged acidosis cause hyperkalemia?

K shifts out of cells

what are signs and symptoms of hyperkalemia?

impaired neuromuscular function, cardiac arrythmias, weakness, paresthesia

what is a tell tale signs that a patient has hyperkalemia?

their EKG will show a peaked T Wave and a very low P Wave