Fluid, Electrolytes, and Renal Management Flashcards

Practice flashcards covering fluid balance, electrolyte ranges, acid-base imbalances, and renal management procedures based on lecture notes.

Osmolality

The pressure of osmotically active particles per kilogram of water, expressed as millimoles per kg ($mOs/kg$).

Normal Plasma Osmolality

The standard concentration of solution in the plasma, ranging from $275 \text{--} 295\,mOs/kg$.

Intracellular Fluid (ICF)

Fluid within cells comprising $\frac{2}{3}$ of total body water, where Potassium is the abundant cation and phosphate is the primary anion.

Active Transport

A physiologic pump that requires $ATP$ to move fluid from a lower concentration area to a higher concentration area.

Osmotic Pressure

The "pull" force that draws solvent from a less concentrated solute through a selectively permeable membrane, determined by solute concentration.

Oncotic Pressure

An osmotic pressure exerted by colloids, specifically albumin, to maintain capillary membrane integrity.

Antidiuretic Hormone (ADH)

A hormone under hypothalamic control that acts on distal tubules to increase water reabsorption, leading to decreased urine output.

Aldosterone

A mineralocorticoid released by the adrenal cortex that promotes sodium and water retention and potassium excretion.

Atrial Natriuretic Peptide (ANP)

A hormone released by the cardiac atria in response to hypervolemia that causes renal vasodilation and increased urinary excretion of sodium and water.

Hypovolemia

An isotonic fluid volume deficit caused by excessive loss of isotonic body fluids, such as hemorrhage or third space shifts.

Isotonic Solutions

Intravenous fluids like $0.9\% NaCl$ (Normal Saline), $D_5W$, and Lactated Ringers that stay within the vascular space.

Hypotonic Solutions

Fluids like $0.45\% NaCl$ that shift out of the vascular space into cells to replace cellular fluid and rehydrate cells.

Hypertonic Solutions

Volume expanders like $D_5NSS$ or $D_{50}W$ that draw fluid into the vascular space from the cells.

Normal Serum Sodium Range

The concentration of the major cation of the Extracellular Fluid ($ECF$), measured at $135 \text{--} 145\,mEq/L$.

Normal Serum Potassium Range

The concentration of the most common intracellular cation, measured at $3.5 \text{--} 5.0\,mEq/L$.

Hyperkalemia ECG Changes

Electrocardiogram manifestations including widened $QRS$, tall peaked/tented $T$ waves, and absent/flat $P$ waves.

Kayexalate (Sodium Polystyrene Sulfonate)

A medication used in chronic renal failure that retains sodium to decrease potassium through defecation.

Chvostek’s Sign

The contraction or twitching of facial muscles in response to a light tap over the facial nerve; a sign of hypocalcemia.

Trousseau’s Sign

A carpal spasm (flexion) induced by inflating a blood pressure cuff above systolic pressure for several minutes; a sign of hypocalcemia.

Normal Serum Calcium Range

Measured at $9.0 \text{--} 10.5\,mg/dL$ or $2.25 \text{--} 2.75\,mEq/L$.

Normal Serum Magnesium Range

Measured at $1.5 \text{--} 2.5\,mg/dL$.

Allen’s Test

A procedure done prior to obtaining $ABG$ to determine the patency of the ulnar artery and presence of collateral circulation.

Kussmaul’s Respiration

Increased respiratory rate and depth (deep rapid breaths) serving as a compensatory mechanism for metabolic acidosis.

Acute Kidney Injury (AKI)

A syndrome resulting in a sudden decline in renal function, reflected by an acute rise in $sCr$ levels and/or a decline in urine output.

Oliguria

Urine output measured between $100\,ml \text{--} 400\,ml$ per $24$ hours.

Chronic Kidney Disease (CKD)

A slow, progressive, irreversible loss of kidney function with a $GFR$ of $60\,ml/min$ or less for $3$ months or longer.

Darbepoetin alfa

A synthetic erythropoietin administered to Promote the maturity of $RBCs$ in patients with renal-related anemia.

Peritonitis

A serious complication of peritoneal dialysis indicated by cloudy drainage, fever, tachycardia, and rebound abdominal tenderness.

Arteriovenous Fistula (AVF)

The "gold standard" permanent hemodialysis access created surgically by anastomosis of a large artery and large vein.

Disequilibrium Syndrome (DDS)

A complication of hemodialysis caused by the rapid removal of urea from the blood, resulting in reverse osmosis and cerebral edema.