NUR318 Fluid and Electrolyte Balance

What is Diffusion?

Movement of particles.

What is Osmosis?

Movement of fluid.

True or False?

Water moves from an area of low concentration of SOLUTES to an area of high concentration of SOLUTES.

True.

True or False?

Water moves from an area of more water to less water.

True.

What is the primary electrolyte inside of the cell?

Potassium.

What is the primary electrolyte outside of the cell?

Sodium.

What is the primary electrolyte that regulates osmotic forces, drives osmosis?

Sodium.

Is Sodium a CATION or an ANION?

CATION.

What is the primary ECF(extracellular fluid) ANION?

Chloride.

True or False?

Chloride is "electroneutral" and follows sodium.

True.

What does "hypotonic" mean?

Lower osmolality than the body.

What does "isotonic" mean?

Same concentration of water/solutes as the body.

What does "hypertonic" mean?

Higher osmolality than the body.

What is an example of an isotonic fluid?

Normal saline.

Discuss the RAAS system and its role in fluid balance and regulation:

Regulates blood pressure by increasing sodium absorption, water retention, and constriction of blood vessels.

What hormone is released by the kidneys when the BP drops?

Renin.

What hormone is released by the Adrenal system after renin is released?

Aldosterone.

What is the function of Aldosterone?

Initiates the kidneys to reabsorb SODIUM and WATER.

True or False?

Water balance is regulated by thirst perception and ADH.

True.

What gland of the body releases ADH in response to thirst?

Posterior Pituitary gland.

What is ADH?

Anti-diuretic hormone; fluid retention.

What causes FVD?

Bleeding, wound drainage, excessive sweating, etc.

What are five (5) symptoms seen in FVD?

(1) Hypotension,

(2) Tachycardia,

(3) Dizziness,

(4) Dry mouth,

(5) Thirst.

True or False?

First symptoms are seen in the vascular compartment.

True.

What are five (5) causes of FVE?

(1) Heart failure,

(2) Kidney failure,

(3) Liver failure,

(4) Cancer,

(5) Endocrine disorders.

What are five (5) symptoms seen in FVE?

(1) Hypertension,

(2) Bounding pulse,

(3) Pulmonary congestion,

(4) SOB,

(5) JVD.

What symptom is later seen in FVE?

Edema.

What is an edema?

Accumulation of fluid in intersitium.

Does edema cause hypertonic, hypotonic, or isotonic alterations?

Hypertonic.

What are seven (7) manifestations of edema?

(1) Localized vs generalized,

(2) Dependent edema,

(3) Pitting edema,

(4) "Third space,"

(5) Swelling/puffy,

(6) Tight-fitting clothes,

(7) Weight gain.

What are three (3) significant treatments for edema?

(1) Treat fluid imbalance,

(2) Restrict salt,

(3) Administer a diuretic.

What are isotonic alterations?

Normal concentrations of sodium in ECF,(extra cellular fluid) no change in shift of fluid in or out of the cells.

What is isotonic fluid loss?

Loss of both fluids and electrolytes (Sodium).

What is isotonic fluid excess?

Gain of total body water in the same proportion as electrolytes.

What is an example of isotonic fluid excess (1)?

Replace electrolytes and fluids at the same time.

What are two (2) examples of isotonic fluid loss?

(1) Dehydration

(2) Hypovolemia (too much Na and fluid into body causing edema).

What are hypertonic alterations?

Related to water loss or sodium gain.

True or False?

Water loss and NOT sodium leaves a high concentration of sodium (hypernatremia).

True.

True or False?

Sodium >145 mEq/L is hypernatremia.

True.

What are hypotonic alterations?

Free water excess.

True or False?

Water gain and LOW sodium (hyponatremia).

True.

What are two (2) examples of isotonic fluids?

(1) 0.9% NS and (2) Lactated Ringers.

True or False?

By giving an isotonic fluid that is the same of body's natural concentration (same osmolality/tonicity), it stays in the veins and arteries.

True.

When is an isotonic solution used?

Mild dehydration.

When is a hypotonic solution used?

Severe dehydration.

What are two (2) examples of hypotonic fluids?

(1) 0.45% NS and (2) 0.25% NS.

True or False?

By giving a hypotonic fluid, it shifts fluid OUT of the vascular space and INTO the cells.

True.

True or False?

If FVD, give ISOTONIC or HYPOTONIC fluids.

True.

When is a hypertonic solution used?

FVE (fluid volume excess)

What are three (3) examples of hypertonic solutions?

(1) D5/0.45%NS,

(2) D5/0.9%NS,

(3) Hypertonic saline HS 3% or 5%.

True or False?

By giving a hypertonic fluid, it shifts fluid OUT of cells and INTO the vascular space.

True.

What are four (4) treatments for FVE?

(1) Fluid restriction,

(2) Sodium restriction,

(3) Hypertonic fluids,

(4) Diuretics.

What is normal sodium levels?

136-145 mEq/L.

True or False?

Chloride mirrors sodium.

True.

What does a sodium deficit (<136 mEq/L) cause?

Seizures.