A liquid such as water that can hold another substance in a solution.

Solvent

A substance that is either dissolved or suspended in a solution.

Solute

A solution that has the same concentration of solutes as another solution.

Isotonic Solution

A solution that has MORE solutes than another solution.

Hypertonic Solution

A solution that has FEWER solutes than another solution.

Hypotonic Solution

0.9 Sodium Chloride or NS is an example of ______ used in a hospital setting.

Isotonic Solution

Elements or compounds that dissolve in water and separate into ions Electrolytes that carry an electric current.

What is the percentage of body water in a young adult, the elderly, and infants. (3 answers)

Young Adult: 60% Elderly: 45% Infants: 80%

An infants BSA is greater than that of an adult relative to his/her weight, with that and a high metabolism and Immature kidneys, these factors puts the infant at a risk for:

Fluid Volume Defecit

This is triggered by the hypothalamus. As we age it becomes diminished, putting the elderly at risk for fluid volume defecit.

Thirst Mechanism

What electrolyte mainy controls the distribution of water throughout Sodium the body?

What is the dominant Cation in ICF?

Pottasium (K+)

What is the dominant Anion in ICF?

Phosphorous (PO4-)

What is the dominant Cation in ECF?

Sodium (Na+)

What is the dominant Anion in ECF?

Chloride (Cl-)

What amount of body water is intracellular fluid?

2/3

What amount of body water is extracellular?

1/3

Estracellular fluid consists of two compartments. What are they?

Interstitial Fluid Intravascular Fluid

What four processes do solutes and solvents move across the membranes?

Diffusion Osmosis Filtration (Hydrostatic Pressure) Active Transport (requires energy)

The MOVEMENT OF WATER through a semipermiable membrane Osmosis from a solution with a lower solute concentration to one with a higher solute concentration.

What is the pulling power of a solution for water?

Osmotic Pressure

Term used to express osmotic pressure?

Osmolality* *The higher the osmolality the greater the pulling power of water

What is the Normal Serum Olsmolality Level?

280-300 mOsm/kg

The process by which large particles, such as protien, that can pull fluid from tissues into the vessels by osmosis?

Colloidal Osmotic Pressure

The movement of a solute in a solution across a semipermable membrane from an area of higher solute concentration to a area of lower solute concentration until both sides are equal.

Diffusion

This requires energy to move substances across cell membranes. It Active Transport allows larger molecules to enter the cell moving thise particles uphisl from areas of lower concentration to areas of higher concenteration.

This hormone is manufactured in the hypothalamus and is stored in ADH the posterior pituitary gland . It makes the kidneys more permable to water. This hormone is realesed by the Adrenal Cortex it causes the kidneys Aldosterone to reabsorb Na+ and water while exreting K+.

Because Sodium retention leads to water retention, Aldosteron acts Volume Expander as a _______.

The production of Aldosterone is stimulated by: Decreased _____ _____ _____ _____ and increased _____

Decreased: B/P, Blood Volume, Sodium (Na+) Increased: Potassium (K+)

Aldosterone is NOT produced with Increased _____ _____ _____ _____ and decreased _____

Increased: B/P, Blood Volume, Sodium (Na+) Decreased : Potassium (K+)

The average adult releases ____-____ ml of fluid output daily

2600-3600 ml

With what four organs does fluid ouput occur?

Kidneys 1500 ml/day (Sensible) Skin 600ml/day (Insensible lungs 400ml/day (Insensible) GI tract 100 ml/day (Sensible) Kidneys 1500 ml/day

When fluid loss is not perceived b the individual, it is called _________

Insensible Fluid Loss

When fluid loss is perceived by the individual, it is called ________

Sensible Fluid Loss

What is the functioning unit of the kidney?

Nephron

The nephron filters blood at a rate of _______/min

125ml

What amounf of uring/kg of body weight/hour is produced by all ages.

1 ml/hr

Name two common fluid imbalances in the body.

Edema and Dehydration

When water and electrolytes gained or lost in equal proportion

Isotonic fluid imbalances

When only water is gained or lost

Osmolar fluid

imbalances

What occurs when water and electrolytes are lost in equal proportions?

Isotonic Dehydration

Fluid losses are primarily in the ____ (the least stable fluid compartment)

Extra Cellular Fluid (ECF)

This occurs when more water is lost than electrolytes

Osmolar Dehydration

A lower Serum Osmolality suggests...

Fluid Overload

A higher Serum Osmolality suggests. .. These two values are often high due to

Fluid Dehydration

Hct and BUN Hemoconcentration. Normal Serum Soduim Level 135-145 mEq/L

Normal Serum Potassium Level

3.5-5.0 mEq/L

Normal Serum Calcium Level

8.5-10.5mg/dl

Normal Serum Chloride Level

95-108 mEq/L

Normal Serum Phosphate Level

2.5-4.5 mg/dL

Normal Serum Magnesium Level

1.4-2.1 mEq/dL

Normal Serum Bicarbonate Level

22-26 mEq/dL

Name the 3 types of IV Solutions

Isotonic (NS 0.9) Hypotonic (1/2 NS 0.45) Hypertonic (D5NS)

What is the main role of Na+

To control water To control water distribution and maintian normal fluid balance

Sodium dilution from increased volume states

Dilutinal Hyponatremia

This is caused by excessive administration of hypotonic fluids, diseases that add increased volume, an increase in ADH, drining excessive amounts of water, excessive Na+ losses from profuse perspiration , GI losses, and Diuresis

Hyponatremia

Signs and symptoms of Hyponatremia

Water shifts from vascular space into the cells causeing headache and altered mental status Abdominal cramps, anorexia, nausea, and diarrhea.

This is caused by Excess sodium intake, or excessive infusion of sodium fluids, decreased sodium loss, excessive water loss, Renal failure, increased aldosterone

Hypernatremia

Signs and symptoms of Hypernatremia

Whater shifts from Cells (cellular dehydration) into the vascular space. Dry

mucous membranes, thirst, decreased urin ouput, agitation , dosorentation , seizures

What is the main role of K+

maintain cell membrane electric potential. Neuromuscular function

Duretics, excessive loss of GI fliuds, increase secretion of Asldosterone, and high glucose levels leading to diuresis leads to

Hypokalemia

Signs and symptoms of Hypokalemia

Weak thready pulse, EKG changes, Paralytic ileus and Muscle weakness: leg cramps

This is caused by excessive intake from foods, salt substitues, IV infusion of KCL, decreased secretion due to renal failure, adrenal insufficiency, ACE inhibitors, decreased Aldosterone, massive Tissue trauma and it is rare in those individuals with normally functioning kidneys

Hyperkalemia

Signs and symptoms of Hyperkalemia

EKG changes, Irregular slow heart rate, Increased peristalsis, causeing nausea, vomiting or diarrhea

Principle functions of this elecrolyte include enhanced bone strength, Calcium normal clotting of the blood and regulation of neuromuscular irritability

Hypoparathyroidism , decreased magnesium leves inadequate Vitamin D, increased Phosphorus levels cause this

Hypocalcemia

Signs and Symptoms of Hypocalcemia

Decreased blood pressure and decreased myocardial contractility, increased bleeding, nubness of fingers and toes, Tetany, positive Chvostek's sign and Positive Trousseau's sign

Positive Chvostek's sign is described as

Tapping on the face at the point just anterior to the ear and just below the cheek bone. Positive if twitching of the facial muscles occurs

Positive Trousseau's sign is described as

inflating a B/P cuff above systolic blood pressue for several minutes. Positive if flexion of the wrist and metacarpophalageal joints and hyperesxtension of the

fingers and flexion of the thumb on palm occurs

Bones stones and grones, hyperparathyroidism, metastic cancer and Hypercalcemia decreased phosphourus levels are significant in patients with

this is clossaly associated with serum sodum levels, principle Chloride (Cl-) functions include serum osmolality and water balance, regulation of pH of stomach

Caused by decreased intake or absorption, prolonged vomiting , sweating, diarrhea, or GI drainage, Na+ and K+ deficiency

Hypochloremia

Caused by certain drugs that lead to retention, usually associated with increased Na+ levels

Hyperchloremia

Thees two elecrolytes have an inverse relationship when one is up the other is down

Calcium and Phosphorus

This causes Increased Serum Calcium Levels (hypercalcemia) and Decresed Serum Phosphorus Levels(hypophosphatemia)

Hyperparathyroidism

This causes Decreased Serum Calcium Levels (hypocalcemia) and Increased Serum Phosphorus Levels (hyperphosphatemia)

Hypoparathyroidism

Name the common complications with IV therapy

Infiltration Phlebitis/Thrombophleb itis Infection (local or systemic) Fluid Overload Bleeding