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71 Cards in this Set

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State of equilibrium in the internal environment of the body is
homeostasis
Total body fluid for infant, adult, and older adult is what % of body weight?
infant = 70-80%<br />adult = 60% (~42 L)<br />older audlt = 45-55%
Substances whose molecules separate into ions when placed into water are
ions (atoms with an electrical charge)
The number of grams of a specific (solute) or electrolyte dissolved in one liter of plasma (solution) is what measurement
mEq/L
What are the two fluid compartments?
intracellular fluid (ICF)<br>extracellular fluid (ECF)
Extracellular fluid is composed of what three fluids?
intravascular (plasma) - 5% of ECF<br />interstitial fluid - 15% of ECF<br />transcellular
The intracellular fluid is _____% of body weight and the extracellular fluid is _____% of body weight.
icf - 40%<br />ecf - 20%
Transcellular fluid includes
cerebrospinal fluid, GI, pleural spaces, synovial spaces, peritoneal fluid spaces
Movement of solvent through semi-permeable membrane (from less to more solute) in response to concentration gradients.
osmosis
Pulling power of H2O, affected by plasma proteins (albumin).
osmotic pressure
Pulling force of proteins within the vascular space.
oncotic pressure
Movement of solute (gas or substance) through semi-permeable membrane from area of higher to lower concentration. Occurs in lungs between alevoli and blood.
diffusion
Movement of solutes and solvents by hydrostatic pressure. H2O and substances move together in response to fluid pressure.
filtration
Requries metabolic activity and energy. Example is sodium-potassium pump.
active transport
What 4 processes shift fluid and electrolytes between compartments?
osmosis<br />diffusion<br />filtration (hydrostatic pressure)<br />active transport
Active transport keeps _____ higher in ICF and _____ higher in ECF.
K+<br />Na+
Changes in the _____ of the ECF affect the volume of cells.
osmolality
A water deficit is caused by a(n) _____ in ECF osmolality.
increase<br />pulls water out of cells into vascular system
A water excess is caused by a(n) _____ in ECF osmolality.
decrease
The normal distribution of fluid in the ICF and ECF is _____ spacing.
first
Abnormal accumulation of intersitial fluid (edema) is _____ spacing.
second
Fluid accumulation in a portion of the body where it is not easily exchange with ECF (e.g., ascites, edema from burns) is _____ spacing
third
A hypotonic solution will cause cells to _____ in size.
increase
An isotonic solution will cause cells to _____ in size.
not change
A hypertonice solution will cause cells to _____ in size.
decrease
Most reliable indicator of fluid volume is
daily weights
If a patient is dehyrated and has less vascular fluid volume, electrolye values will
increase
Fluid deficit will _____ HCT levels and fluid exces will _____ HCT levels.
increase, decrease
ECF excess volume - BP, P, neck veins
BP - increase<br />P - increase (bounding)<br />neck veins - distended
Fluid volume deficit - BP, P, neck veins
BP - increase<br>P - increase (weaker, more thready)<br>neck veins - flat
Fluid volume excess - RR
RR - ?
Fluid volume deficit - RR
RR - increase (due to decreased tissue perfusion and hypoxia)
Neurological changes due to swelling or shrinkage of brain cells
decrease LOC, orientation, slow pupil response, decrease movement of extremities and muscle strength
Osmolality of blood plasma (serum) is _____ - _____ mOsm/L.
285 - 295
Fluids of _____ - _____ mOsm/L are isotonic.
240 - 340 (290 +/- 50)
Fluids with tonicities &gt; _____ mOsm/L are hypertonic.
340 (290+50)
Fluids with tonicities &lt; _____ mOsm/L are hypotonic.
240 (290-50)
With isotonic fluids, no _____ pressure difference is created so the fluids stay in the ECF.
osmotic
Isotonic solutions expand the _____ volume.
intravasular
Isotonic solutions include:
0.9% sodium chlorid (NS)<br>5% dextrose (D5W)<br>Lactated ringers (LR)<br>5% dextrose in 0.225% saline (D51/4NS)
IV solutions are classified by ______ or the concentration of ions in a solution.
osmolality (tonicity)
The osmolality of blood plasma is _____ to _____ mOsm/L.
285 - 295
Isotonic solutions include (3):
0.9% NaCl<br>Lactated Ringers (LR)<br>Dextrose 5% in water
0.9% NaCl used
replace fluid and minor Na losses<br>rapid vascular fluid replacement in hypovolemic shock
Lactated ringers contains
concentrated electrolytes, Na, K, Cl, Ca, and lactate
Lactated ringers used
ECF volume losses from burns<br>Post-operative
Hypertonic solutions include
D5 .45% saline (D5 1/2 NS)<br>5% dextrose in 0.9% saline (D5 NS)<br>3.0% saline<br>10% dextrose in water (D10 W)<br>TPN
Hypertonice solutions fluids from _____ and _____ into _____.
cells, interstitial compartment<br>vascular space
Post-op patients may be given hypertonic fluids to reduce the risk of
edema, stabilize BP, regulate output
Hypertonic solutions also used to treat _____ and _____.
hypovolemia (e.g., 3rd spacing)<br>hyponatremia
Hypotonic solutions shift fluid out of _____ and into _____ and _____.
intravascular compartment<br>cells, interstitial spaces
Hypotonic solutions may be used to treat _____ dehydration.
hypertonic
Hypotonic solutions may cause _____ to swell, so you should monitor for _____.
cells<br>cerebral edema
Isotonic expands _____, hypotonic hydrates _____, and hypertonic expands _____ and replaces electrolytes.
ECF<br>Cells<br>Vascular
Dextrose solutions prevent _____.
ketosis
One ______ supplies blood to an area, while you can have multiple _____ in one location.
artery<br>veins
Most IV infusions run at _____ ml/hr or less.
125
What gauge needles can be used for IVs?
16, 18, 20, 22, 24
You should rotate the IV site every _____ - _____ hours or prn.
72 - 96
IV tubing should be changed every _____ - _____ hours.
72 - 96
A local infection at the IV site is characterized by
redness, warmth, tenderness, purulent drainage at site
With IVs, you may get a venous spasm (pain along vein track) if
solution is too cold or irritating (K+)
If a patient gets an air embolism (rare - air gets into venous system and blocks pulmonary circulation), what should you do?
call for help<br>clamp catheter<br>place patient on left side in reverse trendelenburg<br>O2<br>try to aspirate air prn
What is the Trendelenburg position?
Laying supine with head much lower than feet (i.e., table tilted with head down and feet up)
IV bags should hang no longer than _____ hours.
24
Don't keep the tourniquet in place more than _____ - _____ minutes.
1 - 2
The best vein to use for venipuncture (obtaining blood) is the _____ vein because it's more stationary, less painful, closer to surface, and isn't nestled among nerves or arteries.
median cubital
When doing IVs check the patient for allergies to _____ and _____.
latex, iodine
When drawing blood into tubes with additives, gently _____ back and forth 8-10x. Never _____.
rotate<br>shake
Blood needs to go to the lab within _____ minutes.
30
After a lab draw, instruct patient not to _____ after the needle is withdrawn because it may cause bleeding into the antecubital area and compromise vessels and nerves.
bend