Body Fluid Distribution and Composition

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Questions and Answers

What is the primary function of sodium in the body?

Neutralizing charge with potassium ions

Regulating blood pressure

Maintaining skin integrity

Regulating water balance (correct)

What is the normal range of sodium levels in the blood?

120-130 mEq/L

135-145 mEq/L (correct)

145-155 mEq/L

155-165 mEq/L

Which hormone regulates sodium reabsorption in the renal tubules?

Thyroxine

Adrenaline

Insulin

Aldosterone (correct)

What percentage of total body weight is made up of Intracellular Fluids (ICF)?

42% Signup and view all the answers

What is the term for an abnormally low concentration of sodium in the blood?

Hyponatremia Signup and view all the answers

What is the term for the fluid outside of cells, including interstitial, intravascular, and transcellular fluid?

Extracellular Fluid (ECF) Signup and view all the answers

Why should patients with fluid volume excess avoid high-sodium foods?

To reduce fluid retention and swelling Signup and view all the answers

How often should nurses assess circulation to extremities in patients with fluid volume excess?

Every 8 hours Signup and view all the answers

What is the charge of ions such as Na+, K+, and Ca++?

Positively charged Signup and view all the answers

What is the term for the movement of water into or out of a cell based on the concentration of solutes?

Osmosis Signup and view all the answers

What is the normal concentration of potassium (K+) in the intravascular fluid?

5 mEq/L Signup and view all the answers

What is the main function of the kidney in maintaining fluid and electrolyte homeostasis?

Ion transport and water movement Signup and view all the answers

What would happen if a red blood cell was placed in a hypotonic solution?

The cell would swell Signup and view all the answers

What percentage of total body fluid is made up of Extracellular Fluid (ECF) in a newborn infant?

More than 50% Signup and view all the answers

What is the primary mechanism of osmosis?

Diffusion of water across a selectively permeable membrane Signup and view all the answers

Which hormone regulates fluid intake?

Thirst Signup and view all the answers

What is the primary characteristic of diabetes insipidus?

Deficiency of ADH leading to polyuria and polydipsia Signup and view all the answers

What is the treatment for severe hyponatremia with CNS symptoms?

Saline (3% or 5% NaCl) in addition to fluid restriction and furosemide Signup and view all the answers

What is the primary cause of hypovolemia?

Loss of ECF volume exceeding the intake of fluid Signup and view all the answers

What is the laboratory finding in hypovolemia?

Increased hgb and hct, increased serum and urine osmolality and specific gravity Signup and view all the answers

What is the primary characteristic of SIADH?

Inappropriate secretion of ADH with water retention Signup and view all the answers

What is the primary mechanism of filtration?

Movement across a membrane, under pressure, from higher to lower pressure Signup and view all the answers

What is the primary function of atrial natriuretic peptide?

Inhibition of aldosterone secretion Signup and view all the answers

What is the primary cause of hypervolemia?

Overzealous administration of Na+ fluids Signup and view all the answers

What is the primary indicator of fluid volume status in an adult?

Daily weights Signup and view all the answers

What is the consequence of hypervolemia?

Edema and hypertension Signup and view all the answers

What is the primary cause of fluid volume excess?

Increased total body sodium content Signup and view all the answers

What is the result of isotonic retention of body substances in hypervolemia?

Essentially normal serum sodium concentration Signup and view all the answers

What is a common complication of severe volume overload?

Pulmonary edema Signup and view all the answers

What is the goal of collaborative care management for fluid volume excess?

To restore normal fluid balance and provide symptomatic care Signup and view all the answers

What is the result of trapping water in the interstitial spaces?

Unavailability of water for metabolic processes Signup and view all the answers

What is the term for the accumulation of fluid within the interstitial spaces?

Edema Signup and view all the answers

What is a common cause of fluid volume deficit?

Vomiting and diarrhea Signup and view all the answers

What is a nursing consideration for edema of specific organs?

Edema can be life-threatening Signup and view all the answers

What is a significant complication of severe volume overload?

Pulmonary edema Signup and view all the answers

What is the primary indicator of fluid volume status in an adult?

Daily weights Signup and view all the answers

What is the term for the accumulation of fluid within the interstitial spaces?

Edema Signup and view all the answers

What is the consequence of hypervolemia?

Pulmonary edema Signup and view all the answers

What is the goal of collaborative care management for fluid volume excess?

Restore normal fluid balance Signup and view all the answers

What is the result of isotonic retention of body substances in hypervolemia?

No change in serum sodium concentration Signup and view all the answers

What is a common cause of fluid volume deficit?

Vomiting and diarrhea Signup and view all the answers

What is a nursing consideration for edema of specific organs?

Edema of specific organs can be life-threatening Signup and view all the answers

What is a common complication of fluid volume excess?

Pulmonary edema Signup and view all the answers

What is the result of trapping water in the interstitial spaces?

Edema Signup and view all the answers

What is the primary mechanism of active transport?

Movement of ions against osmotic pressure to an area of higher pressure Signup and view all the answers

Which hormone regulates fluid output in the kidneys?

Antidiuretic hormone Signup and view all the answers

What is the primary characteristic of Diabetes Insipidus?

ADH deficiency leading to polyuria and polydipsia Signup and view all the answers

What is the primary cause of hypovolemia?

Inadequate fluid intake and anorexia Signup and view all the answers

What is the laboratory finding in SIADH?

Low serum sodium and osmolarity Signup and view all the answers

What is the treatment for mild hyponatremia?

Fluid restriction and increased salt intake Signup and view all the answers

What is the primary mechanism of osmosis?

Diffusion of water across a selectively permeable membrane Signup and view all the answers

What is the primary characteristic of hypovolemia?

Loss of water and electrolytes in the same proportion as they exist in normal body fluids Signup and view all the answers

What is the primary function of atrial natriuretic peptide?

Inhibition of renin-angiotensin-aldosterone mechanism Signup and view all the answers

What is the primary mechanism of filtration?

Movement across a membrane under pressure Signup and view all the answers

What is the primary goal of dietary modifications for patients with fluid volume excess?

To control fluid volume and reduce sodium intake Signup and view all the answers

Why are patients with fluid volume excess advised to elevate their extremities?

To reduce dependent edema, except in cases of significant heart failure or pulmonary edema Signup and view all the answers

What is the role of sodium in regulating water balance in the body?

To play a crucial role in regulating water balance Signup and view all the answers

Which of the following hormones does NOT regulate sodium reabsorption in the renal tubules?

Insulin Signup and view all the answers

What is thepurpose of monitoring jugular neck veins and hand veins in patients with fluid volume excess?

To monitor fluid volume status Signup and view all the answers

What is the consequence of fluid volume excess on the body?

Edema and potentially heart failure Signup and view all the answers

What percentage of total body weight is made up of Extracellular Fluid (ECF)?

17% Signup and view all the answers

What happens when a red blood cell is placed in a hypotonic solution?

The cell will swell and possibly burst Signup and view all the answers

What is the primary mechanism of maintaining fluid and electrolyte homeostasis in the body?

Water movement, ion transport, and kidney function Signup and view all the answers

What is the normal concentration of sodium (Na+) in the intravascular fluid?

142 mEq/L Signup and view all the answers

What happens when a red blood cell is placed in a hypertonic solution?

The cell will shrink Signup and view all the answers

What percentage of total body fluid is made up of Extracellular Fluid (ECF) in a newborn infant?

50% Signup and view all the answers

What is the primary function of electrolytes in the body?

To facilitate nerve and muscle function Signup and view all the answers

What is the term for the movement of water into or out of a cell based on the concentration of solutes?

Osmosis Signup and view all the answers

Study Notes

Fluid and Electrolytes

Distribution of body fluids:
- Intracellular fluids (ICF): 42% of total body weight, 28 liters in males, 20 liters in females
- Extracellular fluids (ECF): 17% of total body weight, consists of interstitial, intravascular, and transcellular fluids

Electrolytes

Definition: charged particles (ions) dissolved in body fluids
Types of electrolytes:
- Cations (positively charged): Na+, K+, Ca++, H+
- Anions (negatively charged): Cl-, HCO3-, PO43-
Electrolyte concentration differs in ICF and ECF

Normal Electrolyte Content and Body Fluids

Sodium (Na+): 142-146 mEq/L in ECF, 15 mEq/L in ICF
Potassium (K+): 5 mEq/L in ECF, 150 mEq/L in ICF
Calcium (Ca++): 5 mEq/L in ECF, 2 mEq/L in ICF
Chloride (Cl-): 102-114 mEq/L in ECF, 1 mEq/L in ICF
Bicarbonate (HCO3-): 27 mEq/L in ECF, 10 mEq/L in ICF

Homeostasis

Maintained by:
- Water movement
- Ion transport
- Kidney function
Regulation of body fluids:
- Thirst regulates fluid intake
- Fluid output: kidneys, skin, lungs, and GI tract

Fluid Movement

Types of fluid movement:
- Diffusion: movement of dissolved particles through a semipermeable membrane
- Osmosis: diffusion of water across a selectively permeable membrane
- Filtration: movement across a membrane under pressure
- Active transport: movement of ions against osmotic pressure

Diabetes Insipidus

Causes:
- Hypothalamic tumors, leukemia, lymphoma, sarcoidosis, head trauma, general anesthetics
- Oat-cell carcinoma of the lung, leukemia, head injury, brain tumor, pneumonia, acute respiratory failure, tuberculosis
Pathophysiology:
- ADH deficiency leading to polyuria and polydipsia
- Inappropriate secretion of ADH with water retention
Laboratory findings:
- Normal serum sodium and osmolarity if thirst mechanisms intact
- Low serum sodium and osmolarity if thirst mechanisms impaired
Signs and symptoms:
- Polyuria, nocturia, continuous thirst, polydipsia, craving ice water
- Weight gain, fingerprinting edema, no peripheral edema

Hypovolemia

Definition: fluid volume deficit occurs when loss of ECF volume exceeds intake of fluid
Causes:
- Vomiting, diarrhea, fistulas, fever, excessive sweating, burns, blood loss, GI suction, 3rd space fluid shifts, decreased intake
Signs and symptoms:
- Acute weight loss, decreased skin turgor, oliguria, concentrated urine, weak rapid pulse, > cap refill, low CVP, hypotension, flat neck veins, dizzy, weak, increased thirst, confusion, tachycardia, muscle cramps, sunken eyes
Laboratory findings:
- Increased hgb and hct, increased serum and urine osmolality and specific gravity, decreased urine sodium, increased BUN and creatinine, increased urine specific gravity and osmolality

Hypervolemia

Definition: fluid volume excess occurs when abnormal retention of water and sodium in ECF
Causes:
- Compromised regulatory mechanisms: renal failure, heart failure, cirrhosis, overzealous admin of Na+ fluids, fluid shifts, prolonged corticosteroid therapy, severe stress, hyperaldosteronism
Signs and symptoms:
- Acute weight gain, peripheral edema and ascites, distended jugular veins, crackles, elevated CVP, SOB, hypertension, bounding pulse, cough, tachypnea
Laboratory findings:
- Decreased hgb and hct, decreased serum and urine osmolality, decreased urine sodium and specific gravity

Fluid Volume Deficit; Nursing Care

Assess vital signs regularly
Postural (orthostatic) hypotension: ↓ in sys BP > 15 mmHg or ↑ HR > 15 beats/min
Daily weights: single best indicator of fluid volume status in adults
Apply safety measures: orthostatic hypotension, dizziness, and falls
Accurate record of intake and output: record drainage from body orifices and wound(s)
Administer free water (flush) to patients receiving enteral feedings
Urge caution in drinking coffee, tea, and colas with caffeine, which has a diuretic effect

Fluid and Electrolytes

Distribution of body fluids:
- Intracellular fluids (ICF): 42% of total body weight, 28 liters in males, 20 liters in females
- Extracellular fluids (ECF): 17% of total body weight, consists of interstitial, intravascular, and transcellular fluids

Electrolytes

Definition: charged particles (ions) dissolved in body fluids
Types of electrolytes:
- Cations (positively charged): Na+, K+, Ca++, H+
- Anions (negatively charged): Cl-, HCO3-, PO43-
Electrolyte concentration differs in ICF and ECF

Normal Electrolyte Content and Body Fluids

Sodium (Na+): 142-146 mEq/L in ECF, 15 mEq/L in ICF
Potassium (K+): 5 mEq/L in ECF, 150 mEq/L in ICF
Calcium (Ca++): 5 mEq/L in ECF, 2 mEq/L in ICF
Chloride (Cl-): 102-114 mEq/L in ECF, 1 mEq/L in ICF
Bicarbonate (HCO3-): 27 mEq/L in ECF, 10 mEq/L in ICF

Homeostasis

Maintained by:
- Water movement
- Ion transport
- Kidney function
Regulation of body fluids:
- Thirst regulates fluid intake
- Fluid output: kidneys, skin, lungs, and GI tract

Fluid Movement

Types of fluid movement:
- Diffusion: movement of dissolved particles through a semipermeable membrane
- Osmosis: diffusion of water across a selectively permeable membrane
- Filtration: movement across a membrane under pressure
- Active transport: movement of ions against osmotic pressure

Diabetes Insipidus

Causes:
- Hypothalamic tumors, leukemia, lymphoma, sarcoidosis, head trauma, general anesthetics
- Oat-cell carcinoma of the lung, leukemia, head injury, brain tumor, pneumonia, acute respiratory failure, tuberculosis
Pathophysiology:
- ADH deficiency leading to polyuria and polydipsia
- Inappropriate secretion of ADH with water retention
Laboratory findings:
- Normal serum sodium and osmolarity if thirst mechanisms intact
- Low serum sodium and osmolarity if thirst mechanisms impaired
Signs and symptoms:
- Polyuria, nocturia, continuous thirst, polydipsia, craving ice water
- Weight gain, fingerprinting edema, no peripheral edema

Hypovolemia

Definition: fluid volume deficit occurs when loss of ECF volume exceeds intake of fluid
Causes:
- Vomiting, diarrhea, fistulas, fever, excessive sweating, burns, blood loss, GI suction, 3rd space fluid shifts, decreased intake
Signs and symptoms:
- Acute weight loss, decreased skin turgor, oliguria, concentrated urine, weak rapid pulse, > cap refill, low CVP, hypotension, flat neck veins, dizzy, weak, increased thirst, confusion, tachycardia, muscle cramps, sunken eyes
Laboratory findings:
- Increased hgb and hct, increased serum and urine osmolality and specific gravity, decreased urine sodium, increased BUN and creatinine, increased urine specific gravity and osmolality

Hypervolemia

Definition: fluid volume excess occurs when abnormal retention of water and sodium in ECF
Causes:
- Compromised regulatory mechanisms: renal failure, heart failure, cirrhosis, overzealous admin of Na+ fluids, fluid shifts, prolonged corticosteroid therapy, severe stress, hyperaldosteronism
Signs and symptoms:
- Acute weight gain, peripheral edema and ascites, distended jugular veins, crackles, elevated CVP, SOB, hypertension, bounding pulse, cough, tachypnea
Laboratory findings:
- Decreased hgb and hct, decreased serum and urine osmolality, decreased urine sodium and specific gravity

Fluid Volume Deficit; Nursing Care

Assess vital signs regularly
Postural (orthostatic) hypotension: ↓ in sys BP > 15 mmHg or ↑ HR > 15 beats/min
Daily weights: single best indicator of fluid volume status in adults
Apply safety measures: orthostatic hypotension, dizziness, and falls
Accurate record of intake and output: record drainage from body orifices and wound(s)
Administer free water (flush) to patients receiving enteral feedings
Urge caution in drinking coffee, tea, and colas with caffeine, which has a diuretic effect

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Description

Learn about the distribution of body fluids, including intracellular and extracellular fluids, and how they change with age. Understand the composition of fluids in the human body.