Chronic Illness and Fluid Imbalances

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Questions and Answers

What condition is primarily characterized by fluid retention due to pump failure?

Respiratory failure

Liver failure

Cardiac failure

Renal failure (correct)

Which of the following imbalances relates specifically to excess and deficit of extracellular fluid volume?

Metabolic alkalosis

Respiratory acidosis

Extracellular fluid volume imbalance (correct)

Water deficit or hyperosmolality

Which factor is NOT typically associated with fluid, electrolyte, and acid-base balance disturbances?

Pregnancy

Nutrition intake (correct)

Chronic illnesses

Surgery

What is a common manifestation of fluid, electrolyte, or acid-base imbalances?

Changes in mental status Signup and view all the answers

What age group is at the greatest risk for fluid and electrolyte imbalance?

Older adults Signup and view all the answers

Which condition involves the imbalance of carbon dioxide and pH levels?

Respiratory failure Signup and view all the answers

What is the expected body water percentage in newborns compared to adults?

70-80% Signup and view all the answers

Which type of imbalance is characterized by abnormal tissue hydration?

Fluid imbalance Signup and view all the answers

What primarily regulates the balance of fluid intake and output in a healthy person?

Thirst mechanism and the kidneys Signup and view all the answers

What is the definition of hypovolemia?

A diminished blood volume Signup and view all the answers

What is the normal serum range for calcium levels?

8.2-10.5 mEq/L Signup and view all the answers

Which of the following conditions can lead to hypovolemia?

Frequent urination Signup and view all the answers

Which of the following conditions can result in hypercalcemia?

Low phosphates in the blood Signup and view all the answers

How does hydrostatic pressure affect fluid movement?

It causes filtration from higher to lower pressure Signup and view all the answers

Which hormone system is involved in regulating fluid volume?

Renin-angiotensin-aldosterone system Signup and view all the answers

What is a common complication associated with hypokalemia?

Muscle fatigue Signup and view all the answers

Which test signs are associated with hypocalcemia?

Trousseau’s sign and Chvostek’s sign Signup and view all the answers

What is the result of a significant decrease in extracellular volume?

Stimulation of the thirst response Signup and view all the answers

What role does phosphorus play in the body?

Acts as a major buffer in maintaining acid-base balance Signup and view all the answers

What primarily opposes the outward flow of fluid from blood vessels?

Osmotic pressure Signup and view all the answers

Which clinical sign is commonly associated with hypovolemia?

Hypotension Signup and view all the answers

What condition is characterized by decreased phosphorus levels?

Hypophosphatemia Signup and view all the answers

Which of the following factors can contribute to hyperphosphatemia?

Renal failure Signup and view all the answers

Which of the following nutrients is necessary for GI absorption of calcium?

Vitamin D Signup and view all the answers

What is the normal serum range of magnesium?

1.5-2.5 mg/dL Signup and view all the answers

Which condition is characterized by low magnesium levels?

Hypomagnesemia Signup and view all the answers

What is the primary regulatory mechanism for chloride in the body?

Kidneys Signup and view all the answers

What term describes elevated levels of chloride?

Hyperchloremia Signup and view all the answers

What can lead to hypomagnesemia?

Chronic alcohol consumption Signup and view all the answers

Which of the following plays a significant role in maintaining acid-base balance?

Bicarbonate ions Signup and view all the answers

A fluid with a pH of 5.3 would be classified as what type of substance?

Acidic Signup and view all the answers

What could cause hypermagnesemia?

Excessive magnesium intake Signup and view all the answers

What compartment contains the most bodily fluid in adults?

Intracellular compartment Signup and view all the answers

Which of the following is NOT a risk factor for fluid imbalance?

Increased physical activity Signup and view all the answers

What is the primary reason for conducting daily weights in patients at risk for ECF volume problems?

To evaluate for ECF imbalances Signup and view all the answers

Which method is used to measure fluid intake?

All oral and parenteral fluids Signup and view all the answers

What vital sign is critical in assessing fluid balance?

Blood pressure Signup and view all the answers

How should daily weights be accurately obtained?

Use the same scale at the same time each day Signup and view all the answers

Which assessment can indicate a fluid imbalance?

Change in skin turgor Signup and view all the answers

What should be included in the assessment of fluid intake?

Both liquid foods and parenteral fluids Signup and view all the answers

Study Notes

Fluid and Electrolyte Balance

Antidiuretic hormone (AVP) production increases renal water excretion.
Imbalances often linked to renal failure, cardiac failure (fluid retention), liver failure (ascites), respiratory failure, and chemotherapy.

Factors Influencing Balance

Key conditions affecting fluid, electrolyte, and acid-base balance include:
- Renal failure (filtering issues)
- Cardiac failure (pump issues)
- Liver failure
- Respiratory failure
- Surgery and pregnancy

Fluid Imbalance Types

Extracellular fluid volume imbalance:
- Deficit
- Excess
Water or osmolality imbalance:
- Deficit or hyperosmolality
- Excess or hyposmolality

Acid-Base Imbalance Types

Respiratory acidosis
Metabolic acidosis
Respiratory alkalosis
Metabolic alkalosis

Manifestations of Imbalances

Imbalance in intake/output and body weight.
Changes in mental status and vital signs (respiratory rate, heart rate, blood pressure).
Abnormal tissue hydration and muscle tone.

Life Span Considerations

Very young and very old individuals are at higher risk for fluid and electrolyte imbalances.

Newborn and Infant Considerations

Newborns have a body water percentage of 70-80%, making dehydration more likely.

Pressures Affecting Fluid Movement

Osmotic pressure keeps fluid within blood vessels.
Hydrostatic pressure aids fluid filtration from high-pressure areas to low-pressure zones.
Filtration pressure is the difference between hydrostatic and osmotic pressures.

Mechanisms of Fluid Volume Regulation

Fluid intake and output regulation through:
- Thirst response
- Kidney function
- Renin-angiotensin-aldosterone system
- Atrial natriuretic peptide (ANP)

Fluid Volume Deficits

Hypovolemia refers to decreased blood volume due to fluid loss, reduced intake, or fluid shift.
Causes: Hemorrhage, vomiting, diarrhea, fever, burns.
Symptoms: Hypotension, tachycardia, dry mucous membranes, decreased urine output.

Fluid Volume Excess

Hypervolemia is excess fluid volume, potentially due to conditions like alcohol use or renal failure.
Complications may include apnea, muscle fatigue, and EKG changes.

Key Electrolytes

Calcium:
- Crucial for neuromuscular function, blood clotting, and bone health.
- Normal serum range: 8.2-10.5 mEq/L.
- Low levels (hypocalcemia) can result from hypoparathyroidism or vitamin D deficiency.
Phosphorus:
- Major intracellular anion involved in bone health and metabolism.
- Normal range: 2.5-4.5 mg/dL.
- Decreases (hypophosphatemia) may arise from alkalosis; increases (hyperphosphatemia) associated with renal failure.
Magnesium:
- Major intracellular cation vital for muscle and nerve function.
- Normal range: 1.5-2.5 mg/dL.
- Low levels (hypomagnesemia) can result from malnutrition; high levels (hypermagnesemia) from renal failure.
Chloride:
- Major extracellular anion crucial for acid-base balance.
- Normal serum range: 95-105 mEq/L.
- Low (hypochloremia) often due to excessive vomiting; high (hyperchloremia) due to increased ingestion or decreased excretion.

Acid-Base Balance Overview

Regulation through buffering and compensation mechanisms (respiratory and renal).

Assessment Criteria

Assess history of fluid, electrolyte, or acid-base issues.
Monitor dietary habits and fluid intake/output patterns.
Physical assessment includes vital signs, body weight, and integumentary examination.

Daily Weighing Protocol

Weigh patients daily at the same time, preferably in the morning, for accuracy.
Consistent clothing and scales improve reliability.

Integumentary Assessment

Skin turgor and membrane condition offer insights into hydration status.

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Description

This quiz covers the impact of chronic illnesses such as renal, cardiac, liver, and respiratory failures on fluid imbalances in the body. Learn how these conditions affect renal excretion and overall fluid regulation, including the effects of treatments like chemotherapy. Test your understanding of these critical concepts in managing chronic health issues.