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Questions and Answers
What is one function of water in the body?
What is one function of water in the body?
Which process describes the movement of ions from an area of higher concentration to an area of lower concentration across a semi-permeable membrane?
Which process describes the movement of ions from an area of higher concentration to an area of lower concentration across a semi-permeable membrane?
How is homeostasis related to body fluids primarily maintained?
How is homeostasis related to body fluids primarily maintained?
What role do electrolytes play in the body?
What role do electrolytes play in the body?
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Which of the following best describes osmosis?
Which of the following best describes osmosis?
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Which of the following is a cause of hypercalcemia?
Which of the following is a cause of hypercalcemia?
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What role does magnesium play in the body?
What role does magnesium play in the body?
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Which electrolyte is primarily regulated by the kidneys?
Which electrolyte is primarily regulated by the kidneys?
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Which statement about phosphate is correct?
Which statement about phosphate is correct?
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What percentage of total body weight is typically composed of body water in a healthy adult?
What percentage of total body weight is typically composed of body water in a healthy adult?
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Which of the following can lead to dehydration?
Which of the following can lead to dehydration?
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Which compartment accounts for approximately one-third of total body fluid?
Which compartment accounts for approximately one-third of total body fluid?
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What should a nurse assess to monitor fluid and electrolyte balance?
What should a nurse assess to monitor fluid and electrolyte balance?
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What is the normal range for blood osmolality?
What is the normal range for blood osmolality?
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What role do electrolytes play in the human body?
What role do electrolytes play in the human body?
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Which group of electrolytes carries a positive charge?
Which group of electrolytes carries a positive charge?
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Which condition is likely to predispose an individual to respiratory acidosis?
Which condition is likely to predispose an individual to respiratory acidosis?
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How is the distribution of body fluids primarily affected?
How is the distribution of body fluids primarily affected?
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Which of the following statements is true regarding acid-base balance regulation in the body?
Which of the following statements is true regarding acid-base balance regulation in the body?
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What is the primary function of water in the human body?
What is the primary function of water in the human body?
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What is the primary characteristic of electrolytes in body fluids?
What is the primary characteristic of electrolytes in body fluids?
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What is the normal pH range of body fluids for optimal function?
What is the normal pH range of body fluids for optimal function?
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Which of the following is NOT a nursing management strategy for fluid overload?
Which of the following is NOT a nursing management strategy for fluid overload?
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Which body system plays a significant role in the immediate regulation of acid-base balance?
Which body system plays a significant role in the immediate regulation of acid-base balance?
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What does an increase in blood CO2 levels typically result in?
What does an increase in blood CO2 levels typically result in?
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What is the primary function of buffers in the body?
What is the primary function of buffers in the body?
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Which electrolyte is monitored closely in fluid overload management?
Which electrolyte is monitored closely in fluid overload management?
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How do the kidneys regulate acid-base balance over the long term?
How do the kidneys regulate acid-base balance over the long term?
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Elevating the legs and encouraging movement in fluid overload patients primarily helps to address which issue?
Elevating the legs and encouraging movement in fluid overload patients primarily helps to address which issue?
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What is the main end product of muscle metabolism that is measured for assessing kidney function?
What is the main end product of muscle metabolism that is measured for assessing kidney function?
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Which nursing diagnosis is associated with fluid volume deficit?
Which nursing diagnosis is associated with fluid volume deficit?
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Which is a common cause of dehydration?
Which is a common cause of dehydration?
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What symptom is commonly associated with fluid volume overload?
What symptom is commonly associated with fluid volume overload?
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Which assessment finding indicates acute dehydration?
Which assessment finding indicates acute dehydration?
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Which of the following interventions is a part of acute care for fluid volume issues?
Which of the following interventions is a part of acute care for fluid volume issues?
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What is a common clinical manifestation of hypovolemia?
What is a common clinical manifestation of hypovolemia?
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Which strategy is NOT typically used for managing fluid overload?
Which strategy is NOT typically used for managing fluid overload?
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What is the primary cause of hyponatremia related to sodium excretion?
What is the primary cause of hyponatremia related to sodium excretion?
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Which of the following conditions can lead to hypercalcemia?
Which of the following conditions can lead to hypercalcemia?
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What concentration defines hyponatremia in the serum sodium level?
What concentration defines hyponatremia in the serum sodium level?
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Which factor does not contribute to the development of hypocalcemia?
Which factor does not contribute to the development of hypocalcemia?
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What is the normal calcium level in the serum before it is classified as hypocalcemia?
What is the normal calcium level in the serum before it is classified as hypocalcemia?
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Which of the following reflects a correct understanding of the intracellular and extracellular calcium distribution?
Which of the following reflects a correct understanding of the intracellular and extracellular calcium distribution?
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What effect does excessive ingestion of hypotonic fluids have on sodium levels?
What effect does excessive ingestion of hypotonic fluids have on sodium levels?
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Which factor is least likely to cause hypercalcemia?
Which factor is least likely to cause hypercalcemia?
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Study Notes
Fluid and Electrolyte Balance
- Fluid and electrolytes are crucial for optimal body function
- Homeostasis is the body's mechanism to maintain normal conditions. This includes body temperature, blood electrolytes (sodium, potassium, calcium), blood pH, and blood volume.
- Total body water (TBW) is 50% to 60% of body weight in a healthy adult.
- Infants have significantly more TBW and extracellular fluid (ECF) than adults. Age, sex, and fat content influence TBW.
- Women and obese individuals generally have less body water than men.
Body Fluid Distribution
- Body fluids are categorized into two main compartments:
- Extracellular fluid (ECF): Found outside the cells, comprises approximately one-third of the total body fluid. It further divides into intravascular (within blood vessels) and interstitial (surrounding cells) fluids.
- Intracellular fluid (ICF): Located within the cells, and makes up about two-thirds of the total body fluid.
Body Fluids Summary
- ECF (15 Liters): Comprises interstitial and intracellular fluids
- ICF (25 Liters): Fluid within cells.
Composition of Body Fluids
- Body fluids contain electrolytes:
- Anions (negative charge): Chloride (Cl−), bicarbonate (HCO3−)
- Cations (positive charge): Sodium (Na+), potassium (K+), calcium (Ca2+), Magnesium (Mg2+)
- Electrolytes are measured in milliequivalents per liter (mEq/L).
Functions of Water
- Water is the primary solvent in the body.
- Essential for regulating temperature.
- Transporta nutrients, electrolytes, and oxygen to the cells.
- Facilitates waste excretion.
- Lubricates joints and membranes.
- Essential for digestion.
- Forms a major component of blood plasma.
- Vital for metabolism.
Functions of Electrolytes
- Crucial for neuromuscular function.
- Maintain fluid volume and osmotic pressure.
- Enable the distribution of water between different fluid compartments.
- Regulate acid-base balance.
Movement of Body Fluids and Electrolytes
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Osmosis: Movement of water across a semi-permeable membrane from an area of lower solute concentration to an area of higher solute concentration to equalize concentration.
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Osmotic pressure: Water`s drawing power.
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Osmolarity: Concentration of a solution.
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Diffusion: Movement of ions and molecules (solute) from an area of higher concentration to an area of lower concentration to achieve equilibrium.
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Filtration: Movement of fluid and solute together across a membrane from an area of higher pressure to an area of lower pressure.
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Active Transport: Process that moves substances against a concentration gradient using energy, important in maintaining sodium and potassium concentration gradients between ECF and ICF.
Regulation of Body Fluids
- Homeostasis is maintained through:
- Fluid intake regulation
- Hormonal regulation
- Fluid output regulation
Acid-Base Balance
- Acids: Release hydrogen ions (H+) in solutions.
- Bases: Accept hydrogen ions (H+) in solutions.
- pH: Reflects hydrogen ion (H+) concentration in a solution. A lower pH indicates a higher H+ concentration and acidity. Body fluids are slightly alkaline (normal pH range is 7.35-7.45).
Important Ions
- PaCO2: Partial pressure of carbon dioxide, measured to assess acid-base status. Normal range is about 35-45 mm Hg.
- HCO3−: Bicarbonate, a key component of the body's buffer system and measured to assess acid-base status, normal range is 22-26 mEq/L.
Acid-Base Regulation
- Three body systems regulate acid-base balance:
- Buffers
- Respiratory System
- Renal System.
Buffers
- Prevent drastic pH changes by absorbing or releasing hydrogen ions.
Respiratory Regulation
- Lungs regulate pH by controlling carbon dioxide (CO2) levels in blood. Higher breathing rate reduces CO2, making the resultant blood more alkaline.
Renal Regulation
- Kidneys regulate pH over hours by controlling bicarbonate (HCO3−) levels.
Types of Acid-Base Imbalances
- Respiratory acidosis
- Respiratory alkalosis
- Metabolic acidosis
- Metabolic alkalosis
- Mixed pattern
Home IV therapy
- Nutritional support
- Medication safety
- Patient education
Fluid Intake and Output
- Intake: oral fluids, water in food, metabolism
- Output: urine, feces, insensible losses (lungs, skin, sweat)
Electrolyte Imbalances
- Hypokalemia: Low potassium
- Hyperkalemia: High potassium
- Hyponatremia: Low sodium
- Hypernatremia: High sodium
- Hypocalcemia: Low calcium
- Hypercalcemia: High calcium
- Hypomagnesemia: Low magnesium
Assessment of Fluid Deficits/Overload
- Fluid deficit: Hypotension, weak rapid pulse, decreased temperature if hypovolemic, increased in dehydration, weight loss, poor skin turgor, concentrated urine and blood. Signs in infants include sunken fontanelle, sunken eyes, and poor skin turgor.
- Fluid overload: Weight gain, bounding pulse, dyspnea, cough, crackles, jugular vein distention, edema, increased blood pressure
Causes of Dehydration
- Hemorrhage
- Vomiting
- Diarrhea
- Profuse salivation
- Fistulas
- Abscesses
- Burns
- Severe wounds
- Diuretic therapy
- GIT suctioning
Causes of Fluid Overload
- Excess intake of fluids
- Excess intake of sodium
- Congestive heart failure
- Cirrhosis
- Renal failure
- Normal postoperative response
Nursing Management of Fluid Overload
- Daily weights
- Strict I&O monitoring
- Reduced fluid intake
- Reduced sodium intake
- Diuretics administration
- Electrolyte monitoring
- Elevating the legs
Assessment Cont.
- Nursing history: Age, prior medical history, acute illness, surgery, chronic illness (cancer, CVD, renal disorders, GI disturbances), burns, respiratory disorders, head injury
- Environmental factors: Diet, lifestyle, medications
Laboratory Studies
- Osmolality: Concentration of blood and urine per kilogram.
- Blood osmolarity: 280-300 mOsm/kg
- Urine osmolarity: 50-1400 mOsm/kg
- BUN: 10-20 mg/dL (blood urea nitrogen), produced by the liver
- Creatinine: 0.7-1.5 mg/dL (muscle metabolism by-product)
- Serum electrolytes: Sodium (Na+), potassium (K+)
Nursing Diagnoses
- Decreased cardiac output
- Acute Confusion
- Deficient fluid volume
- Excess fluid volume
- Impaired gas exchange
- Deficient knowledge
- Impaired skin integrity
- Ineffective tissue perfusion
Planning
- Determine goals and outcomes
- Set priorities
- Collaborative care (Medical doctor, dietician, pharmacy)
Implementation
- Health promotion (education)
- Acute care (enteral/parenteral fluid/electrolyte replacement, total parenteral nutrition (TPN), IV fluids, blood products, transfusion reactions).
- Acute Care (enteral/parenteral fluid/electrolyte replacement, total parenteral nutrition (TPN), IV fluids, blood products, transfusion reactions), blood groups, autologous transfusions
- Restoration (Home IV therapy, nutritional support, medication safety, patient education).
Evaluation
- Determine if goals have been met.
- Assess for changes in the patient's assessment (symptoms)
- Evaluate to decide whether the plan should be continued or revised according to patient progress.
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Description
Test your knowledge on fluid and electrolyte balance in the human body. Explore concepts like homeostasis, body fluid distribution, and factors affecting total body water. This quiz will help reinforce your understanding of essential physiological processes.
