Fluid and Electrolyte Basics Quiz
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Questions and Answers

What is fluid osmolality?

How concentrated a fluid is

What does hyperosmolar mean?

More solutes, less water

What does hypoosmolar mean?

Less solutes, more water

What are electrolytes?

<p>Substances that are charged particles when placed in water</p> Signup and view all the answers

What are the fluid compartments of the body?

<p>Intravascular, interstitial, intracellular</p> Signup and view all the answers

Imbalances of electrolytes can be different depending on what fluid compartment was assessed.

<p>True</p> Signup and view all the answers

What three processes is the maintenance of fluid and electrolyte balance dependent on?

<p>Intake and absorption, distribution, output</p> Signup and view all the answers

What is the intake and absorption of fluids and electrolytes?

<p>The addition of fluid and electrolytes to the body and their movement into the blood</p> Signup and view all the answers

What osmolality of body fluids will activate the thirst mechanism?

<p>Increased osmolality</p> Signup and view all the answers

Why do older adults tend to be more dehydrated?

<p>The thirst mechanism is blunted in older adults</p> Signup and view all the answers

What is absorption from the GI tract dependent on?

<p>Healthy intestines</p> Signup and view all the answers

What are the two major extracellular body fluid compartments?

<p>Intravascular, interstitial</p> Signup and view all the answers

What are the two processes that help regulate and determine fluid distribution?

<p>Hydrostatic pressure, colloid osmotic pressure</p> Signup and view all the answers

What is hydrostatic pressure?

<p>The force exerted on capillary walls by the volume of fluid within the intravascular space</p> Signup and view all the answers

What is the main cause of increased hydrostatic pressure and fluid shifting out of the blood vessels?

<p>Venous congestion</p> Signup and view all the answers

What is colloid osmotic pressure?

<p>The contribution of plasma proteins to the total blood osmotic pressure</p> Signup and view all the answers

What is albumin?

<p>A large protein molecule that attracts fluid and holds fluid around it</p> Signup and view all the answers

What are low albumin concentrations caused by?

<p>Severe liver disease, protein malnutrition</p> Signup and view all the answers

What is osmosis?

<p>Movement of fluid across a semipermeable cell membrane</p> Signup and view all the answers

What is diffusion?

<p>Electrolytes will shift opposite of the fluid</p> Signup and view all the answers

What are the normal vs abnormal routes of output?

<p>Normal: renal, GI, skin, lungs. Abnormal: emesis, hemorrhage, drainage</p> Signup and view all the answers

What is the renin-angiotensin-aldosterone system?

<p>The hormone system that regulates blood pressure and fluid balance</p> Signup and view all the answers

What causes antidiuretic hormone to be released?

<p>Increased plasma osmolality</p> Signup and view all the answers

What are the causes of dysfunction in antidiuretic hormone being released?

<p>Diabetes insipidus, syndrome of inappropriate diuretic hormone</p> Signup and view all the answers

What are the causes of greater output than intake and absorption?

<p>Decreased water or sodium intake, vomiting, diarrhea, increased urine output, wound drainage</p> Signup and view all the answers

What are the results of greater output than intake and absorption?

<p>Extracellular fluid deficit, increased serum osmolality, electrolyte deficits</p> Signup and view all the answers

What are the causes of greater intake and absorption than output?

<p>Excessive IV infusion of isotonic fluids, increased intake of Na containing food, oliguria, heart failure, corticosteroids, Cushing's</p> Signup and view all the answers

What are the results of greater intake and absorption than output?

<p>Extracellular fluid excess, decreased serum osmolality, electrolyte excesses</p> Signup and view all the answers

What are the causes of altered fluid and electrolyte distributions between the three body fluid compartments?

<p>Third spacing, specific electrolyte imbalances</p> Signup and view all the answers

What are the results of altered fluid and electrolyte distributions between the three body fluid compartments?

<p>Third spacing, edema, electrolyte deficits or excesses</p> Signup and view all the answers

What are the consequences of intravascular fluid deficit?

<p>Decreased cardiac output, impaired perfusion</p> Signup and view all the answers

What are the consequences of intravascular fluid excess?

<p>Impaired oxygenation, pulmonary edema</p> Signup and view all the answers

What are the consequences of electrolyte imbalances?

<p>Can cause cardiac arrhythmias and impair neuromuscular function.</p> Signup and view all the answers

What are the consequences of changes in osmolality?

<p>Can impair cerebral function</p> Signup and view all the answers

What are the causes of hypervolemia?

<p>Taking in too much fluid, not secreting enough fluid</p> Signup and view all the answers

What abnormal findings will you see when assessing a patient with hypervolemia?

<p>Changes in LOC, skin taut and shiny with edema, lungs congested, heart issues, decreased urine output</p> Signup and view all the answers

How does hypervolemia affect serum sodium?

<p>Causes hyponatremia</p> Signup and view all the answers

How does hypervolemia affect hemoglobin and hematocrit?

<p>Low hemoglobin and hematocrit</p> Signup and view all the answers

What are the symptoms of hyperkalemia?

<p>Musculoskeletal irritability, muscle twitching, anxiety, hypotension, seizures</p> Signup and view all the answers

When is hyperkalemia treated?

<p>Potassium levels near 6 or sometimes near 5.5</p> Signup and view all the answers

What is the treatment of hyperkalemia?

<p>Insulin and dextrose, NaHCO3, CaCl, kayexalate, dialysis</p> Signup and view all the answers

How does acidosis affect potassium levels?

<p>Potassium increases in acidosis</p> Signup and view all the answers

What is hypokalemia?

<p>Serum potassium level &lt; 3.5 mEq/L</p> Signup and view all the answers

What are the causes of hypokalemia?

<p>Loop diuretics, diuresis, alkalosis, GI losses</p> Signup and view all the answers

How does hypokalemia affect heart rhythms?

<p>Arrhythmias, usually tachycardias or ectopics</p> Signup and view all the answers

What are the symptoms of hypokalemia?

<p>Irregular arrhythmias, muscle cramping, weakness, confusion</p> Signup and view all the answers

What is the treatment of hypokalemia?

<p>Potassium replacement (PO or IV)</p> Signup and view all the answers

What is potassium chloride?

<p>Potassium replacement</p> Signup and view all the answers

How does alkalosis affect potassium levels?

<p>Alkalosis decreases potassium levels</p> Signup and view all the answers

How does hypokalemia cause digoxin toxicity?

<p>Hypokalemia can lead to digoxin toxicity, even with therapeutic doses.</p> Signup and view all the answers

Study Notes

Fluid and Electrolyte Basics

  • Fluid osmolality reflects the concentration of solutes in a fluid.
  • Hyperosmolar: more solutes, less water - indicates concentrated fluids.
  • Hypoosmolar: less solutes, more water - indicates diluted fluids.

Electrolytes

  • Electrolytes are charged particles in solution, essential for many bodily functions.
  • Body fluid compartments include intravascular (within blood vessels), interstitial (in tissues), and intracellular (inside cells).
  • Electrolyte imbalances may vary by body fluid compartment assessed.

Fluid Balance Processes

  • Maintenance of fluid and electrolyte balance relies on intake/absorption, distribution, and output.
  • Intake involves adding fluids (e.g., orally or IV) to the body and moving them into the bloodstream.

Osmolality and Thirst Mechanism

  • Increased osmolality activates thirst; older adults experience a blunted thirst response.
  • Absorption from the GI tract requires healthy intestinal function, with vitamin D aiding calcium absorption.

Pressure Influences on Fluid Dynamics

  • Hydrostatic pressure: force from intravascular fluid volume, impacting fluid movement across capillary membranes.
  • Venous congestion (e.g., right-sided heart failure) increases hydrostatic pressure, causing fluid to shift out of vessels and leading to edema.

Colloid Osmotic Pressure

  • Depends on plasma protein concentration, primarily albumin.
  • Low albumin levels can lead to peripheral edema and ascites, often seen in liver disease.

Osmosis and Diffusion

  • Osmosis: fluid movement across cell membranes from lower to higher osmolality regions.
  • Diffusion: electrolyte movement opposite to fluid movement across semi-permeable membranes.

Output Routes and Abnormalities

  • Normal fluid output occurs through renal, GI, skin, and lungs; abnormal losses can stem from emesis, hemorrhage, or drainage.

Hormonal Regulation

  • Renin-angiotensin-aldosterone system regulates blood pressure and fluid balance, enhancing sodium and water retention to improve perfusion during low blood flow events.
  • Antidiuretic hormone (ADH) release is triggered by increased plasma osmolality, promoting water reabsorption in the kidneys.

Fluid and Electrolyte Imbalances

  • Greater output than intake leads to extracellular fluid deficit, increased serum osmolality, and electrolyte deficits.
  • Greater intake than output causes extracellular fluid excess, decreased serum osmolality, and electrolyte excesses.

Consequences of Fluid Deficits and Excesses

  • Intravascular fluid deficit results in decreased cardiac output and impaired perfusion.
  • Intravascular fluid excess leads to pulmonary edema and impaired oxygenation.

Electrolyte Imbalances and Risks

  • Electrolyte imbalances can cause cardiac arrhythmias and impaired neuromuscular function.
  • Hyponatremia and hypernatremia can significantly affect cerebral function.

Hypervolemia Causes and Symptoms

  • Hypervolemia arises from excessive fluid intake or insufficient fluid secretion, leading to changes in LOC, skin edema, pulmonary congestion, and decreased urine output.
  • Causes hyponatremia by diluting serum sodium, alongside low hemoglobin and hematocrit levels.

Hyperkalemia

  • Symptoms include muscle irritability, hypotension, bradycardic rhythms, seizures, and gastrointestinal disturbances.
  • Treated at potassium levels around 5.5 to 6 with methods such as insulin and dextrose, NaHCO3, calcium chloride, kayexalate, or dialysis.

Hypokalemia

  • Defined as serum potassium < 3.5 mEq/L, commonly due to diuretics or GI losses.
  • Symptoms may manifest as bradycardia, cramping, confusion, and fatigue.
  • Treated through potassium replacement, either orally or intravenously.

Potassium Handling

  • Potassium chloride is a key potassium replacement drug but requires careful monitoring due to risks of rapid infusion and phlebitis.
  • Alkalosis leads to lower potassium levels, while acidosis can raise them, influencing digoxin toxicity risk in hypokalemic patients.

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Description

Test your knowledge on fluid and electrolyte basics, including osmolality, electrolyte functions, and fluid balance processes. This quiz covers essential concepts related to the body's fluid compartments and the mechanisms that regulate fluid intake and absorption.

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