JC HBHD 2 Week 1 Chapter 21 Fluid and Electrolytes

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Questions and Answers

What is the approximate total body water volume in liters for a healthy, nonobese 70-kg male?

  • 20 L
  • 30 L
  • 50 L
  • 40 L (correct)

How does fat content affect total body water?

  • Higher fat content leads to higher total body water.
  • Fat content has no impact on total body water.
  • Higher fat content leads to lower total body water. (correct)
  • Higher fat content leads to a more stable total body water.

What is the approximate percentage of body weight attributed to water in a newborn infant?

  • 60%
  • 40%
  • 50%
  • 80% (correct)

Which of the following factors contributes to the variation in total body water?

<p>Gender (C)</p> Signup and view all the answers

Which of the following is not a body fluid compartment?

<p>Blood serum (C)</p> Signup and view all the answers

What is the underlying cause of water intoxication?

<p>Excessive intake of water without sufficient electrolyte replenishment. (A)</p> Signup and view all the answers

Which of these is NOT a characteristic of electrolytes?

<p>They include compounds like glucose. (B)</p> Signup and view all the answers

What is pitting edema?

<p>Swelling caused by high interstitial fluid volume, where depressions in the skin do not rapidly refill. (A)</p> Signup and view all the answers

Which hormone plays a key role in restoring normal extracellular fluid volume?

<p>Aldosterone. (C)</p> Signup and view all the answers

What is a cation?

<p>A positively charged ion like potassium (K+) or sodium (Na+). (B)</p> Signup and view all the answers

What is the main cause of hypernatremia?

<p>A relative deficit of water to salt in extracellular fluid (A)</p> Signup and view all the answers

A patient presents with skeletal muscle weakness, paralysis, and cardiac arrest. Which electrolyte imbalance is most likely present?

<p>Hyperkalemia (D)</p> Signup and view all the answers

Which of the following conditions can cause hypocalcemia?

<p>Pancreatitis (A)</p> Signup and view all the answers

What is the primary symptom associated with both hypernatremia and hyponatremia?

<p>Central nervous system malfunction (A)</p> Signup and view all the answers

A patient with a history of prolonged diarrhea is suspected of having an electrolyte imbalance. Which electrolyte imbalance is most likely to be present?

<p>Hypernatremia (D)</p> Signup and view all the answers

Which condition is characterized by increased neuromuscular irritability, including cramping, muscle twitching, and hyperactive reflexes?

<p>Hypocalcemia (C)</p> Signup and view all the answers

Which of the following is NOT a cause of hyperkalemia?

<p>Excessive secretion of antidiuretic hormone (B)</p> Signup and view all the answers

Which electrolyte imbalance is most commonly associated with the use of certain laxatives and diuretics?

<p>Hypokalemia (C)</p> Signup and view all the answers

Which of the following statements accurately describes the role of antidiuretic hormone (ADH) in fluid balance?

<p>ADH is released from the posterior pituitary gland when ECF volume is low, promoting water reabsorption in the kidneys. (A)</p> Signup and view all the answers

Which fluid compartment contains the largest volume of water in the human body?

<p>Intracellular fluid (ICF) (D)</p> Signup and view all the answers

What is the primary function of aldosterone in regulating fluid balance?

<p>Aldosterone stimulates the kidneys to reabsorb sodium and water, decreasing urine output and increasing ECF volume. (A)</p> Signup and view all the answers

How does increased capillary blood pressure influence fluid movement in the body?

<p>Increased capillary blood pressure promotes fluid movement from the bloodstream into the interstitial fluid. (A)</p> Signup and view all the answers

What is the primary source of metabolic water in the body?

<p>Cellular respiration (B)</p> Signup and view all the answers

Which of the following is NOT a direct contributor to fluid output in the human body?

<p>Liver (D)</p> Signup and view all the answers

How does the body compensate for inadequate fluid intake when thirst sensation is not triggered?

<p>The body conserves available fluids by decreasing saliva production and fluid output. (C)</p> Signup and view all the answers

Which of the following statements best describes the concept of dehydration?

<p>Dehydration occurs only when fluid output exceeds intake for an extended period. (C)</p> Signup and view all the answers

A patient's electrolyte panel reveals a potassium level of 6.2 mEq/L. Which EKG change would you most likely observe?

<p>Tall T wave (D)</p> Signup and view all the answers

Which of the following conditions is most likely to cause the EKG abnormality of a flattened or prolonged ST segment?

<p>Hypocalcemia (C)</p> Signup and view all the answers

A patient undergoing a blood transfusion develops hypocalcemia. What is the most likely cause of this electrolyte imbalance in this scenario?

<p>Citrate chelation (C)</p> Signup and view all the answers

Which EKG change is most closely associated with hypokalemia?

<p>&quot;U&quot; waves (C)</p> Signup and view all the answers

A patient with a history of bone tumors is admitted. Which electrolyte imbalance is the patient most at risk for?

<p>Hypercalcemia (C)</p> Signup and view all the answers

Which of the following electrolyte imbalances is most likely associated with a widened QRS complex on an EKG?

<p>Hyperkalemia (D)</p> Signup and view all the answers

A patient presents with increased cardiac contractility and a very short ST segment on their EKG. Which electrolyte imbalance is most likely?

<p>Hypercalcemia (A)</p> Signup and view all the answers

A patient is diagnosed with rhabdomyolysis. Which electrolyte imbalance is most likely to occur as a direct result of this condition?

<p>Hyperkalemia (D)</p> Signup and view all the answers

A patient's serum sodium level is reported as 150 mEq/L. Which of the following conditions is the patient most likely experiencing?

<p>Hypernatremia (D)</p> Signup and view all the answers

Which of the following physiological processes is directly dependent on sodium ions?

<p>Nerve function (D)</p> Signup and view all the answers

If a patient is diagnosed with hyponatremia, which of the following would be the expected serum sodium level?

<p>130 mEq/L (C)</p> Signup and view all the answers

The kidneys play a crucial role in maintaining sodium balance in the body. How do the kidneys primarily regulate sodium levels?

<p>By excreting or reabsorbing sodium ions (C)</p> Signup and view all the answers

How does sodium contribute to the regulation of fluid balance in the body?

<p>By influencing the distribution of water between intracellular and extracellular fluids (B)</p> Signup and view all the answers

Flashcards

Body Fluid Volume Variation

Total body water varies by weight, fat, gender, and age.

Body Fluid Compartments

Body fluids are divided into plasma, interstitial fluid, and intracellular fluid.

Fluid Balance Mechanisms

The body uses several mechanisms to maintain fluid balance.

Electrolyte Importance

Electrolytes are vital for many body functions, including fluid balance.

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Common Fluid Imbalances

Fluid imbalances can lead to dehydration or overhydration.

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Overhydration

A condition where fluid intake exceeds output, leading to excess body fluid volume.

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Water intoxication

Severe overhydration causing potentially life-threatening neurological impairment and electrolyte imbalance.

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Electrolytes

Compounds that dissociate in water into ions, essential for body fluid balance.

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Cations

Positively charged ions, such as potassium (K+) and sodium (Na+).

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Pitting edema

Swelling from high interstitial fluid volume; persists when pressure is applied to the skin.

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Electrolyte Imbalance

Disruption in homeostatic control of electrolyte levels in body fluids.

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Hypernatremia

Blood sodium level greater than 145 mEq/L; water deficit relative to salt in ECF.

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Hyponatremia

Blood sodium level less than 136 mEq/L; too much water for sodium in ECF.

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Hyperkalemia

Blood potassium level more than 5.1 mEq/L, causing muscle malfunction.

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Hypokalemia

Blood potassium level less than 3.5 mEq/L, causing cardiac and skeletal issues.

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Hypercalcemia

Blood calcium levels exceeding 10.5 mg/dL; leads to decreased neuromuscular activity.

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Hypocalcemia

Blood calcium levels less than 8.4 mg/dL; causes increased neuromuscular irritability.

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CNS Symptoms of Sodium Imbalances

Headache, confusion, seizures, and coma from sodium imbalances.

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Extracellular Fluid (ECF)

The fluid that surrounds cells and transports substances.

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Intracellular Fluid (ICF)

The largest fluid compartment located inside cells.

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Fluid Intake Sources

Ways the body gains fluid: drinking liquids, food, and metabolism.

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Fluid Output Sources

Ways the body loses fluid: respiration, sweating, urine, and feces.

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Antidiuretic Hormone (ADH)

A hormone that conserves water during low ECF volume.

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Fluid Imbalance - Dehydration

Condition where total body fluid volume is less than normal.

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Capillary Blood Pressure Effects

High blood pressure moves fluid from blood to interstitial fluid.

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Regulation of Fluid Intake

Hypothalamus signals thirst when ECF volume changes.

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Ion

An atom or molecule with a net electrical charge due to the loss or gain of electrons.

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Anion

A negatively charged ion.

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Normal Sodium (Na+) Level

Normal range: 135-145 mEq/L, the primary cation in extracellular fluid (ECF).

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Sodium's Location

The main cation of extracellular fluid (ECF).

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Sodium's Role

Kidneys regulate sodium levels, which is essential for nerve & muscle function, and acid-base balance.

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Study Notes

Sodium (Na+)

  • Normal sodium levels are 135-145 mEq/L.
  • Sodium levels are inversely related to potassium levels.
  • Sodium is the main cation of extracellular fluid (ECF).
  • The kidneys regulate sodium.
  • Sodium is essential in regulating water of both intracellular (ICF) and extracellular fluid (ECF).
  • Sodium is necessary for nerve function, muscle contraction, and regulating acid-base balance.
  • Hyponatremia is the most common electrolyte disorder.

Hypernatremia (>145 mEq/L)

  • Characterized by "HIGH" sodium levels.
  • Causes consist of inadequate water intake, fever, excessive sweating, diarrhea, diabetes insipidus, excess sodium intake (IV fluids), and decreased renal sodium excretion.
  • Signs and symptoms include extreme thirst, agitation, confusion, seizures, coma, fluid retention, dry flushed skin, and muscle twitches with contractions.
  • Restrict sodium and fluid intake as ordered for management.
  • Treat water loss with IV fluids.
  • Treat decreased sodium excretion with diuretics that promote sodium loss.

Hyponatremia (<135 mEq/L)

  • Characterized by "LOW" sodium levels.
  • Inadequate sodium intake, dilution of serum sodium (excessive hypotonic fluids, kidney disease, SIADH, heart failure), and increased sodium excretion (excessive sweating, diuretics, vomiting, diarrhea, wound drainage) contribute to this deficit.
  • Signs and symptoms include headache, confusion, seizures, coma, nausea, cramping with diarrhea, muscle weakness, and decreased urinary output.
  • Manage fluid deficits (hypovolemia) with sodium chloride IV, and fluid overload (hypervolemia) with diuretics as prescribed.
  • Increased oral sodium intake as well as monitoring lithium levels due to the potential for lithium toxicity are other facets of treatment.
  • Increasing sodium levels too quickly can cause permanent brain damage.

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