Medical Nursing I: Fluids and Electrolytes
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Questions and Answers

What is a common clinical manifestation of hypovolaemia?

  • Increased appetite
  • High fever
  • Cool, clammy skin (correct)
  • Rapid weight gain

Which diagnostic finding is expected in a patient with hypovolaemia?

  • Increased BUN levels (correct)
  • Decreased hematocrit level
  • Normal BUN levels
  • Decreased heart rate

What is the preferred route of fluid replacement when hypovolaemia is mild?

  • Oral (correct)
  • Subcutaneous
  • Intravenous
  • Inhalation

What vital sign should be monitored hourly until the patient is stable in cases of hypovolaemia?

<p>Blood pressure (B)</p> Signup and view all the answers

Which symptom is NOT typically associated with hypovolaemia?

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

What is contained within the intravascular space?

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

How much fluid is present in the interstitial space of an adult?

<p>11 to 12 L (A)</p> Signup and view all the answers

Which division of the extracellular fluid (ECF) compartment is the smallest?

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

What is the total quantity of cations in the extracellular fluid?

<p>154 mEq/L (C)</p> Signup and view all the answers

Which electrolyte has the highest concentration in extracellular fluid?

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

What primarily governs the movement of water and ions between extracellular and intracellular fluids?

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

What is the total quantity of anions in intracellular fluid?

<p>200 mEq/L (C)</p> Signup and view all the answers

Which of the following is an example of transcellular fluid?

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

What term describes the maintenance of the internal environment within narrow limits?

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

What constitutes the body fluids that surround and are contained within cells?

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

Which fluid compartment includes fluid inside the cells?

<p>Intracellular space (B)</p> Signup and view all the answers

What is the main source of water that contributes to body fluids?

<p>Ingested water and nutrients, and metabolic water (D)</p> Signup and view all the answers

What are the two major compartments of body fluids?

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

What is referred to as hypervolaemia?

<p>Excess blood volume (C)</p> Signup and view all the answers

Which fluid space is NOT part of the extracellular fluid compartment?

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

What is the primary function of the fluid that surrounds cells?

<p>To cushion cells and facilitate exchange (A)</p> Signup and view all the answers

What primarily causes the difference in ion concentration inside and outside the cell?

<p>The cell's ability to pump certain ions in and others out. (A)</p> Signup and view all the answers

What happens when the intracellular fluid becomes hypertonic to the extracellular fluid?

<p>Water moves from the extracellular fluid into the cell. (B)</p> Signup and view all the answers

What regulates the balance of fluids between the interstitial fluid and plasma?

<p>Hydrostatic pressure and osmotic pressure. (C)</p> Signup and view all the answers

What is the average daily fluid loss for an adult under typical conditions?

<p>2,500 mL. (A)</p> Signup and view all the answers

Which of the following is a potential cause of hypovolaemia?

<p>Prolonged fasting without water. (B)</p> Signup and view all the answers

What characterizes fluid volume deficit or hypovolaemia?

<p>Fluid and electrolytes are lost in the proportions that exist in normal body fluids. (C)</p> Signup and view all the answers

Which of the following can disrupt fluid and electrolyte balance?

<p>Acute illness or injury. (D)</p> Signup and view all the answers

Which physiological systems are involved in regulating fluid balance?

<p>Kidneys and glands such as the thyroid. (D)</p> Signup and view all the answers

Flashcards

Intravascular space

Fluid within blood vessels, containing plasma.

Interstitial fluid

Fluid surrounding cells; about 11-12 liters in adults.

Transcellular fluid

Smallest ECF compartment; includes fluids like cerebrospinal, pericardial, etc.; approximately 1 liter.

Electrolytes

Active chemicals (cations & anions) with electrical charges; balance is crucial for body functions.

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Extracellular fluid (ECF) composition

High sodium concentration; includes chloride, bicarbonate, and other anions.

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Intracellular fluid (ICF) composition

High potassium concentration; includes phosphates, sulfates, and other anions within the cell.

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Fluid movement (between compartments)

Body fluid shifts between spaces to maintain balance.

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Cell membrane permeability

Cell membranes control the movement of water and ions between fluid compartments.

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Homeostasis

Maintaining a stable internal environment in the body, within narrow limits.

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Body Fluids

Water and electrolytes that surround and are inside cells, crucial for life processes.

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Intracellular Fluid

Fluid inside the cells.

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Extracellular Fluid

Fluid outside the cells.

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Intravascular Fluid

Fluid within blood vessels (e.g., blood plasma).

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Interstitial Fluid

Fluid surrounding cells, tissues.

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Transcellular Fluid

Fluid in specialized body compartments like cerebrospinal fluid, synovial fluid, and digestive juices.

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Fluid Compartments

Different areas in the body where fluid is located and it plays different physiological roles.

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Hypovolemia Clinical Manifestations

Decreased blood volume causing symptoms like weak pulse, cool skin, thirst, and decreased blood pressure.

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Hypovolemia Diagnosis

Diagnosed through elevated BUN levels and increased hematocrit; also checking physical assessment and health history.

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Hypovolemia Treatment (oral)

Mild hypovolemia often treated orally, but acute or severe cases need intravenous fluids.

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Hypovolemia Treatment (IV)

Intravenous fluids like NS and R/L are typically used; carefully monitor intake and output.

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Hypovolemia Nursing Management

Nursing management involves monitoring vital signs, skin turgor, mental status, and checking for shock.

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Fluid Balance

Maintaining equilibrium of fluids and electrolytes between compartments (intracellular and extracellular fluids) in the body.

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Hypovolemia

Fluid loss where water and electrolytes are lost in the same proportions as found in normal body fluids, causing a decrease in extracellular fluid.

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Dehydration

Fluid loss of 1% or more of body weight, often due to insufficient fluid intake or excessive fluid loss.

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Causes of Hypovolemia

Abnormal fluid losses (vomiting, diarrhea, sweating), inadequate intake (poor oral intake, fever), or conditions like diabetes insipidus, adrenal insufficiency, osmotic diuresis, or hemorrhage can contribute to hypovolemia

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Fluid Loss Pathways

Water is lost through the skin, lungs, gastrointestinal tract, and primarily through urine production.

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Fluid and Electrolyte Imbalances

Disruptions in the balance of fluids and electrolytes in the body, which are critical for health and can be caused by various factors.

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Fluid balance regulation

Balance regulated by hydrostatic and osmotic pressures, along with fluid and electrolyte intake and losses.

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Extracellular Fluid

Fluid outside the cells, including interstitial fluid and plasma; essential for transporting nutrients and waste.

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Study Notes

Course Information

  • Course Title: Medical Nursing I
  • Course Code: PNUR201
  • University: Presbyterian University, Ghana
  • Faculty: Faculty of Health and Medical Sciences
  • Department: Department of Nursing and Midwifery
  • Instructor: A. B. Frank

Fluids and Electrolytes

  • Objectives:
    • Discuss physiological processes for homeostasis
    • Identify fluid compartments and their functions
    • Explain how kidneys maintain fluid and electrolyte balance
    • Explain hypervolemia and hypovolemia
  • Introduction:
    • External environment changes constantly, but internal environment must remain relatively stable
    • Homeostasis (equilibrium) is maintaining a stable internal environment (body fluids)
    • Body fluids include fluids inside cells, blood, tissue fluids, etc.

Body Fluids

  • Composition:
    • Suspended in a saline solution (0.9% salt concentration)
    • Contains water and electrolytes
    • Water comes from ingested water and nutrients, and metabolism

Body Fluids (cont'd)

  • Functions:
    • Most of body weight is due to body fluids
    • Cushions cells and acts as a medium for exchange
    • Everything that enters/exits cells passes through these fluid layers

Fluid Compartments

  • Intracellular:
    • Fluid inside the cells
  • Extracellular:
    • Fluid outside the cells
    • Divided into intravascular (blood vessels), interstitial (surrounding cells), and transcellular (cerebrospinal, pericardial)

Intracellular Fluid

  • Cation: Potassium (150 mEq./L)
  • Cation: Magnesium (40 mEq./L)
  • Cation: Sodium (10 mEq./L)
  • Total Cations: 200 mEq./L
  • Anion: Phosphates and sulfates (150 mEq./L)
  • Anion: Bicarbonate (10 mEq./L)
  • Anion: Proteinate (40 mEq./L)
  • Total Anions: 200 mEq./L

Extracellular Fluid

  • Cation: Sodium (142 mEq/L)
  • Cation: Calcium (5 mEq/L)
  • Cation: Potassium (5 mEq/L)
  • Cation: Magnesium (2 mEq/L)
  • Total Cations: 154 mEq/L
  • Anion: Chloride (103 mEq/L)
  • Anion: Bicarbonate (26 mEq/L)
  • Anion: Phosphate (2 mEq/L)
  • Anion: Sulfate (1 mEq/L)
  • Anion: Organic acid (17 mEq/L)
  • Total Anions: 154 mEq/L

Movement of Fluid and Electrolytes

  • Water and ions move across cell membranes
  • Movement governed primarily by osmosis
  • Diffusion and active transport also affect movement

Movement of Fluids and Electrolytes (cont'd)

  • Differences in ion concentration due to active transport
  • Hypertonic intracellular fluid leads to water movement into cells
  • Fluid balance also between interstitial fluid and plasma

Fluid and Electrolyte Balance

  • Balance consumed and lost electrolytes daily
  • Water lost through skin, lungs, GI tract, and urine
  • Daily adult loss is approximately 2,500 mL

Fluid and Electrolyte Loss Routes

  • Skin
  • Lungs
  • GI Tract
  • Kidneys (ADH, RAAS, aldosterone)
  • Glands (thyroid, parathyroid)
  • Fluid and food intake
  • Thirst

Fluid and Electrolyte Imbalances

  • Illness, injury, surgery, and treatments can disrupt balance
  • Even minor illness can put people at risk for imbalances

Hypovolemia

  • Definition: Fluid intake less than loss, electrolytes lost in same proportion as fluids

  • Definition: 1%+ loss of body weight

  • Etiology (Causes):

    • Fever and poor oral intake
    • Prolonged poor fluids/food
    • Vomiting, diarrhea, GI suctioning, sweating
    • Diabetes insipidus, adrenal insufficiency, osmotic diuresis, hemorrhage

  • Clinical Manifestations:

    • Weight loss
    • Decreased skin turgor
    • Postural hypotension
    • Weak/rapid heart rate
    • Flattened neck veins
    • Decreased central venous pressure
    • Cool, clammy skin
    • Thirst
    • Anorexia, nausea
    • Lassitude, muscle weakness/cramps

Hypovolemia Diagnosis

  • BUN increase
  • Hematocrit level increases
  • Physical assessment and health history

Hypovolemia Management

  • Medical:
    • Correct underlying cause (e.g., address infection)
    • Oral route preferred for mild deficits
    • IV fluids (isotonic solutions like NS, RL) for acute/severe cases
  • Nursing:
    • Monitor I&O
    • Daily body weight
    • Monitor vital signs hourly until stable
    • Monitor skin turgor
    • Monitor mental function
    • Monitor for shock

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Description

This quiz covers key concepts in fluids and electrolytes, focusing on their roles in maintaining homeostasis within the body. It includes discussions on fluid compartments, kidney function, and conditions like hypervolemia and hypovolemia. Prepare to test your understanding of physiological processes and body fluid composition.

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