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?

Blood pressure Signup and view all the answers

Which symptom is NOT typically associated with hypovolaemia?

Abdominal pain Signup and view all the answers

What is contained within the intravascular space?

Plasma Signup and view all the answers

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

11 to 12 L Signup and view all the answers

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

Transcellular space Signup and view all the answers

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

154 mEq/L Signup and view all the answers

Which electrolyte has the highest concentration in extracellular fluid?

Sodium Signup and view all the answers

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

Osmosis Signup and view all the answers

What is the total quantity of anions in intracellular fluid?

200 mEq/L Signup and view all the answers

Which of the following is an example of transcellular fluid?

Cerebrospinal fluid Signup and view all the answers

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

Homeostasis Signup and view all the answers

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

Saline solution Signup and view all the answers

Which fluid compartment includes fluid inside the cells?

Intracellular space Signup and view all the answers

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

Ingested water and nutrients, and metabolic water Signup and view all the answers

What are the two major compartments of body fluids?

Intracellular and extracellular Signup and view all the answers

What is referred to as hypervolaemia?

Excess blood volume Signup and view all the answers

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

Intracellular space Signup and view all the answers

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

To cushion cells and facilitate exchange Signup and view all the answers

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

The cell's ability to pump certain ions in and others out. Signup and view all the answers

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

Water moves from the extracellular fluid into the cell. Signup and view all the answers

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

Hydrostatic pressure and osmotic pressure. Signup and view all the answers

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

2,500 mL. Signup and view all the answers

Which of the following is a potential cause of hypovolaemia?

Prolonged fasting without water. Signup and view all the answers

What characterizes fluid volume deficit or hypovolaemia?

Fluid and electrolytes are lost in the proportions that exist in normal body fluids. Signup and view all the answers

Which of the following can disrupt fluid and electrolyte balance?

Acute illness or injury. Signup and view all the answers

Which physiological systems are involved in regulating fluid balance?

Kidneys and glands such as the thyroid. Signup and view all the answers

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.