Fluid Balance 112DT

  • Created by: vdagnan
  • Created on: 07-05-14 10:33
Why is fluid balance important?
Aid assessment of hydration status, fluid is essential to life and it it aids assessment of body compo
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What is the distribution of body solids and fluids in a lean adult female?
45% solids, 55% fluids
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What is the distribution of body solids and fluids in a lean adult male?
40% solids. 60% fluid
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Why do males have more fluids?
They carry more muscle and muscle contains lots of water
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In the fluids what is the distribution of Intracellular fluids (ICF) and extracellular fluids (ECF)?
2/3 is ICF and 1/3 in ECF
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Of the ECF what is the breakdown of interstitial fluid and plasma?
80 is interstitial and 20% is plasma
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What three factors can affect fluid balance?
Gender, age and obesity
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What two ways does the body gain water?
Ingestion of liquids and moist foods (2300ml/day), synthesis of water through cellular respiration and dehydration synthesis (200ml/day)
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What four ways does the body lose water?
Kidneys (1500ml/day), evaporation from skin (600ml/day), exhalation from lungs (300ml/day), faeces (100ml/day)
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What electrolytes make up body fluids?
Sodium, potassium, calcium, magnesium, chloride, bicarbonate, organic phosphorus, sulphate, protein anions
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What functions do these electrolytes have?
Control osmosis of water between compartments, help maintain acid base balance, carry electrical current, cofactors for enzymes
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A small amount of fluid can be found in other areas of the extra cellular fluid ie the digestive secretions, what is this called?
Transcellular fluid
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What is the fluid called that can be found in the spine
Cerebrospinal fluid
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Where can pericardial fluid be found?
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Where can the fluid of pleural spaces be found?
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Where can the fluid of synovial spaces be found?
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Where is intraocular fluid found?
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What are the four transport processes that affect fluid and electrolyte movement?
Osmosis, Diffusion, Active transport and filtration
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What is osmosis?
The movement of water between two compartments by a membrane that is permeable to water (but not solute)
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Explain the movement of osmosis in terms of concentration
Water moves from low solute concentrations to high solute concentrations
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Does it require energy?
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What is osmotic pressure?
pressure required to stop osmotic flow of water, determined by concentration of solutes in solution
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What is oncotic pressure?
Pressure excerted by colloids (proteins such as albumin)
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What is osmotic diuresis?
Increased urine output, caused by substances such as mannitol, glucose or contract medium
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Explain the term isotonic
fluid with the same osmolality as the cell interior
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explain term hypotonic
fluid with solutes less concentrated than cells
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explain the term hypertonic
fluid with solutes more concentrated than cells
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What is the result on the cell size of changing osmolarity?
Increasing osmolarity of interstitial fluid causes the cell to shrink as water is drawn out of the cell, decreasing osmolarity causes cells to swell
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What is diffusion?
Random movement of particles in all directions from an area of high concentration to low concentration
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What is active transport?
The transport of solutes in and out of cells that requires carrier substances which involve energy use (ATP)
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Give three examples of solutes requiring active transport
Sodium, potassium, hydrogen, glucose, amino acids
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What is filtration?
Movement of water and solutes from an area of high hydrostatic pressure to low hydrostatic pressure (created by weight of the fluid, think kidneys)
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What is hydrostatic pressure?
Major force within a fluid compartment that pushes water out of vascular system at capillary level
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Fluid movement in capillaries is determined by what?
Capillary hydrostatic pressure, plasma oncotic pressure, interstitial hydrostatic pressure, interstitial oncotic pressure
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Changes in these pressures lead to....?
Oedema, abnormal accumulation of interstitial fluid
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What is the main factor that determines body fluid osmolarity?
Urinary water oss
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What is the main factor that determines body fluid volume?
Urinary salt loss (Water will follow Na+ and Cl-)
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What are the three hormones that regulate renal Na+ and Cl-?
Angiotensin 2, aldosterone and ANP (atrial natriuretic peptide)
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What do Angiotensin 2 & aldosterone do
Promote urinary NA+ and Cl- reabsorption (and water will follow by osmosis) when dehydrated. (Angiotensin 2 stimulates secretion of aldosterone)
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What does ANP do?
promotes natriuresis, excretion of NA+ and Cl- (and water will follow) to decrease blood volume
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What does antidiuretic hormone (ADH) do? (also known as vasopressin)
Inserts water channel proteins into the collecting ducts of kidneys, increasing permeability to absorb more water
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What are the receptors called in the hypothalamus that detect fluid balance status?
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Under control of the hypothalamus what hormone doe the posterior pituitary release?
Anti diuretic hormone
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Where is it's site of action?
The renal tubules of the kidney
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What can also stimulate the release of ADH?
Stress, nausea, nicotine, and morphine
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What hormones are part of the Adrenal Cortical regulation of fluid balance
Glucocorticoids (Cortisol) and Mineralocorticoids (aldosterone)
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What is renal regulation affects on fluid balance?
Kidneys are primary organ for regulating fluid and electrolyte balance, by selective reabsorption of water and electrolytes.
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How does the cardiac regulation of fluid balance work?
Increased atrial pressure (caused by increased blood volume) produces Natriuretic peptides which surpress secretion of aldosterone, renin and ADH to decrease blood volume and pressure
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How does the gastrointestinal regulation work to control fluid balance?
Small amounts of water are excreted in faeces, diarrhoea and vomiting can lead to significant fluid and electrolyte loss.
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What is insensible water loss?
Invisible vaporization from lungs and skin to regulate body temperature (600 - 900 ml/day are lost), no electrolytes are lost. (Not the same as sweat)
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Fluid blanace is common in most patients with illness, what are some of the main reasons?
Burns, heart failure, renal disease, liver disease, diabetes insipidus, laxative abuse, marathon runners, also the result of poor iv fluid replacement.
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What is Hypovolemia?
A state of decreased blood volume in the ECF, blood plasma. It is characterised by loss of sodium and differs from dehydration (which is loss of body water)
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What are the main causes of Hypovolemia?
Gastrointestinal sodium loss, skin sodium loss, renal sodium loss, haemorrhage,
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What are the first symptoms of mild to moderate dehyration?
thirst, dizziness, lighhead, headache, tiredness, dry mouth, lips and eyes. Strong smelling concentrated urine which is passed infrequently
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What are the moderate signs of dehydration?
Loss of strength and stamina, heat exhaustion, can lead to kidney stones, harm to the liver, joints and muscles and constipation.
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What are the symptoms of severe dehydration?
Severe thirst, dry and wrinkled skin, inability to urinate, irratibility, sunken eyes, low blood pressure, rapid heartbeat, sool hands and feet, low level of conciousness. Can lead to death
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What is Hyponatraemia
When sodium concentration is to low in the plasma
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What can cause Hyponatraemia?
DRinking to much fluid leading to water intoxication.
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What are the signs and symptoms of Hypervolemia (increased blood volume in ECF)?
Ankle swelling. breathlessness, Oedema, pulmonary crepitations (crackling sound in lungs), weight gain
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What are the signs and symptoms of Hypovolemia?
Thirst, dizziness, confusion, Dry mouth, reduced urine output, weight loss
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Other cards in this set

Card 2


What is the distribution of body solids and fluids in a lean adult female?


45% solids, 55% fluids

Card 3


What is the distribution of body solids and fluids in a lean adult male?


Preview of the front of card 3

Card 4


Why do males have more fluids?


Preview of the front of card 4

Card 5


In the fluids what is the distribution of Intracellular fluids (ICF) and extracellular fluids (ECF)?


Preview of the front of card 5
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