• NURS 8022 Fluids - Exam 3 Study Guide, University of Cincinnati, Main Campus
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Course
NURS 8022
Institution
NURS 8022
•
NURS 8022 Fluids - Exam 3 Study Guide, University of Cincinnati, Main Campus
Water Movement
• Osmosis
o Movement of water down concentration gradient
• Osmolality
o Concentration of molecules per weight of water
o Controls osmosis
• Osmotic Forces
o Amount of hydrostatic press...
NURS 8022 Fluids - Exam 3 Study Guide, University
of Cincinnati, Main Campus
Water Movement
Osmosis
o Movement of water down concentration gradient
Osmolality
o Concentration of molecules per weight of water
o Controls osmosis
Osmotic Forces
o Amount of hydrostatic pressure (pushing) required to oppose the
osmotic movement of water
o Determined by thickness of plasma membrane, size of molecules,
concentration molecule gradient, solubility of molecules to membrane
Sodium is most abundant in ECF
o Responsible for osmotic balance of ECF
Potassium responsible for osmotic balance of ICF
Proteins in ICF cannot diffuse out of cell so osmotic equilibrium is maintained by active
transport
Changes in osmolality transfers water from one compartment to the other
until equilibrium is reached
Filtration
o Movement of fluid from capillary into interstitial space
Reabsorption
o Movement of fluid from interstitial space into capillary
Forces that determine filtration or reabsorption
o Capillary hydrostatic pressure (blood pressure)
Facilitates outward movement of water from capillary to interstitial space
o Capillary oncotic pressure (plasma)
Attracts water from interstitial space back to capillary
o Interstitial hydrostatic pressure
Facilitates inward movement of water from interstitial space into the
capillary
o Interstitial oncotic pressure
Attracts water from the capillary into the interstitial space
Starling hypothesis
o Net filtration is equal to forces favoring filtration minus the forces opposing
filtration
Forces favoring filtration/opposing reabsorption
o Capillary hydrostatic pressure (blood pressure)
o Interstitial oncotic pressure (water pulling)
Forces opposing filtration/forces favoring reabsorption
o Capillary oncotic pressure (water pulling)
o Interstitial hydrostatic pressure
, Major forces for filtration and reabsorption are those within the capillary
o Capillary hydrostatic pressure (filtration)
o Capillary oncotic pressure (reabsorption)
Arterial end of capillary
o Hydrostatic pressure > interstitial oncotic pressure = water filters into interstitial
space FILTRATION
Venous end of capillary
o Capillary oncotic pressure > interstitial hydrostatic pressure = fluids move into
circulation REABSORPTION
Integrity of capillary membrane is essential in capillary filtration of fluid
Fluids and patho of edema
Accumulation of fluids in interstitial spaces
Causes
o capillary hydrostatic pressure (venous obstruction)
o plasma oncotic pressure (diminished production of albumin)
o capillary permeability (inflammation and immune response)
o Lymph obstruction (lymphedema)
o Sodium retention
Pathophysiology
o forces favoring fluid filtration from the capillaries or lymphatic channels into
tissues
Manifestations
o Localized
Limited to site of trauma or specific organ system
o Generalized
Dependent edema
o Weight gain, swelling, puffiness, limited movement of affected area
Third spacing
o Fluid moves to interstitial space, pleural space, pericardial space
o Not available for metabolic processes or perfusion
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