alterations in fluid & electrolyte balance

Question 1

diffusion

Answer 1

movement of molecules down a concentration gradient (high to low concentration)

PASSIVE

Question 2

colloid osmotic (oncotic) pressure

Answer 2

pressure created by plasma proteinspulls fluid back into blood vessels at venous end of capillary bed

Question 3

osmotic pressure

Answer 3

minimum pressure which needs to be applied to a solution to prevent the inward flow of water across a semipermeable membrane;

the measure of the tendency of a solution to take in water by osmosis

Question 4

arterial hydrostatic pressure

Answer 4

caused by the pumping action of the heart pushes water, electrolytes, nutrients through capillary walls

Question 5

venous colloid osmotic (oncotic) pressure

Answer 5

• created by plasma proteins- pulls WATER, electrolytes, cell waste products into capillaries- higher at VENOUS end, lower at arterial end

Question 6

extracellular fluid types (2)

Answer 6

• interstitial- intravascular (blood plasma)

Question 7

ADH produced by…

Answer 7

posterior pituitary gland

Question 8

ADH production stimulated by…

Answer 8

hypothalamus, after osmoreceptors triggered by high osmolality in internal carotid artery

Question 9

sensation of thirst stimulated by

Answer 9

• low blood volume- high plasma osmolality

Question 10

thirst cascade

Answer 10

• ADH secreted- Renin-angiotensin-aldosterone activated- water and sodium retained- urine output decreases

Question 11

osmolarity

Answer 11

the osmotic concentration / liter of solution

number of milliosmoles in a liter of solution

Question 12

osmolality

Answer 12

osmotically active particles / kg of water

number of milliosmoles in a kilogram of solution

Question 13

dominant particle in ICF

Answer 13

K+

Question 14

dominant particle in ECF

Answer 14

Na+

Question 15

particles that govern osmolarity

Answer 15

• electrolytes, especially sodium- glucose and urea- plasma proteins (albumin)

Question 16

prostaglandin effects (x2)

Answer 16

• increased vasodilation of renal capillaries - may reduce ADH effect

Question 17

osmosis

Answer 17

movement of water only through a semipermeable (selectively permeable) membrane down its hydrostatic pressure gradient from the dilute fluid to the more concentrated fluid until a concentration equilibrium occurs

ACTIVE

Question 18

hydrostatic pressure

Answer 18

“water-pushing pressure” - force of the weight of water molecules pressing against the confining walls of a space

created by heart pumping: forces O2, H2O, nutrients across capillary walls into interstitial space;

higher at ARTERIAL end, lower at venous end

Question 19

filtration

Answer 19

movement of fluid through cell or blood vessel membrane because of hydrostatic pressure differences on both sides of the membrane

water/solutes forced across semi-permeable membrane away from an area of high concentration

Question 20

Sodium/Potassium pump

Answer 20

• powered by energy from metabolism, ATP- O2, glucose must be available to make ATP- pumps sodium out, potassium into

Question 21

ascites

Answer 21

abnormal serous fluid collection in peritoneum

Question 22

effusion

Answer 22

escape of fluid into a part (ex: pleural, pericardial)

Question 23

examples of fluid shift

Answer 23

• decreased vascular colloid osmotic pressure- increased capillary hydrostatic pressure- increased capillary permeability- lymph obstruction

Question 24

causes of decreased colloid osmotic (oncotic) pressure

Answer 24

decrease in serum protein (as in malnutrition, burns, nephrosis, or liver disease)

Question 25

hypervolemia

Answer 25

sodium and water excess, abnormal increase in blood volume

Question 26

hypovolemia

Answer 26

reduced circulating blood volume due to loss of water and electrolytes (primarily sodium)NOT THE SAME AS DEHYDRATION (loss of water alone)

Question 27

hypovolemia activates...

Answer 27

all the regulatory mechanisms: kidneys, adrenal gland, ADH, central nervous system

Question 28

oliguria

Answer 28

diminished urine excretion in relation to fluid intake

Question 29

causes of hypovolemia

Answer 29

- blood loss- reduced fluid intake- excessive water loss- fluid lost to the interstitial space- loss of excessive water and sodium from GI track or via the urine or skin

Question 30

urine specific gravity

Answer 30

density of urine compared to water (indicates concentration of solutes)

Question 31

causes of hypervolemia

Answer 31

- congestive heart failure- renal failure- cirrhosis of the liver- Cushing's syndrome- Excessive use of corticosteroid drugs- Excessive use of salt (sodium chloride)- Excessive amounts of sodium-containing IV fluids

Question 32

electrolytes

Answer 32

- when added, increase the ability of water to conduct electricityELECTRIC CHARGE!

Question 33

ECF electrolytes

Answer 33

Na+ Cl- HCO3-

Question 34

ICF electrolytes

Answer 34

K+ Mg2+ PO4-3 SO4-2 protein

Question 35

electrolytes reported in

Answer 35

mEq/Lthe number of electrolytes able to chemically combine in one liter of body fluid(sometimes mmol/L)

Question 36

electrolyte diffusion

Answer 36

ions moving toward opposite charges is called diffusion along the electrical potential gradient

Question 37

active transport

Answer 37

molecules move across cell membrane "uphill" against concentration gradient

Question 38

osmotic power

Answer 38

extent to which solutes (non-protein solutes) affect the movement of water

Question 39

K+ balance change leads to...

Answer 39

cells will fire excessively with little stimulation -or- cells will barely respond to stimulation(see in skeletal and heart muscle tissues)

Question 40

K+ importance (a few)

Answer 40

neuromuscular irritability especially heart (HYPERkalemia), intracellular osmotic activity and acid-base balance

Question 41

hypokalemia

Answer 41

low SERUM concentration K+

Question 42

osmotic diuretic

Answer 42

inhibits reabsorption of water and Na+

Question 43

kwashiorkor

Answer 43

adequate calories, lack of proteinsee hella fluid in abdomen

Question 44

marasmus

Answer 44

inadequate calories AND protein

Question 45

Na+ deficit

Answer 45

cell swelling and reduced neuromuscular functionlargely preventable

Question 46

hypernatremia

Answer 46

water loss exceeds sodium lossORgain sodium with no water loss

Question 47

edema

Answer 47

tissue swelling as a result of the accumulation of excessive fluid in the interstitial spaces

Question 48

facilitated diffusion

Answer 48

aka facilitated transport; diffusion across a cell membrane that requires the assistance of a membrane-altering system

Question 49

osmotic pressure in body primarily created by ...?

Answer 49

sodium

Question 50

osmole

Answer 50

unit of osmotic pressure equivalent to the amount of solute that dissociates in solution to form one mole (avogadro's number) of particles (molecules and ions)

Question 51

obligatory urine output

Answer 51

minimum amount of urine output required to excrete toxic waste products 400 - 600mL

Question 52

insensible water loss

Answer 52

water loss from skin, lungs, stool - that cannot be controlled

Question 53

isotonic dehydration

Answer 53

water and electrolyte loss