ch 5: fluid and electrolytes, acid and bases

Question 1

what is the body’s normal pH?

Answer 1

7.35-7.45

Question 2

how does hydrogen relate to pH?

Answer 2

low H+, low pH

high H+, high pH

Question 3

what the two forms of body acids?

Answer 3

volatile and nonvolatile

Question 4

what is a volatile example?

Answer 4

carbonic acid

Question 5

what are nonvolatile examples?

Answer 5

sulfuric, phosphoric, and other organic acids

Question 6

what are the acid end products?

Answer 6

proteins, carbohydrates, and fat metabolism

Question 7

what charge do protein buffers have? what do they buffer?

Answer 7

• negative

- H+

Question 8

what is the cellular ion exchange for acidosis?

Answer 8

K+ out of the cell

Question 9

what is the cellular ion exchange for alkalosis?

Answer 9

K+ into the cell

Question 10

what is a buffer?

Answer 10

a chemical that can bind excessive H+ or OH- without a significant change in pH

Question 11

what makes up a buffer pair?

Answer 11

a weak acid and its conjugate base

Question 12

what are the two most important buffering systems? which one is intracellular? extracellular?

Answer 12

• carbonic acid-bicarbonate system: extracellular

- hemoglobin: intracellular

Question 13

what is acidosis? what are the 3 compensations for this?

Answer 13

• pH 6.8-7.35
• increase ventilation
• increase urine output
• increase reabsorption

Question 14

what is alkalosis? what are the 2 compensations for this?

Answer 14

pH 7.45-7.8

• decrease ventilation
• decrease urine output
• decrease reabsorption

Question 15

what causes metabolic acidosis? what are symptoms? what are the compensations? what are the treatments?

Answer 15

• lactic acidosis, diabetic ketoacidosis, starvation that causes gluconeogenesis
• headache, lethargy, confusion, warm to hot, hypotension, abdominal pain, anorexia, kussmaul respirations
• increase ventilation increase urine output, increase reabsorption
• eliminate underlying pathology, decrease ventilation and fluid/electrolyte replacement

Question 16

what causes metabolic alkalosis? what are symptoms? what are the compensations? what are the treatments?

Answer 16

• prolonged vomiting, gastric suctioning, diruetics, hyperaldosteronism, excessive antacids intake
• weakness, muscle cramps, hyperactive reflexes, nervousness, dizziness, paresthesias in fingers and toes, shallow respirations
• decrease ventilation, decrease urine output, decrease reaborption
• eliminate underlying pathology, reventilation, fluid and electrolyte replacement

Question 17

what causes respiratory acidosis? what are symptoms? what are the compensations? what are the treatments?

Answer 17

• lung disease, oversedation, brainstem trauma, mechanical ventilation
• headache, lethargy, blurred vision, irritability, disorientation, muscle twitching, tremors, convulsions, coma, dyspnea, tachycardia, warm flushed skin
• increase ventilation, increased urine output, increased reabsorption
• eliminate underlying pathology, improve ventilation, fluid/electrolyte replacement

Question 18

what causes respiratory alkalosis? what are symptoms? what are the compensations? what are the treatments?

Answer 18

• lung disease, congestive heart failure, high altitudes, mechanical ventilation
• hyperventilation, dizziness, confusion, paresthesia of fingers and toes, convulsions, coma, tachycardia, spasms of fingers and toes
• decrease ventilation, decrease urine output, decrease reabsorption

Question 19

what happens with the cell during hypertonic? hypotonic? isotonic?

Answer 19

• cell swells
• cell shrinks
• cell does nothing

Question 20

what % of pediatrics is water? adults? geriatrics?

Answer 20

• 65-80%
• 60%
• 45-55%

Question 21

what is osmosis?

Answer 21

diffusion of water across the semipermiable membrane

Question 22

what is edema? what are some complications with this?

Answer 22

• excessive accumulation of fluid within the interstitial spaces
• can lead to hypoxia and strangulation from lack of oxygen to the blood and can effect the brain, lungs, and heart

Question 23

what regulates the sodium chloride balance?

Answer 23

• RAA pathway: increases Na+ absorption to increase BP

- natriuretic peptides: increase urine output of Na+ and H2O

Question 24

would hypothyroidism increase or decrease pH? why?

Answer 24

decrease pH bc calcium would increase

Question 25

is CO2 acidic or alkaline?

Answer 25

very acidic

Question 26

what causes isotonic fluid loss? what are some clinical manifestations? what is the treatment?

Answer 26

• hemorrhage, wound drainage, excessive sweating, and inadequate fluid intake
• weight loss, dry skin, decreased urine output, rapid heart rate, flattened jugular veins, normal or decreased BP
• fluid replacement

Question 27

what causes isotonic fluid excess? what are some clinical manifestations? what is the treatment?

Answer 27

• excessive fluids via IV and hypersecretion of aldosterone
• weight gain, increased BP, edema, jugular vein distention, decreased hematocrit, pulmonary edema, and heart failure
• diuretics

Question 28

is HCO3- (bicarbonate) an acid or base? what makes this? where?

Answer 28

• base

- bile in the liver

Question 29

what are the 3 types of hyperatremia? which is the most common? what are clinical manifestations?

Answer 29

• isovolemic hyperatremia (most common)
• hypovolemic hyperatremia
• hypervolemic hyperatremia
• thirst, weigh gain, bounding pulse, increased BP, muscle twitching

Question 30

what is the pH of urine?

Answer 30

5.0-6.0

Question 31

what is the pH of gastric juices?

Answer 31

2.0-3.0

Question 32

what is isovolemic hyperatremia?

Answer 32

occurs with the loss of free water with near normal sodium concentration

Question 33

what inverse relationships does CO2 have?

Answer 33

O2 and pH

Question 34

what is hypovolemic hyperatremia?

Answer 34

loss of sodium with a greater loss of fluid

Question 35

what is hypervolemic hyperatremia?

Answer 35

increased fluid and greater increased sodium