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Pathophysiology > Ch2 electrolytes > Flashcards

Ch2 electrolytes Flashcards

1
Q

the major component of the body is water in these compartments

A

intercellular fluid compartment and extracellular fluid compartment

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2
Q

balance of water in the compartments is essential for

A

homeostasis

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3
Q

What percent of a males body weight is water

A

60

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4
Q

what percent of an infants body weight is water

A

70

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5
Q

who has a higher % of fatty tissue, lower water content than the other sex

A

females

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6
Q

what type of people lower proportion of water

A

older adults and obese people

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7
Q

individuals with less fluid reserve are more likely to be adversely affected by what

A

any fluid or electrolyte imbalance

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8
Q

what percent of a females body weight is water

A

50

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9
Q

where are transcellular fluids present

A

present in various secretions
pericardial cavity
synovial cavities of joints

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10
Q

the amount of water entering the body should equal the what

A

amount of water leaving the body

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11
Q

what ways is fluid balance controlled

A

thirst mechanisms
antidiuretic hormone
aldosterone
atrial natriuretic peptide

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12
Q

how is the thirst mechanism a control of fluid balance

A

osmoreceptors in the hypothalamus

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13
Q

how does the antidiuretic hormone control fluid balance

A

promotes resorption of water into blood from kidney tubules

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14
Q

how does aldosterone control fluid balance

A

determines resorption of sodium ions and water

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15
Q

how does atrial natriuretic peptide control fluid balance

A

regulates fluid, sodium, and potassium levels

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16
Q

how does fluid circulate throughout the body

A

filtration and osmosis

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17
Q

how does water move between compartments

A

hydrostatic pressure and osmotic pressure

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18
Q

push force

A

hydrostatic pressure

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19
Q

pull force

A

osmotic pressure

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20
Q

movement of water from low solute concentration to high concentration

A

osmosis

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21
Q

movement of water and solutes from blood to ISF area (high to low pressure)

A

filtration

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22
Q

excessive amount of fluid in the interstitial compartment

A

edema

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23
Q

causes swelling or enlargement of tissue
may be localized or throughout the body
may impair tissue perfusion
may trap drugs in ISF

A

edema

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24
Q

what are the four causes of edema

A

increased capillary hydrostatic pressure
loss of plasma proteins
obstruction of lymphatic circulation
increased capillary permeability

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25
Q

what causes increased capillary hydrostatic pressure

A

by higher blood pressure or increased blood volume

forces increased fluid out of capillaries into tissues

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26
Q

increased capillary hydrostatic pressure is a cause for what type of edema

A

pulmonary

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27
Q

what is the result of the loss of plasma proteins

A

decreased plasma osmotic pressure

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28
Q

what is particularly lost in plasma proteins

A

albumin

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29
Q

obstruction of lymphatic circulation causes what type of edema

A

localized

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30
Q

excessive fluid and protein not being returned to the general circulation has to do with what type of cause of edema

A

obstruction of lymphatic circulation

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31
Q

increased capillary permeability can result from what and can lead to what

A

some bacterial toxins or large burn wounds and results in widespread edema
can lead to shock

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32
Q

increased capillary permeability usually causes what type of edema

A

localized

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33
Q

may result from an inflammatory response or infection is what type of cause of edema

A

increased capillary permeability

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34
Q

what increases capillary permeability

A

histamines and other chemical mediators

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35
Q

effects of edema

A 
functional impairment
pain
impaired arterial circulation
dental practice
edema in skin
swelling
pitting edema
increased in body weight
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36
Q

pale or red in color

A

swelling

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37
Q

presence of excess interstitial fluid
moves aside when pressure is applied by finger
depression remains when finger is removed

A

pitting edema

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38
Q

restricts range of joint movement
reduced vital capacity
impaired diastole

A

functional impairment

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39
Q

edema exerts pressure on nerves locally
headache with cerebral edema
stretching of capsule in organs

A

pain

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40
Q

ischemia leading to tissue breakdown

A

impaired arterial circulation

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41
Q

difficult to take accurate impressions

dentures do not fit well

A

dental practice

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42
Q

susceptible to tissue breakdown from pressure

A

edema in skin

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43
Q

insufficient body fluid either inadequate intake or excessive loss

A

dehydration

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44
Q

fluid loss is often measured by a change in what

A

body weight

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45
Q

dehydration is more serious in who

A

infants and older adults

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46
Q

water loss may be accompanied by what

A

loss of electrolytes and proteins

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47
Q

causes of dehydration

A

vomiting and diarrhea
excessive sweating with loss of sodium and water
diabetic ketoacidosis
insufficient water intake in older adults or unconscious persons
use of concentrated formula in infants

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48
Q

loss of fluid, electrolytes, and glucose in the urine

A

diabetic ketoacidosis

49
Q

effects of dehydration

A

dry mucous membranes in the mouth
decreased skin turgor or elasticity
lower blood pressure, weak pulse, and fatigue
decreased mental function, confusion, loss of consciousness

50
Q

body compensations for dehydration

A

increased thirst
increased heart rate
constrict cutaneous blood vessels-pale, cool skin
concentrated urine or less urine

51
Q

lab values of dehydration

A

increased hematocrit
increased electrolytes
urine is high specific gravity, low volume

52
Q

lab values of edema

A

decreased hematocrit
decreased serum sodium
urine is low specific gravity, high volume

53
Q

fluid shifts out of the blood into a body cavity or tissue and can no longer reenter vascular compartment like burns, inflammation and infection

A

third-spacing of fluid

54
Q

primary cation in ECF
sodium diffuses between vascular and interstitial fluids
transport into and out of cells by sodium-potassium pump
actively secreted into mucus and other secretions
exists in form of sodium chloride and sodium bicarbonate
ingested in food and beverages

A

sodium imbalance

55
Q

causes of hyponatremia

A

losses from excessive sweating, vomiting, and diarrhea
use of certain diuretic drugs combined with low-salt diet
hormonal imbalances such as insufficient aldosterone, adrenal insufficiency, excess ADH secretion
early chronic renal failure
excessive water intake

56
Q

effects of hyponatremia

A

low sodium levels and decreased osmotic pressure in ECF compartment

57
Q

hyponatremia what effect has to do with fatigue, muscle cramps, abdominal discomfort or cramps, nausea, vomiting
impair nerve conduction

A

low sodium levels

58
Q

hyponatremia what effect has to do with cerebral edema (confusion, headache, weakness, seizures) and fluid shift into cells (hypovolemia and decreased blood pressure)

A

decreased osmotic pressure in ECF compartment

59
Q

cause of the imbalance in sodium and water of hypernatremia

A

insufficient ADH results in large volume of dilute urine
loss of thirst mechanism
watery diarrhea
prolonged periods of rapid respiration
ingestion of large amounts of sodium without enough water

60
Q

effects of hypernatremia

A 
weakness
agitation
dry, rough, mucous membranes
edema
increased thirst
increased blood pressure
decreased urine output because ADH is secreted
61
Q

major intracellular cation
serum levels are low, with a narrow range
ingested in foods
excreted primarily in urine
insulin promotes movement of this into cells
level influenced by acid-base balance
excess ions in interstitial fluid may lead to hyperkalemia
abnormal levels cause changes in cardiac conduction and are life-threatening

A

potassium imbalance

62
Q

signs of potassium imbalance in hypokalemia

A

cardiac arrhythmias, cardiac arrest
anorexia, nausea, constipation
fatigue, muscle twitch, weakness, leg cramps
shallow respirations, parethesias
postural hypotension, polyuria, and nocturia
serum pH elevated

63
Q

signs of potassium imbalance in hyperkalemia

A

arrhythmias, cardiac arrest
nausea, diarrhea
muscle weakness, paralysis beginning in legs
paresthesias in fingers, toes, face, tongues
oliguria
serum pH decreased

64
Q

resting state of semipermeable membrane

A

polarization

65
Q

stimulates open Na+ channels Na+ moves into cell

A

depolarization

66
Q

as impulse moves along membrane Na+ channels close and K+ channels open allowing K+ to move outward

A

repolarization

67
Q

channels close. Sodium-potassium pump returns Na+ outside cell and K+ inside cell

A

resting state

68
Q

causes of hypokalemia

A

excessive losses caused by diarrhea
diuresis associated with some diuretic drugs
excessive aldosterone or glucocorticoids
decreased dietary intake such as alcoholism, eating disorders, starvation
treatment of diabetic ketoacidosis with insulin

69
Q

effects of hypokalemia

A

cardiac dysrhythmias caused by impaired repolarization leading to cardiac arrest
interference with neuromuscular function
paresthesias
decreased digestive tract motility

70
Q

effects of severe hypokalemia

A

shallow respirations

failure to concentrate urine

71
Q

causes of hyperkalemia

A

renal failure
deficit of aldosterone
potassium-sparing diuretics
leakage of intracellular potassium into extracellular fluids
displacement of potassium from cells by prolongs or severe acidosis

72
Q

effects of hyperkalemia

A

cardiac dysrhythmias
muscle weakness: may cause respiratory arrest, progressive to paralysis, and impairs neuromuscular activity
fatigue, nausea, paresthesias

73
Q

important extracellular cation
ingested in food
stored in bone
excreted in urine and feces
balance controlled by parathyroid hormone and calcitonin
Vitamin D promotes absorption from intestine (ingested or synthesized in skin in the presence of UV rays or activated in kidneys

A

calcium imbalance

74
Q

functions of calcium

A

provides structural strength for bones and teeth
maintenance of the stability of nerve membranes
required for muscle contractions
necessary for many metabolic processes and enzyme reactions
essential for blood clotting

75
Q

causes of hypocalcemia

A 
hypoparathyroidism
malabsorption syndrome
deficient serum albumin
increased serum pH level
renal failure
76
Q

effects of hypocalcemia

A

increase in the permeability and excitability of nerve membranes (carpopedal spasm and muscle twitching)
weak heart contractions (delayed conduction and leads to dysrhythmias and decreased blood pressure)

77
Q

causes of hypercalcemia

A

uncontrolled release of calcium ions from bones (neoplasms)
hyperparathyroidism
demineralization caused by immobility (decrease stress on bone)
increased calcium intake
milk-alkali syndrome

78
Q

what increases calcium intake

A

excessive vitamin d

excess dietary calcium

79
Q

associated with increased milk and antacid intake

A

milk-alkali syndrome

80
Q

effects of hypercalcemia

A

depressed neuromuscular activity (muscle weakness, loss of muscle tone, lethargy, stupor, personality changes, anorexia, nausea)
interference with ADH function (less absorption of water and decrease in renal function)
increased strength in cardiac contractions (dysrhythmias may occur)

81
Q

results from malabsorption or malnutrition; often associated with alcoholism

A

hypomagnesemia

82
Q

causes of hypomagnesemia

A

use of diuretics
diabetic acidosis
hyperthyroidism
hyperaldosteronism

83
Q

hypomagnesemia leads to

A

neuromuscular hyperirritability, insomnia, personality changes and increased heart rate with arrhythmias

84
Q

occurs with renal failure
depresses neuromuscular function
decreased reflexes

A

hypermagnesemia

85
Q 
bone and tooth mineralization
important in metabolism (ATP)
acid-base balance
integral part of the cell membrane
reciprocal relationship with serum calcium
A

phosphate imbalances

86
Q

malabsorption syndromes, diarrhea, excessive antacids
neurologic function is impaired
blood cells function less effectively

A

hypophosphatemia

87
Q

from renal failure and same manifestations as hypocalcemia

A

hyperphosphatemia

88
Q

major extracellular anion

related to sodium levels

A

chloride

89
Q

what ions can shift in response to acid-base imbalances

A

chloride and bicarbonate

90
Q

usually associated with alkalosis

early stages of vomiting (loss of hydrochloric acid)

A

hypochloremia

91
Q

excessive sodium chloride intake

A

hyperchloremia

92
Q

increased H+ results in

A

acidosis

93
Q

decreased H+ results in

A

alkalosis

94
Q

what can modify the excretion rates of acids and absorption of bicarbonate ions to regulate pH

A

kidneys

95
Q

respiratory system can alter what levels to change pH

A

carbonic acids

96
Q

what pairs in the blood respond to pH changes immediately

A

buffer

97
Q

which mechanism is the slowest regarding to controlling the pH

A

kidneys

98
Q

carbonic acid system
major ECF buffer
controlled by the respiratory system and kidneys

A

sodium bicarbonate

99
Q

buffering systems

A

sodium bicarbonate
phosphate
hemoglobin
protein

100
Q

when does decompensation occur

A

causative problem becomes more severe
additional problems occur
compensation mechanisms are exceeded or fail

101
Q

decompensation requires what

A

intervention to maintain homeostasis

102
Q

is decompensation life threatening

A

yes

103
Q

is compensation long term or short term

A

short term

104
Q

compensation occurs to what

A

balance the relative proportion of hydrogen ions and bicarbonate ions in circulation : buffers, change in respiration, and change in renal function

105
Q

excess hydrogen ions

decrease in serum pH

A

acidosis

106
Q

deficit of hydrogen ions

increase in serum pH

A

alkalosis

107
Q

pneumonia, airway obstruction, chest injuries

drugs that depress the respiratory control center

A

acute problems

108
Q

common with chronic obstructive pulmonary disease

A

chronic respiratory acidosis

109
Q

may develop if impairment becomes severe or if compensation mechanisms fail

A

decompensated respiratory acidosis

110
Q

excessive loss of bicarbonate ions to buffer hydrogen
increased use of serum bicarbonate
renal disease or failure
decompensated metabolic acidosis

A

metabolic acidosis

111
Q

additional factor interferes with compensation

A

decompensated metabolic acidosis

112
Q

decreased excretion of acids

decreased production of bicarbonate ions

A

renal disease or failure

113
Q

loss of bicarbonate from intestines

A

diarrhea

114
Q

what are the effects of acidosis

A

compensation (deep rapid breathing and secretion of urine with a low pH) and impaired nervous system function (headache, lethargy, weakness, confusion, coma and death)

115
Q

hyperventilation caused by anxiety, high fever, overdose of aspirin, head injuries, and brainstem tumor

A

respiratory alkalosis

116
Q

increase in serum bicarbonate ion
loss of hydrochloric acid from stomach
hypokalemia
excessive ingestion of antacids

A

metabolic alkalosis

117
Q

what are the effects of alkalosis

A

increased irritability of the nervous system causes restlessness, muscle twitching, tingling and numbness of the fingers, tetany, seizures, and coma

118
Q

treatments of imbalance

A

treatment of underlying cause
immediate corrective measures to include fluid and electrolyte replacement or removal
caution is required when adjusting fluid levels to ensure appropriate electrolyte balance
addition of bicarbonate to the blood to reverse acidosis
modification of diet to maintain better electrolyte balance

Pathophysiology (4 decks)

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