Ch2 electrolytes Flashcards
the major component of the body is water in these compartments
intercellular fluid compartment and extracellular fluid compartment
balance of water in the compartments is essential for
homeostasis
What percent of a males body weight is water
60
what percent of an infants body weight is water
70
who has a higher % of fatty tissue, lower water content than the other sex
females
what type of people lower proportion of water
older adults and obese people
individuals with less fluid reserve are more likely to be adversely affected by what
any fluid or electrolyte imbalance
what percent of a females body weight is water
50
where are transcellular fluids present
present in various secretions
pericardial cavity
synovial cavities of joints
the amount of water entering the body should equal the what
amount of water leaving the body
what ways is fluid balance controlled
thirst mechanisms
antidiuretic hormone
aldosterone
atrial natriuretic peptide
how is the thirst mechanism a control of fluid balance
osmoreceptors in the hypothalamus
how does the antidiuretic hormone control fluid balance
promotes resorption of water into blood from kidney tubules
how does aldosterone control fluid balance
determines resorption of sodium ions and water
how does atrial natriuretic peptide control fluid balance
regulates fluid, sodium, and potassium levels
how does fluid circulate throughout the body
filtration and osmosis
how does water move between compartments
hydrostatic pressure and osmotic pressure
push force
hydrostatic pressure
pull force
osmotic pressure
movement of water from low solute concentration to high concentration
osmosis
movement of water and solutes from blood to ISF area (high to low pressure)
filtration
excessive amount of fluid in the interstitial compartment
edema
causes swelling or enlargement of tissue
may be localized or throughout the body
may impair tissue perfusion
may trap drugs in ISF
edema
what are the four causes of edema
increased capillary hydrostatic pressure
loss of plasma proteins
obstruction of lymphatic circulation
increased capillary permeability
what causes increased capillary hydrostatic pressure
by higher blood pressure or increased blood volume
forces increased fluid out of capillaries into tissues
increased capillary hydrostatic pressure is a cause for what type of edema
pulmonary
what is the result of the loss of plasma proteins
decreased plasma osmotic pressure
what is particularly lost in plasma proteins
albumin
obstruction of lymphatic circulation causes what type of edema
localized
excessive fluid and protein not being returned to the general circulation has to do with what type of cause of edema
obstruction of lymphatic circulation
increased capillary permeability can result from what and can lead to what
some bacterial toxins or large burn wounds and results in widespread edema
can lead to shock
increased capillary permeability usually causes what type of edema
localized
may result from an inflammatory response or infection is what type of cause of edema
increased capillary permeability
what increases capillary permeability
histamines and other chemical mediators
effects of edema
functional impairment pain impaired arterial circulation dental practice edema in skin swelling pitting edema increased in body weight
pale or red in color
swelling
presence of excess interstitial fluid
moves aside when pressure is applied by finger
depression remains when finger is removed
pitting edema
restricts range of joint movement
reduced vital capacity
impaired diastole
functional impairment
edema exerts pressure on nerves locally
headache with cerebral edema
stretching of capsule in organs
pain
ischemia leading to tissue breakdown
impaired arterial circulation
difficult to take accurate impressions
dentures do not fit well
dental practice
susceptible to tissue breakdown from pressure
edema in skin
insufficient body fluid either inadequate intake or excessive loss
dehydration
fluid loss is often measured by a change in what
body weight
dehydration is more serious in who
infants and older adults
water loss may be accompanied by what
loss of electrolytes and proteins
causes of dehydration
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
loss of fluid, electrolytes, and glucose in the urine
diabetic ketoacidosis
effects of dehydration
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
body compensations for dehydration
increased thirst
increased heart rate
constrict cutaneous blood vessels-pale, cool skin
concentrated urine or less urine
lab values of dehydration
increased hematocrit
increased electrolytes
urine is high specific gravity, low volume
lab values of edema
decreased hematocrit
decreased serum sodium
urine is low specific gravity, high volume
fluid shifts out of the blood into a body cavity or tissue and can no longer reenter vascular compartment like burns, inflammation and infection
third-spacing of fluid
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
sodium imbalance
causes of hyponatremia
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
effects of hyponatremia
low sodium levels and decreased osmotic pressure in ECF compartment
hyponatremia what effect has to do with fatigue, muscle cramps, abdominal discomfort or cramps, nausea, vomiting
impair nerve conduction
low sodium levels
hyponatremia what effect has to do with cerebral edema (confusion, headache, weakness, seizures) and fluid shift into cells (hypovolemia and decreased blood pressure)
decreased osmotic pressure in ECF compartment
cause of the imbalance in sodium and water of hypernatremia
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
effects of hypernatremia
weakness agitation dry, rough, mucous membranes edema increased thirst increased blood pressure decreased urine output because ADH is secreted
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
potassium imbalance
signs of potassium imbalance in hypokalemia
cardiac arrhythmias, cardiac arrest
anorexia, nausea, constipation
fatigue, muscle twitch, weakness, leg cramps
shallow respirations, parethesias
postural hypotension, polyuria, and nocturia
serum pH elevated
signs of potassium imbalance in hyperkalemia
arrhythmias, cardiac arrest
nausea, diarrhea
muscle weakness, paralysis beginning in legs
paresthesias in fingers, toes, face, tongues
oliguria
serum pH decreased
resting state of semipermeable membrane
polarization
stimulates open Na+ channels Na+ moves into cell
depolarization
as impulse moves along membrane Na+ channels close and K+ channels open allowing K+ to move outward
repolarization
channels close. Sodium-potassium pump returns Na+ outside cell and K+ inside cell
resting state
causes of hypokalemia
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
effects of hypokalemia
cardiac dysrhythmias caused by impaired repolarization leading to cardiac arrest
interference with neuromuscular function
paresthesias
decreased digestive tract motility
effects of severe hypokalemia
shallow respirations
failure to concentrate urine
causes of hyperkalemia
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
effects of hyperkalemia
cardiac dysrhythmias
muscle weakness: may cause respiratory arrest, progressive to paralysis, and impairs neuromuscular activity
fatigue, nausea, paresthesias
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
calcium imbalance
functions of calcium
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
causes of hypocalcemia
hypoparathyroidism malabsorption syndrome deficient serum albumin increased serum pH level renal failure
effects of hypocalcemia
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)
causes of hypercalcemia
uncontrolled release of calcium ions from bones (neoplasms)
hyperparathyroidism
demineralization caused by immobility (decrease stress on bone)
increased calcium intake
milk-alkali syndrome
what increases calcium intake
excessive vitamin d
excess dietary calcium
associated with increased milk and antacid intake
milk-alkali syndrome
effects of hypercalcemia
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)
results from malabsorption or malnutrition; often associated with alcoholism
hypomagnesemia
causes of hypomagnesemia
use of diuretics
diabetic acidosis
hyperthyroidism
hyperaldosteronism
hypomagnesemia leads to
neuromuscular hyperirritability, insomnia, personality changes and increased heart rate with arrhythmias
occurs with renal failure
depresses neuromuscular function
decreased reflexes
hypermagnesemia
bone and tooth mineralization important in metabolism (ATP) acid-base balance integral part of the cell membrane reciprocal relationship with serum calcium
phosphate imbalances
malabsorption syndromes, diarrhea, excessive antacids
neurologic function is impaired
blood cells function less effectively
hypophosphatemia
from renal failure and same manifestations as hypocalcemia
hyperphosphatemia
major extracellular anion
related to sodium levels
chloride
what ions can shift in response to acid-base imbalances
chloride and bicarbonate
usually associated with alkalosis
early stages of vomiting (loss of hydrochloric acid)
hypochloremia
excessive sodium chloride intake
hyperchloremia
increased H+ results in
acidosis
decreased H+ results in
alkalosis
what can modify the excretion rates of acids and absorption of bicarbonate ions to regulate pH
kidneys
respiratory system can alter what levels to change pH
carbonic acids
what pairs in the blood respond to pH changes immediately
buffer
which mechanism is the slowest regarding to controlling the pH
kidneys
carbonic acid system
major ECF buffer
controlled by the respiratory system and kidneys
sodium bicarbonate
buffering systems
sodium bicarbonate
phosphate
hemoglobin
protein
when does decompensation occur
causative problem becomes more severe
additional problems occur
compensation mechanisms are exceeded or fail
decompensation requires what
intervention to maintain homeostasis
is decompensation life threatening
yes
is compensation long term or short term
short term
compensation occurs to what
balance the relative proportion of hydrogen ions and bicarbonate ions in circulation : buffers, change in respiration, and change in renal function
excess hydrogen ions
decrease in serum pH
acidosis
deficit of hydrogen ions
increase in serum pH
alkalosis
pneumonia, airway obstruction, chest injuries
drugs that depress the respiratory control center
acute problems
common with chronic obstructive pulmonary disease
chronic respiratory acidosis
may develop if impairment becomes severe or if compensation mechanisms fail
decompensated respiratory acidosis
excessive loss of bicarbonate ions to buffer hydrogen
increased use of serum bicarbonate
renal disease or failure
decompensated metabolic acidosis
metabolic acidosis
additional factor interferes with compensation
decompensated metabolic acidosis
decreased excretion of acids
decreased production of bicarbonate ions
renal disease or failure
loss of bicarbonate from intestines
diarrhea
what are the effects of acidosis
compensation (deep rapid breathing and secretion of urine with a low pH) and impaired nervous system function (headache, lethargy, weakness, confusion, coma and death)
hyperventilation caused by anxiety, high fever, overdose of aspirin, head injuries, and brainstem tumor
respiratory alkalosis
increase in serum bicarbonate ion
loss of hydrochloric acid from stomach
hypokalemia
excessive ingestion of antacids
metabolic alkalosis
what are the effects of alkalosis
increased irritability of the nervous system causes restlessness, muscle twitching, tingling and numbness of the fingers, tetany, seizures, and coma
treatments of imbalance
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
