Chapter 2 Study and Book Questions Flashcards
The location of intracellular fluids
fluid is contained within the cells
The location of extracellular fluid
fluid includes all fluids outside the cells, such as blood, interstitial fluid, CSF, digestive tract secretions, pleural fluid and lymph
Which makes up the higher proportion of body fluid, intracellular fluid or extracellular fluid?
Intracellular fluid makes up the higher proportion of body fluid.
How does the proportion of fluid in the body change with age?
The proportion of fluid in the body decreases throughout the life span.
Why does dehydration affect cell function?
Dehydration affects cell function because the transport of nutrients into the cell and removal of wastes from the cell are decreased, impairing cell metabolism and function.
What is the function of sodium ion in the body?
Sodium ions (Na+) help maintain extracellular fluid volume (as the major cation exerting osmotic pressure), contribute to neuromuscular function, and play a role in acid-base balance and metabolic processes.
Describe the effect of hypernatremia on extracellular fluid volume and on intracellular fluid volume.
Hypernatremia tends to increase extracellular fluid volume by drawing water out of the cells, thus decreasing intracellular volume.
State the primary location (compartment) of potassium.
The primary location of potassium is in the intracellular compartment.
How are sodium and potassium levels controlled in the body?
Aldosterone and the kidney control sodium and potassium levels through the exchange of Na+ and K+ in the renal tubules.
Describe the signs and symptoms of hypocalcemia.
Signs and symptoms of hypocalcemia include skeletal muscle twitches and tetany, numbness and tingling in the face and fingers, and weak cardiac contraction.
skeletal muscle twitches and tetany, numbness and tingling in the face and fingers, and weak cardiac contraction are signs and symptoms of what
Hypocalcemia
Describe how a deficit of vitamin D would affect the following:
a. bones
b. serum calcium level
A vitamin D deficit would lead to (1) bone demineralization and decreased bone density and (2) a low serum calcium level.
- Explain how hypochloremia affects acid-base balance.
leads to increased serum bicarbonate levels as bicarbonate moves out of the red blood cells to maintain electrochemical neutrality by making up for a low chloride level. Increased serum bicarbonate results in higher serum pH or alkalosis.
- State the normal range of pH for the following:
a. blood
b. urine
- The normal range of pH for blood is 7.35 to 7.45 and for urine is 4.5 to 8.
- Describe how very slow, shallow respirations are likely to affect the following:
a. PCO2
b. serum pH
Very slow, shallow respirations would (1) increase Pco2 and(2) decrease serum pH (increase carbonic acid).
- State three possible causes of metabolic acidosis.
Metabolic acidosis may occur with infection (increased BMR), renal disease (retention of acids), severe vomiting or diarrhea (loss of bicarbonate and increased acids), starvation, or diabetic ketoacidosis (increased acid production).
- A diabetic client is producing excess amounts of ketoacids.
a. Describe the effects of this excess on serum bicarbonate levels and serum pH.
b. Explain the possible compensations for this imbalance.
c. Describe the signs of this compensation.
a. Ketoacids bind with bicarbonate ions, decreasing serum bicarbonate and serum pH.
b. Respirations increase. Kidneys excrete more acids and increase bicarbonate production and reabsorption.
c. Rate and depth of breathing increase, and urine has a low pH (pH = 5).
The respirations that accompany metabolic acidosis are frequently called Kussmaul respirations or “air hunger.” What is the purpose of such respirations?
Carbon dioxide or carbonic acid levels in the blood decrease, resulting in decreased total acid levels in the body.
A person is found unconscious. He is wearing a Medic-Alert bracelet for diabetes, and his breath has the typical odor of acetone (ketoacids).
a. Predict his serum pH and the rationale for this prediction.
b. Predict his serum potassium level.
a. Serum pH is less than 7.35 because acidosis depresses CNS function. Bicarbonate raises serum pH to normal by combining with ketoacids.
b. The serum potassium level is elevated because of acidosis.
How does insulin administration affect serum potassium?
Insulin reduces serum potassium by promoting the movement of potassium into cells.
A person will probably become very dehydrated as ketoacidosis develops. What heart rate and pulse characteristics would you expect to be present in this dehydrated condition?
The pulse would be weak and thready because of hypovolemia. When CNS function is decreased, the heart rate is slow or irregular.
Prolonged strenuous exercise usually leads to an increase in lactic acid. Given your knowledge of normal circulation, explain why it is helpful to have a cool-down period with mild exercise rather than total rest immediately after strenuous exercise.
Mild exercise promotes continued circulation to remove lactic acid from muscle tissue, decrease acidosis, and restore oxygen reserves.
General anesthetics, the presence of pain, and narcotic analgesics for pain often lead to slow, shallow respirations after surgery, circulation is frequently slow, and oxygen levels are somewhat reduced. Predict the effects on the partial pressure of carbon dioxide and how this would affect serum pH.
Slow, shallow respirations lead to increased carbon dioxide in the blood. Reduced oxygen and sluggish circulation contribute to more anaerobic metabolism and increased lactic acid levels. Therefore, the serum pH is decreased, and acidosis is common during and following surgery.
Define edema
An excess fluid in the interstial compartment
Identify the four general causes of edema, and explain how each one result in accumulation of fluid in the extracellular compartment
i. increased capillary, hydrostatis pressure, focing excessive amounts of fluids out and preventing return of fluid from the interstitial compartment
ii. loss of plasma proteins , reducing plasma osmotic pressure
iii. obstruction of lymphatic circulation, restricting the return of excess fluid and protein to the general circulation
iv. increased capillary permeability-as in inflammation, resulting in fluid and protein movement into the interstitial compartment
Sunken, soft eyes decreased skin turgor thirst wt loss rapid weak pulse low BP fatigue and weakness dizziness and possible stupor and increased body temp the most serious problems are decreased BP and potential shock What are the manifestation of this
dehydration
Identify the compensatory mechanism that is recruited during dehydration
increasing thirst, falling BP, increasing HR, constricting cutaneous blood vessels and decreasing urinary output
electrolyte imbalance
renal failure
hyponatremia, hyperkalemia, hypocalcemia, hypermagnesemia, hyperphosphatemia
electrolyte imbalance
prolonged vomiting
hyponatremia, hypochloremia
electrolyte imbalance
insufficient secretion of ADH
hypernatremia, hyperchloremia
electrolyte imbalance
prolonged use of corticosteroid
hypernatremia, hypokalemia, hyperchloremia
electrolyte imbalance
hyperparathyroidism
hypercalcemia, hypophosphatemia, hypomagnesemia
electrolyte imbalance excessive sweating
hyponatremia, hypochloremia
electrolyte imbalance
prolonged immobility
hypercalcemia
electrolyte imbalance
diuretic therapy
hyponatremia, hypokalemia, hypomagnesemia
electrolyte imbalance
aldosterone insufficiency
hyponatremia, hyperkalemia, hypochloremia
electrolyte imbalance
inadequate dietary intake of vitamin D
hypocalcemia
electrolyte imbalance of inadequate dietary intake of vitamin D
hypocalcemia
electrolyte imbalance of cancers involving bone
hypercalcemia
electrolyte imbalance of prolonged diarrhea
hyponatremia, hypokalemia, hypophosphatemia
define tetany. identify the electrolyte imbalance in which tetany occurs
skeletal muscle spasm d/t hypocalcemia
What is the the pH range of normal human plasma? At what pH levels does death usually result
Normal pH range is 7.35-7.45
ph <6.8 and >7.8 usually results in death
State the normal bicarbonate ion to carbonic acid ration
20:1
Identify the four major buffer systems
sodium bicarbonate-carbonic acid system
phosphate system
hemoglobin system
protein system
An individuals bicarbonate ion to carbonic acid ration is 5:1. What acid-base imbalance is present? What effects would the individual experience?
the imbalance is metabolic acidosis. The individual would experience the following manifestations:
rapid, deep respirations, lethargy, weakness, confusion, coma and decreased pH of urine
what acid balance develops and whats the compensatory mechanism?
chronic bronchitis
respiratory acidosis-more acidic uring
what acid balance develops and whats the compensatory mechanism? induced vomiting (e.g. bulimia)
metabolic alkalosis-slow, shallow respiration and increased pH of urine
what acid balance develops and whats the compensatory mechanism?
narcotic or barbiturate overdose resulting in respiratory depression
respirator acidosis-more acidic urine
what acid balance develops and whats the compensatory mechanism?
extreme weight loss resulting in lipolysis
metabolic acidosis-increased renal excretion of acids and conservation of bicarbonate
what acid balance develops and whats the compensatory mechanism?
panic attack with hyperventilation
respiratory alkalosis
less acidic uring
what acid balance develops and whats the compensatory mechanism?
pneumonia with severe brochial congestion
respiratory acidosis-more acidic urine and increased rate and depth of respiration (if possible)
what acid balance develops and whats the compensatory mechanism?
chronic diarrhea
metabolic acidosis-increased rate and depth of respiration, more acidic urine
what acid balance develops and whats the compensatory mechanism?
renal failure
metabolic acidosis-increased rate and depth of respiration
Electrolyte imbalances that affect normal cardiac function
hypocalcemia, hypercalcemia
hyperkalemia, hypokalemia
What electrolyte excess may result in the formation of kidney stones
hypercalcemia
