Chapter 2 Study and Book Questions

Question 1

The location of intracellular fluids

Answer 1

fluid is contained within the cells

Question 2

The location of extracellular fluid

Answer 2

fluid includes all fluids outside the cells, such as blood, interstitial fluid, CSF, digestive tract secretions, pleural fluid and lymph

Question 3

Which makes up the higher proportion of body fluid, intracellular fluid or extracellular fluid?

Answer 3

Intracellular fluid makes up the higher proportion of body fluid.

Question 4

How does the proportion of fluid in the body change with age?

Answer 4

The proportion of fluid in the body decreases throughout the life span.

Question 5

Why does dehydration affect cell function?

Answer 5

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.

Question 6

What is the function of sodium ion in the body?

Answer 6

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.

Question 7

Describe the effect of hypernatremia on extracellular fluid volume and on intracellular fluid volume.

Answer 7

Hypernatremia tends to increase extracellular fluid volume by drawing water out of the cells, thus decreasing intracellular volume.

Question 8

State the primary location (compartment) of potassium.

Answer 8

The primary location of potassium is in the intracellular compartment.

Question 9

How are sodium and potassium levels controlled in the body?

Answer 9

Aldosterone and the kidney control sodium and potassium levels through the exchange of Na+ and K+ in the renal tubules.

Question 10

Describe the signs and symptoms of hypocalcemia.

Answer 10

Signs and symptoms of hypocalcemia include skeletal muscle twitches and tetany, numbness and tingling in the face and fingers, and weak cardiac contraction.

Question 11

skeletal muscle twitches and tetany, numbness and tingling in the face and fingers, and weak cardiac contraction are signs and symptoms of what

Answer 11

Hypocalcemia

Question 12

Describe how a deficit of vitamin D would affect the following:

a. bones
b. serum calcium level

Answer 12

A vitamin D deficit would lead to (1) bone demineralization and decreased bone density and (2) a low serum calcium level.

Question 13

11. Explain how hypochloremia affects acid-base balance.

Answer 13

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.

Question 14

12. State the normal range of pH for the following:
    a. blood
    b. urine

Answer 14

12. The normal range of pH for blood is 7.35 to 7.45 and for urine is 4.5 to 8.

Question 15

13. Describe how very slow, shallow respirations are likely to affect the following:
    a. PCO2
    b. serum pH

Answer 15

Very slow, shallow respirations would (1) increase Pco2 and(2) decrease serum pH (increase carbonic acid).

Question 16

14. State three possible causes of metabolic acidosis.

Answer 16

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).

Question 17

15. 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.

Answer 17

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).

Question 18

The respirations that accompany metabolic acidosis are frequently called Kussmaul respirations or “air hunger.” What is the purpose of such respirations?

Answer 18

Carbon dioxide or carbonic acid levels in the blood decrease, resulting in decreased total acid levels in the body.

Question 19

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.

Answer 19

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.

Question 20

How does insulin administration affect serum potassium?

Answer 20

Insulin reduces serum potassium by promoting the movement of potassium into cells.

Question 21

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?

Answer 21

The pulse would be weak and thready because of hypovolemia. When CNS function is decreased, the heart rate is slow or irregular.

Question 22

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.

Answer 22

Mild exercise promotes continued circulation to remove lactic acid from muscle tissue, decrease acidosis, and restore oxygen reserves.

Question 23

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.

Answer 23

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.

Question 24

Define edema

Answer 24

An excess fluid in the interstial compartment

Question 25

Identify the four general causes of edema, and explain how each one result in accumulation of fluid in the extracellular compartment

Answer 25

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

Question 26

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

Answer 26

dehydration

Question 27

Identify the compensatory mechanism that is recruited during dehydration

Answer 27

increasing thirst, falling BP, increasing HR, constricting cutaneous blood vessels and decreasing urinary output

Question 28

electrolyte imbalance

renal failure

Answer 28

hyponatremia, hyperkalemia, hypocalcemia, hypermagnesemia, hyperphosphatemia

Question 29

electrolyte imbalance

prolonged vomiting

Answer 29

hyponatremia, hypochloremia

Question 30

electrolyte imbalance

insufficient secretion of ADH

Answer 30

hypernatremia, hyperchloremia

Question 31

electrolyte imbalance

prolonged use of corticosteroid

Answer 31

hypernatremia, hypokalemia, hyperchloremia

Question 32

electrolyte imbalance

hyperparathyroidism

Answer 32

hypercalcemia, hypophosphatemia, hypomagnesemia

Question 33

electrolyte imbalance excessive sweating

Answer 33

hyponatremia, hypochloremia

Question 34

electrolyte imbalance

prolonged immobility

Answer 34

hypercalcemia

Question 35

electrolyte imbalance

diuretic therapy

Answer 35

hyponatremia, hypokalemia, hypomagnesemia

Question 36

electrolyte imbalance

aldosterone insufficiency

Answer 36

hyponatremia, hyperkalemia, hypochloremia

Question 37

electrolyte imbalance

inadequate dietary intake of vitamin D

Answer 37

hypocalcemia

Question 38

electrolyte imbalance of inadequate dietary intake of vitamin D

Answer 38

hypocalcemia

Question 39

electrolyte imbalance of cancers involving bone

Answer 39

hypercalcemia

Question 40

electrolyte imbalance of prolonged diarrhea

Answer 40

hyponatremia, hypokalemia, hypophosphatemia

Question 41

define tetany. identify the electrolyte imbalance in which tetany occurs

Answer 41

skeletal muscle spasm d/t hypocalcemia

Question 42

What is the the pH range of normal human plasma? At what pH levels does death usually result

Answer 42

Normal pH range is 7.35-7.45

ph <6.8 and >7.8 usually results in death

Question 43

State the normal bicarbonate ion to carbonic acid ration

Answer 43

20:1

Question 44

Identify the four major buffer systems

Answer 44

sodium bicarbonate-carbonic acid system
phosphate system
hemoglobin system
protein system

Question 45

An individuals bicarbonate ion to carbonic acid ration is 5:1. What acid-base imbalance is present? What effects would the individual experience?

Answer 45

the imbalance is metabolic acidosis. The individual would experience the following manifestations:
rapid, deep respirations, lethargy, weakness, confusion, coma and decreased pH of urine

Question 46

what acid balance develops and whats the compensatory mechanism?
chronic bronchitis

Answer 46

respiratory acidosis-more acidic uring

Question 47

what acid balance develops and whats the compensatory mechanism?
induced vomiting (e.g. bulimia)

Answer 47

metabolic alkalosis-slow, shallow respiration and increased pH of urine

Question 48

what acid balance develops and whats the compensatory mechanism?
narcotic or barbiturate overdose resulting in respiratory depression

Answer 48

respirator acidosis-more acidic urine

Question 49

what acid balance develops and whats the compensatory mechanism?
extreme weight loss resulting in lipolysis

Answer 49

metabolic acidosis-increased renal excretion of acids and conservation of bicarbonate

Question 50

what acid balance develops and whats the compensatory mechanism?
panic attack with hyperventilation

Answer 50

respiratory alkalosis

less acidic uring

Question 51

what acid balance develops and whats the compensatory mechanism?
pneumonia with severe brochial congestion

Answer 51

respiratory acidosis-more acidic urine and increased rate and depth of respiration (if possible)

Question 52

what acid balance develops and whats the compensatory mechanism?
chronic diarrhea

Answer 52

metabolic acidosis-increased rate and depth of respiration, more acidic urine

Question 53

what acid balance develops and whats the compensatory mechanism?
renal failure

Answer 53

metabolic acidosis-increased rate and depth of respiration

Question 54

Electrolyte imbalances that affect normal cardiac function

Answer 54

hypocalcemia, hypercalcemia

hyperkalemia, hypokalemia

Question 55

What electrolyte excess may result in the formation of kidney stones

Answer 55

hypercalcemia