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Pathophysiology Summer 2019 > Chapter 6: Fluid, Electrolyte, and Acid–Base Homeostasis > Flashcards

Chapter 6: Fluid, Electrolyte, and Acid–Base Homeostasis Flashcards

1
Q

Intracellular fluid

A

inside the cells

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2
Q

Extracellular fluid

A

fluid outside the cells

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3
Q

Interstitial fluid

A

between the cells

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4
Q

Intravascular fluid

A

inside the blood vessels

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5
Q

Tonicity

A

osmotic pressure of two solutions separated by a semipermeable membrane

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6
Q

Isotonic

A

equal solute concentrations, causes no fluid shifts

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7
Q

Hypotonic

A

lower solute concentrations, cell swells

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8
Q

Hypertonic

A

higher solute concentrations, cell shrinks

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9
Q

Fluid movement

A

Isotonic, Hypotonic,

Hypertonic

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10
Q

Fluid compartment

A

Intracellular fluid, Extracellular fluid, Interstitial fluid, Intravascular fluid

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11
Q

Fluid Sources

A

Oral intake

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12
Q

Intravenous solutions

A

Isotonic – 0.9% saline, lactated ringers, Hypotonic – 0.45% saline, Hypertonic – 5% dextrose in 0.9% saline, 3% saline

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13
Q

Fluid Loses

A

In Urine, Feces, Insensible losses (Through skin, respiratory tract)

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14
Q

Thirst mechanism

A

Triggered by decreased blood volume and increased osmolarity

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15
Q

Antidiuretic hormone

A

Promotes reabsorption of water in the kidneys

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16
Q

Aldosterone

A

Increases reabsorption of sodium and water in the kidneys

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17
Q

Atrial natriuretic peptide (ANP)

A

Stimulates renal vasodilatation and suppresses aldosterone, increasing urinary output

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18
Q

Edema

A

fluid in the interstitial space

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19
Q

Hypervolemia

A

fluid in the intravascular space

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20
Q

Water intoxication

A

fluid in the intracellular space

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21
Q

Manifestations of Fluid Excess

A

peripheral edema, periorbital edema, anasarca, cerebral edema

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22
Q

Treatment for Fluid Excess

A

administering diuretics

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23
Q

Causes of Fluid Excess

A

Excessive sodium or water intake, and Inadequate sodium or water elimination

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24
Q

Fluid Deficit

A

Dehydration, Decreased fluid in the intravascular space

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25
Q

Causes of Fluid Deficit

A

Inadequate fluid intake, and Excessive fluid or sodium losses

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26
Q

Manifestations of Fluid Deficit

A

thirst, altered level of consciousness, hypotension, tachycardia, weak pulse

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27
Q

Treatment for Fluid Deficit

A

fluid replacement

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28
Q

Electrolyte Balance

A

cations, anions

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29
Q

Cations

A

Positively charged electrolytes

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30
Q

Anions

A

Negatively charged electrolytes

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31
Q

Sodium

A

Most significant cation and prevalent electrolyte of extracellular fluid

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32
Q

Hypernatremia

A

Results in fluid shifts

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33
Q

Causes of Hypernatremia

A

Excessive sodium ingestion,
Hypertonic IV saline (3% saline) administration,
Cushing’s syndrome,
Corticosteroid use, Deficient water, Vomiting, Diarrhea

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34
Q

Manifestations of Hypernatremia

A

headache, seizures, lethargy, coma, blood pressure changes, tachycardia,

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35
Q

Treatment for Hypernatremia

A

fluid replacement, and diuretics

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36
Q

Hyponatremia

A

Sodium < 135 mEq/L

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37
Q

Manifestations of Hyponatremia

A

diminished deep tendon reflexes, muscle weakness, seizures, and coma

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38
Q

Causes of Hyponatremia

A

Deficient sodium, Insufficient aldosterone levels, Excessive water, Renal failure, Syndrome of inappropriate antidiuretic hormone

39
Q

Chloride

A

Major extracellular anion, Found in gastric secretions, pancreatic juices, bile, and cerebrospinal fluid

40
Q

Hyperchloremia

A

Increased chloride intake or exchange: hypernatremia, hypertonic intravenous solution, metabolic acidosis, and hyperkalemia
Decreased chloride excretion: hyperparathyroidism, hyperaldosteronism, and renal failure

41
Q

Hypochloremia

A

Decreased chloride intake or exchange: hyponatremia, 5% dextrose in water intravenous solution, water intoxication, and hypokalemia
Increased chloride excretion: diuretics, vomiting, metabolic alkalosis, and other gastrointestinal losses

42
Q

Potassium

A

electrical conduction

43
Q

Hyperkalemia

A

Deficient excretion, and Excessive intake: oral potassium supplements

44
Q

Manifestations of Hyperkalemia

A

paresthesia, flaccid paralysis, bradycardia, dysrhythmias, electrocardiogram changes, cardiac arrest, respiratory depression, abdominal cramping, nausea, and diarrhea

45
Q

Diagnosis of Hyperkalemia

A

electrocardiogram

46
Q

Hypokalemia

A

Increased shift into the cell: alkalosis and insulin excess, Excessive loss, Deficient intake

47
Q

Manifestations of Hyperkalemia

A

muscle weakness, paresthesias, hyporeflexia

48
Q

Calcium

A

Mostly found in the bone and teeth

49
Q

Calcium regulated by

A

Vitamin K, Parathyroid hormone, Calcitonin

50
Q

Calcium plays a role in?

A

blood clotting, hormone secretion, receptor functions, nerve transmission, and muscular contraction

51
Q

Hypercalcemia

A

Increased intake or release, Deficit excretion

52
Q

Manifestations of Hypercalcemia

A

electrocardiogramchange, confusion, renal calculi

53
Q

Hypocalcemia Excessive losses

A

hypoparathyroidism, renal failure, hyperphosphatemia

54
Q

Manifestations of Hypocalcemia

A

dysrhythmias, electrocardiogram changes, increased bleeding tendencies, Trousseau’s and Chvostek’s signs

55
Q

Acid-Base Balance

A

Normal serum pH 7.35-7.45, Body fluids, kidneys, and lungs maintain balance

56
Q

Sodium and potassium relationship

A

have an inverse relationship; thus, when one goes up, the other goes down.

57
Q

Calcium and phosphorus relationship

A

have an inverse relationship

58
Q

Calcium and magnesium relationship

A

have a synergistic relationship, so one enhances the other.

59
Q

pH reflects hydrogen concentrations

A

The more hydrogen, the lower the pH

60
Q

3 systems work to maintain acid-base balance

A

the buffers, respiratory system, and renal system

61
Q

4 major blood buffer mechanisms

A

The bicarbonate-carbonic acid system, The phosphate system, The hemoglobin system, The protein system

62
Q

Key players in Bicarbonate-Carbonic Acid System

A

Carbonic acid and bicarbonate

63
Q

Carbonic anhydrase causes?

A

carbonic acid to separate into hydrogen and bicarbonate

64
Q

Carbonic anhydrase in the lungs allows for?

A

carbon dioxide excretion and in the kidneys allows for hydrogen excretion

65
Q

Bicarbonate-Carbonic Acid System

A

Most significant in the extracellular fluid

66
Q

Phosphate System

A

intracellular fluid, primarily occurs in the kidneys by accepting or donating hydrogen

67
Q

Hemoglobin System

A

in the capillaries, taking up extra hydrogen, Binding with oxygen makes hemoglobin more prone to release hydrogen

68
Q

Protein System

A

Most abundant buffering system

69
Q

Albumin in plasma

A

is the primary buffer in the intravascular space

70
Q

pH Regulation

A

Respiratory Regulation, Renal Regulation

71
Q

Respiratory Regulation

A

Responds quickly, but is short-lived

72
Q

Renal Regulation

A

Alters the excretion or retention of hydrogen or bicarbonate, Responds slowly, but longer lasting

73
Q

CO2 is an?

A

acid

74
Q

If the problem causing the pH imbalance originates in the lungs

A

the kidneys initiates efforts to correct it

75
Q

If the problem causing the pH imbalance originates outside the lungs

A

the lungs initiate efforts to correct it

76
Q

Metabolic Acidosis

A

Results from a deficiency of bicarbonate or an excess of hydrogen, pH below 7.35

77
Q

Metabolic Acidosis causes

A

Bicarbonate deficit, Acid excess

78
Q

Bicarbonate deficit

A

intestinal and renal losses

79
Q

Acid excess

A

tissue hypoxia resulting in lactic acid

80
Q

Manifestations of Metabolic Acidosis

A

Kussmaul’s respirations

81
Q

Metabolic Acidosis treatment

A

Intravenous bicarbonate, correction of electrolyte disturbances, improving oxygenation

82
Q

Metabolic Alkalosis

A

Results from excess bicarbonate or deficient acid or both (remember, this is opposite of metabolic acidosis)

83
Q

Metabolic Alkalosis causes

A

Excess bicarbonate, Deficient acid

84
Q

Treatment for Metabolic Alkalosis

A

adequate hydration, correcting electrolyte disturbances, Diamox, arginine hydrochloride, and administering a weak hydrochloric acid solution

85
Q

Respiratory Acidosis

A

Results from carbon dioxide retention, which increases carbonic acid, result in hypoventilation

86
Q

Respiratory Alkalosis

A

Results from excess exhalation of carbon dioxide, which leads to carbonic acid deficits (opposite of resp. acidosis), result in hyperventilation

87
Q

Respiratory Alkalosis Treatment

A

breath into a paper bag, mechanical ventilation, and anxiety reduction strategies

88
Q

pH

A

serum hydrogen concentration

89
Q

PaCO2

A

partial pressure of carbon dioxide

90
Q

HCO3

A

bicarbonate

91
Q

PaO2

A

partial pressure of oxygen

92
Q

Base excess/deficit

A

Indicates serum buffer concentration, particularly bicarbonate

93
Q

Positive values

A

indicate an excess of base or a deficit of acid

94
Q

Negative values

A

indicate a deficit of base or an excess of acid

Pathophysiology Summer 2019 (8 decks)

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