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Pathophysiology and Pharmacology > Chapter 8 Altered Fluid and Electrolyte Balance > Flashcards

Chapter 8 Altered Fluid and Electrolyte Balance Flashcards

1
Q

electrolytes

A

produce ions when dissolved in water

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2
Q

cations

A

positively charged

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3
Q

anions

A

negatively charged

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4
Q

Na+ (Sodium

A

135-145 mEq/L

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5
Q

K+ (Potassium)

A

3.5-5 mEq/L

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6
Q

Cl- (Chloride)

A

98-106 mEq/L

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7
Q

Ca 2+ (Calcium)

A

8.5-10.5 mg/dL

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8
Q

HCO 3- (Bicarbonate)

A

24-31 mEg/L

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9
Q

Passive transport

A

diffusion (high to low concentration), osmosis (movement of water through semi-permeable membrane

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10
Q

Active transport

A

ATP is needed to actively move ions across membrane

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11
Q

Intercellular Fluid (ICF)

A

prevalent cation is K+
prevalent anion is PO4 3-

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12
Q

Extracellular Fluid (ECF)

A

Prevalent cation is Na+
Prevalent anion is Cl-

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13
Q

Starling forces

A

hydrostatic (fluid moves out of capillaries and into the interstitial space, blood pressure goes down) and osmotic (large protein will cause reabsorption of this fluid); if osmotic and lymphatic system fails, enema occurs

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14
Q

Regulation

A

thirst, Renin-angiotensin-aldosterone system (RAAS), antidiuretic hormone (ADH), diuretics

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15
Q

tonicity

A

tension or effect that the osmotic pressure of a solution with impermeable solutes exerts on cell size because of water movement from one compartment to another

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16
Q

isotonic solution

A

neither shrink nor swell the cell

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17
Q

hypotonic solution

A

swell the cell

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18
Q

hypertonic solution

A

shrink the cell

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19
Q

Hypovolemia

A

occurs when loss of ECF volume exceeds the intake of fluid; dehydration, hemorrhage, treatment usually is isotonic or hypotonic IV solution

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20
Q

Hypervolemia

A

isotonic expansion of the ECF caused by the anormal retention of water and sodium; Edema, increased blood pressure, tachycardia, treatments are diuresis and sodium restriction

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21
Q

Edema

A

accumulation of fluid within the interstitial spaces, increase in capillary hydrostatic pressure

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22
Q

Osmolality level

A

275 to 295 mOsm/kg

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23
Q

urine specific gravity levels

A

1.005 to 1.030

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24
Q

blood urea nitrogen (BUN)

A

6-24 mg/dL

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25
Q

creatinine

A

0.7 to 1.3 mg/dL (men) and 0.6 to 1.1 mg/dL (women)

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26
Q

hematocrit

A

41% to 50% (men) and 36% to 48% (women)

27
Q

Sodium imbalance

A

hypo-/hypernatremia

28
Q

Calcium imbalance

A

hypo-/hypercalcemia

29
Q

Potassium imbalance

A

hypo-/hyperkalemia

30
Q

Magnesium imbalance

A

hypo-/hypermagnesemia

31
Q

Chloride imbalance

A

hypo-/hyperchloremia

32
Q

Phosphate imbalance

A

hypo-/hyperphosphatemia

33
Q

Sodium in the body

A

regulated by kidney, primary ECF cation

34
Q

Chloride

A

primary ECF anion, provides electron neutrality

35
Q

Hypothalamic-pituitary regulation

A

osmoreceptors in hypothalamus sense fluid deficit (stimulates thirst and antidiuretic hormone, ADH) or increase (water excess suppresses ADH release)

36
Q

Renin-angiotensin-aldosterone system (RAAS)

A

triggered by decrease in renal blood flow, angiotensinogen is converted to angiotensin l by renin, Angiotensin l converted to angiotensin ll by the angiotensin converting enzyme (ACE), Aldosterone leads to NA and water reabsorption into circulation, uses angiotensin ll to increase Na absorption by constricting renal blood vessels to decreases filtration rate (increases blood pressure)

37
Q

Antidiuretic Hormone (ADH/Vasopressin)

A

restricts how much you need to pee

38
Q

Atrial Natriuretic Peptide

A

opposite of RAAS, produced by cardiomyocytes in response to increase atrial pressure, supress secretion of aldosterone, renin, and ADH to decreases blood volume and pressure

39
Q

Hypodipsia

A

decreased sensation of thirst, common in elderly

40
Q

polydipsia

A

decreased thirst, cigarette smoking can be cause b/c stimulates ADH secretion

41
Q

Diabetes insipidus

A

decrease response to ADH
central or neurogenic: problem with release of ADH
nephrogenic: kidneys do not respond to ADH
High urinary output, low levels of ADH, hypernatremia, dehydrated, lose too much fluid, excessive thirst

42
Q

Syndrome of inappropriate ADH (SIADH)

A

feedback system fails to regulate ADH
low urinary output, high levels of ADH, hyponatremia, over hydrated, retain too much fluid, excessive thirst

43
Q

Hypernatremia

A

water movement from ICF to ECF, ICF dehydration, hypotension

44
Q

Hyponatremia

A

decrease levels of sodium, decreased osmolality, cells expand, low intake, lethargy, confusion, seizures, hypotension

45
Q

Hypochloremia

A

develops as result of vomiting and loss of HCl, occurs in CF, where sodium goes, chloride goes, weakness, twitching of muscles

46
Q

Potassium

A

essential for transmission and conduction of nerve impulses, cellular growth, normal cardia rhythms, muscle contraction, acid-base balances
regulated through renal mechanisms conserve or eliminate potassium and transcellular shift between the ICF and ECF compartments
dietary sources

47
Q

hypokalemia

A

inadequate intake, excessive gastro, renal, skin losses
causes decrease in neuromuscular excitability, skeletal muscle weakness and cardiac dysthymias

48
Q

Hyperkalemia

A

rare b/c of renal excretion, caused by increased intake, shift K+ from ICF into ECF, decrease renal excretion

49
Q

Calcium

A

bone strength, stability, membrane potentials and excitability, contraction of all muscle types, clotting

50
Q

hypocalcemia

A

nerves fire more easily, muscle spasms, tingling, cardiac arrest, decrease in PTH and vit D (helps absorb calcium)

51
Q

Hypercalcemia

A

nerves are less able to fire, renal stones, bone pain, osteoporosis, dysrhythmias

52
Q

Phosphorus

A

bone and ATP formation, glucose, fat, protein metabolism, DNA, RNA, phospholipids, acid-base buffer

53
Q

Magnesium

A

cofactor in ATP generation, DNA replication, mRNA production and translation

54
Q

Hypermagnesemia

A

usually renal insufficiency or failure, excessive intake of mangesium, excess nerve function, loss of deep tendon reflexes, nausea and vomiting, muscle weakness, bradycardia

55
Q
  1. Fluid loss in response to hypervolemia is promoted by:

a. stimulating secretion of ADH, thereby promoting urinary sodium and water elimination.
b. inhibiting the secretion of aldosterone, thereby promoting urinary sodium and water elimination.
c. lowering mean arterial pressure.
d. administering osmotically active fluids.

A

inhibiting the secretion of aldosterone, thereby promoting urinary sodium and water elimination.

56
Q
  1. Which of the following ions is most closely related to water movement?

a. Potassium
b. Sodium
c. Chloride
d. Calcium

A

Sodium

57
Q
  1. Which compartment contains the greatest amount of body water?

a. Transcellular
b. Plasma
c. Interstitial
d. Intracellular

A

Intracellular

58
Q
  1. Which of the following transport mechanisms is associated with movement oof water across a semi-permeable membrane?

a. Diffusion
b. Osmosis
c. Facilitated diffusion
d. Active transport

A

Osmosis

59
Q
  1. Which one of the following conditions will most likely result in edema?

a. Intravascular filtration pressure greater than interstitial filtration pressure
b. Intravascular reabsorption greater than interstitial reabsorption
c. Intravascular colloid osmotic pressure greater than interstitial colloid osmotic pressure
d. Increased lymphatic reabsorption

A

a. Intravascular filtration pressure greater than interstitial filtration pressure

60
Q
  1. Ascites is the primary mechanism of body fluid imbalance in which of the following conditions?

a. Salt-losing tubulopathy
b. Cirrhosis
c. AIDS
d. Isonatremic dehydration

A

Cirrhosis

61
Q
  1. Hypokalemia is a hallmark of which of the following conditions?

a. Salt-losing tubulopathy
b. Cirrhosis
c. AIDS
d. Isonatremic dehydration

A

a. Salt-losing tubulopathy

62
Q
  1. Hypotonic fluid loss may result in:

a. hyponatremic dehydration
b. isonatremic dehydration
c. hypernatremic dehydration
d. none of the above

A

hypernatremic dehydration

63
Q
A

Pathophysiology and Pharmacology (11 decks)

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