Chapter 8- Fluids, Electrolytes, Acid-Base Balance Flashcards
1
Q
Relative concentration Cl-
A
ECF: 98-106 mEq/L
ICF: 3-4 mmol/L
2
Q
Relative concentration Mg
A
ECF: 1.8-3.0 mg/dL (slides: 1.5-2.5)
ICF: 20 mmol/L
3
Q
Relative concentration bicarbonate
A
ECF: 24-31 mEq/L
ICF: 7-10 mmol/L
4
Q
Relative concentration Na+
A
ECF: 135-145 mEq/L
ICF: 10-14 mmol/L
5
Q
Relative concentration K+
A
ECF: 3.5-5.0 mEq/L
ICF: 140-150 mmol/L
6
Q
Relative concentration Ca2+
A
ECF: 8.5-10.5 mg/dL
ICF: <0.25 mmol/L
7
Q
Relative concentration P
A
ECF: 2.5-4.5 mg/dL
ICF: variable
8
Q
Electrolytes
A
Dissociate into ions in water
Conduct electricity
Eg: Na+ and Cl-
9
Q
Non-electrolytes
A
Anything that does not dissociate into ions (urea and glucose)
10
Q
Cations
A
Positively charged ions
11
Q
What do electrolytes impact?
A
All cell functions
12
Q
Barrier for movement of substances between ECF and ICF
A
Cell membrane
- Lipid soluble pass through (02 or C02)
- Ions need transport mechanism (Na+, K+)
- Water passes through via osmosis and the use of TMPs
13
Q
Organ that maintains electrolytic ranges
A
Kidneys main regulators
- maintain electrolytes within narrow ranges
14
Q
Control H+ concentration
A
Buffers
15
Q
Acidosis
A
Too many acids are present
Imbalance of acids and bases
16
Q
Alkalosis
A
Imbalance of acids and bases
More bases than acids
17
Q
Where are fluids and electrolytes present in the body?
A
Cells, tissue spaces between cells, blood (vascular)
18
Q
Body fluids transport
A
Nutrients, gases, wastes, transform food to energy, generate electrical activity
19
Q
Where are body fluids found?
A
ECF and ICF
20
Q
What is an ECF compartment?
A
Extracellular fluid compartment; outside of cell and interstitial tissues spaces, blood volumes
Large amounts of NaCl, moderate bicarbonate, small K, Mg, Ca, P
21
Q
What is the ICF compartment?
A
Intracellular fluid compartment; inside the cell
2/3 of water in body
No Ca2+, little Na, Cl, bicarbonate, P; moderate Mg; lots of K+
22
Q
Anions
A
Negatively charged ions
23
Q
Diffusion
A
Movement of charged or uncharged particles along a concentration gradient (move from higher concentration to lower concentration)
Energy is a result of collision of particles
24
Q
Electroneutrality
A
The total number of cations in the body equals the total number of anions
25
Osmosis
Movement of water across semipermeable membrane (permeable to water but impermeable to most solutes)
Moves down concentration gradient
26
What kind of pressure is created during osmosis?
Osmotic pressure which equals hydrostatic pressure
27
Osmolarity
Refers to fluids outside the body
Higher the osmolarity, the higher the solutes in the fluid
28
Osmolality
Refers to body fluids
The higher the osmolality, the more solutes present in the body fluid
29
What is a normal range for serum osmolality?
275-295 mOsm/kg
30
What key clinical manifestation does urine osmolality tell us?
It tells us about the kidney’s ability to produce a concentrated or diluted urine based on serum osmolality, as well as the need for water conservation or excretion
31
Tonicity
Tension or effect that the effective osmotic pressure of a solution with impermeable solutes exerts on cell size due to water movement across cell membrane
32
Effective osmole
One that exerts an osmotic force and cannot permeate the cell membrane
33
Ineffective osmole
Exerts an osmotic force but cross the CM
34
What determines tonicity?
Effective solutes (glucose) that cannot permeate CM —> creates osmotic force that pull water out of cell
35
Isotonic Solution
Same effective osmolality as ICF
Cell neither shrinks or swells
Eg: NaCl
36
Hypotonic Solution
Lower effective osmolality than ICF, cells swell
37
Hypertonic Solution
Greater effective osmolality than ICF
Cells shrink as water is pulled out of cell
38
What areas of the body constitute the ECF?
Interstitial fluid
Plasma compartment
Transcellular compartment (CSF and fluid in body spaces like the peritoneal cavity, joint spaces, GI tract)
39
What regulates ICF volume?
Proteins and organic compounds within cells
| Water and solutes that move between the ECF and ICF
40
What charge do intracellular proteins typically contain?
Negative, so they attract positively charged ions
41
What does the sodium potassium pump do?
Removes three sodium ions from cell for every two potassium ions that move into cell
- helps to ensure sodium doesn’t pull water until cell until rupture
42
What conditions impair function of sodium potassium pump?
Hypoxia —> causes cells to swell due to accumulation of sodium ions in the cell
43
Function of vascular compartment
Contains blood that transports substances (electrolytes, gases, nutrients, waste) throughout the body
44
Function of fluid in interstitial spaces
Transports gases, nutrients, wastes,and other materials that move between vascular compartment and body cells
Serves as reservoir where vascular volume can be help during hemorrhage of loss of vascular fluid
45
Tissue gel
Sponge-like material that has lots of proteoglycan filaments
Fills tissues spaces
Aids in even distribution of interstitial fluids
Helps prevent accumulation of free water here and opposes outflow of water from capillaries
46
Where does the transfer of water from the vascular and interstitial compartments occur?
Capillaries
47
What controls movement of water between capillary and interstitial spaces?
1- Capillary filtration pressure
2- Capillary colloidal osmotic pressure
3- Interstitial hydrostatic pressure
4- Tissue colloidal osmotic pressure
Work together to leave small amount of fluid in interstitial compartment that will later be removed by the lymphatic system and returned to circulation
48
Capillary filtration pressure
Pushes water out of capillary and into interstitial spaces
49
Capillary colloidal osmotic pressure
Plus water back into capillary
50
Interstitial Hydrostatic pressure
Opposes movement of water out of capillary
51
Tissues colloidal osmotic pressure
Pulls water out of capillary and into interstitial spaces
52
Capillary filtration
Movement of water through capillary pores due to mechanical forces
53
Capillary filtration pressure or capillary hydrostatic pressure
Pressure pushing water out of capillary and into interstitial space
Reflects arterial, venous pressures, precapillary and postcapillary resistances, force of gravity
54
What happens to capillary pressure where there is an increase in arterial or venous pressure?
It will increase
55
Capillary colloidal osmotic pressure
Osmotic pressure generated by plasma proteins that are too large to pass through pores of capillary wall
Pulls fluid back into capillary since the plasma proteins do not normally penetrate the capillary pores and their concentration is greater in the plasma than in the the interstitial fluids
56
Edema
Palpable swelling produced by expansion of interstitial fluid volume
57
Contributors to edema
Factors that increase capillary pressure, decrease capillary colloidal osmotic pressure, increase capillary permeability, produce obstruction to lymph flow
58
What does the lymphatic do for excess fluid in interstitial spaces?
Returns fluid to circulation
| Removes plasma proteins and osmotically active particulate matter from tissue spaces
59
What are factors that increase capillary pressure?
Increased vascular volume (heart failure, kidney disease, premenstrual sodium retention, pregnancy, environmental heat stress, thiazolidinedione (eg: pioglitazone and rosiglitazone) therapy)
Venous Obstruction (liver disease with portal vein obstructions, acute pulmonary edema, venous thrombosis (thrombophlebitis))
Decreased arteriolar resistance (calcium channel-blocking drug responses)
60
What are factors that decrease colloidal osmotic pressure?
Increased loss of plasma proteins (protein-losing kidney diseases, extensive burns)
Decreased production of plasma proteins (liver disease, starvation, malnutrition)
61
What are factors that increase capillary permeability?
Inflammation
Allergic reactions (eg: hives)
Malignancy (eg: ascites and pleural effusion)
Tissue injury and burns
62
What are factors that obstruct lymphatic flow?
Malignant obstruction of lymphatic structures
| Surgical removal of lymph nodes
63
What happens to vascular fluid when capillary filtration pressure rises?
Movement of vascular fluid into interstitial spaces increases
64
What factors increase capillary pressure?
Increased arterial pressure, decreased resistance to flow through precapillary sphincters, increase in venous pressure or increased resistance to outflow of the postcapillary sphincter, and capillary distinction due to increased vascular volume
65
Localized edema
Occurs in a limited anatomical space (eg: thrombophlebitis obstructs venous flow —> elevation of venous pressure and edema)
66
Generalized edema (anasarca)
Due to increased vascular volume
| Eg: CHF, fluid retention
67
Dependent edema
Impacted by gravity, resulted when fluid accumulates in dependent parts of body (eg: ankles when standing for longer periods of times)
68
Examples of plasma proteins and their functions
Albumin, globulins, fibrinogen
Work to pull fluid back into capillary from tissue spaces by exerting osmotic force
Impairment of protein production or lack of can lead to edema
69
When does capillary permeability increase?
Capillary pores become enlarged or the integrity of the capillary wall is damaged —> increase in interstitial fluid to due leaking of proteins and particles into interstitial spaces
Eg: burn injury, capillary congestion, inflammation, immune response
