(D) FLUIDS AND ELECTROLYTES - PHARMA

Question 1

fluid within the cell.

Answer 1

Intracellular

Question 2

fluid outside the cell but in the interstitial
space and in intravascular fluid.

Answer 2

Extracellular

Question 3

fluid between the cell – in the interspaces of a
tissue – situated between the parts.

Answer 3

Interstitial

Question 4

within the vessel/s

Answer 4

Intravascular

Question 5

the tendency of biological systems to
maintain relatively constant conditions in the internal
environment, while continuously interacting with and
adjusting to changes that originate within the system and
outside the system.

Answer 5

HOMEOSTASIS

Question 5

fluid going through a filter under pressure or
passage through a material that prevents passage of
certain molecules.

Answer 5

FILTRATION

Question 6

TRANSPORT OF FLUIDS (DOFA)

Answer 6

DIFFUSION
OSMOSIS
FILTRATION
ACTIVE TRANSPORT

Question 7

the movement of molecules/solutes through a
semipermeable membrane from a high concentration to a
low concentration.

Answer 7

DIFFUSION

Question 7

the one way passage of water through a
semipermeable membrane from a low concentration of
particles to a high concentration of particles.

Answer 7

OSMOSIS

Question 8

electrolytes move from a low
concentration to a high concentration by moving against
the concentration gradient. ATP provides the energy
needed to do this.

Answer 8

ACTIVE TRANSPORT

Question 8

1/3 EXTRACELLULAR F

Answer 8

➔ Interstitial fluid
➔ Plasma or intravascular
fluid
➔ Transcellular fluid

Question 9

DISTRIBUTION OF FLUID

Answer 9

1/3 EXTRACELLULAR F
2/3 INTRACELLULAR F

Question 10

2/3 INTRACELLULAR FLUID

Answer 10

➔ Fluid within a cell
➔ RBC
➔ Other cells

Question 11

3 TYPES OF IV FLUIDS

Answer 11

CRYSTALLOIDS
COLLOIDS
BLOOD & BLOOD PRODUCTS

Question 11

• Water with electrolytes that form a solution that can
  pass through semi permeable membranes
• Lost rapidly from the intravascular space into the
  interstitial space
• Can remain in the extracellular compartment for about
  45 mins
• Because of this, larger volumes than colloids are
  required for fluid resuscitation
• Eventually, water form this diffuses through the
  intracellular fluid

Answer 11

CRYSTALLOIDS

Question 12

• draws fluid into the intravascular
  compartment from the cells and the interstitial
  compartments.

Osmolarity is higher than serum osmolarity

Answer 12

HYPERTONIC

Question 13

shifts fluid out of the intravascular
compartment, hydrating the cells and the interstitial
compartments.

Osmolarity is lower than serum osmolarity

Answer 13

HYPOTONIC

Question 14

stays in the intravascular space, it expands
the intravascular component.

Osmolarity is the same as serum osmolarity

Answer 14

ISOTONIC

Question 15

• Contain solutes in the form of a large proteins or other
  similar sized molecules
• Cannot pass through the walls of capillaries and into
  cells
• Remain in blood vessels longer and increase increase
  intravascular volume
• Attract water from the cells into the blood vessels
• But this is a short term benefit and prolonged
  movement can cause the cells to lose too much water
  and become dehydrated

Answer 15

COLLOIDS

Question 16

• Minerals in body fluids that carry an electric charge
• It affect the amount of water, the acidity of blood (pH),
  muscle function, and other important processes in the
  body

Answer 16

ELECTROLYTES

Question 17

6 MAJOR ELECTROLYTES

Answer 17

1. Sodium - Na+ Major cation in extracellular fluid (ECF)
2. Potassium - K+ Major cation in intracellular fluid (ICF)
3. Calcium - Ca++ Major cation found in ECF and teeth and
   bones
4. Chloride - CI- Major anion found in ECF
5. Phosphate - PO43- Major anion found in ICF
6. Magnesium - Mg++ Major cation found in ICF (closely
   related to Ca++ and PO4)

Question 18

Normal Serum Level 135 – 145 mmol/L
Function:
➔ Maintains extracellular function (ECF) osmolarity
➔ Influences water distribution
➔ Affects concentration, excretion and absorption of
potassium and chloride
➔ Helps regulate acid-base balance
➔ Aids nerve and muscle fiber impulse transmission

Answer 18

SODIUM (Na+)

Question 19

• fatigue, muscle weakness, muscle twitching,
  decreased skin turgor, headache, tremor, seizures, coma

Answer 19

HYPONATREMIA

Question 20

• thirst, fever, flushed skin, oliguria,
  disorientation, dry skin membranes

Answer 20

HYPERNATREMIA

Question 21

Normal Serum Level 3.5 – 5.0 mmol/L Function: ➔ Maintains cell electro-neutrality ➔ Maintains cell osmolarity ➔ Assists in conduction of nerve impulses ➔ Directly affects cardiac muscle contraction (repolarization in the action potential) ➔ Plays a major role in acid-base balance LNJ, A. | 11 ➔ Sodium - Potassium gradient plays a major role in fluid balance between extracellular (ECF) and intracellular (ICF) compartments

Answer 21

POTASSIUM (K+)

Question 22

decreased peristalsis, skeletal muscle and cardiac muscle function, muscle weakness or irritability/cramps, decreased reflexes, fatigue, rapid, weak irregular pulse, cardiac arrhythmias/cardiac arrest, decreased blood pressure, decreased bowel motility, paralytic ileus

Answer 22

HYPOKALEMIA

Question 23

muscle weakness, nausea, diarrhea, oliguria, paraesthesia (altered sensation) od the face, tongue, hands and feet, cardiac arrest

Answer 23

HYPERKALEMIA

Question 24

Normal Serum Level 2.15 – 2.55 mmol/L Function: ➔ Enhances bone strength and durability ➔ Helps maintain cell-membrane structure, function and permeability ➔ Affects activation, excitation and contraction of sino-atrial node (intrinsic cardiac pacemaker), cardiac and skeletal muscles ➔ Participates in neurotransmitter release at synapses ➔ Helps activate specific steps in blood coagulation ➔ Activates serum complement in immune system function

Answer 24

CALCIUM (Ca++)

Question 25

muscle tremor, muscle cramps, tetany, tonic-clonic seizures, paresthesia, bleeding, arrhythmias, hypotension, numbness or tingling in fingers, toes and around the mouth

Answer 25

HYPOCALCEMIA

Question 26

lethargy, fatigue, depression, confusion, headache, muscle flaccidity, nausea, vomiting, anorexia, constipation, hypertension, polyuria, cardiac arrhythmias and ECG changes

Answer 26

HYPERCALCEMIA

Question 27

Normal Serum Level 95 – 110 mmol/L Function: ➔ Maintains serum osmolarity ➔ Combines with major cations to create important compounds, such as sodium chloride (NaCl), hydrochloride (HCl), potassium chloride (KCl), and calcium chloride (CaCl₂) which contribute to acid/base and/or electrolyte balance

Answer 27

CHLORIDE (Cl-)

Question 28

Normal Serum Level 0.8 – 1.5 mmol/L Function: ➔ Helps maintain bones and teeth ➔ Helps maintain cell integrity ➔ Plays a major role in acid-base balance (urinary buffer) ➔ Promotes energy transfer to cells ➔ Plays essential role in muscle, RBC and neurological function

Answer 28

PHOSPHATE (PO4)

Question 29

- paresthesia (circumoral and peripheral), lethargy, speech defects (stuttering), muscle pain and tenderness

Answer 29

HYPOPHOSPHATEMIA

Question 30

renal failure, vague neuronal-excitability to tetany and seizures, arrhythmias and muscle twitching with sudden rise in phosphate (PO₄)level

Answer 30

HYPERPHOSPHATEMIA

Question 31

Normal Serum Level 0.70 – 1.05 mol/L Function: ➔ Activates intracellular enzymes; active in carbohydrate and protein metabolism ➔ Acts on myo-neural vasodilation ➔ Facilitates Na+ and K+ movement across all membranes ➔ Influences Ca++ levels

Answer 31

MAGNESIUM (Mg++)

Question 32

dizziness, confusion, seizures, tremor, leg and foot cramps, hyperirritability, arrhythmias, vasomotor changes, anorexia, nausea

Answer 32

HYPOMAGNESEMIA

Question 33

drowsiness, lethargy, coma, arrhythmias, hypotension, vague neuromuscular changes (tremor), vague GI symptoms (nausea), peripheral vasodilation, facial flushing, sense of warmth, slow, weak pulse

Answer 33

HYPERMAGNESEMIA