Electrolytes and Acid-Base Flashcards
Parts of bone and teeth, blood clotting, muscle contraction, release of neurotransmitter
Ca
Membrane Potentials
Na and K
Red blood cell formation
Iron
Necessary for enzyme
Magnesium
Present in Thyroid Horomone
Iodide
Water balance
Chloride
Acid-Base Balance
Hydrogen, Hydroxide, Bicarbonate and Phosphate
Sodium
Na+
Normal Value
135-145 mEq/L
Major ion in ECF
Sodium
Routes of Excretion of Sodium
Urine and Sweat
Affected by hormonal factors of Sodium
ADH & ANH
When drawing blood, we measure
Extracellular Value
What arteriole where Na are regulated
Afferent Pathway
It relaxes afferent arteriole of the kidney to stimulate Renin
Decrease BP
Foods rich in Na
Cured Meat
Canned Foods
Junk Foods
Condiments
Imbalances typically associated with parallel changes in
Osmolality
Major Role of Na
ECF volume and concentration
Generation and transmission of nerve impulses
Acid Base balance
High Sodium
Increased intake of eating salty foods
Hypernatremia
Ethiology of Hypernatremia
Near drowning (Ocean)
-drink a lot of Na
Manifestation
Dehydration
Headache/Fever
Diarrhea
Seizure (severe cases)
Treatment of Na
Replace it with Ca (yogurt and milk)
Results from loss of Na
Hyponatremia
Causes
Head Trauma
Adrenal Insufficiency
Gastrointestinal losses
Drinking hypo-osmolar fluids
Critical Values of Hypernatremia
CNS changes > 155 mEq/L
Hyponatremia Symptoms
Headache
Seizure (severe)
Ethiology of Hyponatremia
Caused by water excess
Fluid restriction is needed
Treament
Give small amount of IV hypertonic saline solution
Serious Value
125 mEq/L
Potassium
K+
Normal Values
3.5-4.5 mEq/L
Mostly in intracellular
K
How many percent in intracellular and intravascular
96%
4%
Major source of
K
Normal route of excretion
Kidneys
Cousin of K
Mg
High K
Low K
High Mg
Low Mg
Critical Value >8
Cardiac Arrest
Level required for normal function of the Na-K pump
Normal Mg
Food rich in K
Spinach
Legumes
Beans
Fruits
What makes animal sleep
Potassium Chloride
Necessary for
Transmission and conduction of nerve and muscle impulses
Cellular Growth
Maintenance of Cardiac Rhythms
Acid-Base Balance
Increase intake of K
Hyperkalemia
High serum K by
Massive Intake
Kidney Failure
Adrenal Insufficiency
ICF-ECF
Symptoms of Hyperkalemia
Muscle weakness (Cramping)
ECG changes
Peak T-waves
Hyperkalemia
Cause Diarrhea
Low serum of K
Hypokalemia
Associated with K loss in the kidney or gastrointestinal tracts
Metabolic Alkalosis
Mg Deficiency
Hypokalemia
Symptoms of Hypokalemia
Weakness, fatigue
Decreased muscle tone, leg cramps
Cardia changes
Calcium
Ca++
T wave inversion
ST depression
Prominent U wave
Hypokalemia
Normal Range
9-11 mg/dL
How many percent bound to protein albumin
50%
99% of Calcium can be found in
Bones
Inverse relationship with
PO4
Low Protein
Hard to absorb Ca
Blocks Na transport and stabilize cell membrane
Plays a role in clotting (Prothrombin)
Ca
High Ca
Low Ca
Low P
High P
Ca balance is controlled by
PTH
Thyroid Calcitonin
GI absorption: Vit D (Calcitriol)
Too much Na
Eat Ca
Calcium need to be regulated in the
GI Tract
Blood
Bones
It helps increase in Ca reabsorption into the bone with the mobilization of osteoclast through negative feedback mechanism
PTH
Produce by the thyroid gland helps in bone deposition to resolve too much Ca in the bloodstream by using osteoblast
Calcitonin
Allows the absorption of Ca
Vit D Calcitriol
Ca is poorly absorbed
GI Tract
Strengthen bones and teeth
Promotes absorption of B12
Transmission of nerve impulses
Myocardial contractions
Muscle contractions
Ca++
Promotes coagulation
Convert prothombin to thrombin
Foods rich in Ca
Dairy Products
Vegetables
Soy Beans
Increased level of Ca in the blood
Hypercalcemia
Disease of Hypercalcemia
Multiple Myeloma
Prolonged Immobility
Hyperparathyroidism
OD of Vit D
Decreased pH increased ionized Ca
Acidosis
Shortened ST segment
shortened QR
Hypercalcemia
Weakness, lethargy, forgetful, confusion
Hypercalcemia
Low serum Ca level
Hypocalcemia
Disease state
Kidney Failure
Decreased production of PTH
Acute Pancreatitis
Multiple blood transfusion
Alkalosis
Abuse Diuretics
Symptom of Hypocalcemia
Hyrreflexia
Tap the face and observe twitching
Chvostek’s sign
Observe Carpal spasm
As you inflate BP cuff
Above systolic pressure
Trousseau’s sign
Elongation of ST segment
Prolonged QT interval
Ventricular TachycardiA
Hypocalcemia
Phosphate
PO4
Normal Value
2.8-4.5 mg/dL
Intracellular fluid anion
Deposited within bones and teeth
Phosphate
Phosphate is essential to
Muscles, RBC
Phosphate excretion
Kidney
Involved in acid-base buffer system,
Involved in metabolism of CHO, fats and CHON
PO4—
Phosphate reciprocal relationship with
Ca
Low kidney Function
Not much excrete P
Foods rich in P
Liver
Sardines
Sausage
Egg
High serums of PO4
Hyperphosphatemia
Disease state
Kidney Failure
Chemotherapy
Excessive intake of dairy products and Vit D
Hypoparathyroidism
Hyperphosphatemia is accompanied by
Hypocalcemia
Low serums of PO4
Hypophophatemia
Disease
Malnutrition
Alcohol withdrawal
Chloride
Cl
Normal Level
97-107 mEq/L
Major ECE anion and assist in determining osmotic pressure
Cl
It reflects change in osmolality and dilution or concentration level of ECF
Na and CL
Cl are found mainly in
Interstitial Fluid and Lymph Fluid compartments
Produce by the stomach where it come with H ion to form
HCl
Also contained in pancreatic juices, sweat, saliva, bile
HCl
Low salt intake causes Vomiting
Hypochloremia
Inverse relationship with Cl
Bicarbonate HCO3
Manifestation of Hypochloremia
Signs of Metabolic Alkalosis (elevated pH and high serum HCO3)
ABG- paCo2 may increase to 50 mm HG
Low Cl parallels to
Na level
Near drowning
too much salt
Hyperchloremia
Occurs with?
Hypernatremia
Loss of HCO3
Hyperchloremic metabolic acidosis
Magnesium
Mg++
Most abundant ICF cation next to K
Magnesium
Normal Level of Mg
1.3-2.3 mEq/L
50-60% contained in
Bone
Coenzyme in metabolism of protein and carbs
Factors that regulate calcium balance appear
Predominantly found in bone and soft tissue
Mg
1/3 of Mg
Protein Albumin
Activator for many enzyme systems, CHO, CHON
Mg
Absorption from
Small distal bowel
Excretion vis
Kidney
Mg acts directly on
Myoneural JunctioN
Mg imbalance affect
Neuromuscular irritability and contractility
What Mg produces at the neuromuscular junction
Sedative Effect
Low serum of Mg
Hypomagnesemia
Affects cardiovascular systen
Peripheral vasodilation of arteries and arterioles
ETOH withdrawal
GI losses
Inflammatory Bowel Disease
Deficient TPN and enteral therapy
Hypomagnesemia
Kidney Failure
High Mg
Addison’s disease
Hypermagnesemia
Prolonged fasting or starvation
Chronic Alcoholiusm
Diuretics
Hypo
Occurs concurrently with increased K and Ca
Low bp
Facial flushing
Hyporeflexia of DTR
Hypermagnesemia
Foundation of body building minerals
H
Formation of fragile bonds important to maintain structure of protein molecules
H
Weak bonds
Forms a bridge between Nitrogen and Oxygen
Hydrogen
Sour taste
Burns
Protein donor
Substance thar can release H ions in detectable amount
Acid
Bitter taste
Feels slippery to touch
Proton acceptors
Hydroxide is the most common inorganic base
Base OH
Prevent major change in pH by removing or releasing H ion
Buffer SYstem
Increase H
Acidity
Decrease H
Alkalinity
Extracellular buffer system
Bicarbonate
Monohydrogen-dihydrogen phosphate
Intracellular Proteins
Plasma Proteins
RBC and Hb
Produced by protein metabolism
Sulfuric Acid and Phosphoric Acid
Produced by incomplete lipid metabolism
Keto Acid
Produced by anaerobic CHO metabolism
Lactic Acid
3 Principal buffers in Kidney
Bicarbonate HCO3
Ammonia NH3
Phosphate PO4
Combines with H to form the non-reabsorbable NH4 and combine with CL
Ammonia
From hydrolysis reaction, CO2 is reabsorbed into the blood for excretion by the lungs and H2O to be eliminated by the kidneys
Bicarbonate
Presence in the filtrate, exchange H ion and is excreted in the urine whereas HCO3 enter the blood
Phosphate
ratio of CO2 to HCO3
1:20
> 7.45
Alkalosis
<7.35
Acidosis
<6.8/ >7.8
Death
Eliminates Co2
Medulla controls breathing
Responds within minutes/hours to changed in acid/base
Increased respiration
Respiratory System
Eliminates H and reabsorbs HCO3
Reabsorption and secretions of electrolytes
Responds within hours to days
Renal System
Imbalances occur when
Compensatory Mechanism fail
Imbalances of Respiratory
Affect Carbonic Acid Concentration
