Electrolytes: Sodium Flashcards
__________
-electrically charged substances
-can be positively charged (______) or negatively charged (________)
-fluids in the body always contains ________ amounts of cations and anions
-___________- balance of charges
-___________- average water content of the human body (decreased values due to old age and obesity)
-_____ of body’s water is inside the cells and the rest is in the blood stream or tissue fluids
-about_____ passes from the blood to the tissue spaces daily
Electrolytes
cation
anion
equal
Electroneutrality
40-75%
60%
30%
-Extracellular fluid: ____ of the total BW (__L)
-Intracellular fluid: ____ of the total BW (__L)
-Normal Plasma: ____ water & ____solutes
-solutes: _______, ________, ______, _________, __________, _____
-water content of plasma: always _____ higher than the whole blood
-Electrolyte Panel: _______, __________, __________, __________
-Anticoagulant of choice for electrolyte analysis: ________
1/3 - 16L
2/3 - 24L
93% water - 7% solutes
glucose, lipids, NPNs, proteins, amino acids, ions
12% higher
SPCB - Sodium, Potassium, Chloride, Bicarbonate
Heparin
Functions of Electrolytes
1. For _______ and ________ regulation
2. For ___________ and ________
3. Important _________ in enzyme activation
4. For the regulation of _________ ______________ ion pumps
5. For ______________ ___________
6. For the production and use of ____ from ______
7. Maintenance of ________________
8. Replication of ____ and the translation of _____
- volume and osmotic
- myocardial rhythm and contractility
- cofactors
- adenosine triphosphate (ATPase)
- neuromuscular excitability
- ATP from glucose
- Acid-base balance
- DNA, mRNA
________
-AKA ________
-major extracellular cation
-major intracellular cation: _______
-contributes most to the total serum osmolality
-Plasma concentration: depends greatly on the _______ and _________ of water
-Blood levels of Na: mainly controlled by hormone ____________
-all confirmed serum Na abnormalities must be followed up by ______________ including sodium and urine osmolality. Px should be _____ __________
-Function: regulates ___________ and _______ _________
-Reference value: ____________ mmol/L
-Threshold critical value:
o _____________ (hypernatremia)
o _____________ (hyponatremia)
-CSF sodium: ________________
Sodium
Natrium
Potassium
intake and excretion of water
hormone Aldosterone
urinalysis - fluid restricted
osmolality and blood volume
135-145 mmol/L
160 mmol/L
120 mmol/L
136-160 mmol/L
Hormones Affecting Sodium Levels
1. _____________
-promotes absorption of sodium in the ______ _________
-promotes ____ retention and ___ excretion
2. ________ __________ __________
-an endogenous anti-hypertensive agent
-secreted from _________ _____
-blocks _____________ and _______ secretion, and inhibits the action of _______________ and _____________
-causes __________ -excretion of Na in urine
- Aldosterone
-distal tubule
-Na retention, K excretion - ## Atrial Natriuretic Factor (ANF)-cardiac atria
-blocks aldosterone and renin, inhibits angiotensin II and vasopressin
-natriuresis
SIADH
syndrome of inappropriate anti-diuretic hormone secretion
__________________
-defined as increase in sodium conc in plasma water, generally it is diagnosed at serum sodium levels of ______________
-caused by ___________, ____________, or both
-_______________ - moderate deficit of water
-_______________ - severe water deficit
-________________________ - in alert px, indicative of hypothalamic disease
Hypernatremia
>145 mmol/L
loss of water, gain of sodium
150-160 mEq/L
>165 mEq/L
Chronic hypernatremia
_____________________
-reduction in serum sodium concentration which is caused by a systematic error in the measurement
-most common but not widely known cause:_________________
-_________________ –> may cause decreased Na levels
Pseudohypernatremia
In vitro hemolysis
Marked hemolysis
_____________
-the most common electrolyte disorder
-reduced plasma sodium conc
-______________
-________ ________ - kidneys ultimately fail to concentrate the urine resulting to hyponatremia
-______________: ongoing renal loss of sodium and water
-_________ _________ - sodium loss occurs with ketonuria
-________ - due to excess retention of water in collecting ducts
-__ __________ - also causes of loss of sodium, due to the ________ ____________ of the two ions in renal tubules. When K is low, tubule will conserve K and excrete Na in exchange for the loss of the monovalent cation
Hyponatremia
<135 mmol/L
renal failure
>20 mmol/day
Diabetes Mellitus
SIADH (syndrome of inappropriate antidiuretic hormone secretion)
K deficiency - inverse relationship
__________ ___________
-quantity of a substance excreted in the urine expressed as a fraction of the filtered node of the same substance
-FE of sodium: often used to distinguish between _________ ________ _________ and _________ ___________
*______________ - Pre-renal azotemia
*______________ - Acute tubular necrosis/Acute kidney injury
Fractional Excretion (FE)
acute tubular necrosis/acute kidney injury and pre-renal azotemia
<0.01/<1%
>0.01/>1%
Specimen Considerations
*Specimen of choice: _______, ________, __________________
o_______, ______
*Heparin - If plasma: ________ and __________________ of heparin
o As well as______________
*_____________ does not cause significant changes
o_________________: should be avoided
*Na = ______+ ____ + ____ or Na = ____ + ___ + __
Serum, plasma, 24-hour urine sample
CSF, Sweat
Lithium and ammonium salts of heparin
Lithium oxalate
Hemolysis
Marked hemolysis
CO2 + Cl + 10
CO2 + Cl + 12
______ ____________ _______________
-uses _________ or ________ as an internal standard
-sodium produces a ______ color when exposed to flame
-sodium emits light at wavelength of _________
-dilute samples with high purity water - to prevent_________, to prevent ________ __________ ,and to acquire _________ ___________
-____ _______ ______ - deionized water with electrolyte content of ___________ (parts per million)
-usually diluted at _______ or _______
Flame Emission Photometry (FEP)
lithim or cesium
yelloe
519 nm
prevent interferences, atomizer plugging, acquire increased sensitivity
high purity water - <5 ppm
1:100 or 1:200
*Atomic absorption photometry
*____ _________ ________
-uses ______ ___________ _______
-most commonly used method
*Colorimetry (_________)
Ion selective electrode
glass aluminum silicate
Albanese Lein
Reference values:
*Serum: __________________
*24-hour urine: _____________
*CSF: __________________
Conversion factor:
*mEq/L to mmol/L = ____
135-145 mmol/L
40-220 mmol/day
138-150 mmol/L
1.0
