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CC 2 LEC > ELECTROLYTES & SODIUM > Flashcards

ELECTROLYTES & SODIUM Flashcards

1
Q

Total body water volume =

A

40 L, 60% body weight

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2
Q

Intracellular fluid volume =

Extracellular fluid volume =

A

25 L, 40% body weight

15 L, 20% body weight

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3
Q

Interstitial fluid volume =
Plasma volume =

A

12 L, 80% of ECF

3 L, 20% of ECF

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4
Q

• requires energy to move ions across cellular membranes
• e.g.: ATPase-dependent Na+-K+ ion pumps

A

Active transport

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5
Q

passive movement of ions across a membrane depends on size and charge of ion
• may be altered by physiologic and hormonal processes

A

Diffusion

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6
Q

• physical property of a solution that is based on the concentration of solutes (expressed as millimoles)
per kilogram of solvent (w/w)

A

OSMOLALITY

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7
Q

w/v
• inaccurate
> in cases of hyperlipidemia / hyperproteinemia for urine specimen

• presence of osmotically active substances (alcohol/mannitol)

A

Osmolarity

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8
Q

Normal plasma osmolality
_______ of plasma H20
•osmoreceptors respond to small changes
•regulated by AVP and thirst

A

> 275 - 295 mOsm/kg

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9
Q

URINE OSMOLALITY
• vary widely depending on water intake and collection circumstances

• decreased in:

• increased in:

A

• diabetes insipidus
• polydipsia

• SIADH
• hypovolemia

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10
Q

ELECTROLYTES

A

•Sodium
•Potassium
•Chloride
•Calcium
•Magnesium
•Lactate
•Phosphate
•Bicarbonate

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11
Q

• carry electric charge
• (+)
• (-)
• Exist in solid, liquid or gaseous environments

A

Ions

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12
Q

(Na, Cl, K)

A

Volume and osmotic regulation

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13
Q

(K, Mg, Ca)

A

• Myocardial rhythm and contractility

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14
Q

(Mg, Ca, Zn)

A

• Cofactors in enzyme activation

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15
Q

(Mg)

A

• Regulation of ATPase ion pumps

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16
Q

(HCO3, K, CI)

A

• Acid-base balance

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17
Q

(Ca, Mg)

A

• Blood coagulation

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18
Q

(K, Ca, Mg)

A

• Neuromuscular excitability

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19
Q

(Mg, PO4)

A

• Production and use of ATP from glucose

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20
Q

‹ Monovalent cation

A

SODIUM ION

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21
Q

• Most abundant cation in
the ECF

A

SODIUM ION

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22
Q

SODIUM

• Accounts ___of all the ECF cations
• Large determinant of____

A

90%

plasma osmolality

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23
Q

SODIUM ION REGULATION:

A

a) Intake of water in response to thirst

b) Excretion of water (affected by ADH in response to changes in either blood volume or osmolality)

c) Blood volume status (affects sodium excretion through aldosterone, angiotensin Il, and atrial natriuretic peptide)

24
Q

SODIUM ION REGULATION:
Primary active transport

A

• Na-K adenosine triphosphatase pump
• Na-K leak channels

25
Q

REFERENCE RANGES FOR
TABLE 16-6
SODIUM

Serum, plasma

Urine (24 h)

Cerebrospinal fluid

A

136-145 mmol/L

40-220 mmol/d, varies with diet

136-150 mmol/L

26
Q

Clinical Significance
HYPONATREMIA
• ____mmol/L
• One of the most common electrolyte disorders

A

<135 mmol/L

27
Q

Hyponatremia

• Probable cause

A

• ^ sodium loss
• 1 water retention
• Water imbalance

28
Q

Hypernatremia

• Probable cause:

A

• Excess water loss
• Decrease water intake
• ^ sodium intake or retention

29
Q

HYPERNATREMIA
•_______ mmol/L
• Less common

A

> 142 or >145

30
Q

CAUSES OF HYPONATREMIA
INCREASED SODIUM LOSS

A

Hypoadrenalism
Potassium deficiency
Diuretic use
Ketonuria
Salt-losing nephropathy
Prolonged vomiting or diarrhea
Severe burns

31
Q

CAUSES OF HYPONATREMIA

INCREASED WATER RETENTION

A

Renal failure
Nephrotic syndrome
Hepatic cirrhosis
Congestive heart failure

32
Q

CAUSES OF HYPONATREMIA

WATER IMBALANCE

A

Excess water intake
SIADH
Pseudohyponatremia
SIADH, syndrome of inappropriate arginine vasopressin hormone secretion.

33
Q

WITH LOW OSMOLALITY

A

Increased sodium loss
Increased water retention

34
Q

CLASSIFICATION OF HYPO-NATREMIA BY OSMOLALITY

WITH NORMAL OSMOLALITY

Increased nonsodium cations

A

Lithium excess
Increased y-globulins-cationic (multiple myeloma)
Severe hyperkalemia
Severe hypermagnesemia
Severe hypercalcemia
Pseudohyponatremia
Hyperlipidemia
Hyperproteinemia
Pseudohyperkalemia as a result of in vitro hemolysis

35
Q

WITH HIGH OSMOLALITY

A

Hyperglycemia
Mannitol infusion

36
Q

HYPONATREMIA
Treatment

A

o Directed at correction of the condition that caused either water loss or sodium loss in excess of water loss
o fluid restriction and providing hypertonic saline and/ or other pharmacologic agents

37
Q

HYPONATREMIA
Treatment

A

• Correcting severe hyponatremia too rapidly can cause cerebral myelinolysis and too slowly can cause cerebral edema

38
Q

CAUSES OF HYPERNATREMIA
EXCESS WATER LOSS

A

Diabetes insipidus
Renal tubular disorder
Prolonged diarrhea
Profuse sweating
Severe burns

39
Q

CAUSES OF HYPERNATREMIA

DECREASED WATER INTAKE

A

Older persons
Infants
Mental impairment

40
Q

CAUSES OF HYPERNATREMIA

INCREASED INTAKE OR RETENTION

A

Hyperaldosteronism
Sodium bicarbonate excess
Dialysis fluid excess

41
Q

• Excess loss of water relative to sodium loss

A

HYPERNATREMIA

42
Q

HYPERNATREMIA

• Diabetes Insipidus
• Neurogenic:
• Nephrogenic:

A

Deficiency of ADH

Renal Tubules cannot respond to ADH

43
Q

• Patient drink large volumes of water, hypernatremia usually does not occur unless the thirst mechanism is also impaired

A

Huoernatremia

44
Q

• Decreased water intake
• Commonly occurs in those persons Who may be thirsty out who are unable to ask for or obtain water (adults with altered mental status and infants)

A

HYPERNATREMIA

45
Q

HYPERNATREMIA
•
•
•
•

A

Increased sodium intake or retention

Administration of hypertonic solutions of sodium

Sodium bicarbonate

Hypertonic dialysis solutions

46
Q

Treatment
• Directed at correction of the underlying condition that caused the water depletion or sodium retention

• Rapid correction can induce cerebral edema and death

A

HYPERNATREMIA

47
Q

URINE OSMOLALITY

Diabetes insipidus (impaired secretion of AVP or kidneys cannot respond to AVP)

A

<300 mOsm/kg

48
Q

URINE OSMOLALITY
Partial defect in AVP release or response to AVP
Osmotic diuresis

A

300-700 mOsm/kg

49
Q

URINE OSMOLALITY
Loss of thirst
Insensible loss of water (breathing, skin)
Gastrointestinal loss of hypotonic fluid
Excess intake of sodium
AVP, arginine vasopressin hormone.

A

> 700 mOsm/kg

50
Q

• Neuropsychiatric

A

HYPONATREMIA

51
Q

• Nausea
• Vomitting
• Lethargy
• Seizure
• Coma
• Respiratory depression
• Muscular weakness
• Headache
• ataxia

A

HYPONATREMIA

52
Q

• Lethargy o Irritability
• Restlessness
• Seizures
• Muscle twitching
• Hyperreflexes
• Difficult respiration
• Increased thirst
• Nausea

A

HYPERNATREMIA

53
Q

• Altered mental status

A

HYPERNATREMIA

54
Q

Less than 125
<120

A

HYPONATREMIA

55
Q

Above 160

A

HYPERNATREMIA

CC 2 LEC (13 decks)

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