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Pathophysiology > Exam 1 - Electrolyte And Fluid Balance > Flashcards

Exam 1 - Electrolyte And Fluid Balance Flashcards

1
Q

Normal ranges of Na+

A

135-145 mEq/L

135-145 mmol/L

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2
Q

Normal ranges of K+

A
  1. 5-5 mEq/L

3. 5-5 mmol

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3
Q

Normal ranges of Ca++

A
  1. 4-10.6 mg/dL

2. 1-2.65 mmol/L

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4
Q

Normal ranges of Mg++

A
  1. 3-2.1 mg/dL

0. 65-1.05 mmol/L

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5
Q

Normal ranges of Cl-

A

96-106 mEq/L

96-106 mmol/L

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6
Q

Normal ranges of HCO3-

A

23-29 mEq/L

23-29 mmol/L

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7
Q

Normal ranges of Phosphate

A

3-4.5 mg/L

1-1.5 mmol/L

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8
Q

Definition of TBW

A

(Total body water)

Sum of all fluids within all body compartments

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9
Q

What is ICF and where is it located?

A

Intracellular fluid

All fluid within cells

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10
Q

How much of TBW is made up of intracellular fluid?

A

2/3 of it

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11
Q

What is ECF and where is it located?

A

Extracellular fluid

All fluid outside the cells (literally anywhere outside of cells, could be in tissue, etc.)

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12
Q

How much TBW makes up extracellular fluid?

A

1/3 of it

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13
Q

What is ISF and where is it located?

A

Interstitial fluid

In space between cells and outside the blood vessels

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14
Q

What is intravascular fluid and where is it located?

A

Fluid volume in intravascular space

Intravascular fluid is blood plasma

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15
Q

What does intravascular fluid regulate?

A

Blood pressure
Pulse
Fluid balance in general

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16
Q

Edema is fluid accumulation, where?

A

In interstitial space

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17
Q

Ways we intake water

A
  • drinking
  • ingestion of water from food
  • IVs
  • water derived from metabolism
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18
Q

Ways we output water

A
  • renal excretion
  • stool
  • vaporization from skin (sweat) and lungs (breathing)
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19
Q

Biggest way we output water?

A

Vaporization from lungs during breathing

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20
Q

TBW range of infants

A

75-80%

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21
Q

TBW range of children and adolescents:

A

60-65%

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22
Q

What happens to our TBW as we age?

A

It decreases

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23
Q

Why does TBW decrease as we age?

A

Decreased muscle mass & increse in fat cells

Decreased ability to regulate sodium and water balance

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24
Q

Put the different age groups in order from least to most able to fight illness:

A

1- infants
2- children
3- Elderly
4- Adults

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25
Q

Why do geriatriac people have such a hard time regulating sodium?

A

B/c of failure in the sodium/potassium pump

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26
Q

What is a sensible loss?

A

An expected loss that can be quantified with a number

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27
Q

What is an insensible loss?

A

A loss of fluid that occurs without awareness and cannot be quantified with a number

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28
Q

Examples of a sensible loss

A

Urine

Feces

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29
Q

Examples of an insensible loss

A

Vapors leaving lungs and skin

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30
Q

How does water move through our body?

A

Through the processes of filtration and diffusion

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31
Q

Two types of filtration

A
  • Capillary hydrostatic pressure

- Interstitial oncotic pressure

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32
Q

Other names for interstitial oncotic pressure:

A

Capillary oncotic pressure

Plasma pressure

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33
Q

Which two things help determine blood pressure?

A
  • capillary hydrostatic pressure

- interstitial oncotic pressure

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34
Q

What does capillary hydrostatic pressure do?

A

Pushes water from capillaries into interstitial spaces

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35
Q

What if capillary hydrostatic pressure is too high?

A

Causes edema

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36
Q

What does interstitial oncotic pressure do?

A

Pulls water back into capillary space from tissues

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37
Q

How does capillary membrane play a part in water movement through the body?

A

Its integrity is key in the movement of water and solutes

This is how everything moves back and forth

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38
Q

What is diffusion?

A

Movement of particles along a concentration gradient from an area of higher concentration to an area of lower concentration

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39
Q

Where does diffusion take place regarding water movement in the body?

A

Through the capillary membrane

Diffusion is how everything moves in and out through the membrane

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40
Q

Why is the sodium/potassium pump a thing?

A

To balance intracellular and extracellular fluid

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41
Q

Regarding the sodium/potassium pump, which electrolyte is inside vs. outside the cell?

A

Potassium (K) is inside the cell

Sodium (Na) is outside the cell

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42
Q

What is another balancing agent at work with the sodium/potassium pump?

A

Albumin

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43
Q

What happens if potassium leaves the cell?

A

Sodium goes in the cell

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44
Q

What is albumin?

What is its function?

A
  • Protein backbone for intravascular volume
  • Albumin strands create a band that holds intravascular volume in place
    • maintains effective osmolarity by generating plasma oncotic pressure
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45
Q

What substances redily move across intact capillary membranes?

A
  • sodium
  • water
  • glucose
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46
Q

What moves between intracellular and extracellular fluid?

A

Potassium

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47
Q

Major cation in ICF

A

Potassium

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48
Q

Daily dietary requirement of potassium

A

60-100 mEq

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49
Q

Foods that are high in potassium content

A
  • Meats
  • Dried fruits
  • Fruit juices (orange)
  • Bananas
  • Avocados
  • Potatoes
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50
Q

How does the body eliminate potassium?

A

Kidneys eliminate about 80% of ingested K

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51
Q

Which disease would cause patients to have high potassium?

A

Renal failure because the kidneys aren’t getting rid of the K

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52
Q

Major cation in ECF

A

Sodium

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53
Q

Excretion or absorption of Na usually involves what?

A

Proportionate excretion or absorption of water and Cl

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54
Q

Minimal daily requirement of sodium

A

2 grams/day

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55
Q

What type of protection does sodium provide?

A

ECF protection

56
Q

Term for low sodium

A

Hyponatremia

57
Q

Term for high sodium

A

Hypernatremia

58
Q

Major extracellular cation involved in structure and function of teeth and bones

A

Calcium

59
Q

What type of relationship do calcium and phosphorous have?

A

An inverse relationship. Increased serum Ca results in decreased serum P

60
Q

Recommended daily dietary calcium intake?

A

800 mg/ day

61
Q

How does Ca absorption occur?

A

Because of calcitriol, and calcitriol is activated by Vitamin D

62
Q

What organ regulates calcium?

A

Parathyroid

63
Q

Major cation in ICF, closely related to Ca and P

A

Magnesium

64
Q

Major anion in ICF

A

Phosphorous

65
Q

What causes edema?

A

Movement of water into interstitial space causes accumulation of water into tissue

66
Q

What is localized edema?

A

Edema limited to site of trauma

Occurs from injury

67
Q

What is generalized edema?

A

Edema with a uniform distribution in area that hangs down (arms, legs, genitals)
Occurs due to disease

68
Q

What is nonpitting edema?

A

Plasma proteins accumulated into tissue spaces and coagulated

69
Q

Ways nonpitting edema occur?

A

Local infection or trauma

70
Q

What is brawny edema?

A

A type of nonpitting edema characterized by thick/hardened & tight skin

71
Q

What does pitting and nonpitting mean?

A

Pitting means if you push on the edema, an indention is left

Nonpitting means no indention is left

72
Q

What is pitting edema?

A

Accumulation of interstitial fluid exceeds the absorptive capacity of tissue; water is mobile and can be translocated with finger pressure

73
Q

Which two types of edema only occur with generalized edema?

A

Brawny and pitting

74
Q

What is third spacing?

A

Fluid gets pushed from interstitial spaces into other body cavities

75
Q

Why does third spacing occur?

A

The body is trying to get rid of the extra fluid to restore balance so it pushes it to empty areas

76
Q

Where does third space accumulation occur?

A

Transcellular spaces (serous cavities)

77
Q

Examples of transcellular spaces where third spacing can occur:

A
  • pericardial sac
  • peritoneal cavity
  • pleural cavity
78
Q

Excessive fluid in the pleural cavity

A

Hydrothorax

79
Q

Excessive fluid in the peritoneal cavity

A

Ascites

80
Q

Fluid in the serous cavities

A

Effusion

81
Q

What type of fluid goes into serous cavities with effusion?

A

Blood, plasma, proteins, inflammatory cells (pus)

82
Q

Most common type of third spacing

A

Ascities

83
Q

What can cause ascities?

A

Liver failure

84
Q

Which hormone regulates water balance through out the body?

A

ADH (antidiuretic hormone)

85
Q

No sense of thirst (spelling)

A

Adipsia

86
Q

Decrease in thirst sensation (spelling)

A

Hypodipsia

87
Q

Excessive thirst sensation (spelling)

A

Polydipsia

88
Q

Process that stimulates thirst?

A
  • ADH is released from pituitary gland and
  • The hypothalamus sends a message to
  • Antiotension II, which turns on thirst
89
Q

Where is ADH released from?

A

The pituitary gland

90
Q

What is another name for antidiuretic hormone?

A

Vasopressin

91
Q

When is ADH secreted?

A

When plasma osmolality increases due to

  • water deficit
  • sodium excess
92
Q

What happens to activate ADH?

A

Circulating blood volume decreases and blood pressure drops (due to dehydration)

93
Q

What is natriuretic hormone (ANP)?

A

Hormone that provides intravascular balance: volume balance, and vascular tone

94
Q

Where is NAP produced?

A

Atria of the heart

95
Q

Functions of ANP

A
  • Renal elimination of sodium (water follows)

- Decreases plasma, lowering blood pressure

96
Q

What is tonicity?

A

Change in water content resulting in cellular swelling/shrinking

97
Q

Fluid that has the same concentration as blood:

A

Isotonic

98
Q

Fluid that has the same concentration as ICF or ECF

A

Isotonic

99
Q

Fluid that has lower concentration of particles (more dilute) than blood

A

Hypotonic

100
Q

Fluid that has a higher concentration of particles than blood

A

Hypertonic

101
Q

Measurement of an isotonic solution

A

0.9% NS per liter of fluid

102
Q

Measurement of a hypotonic solution

A

<0.9% NS

103
Q

Measurement of a hypertonic solution

A

> 0.9% NS

104
Q

What happens to cells when they are in a hypotonic solution?

A

Cells swell up

105
Q

What happens to cells when they are in a hypertonic solution?

A

Cells shrink

106
Q

What do hyoptonic solutions do to cells?

A

Invite more water into cell = increase in volume

107
Q

What do hypertonic solutions do to cells?

A

Pulls water out of cell = decrease in volume

108
Q

Give an example of when a hypertonic solution would be given to a patient

A

Increased intercranial pressure. Would want to quickly pull fluid out of head

109
Q

0.9% NS is an example of which type of solution?

A

Isotonic

110
Q

0.45% NS is an example of which type of solution?

A

Hypotonic

111
Q

2.0% NS is an example of which type of solution?

A

Hypertonic

112
Q

How is sodium regulated? Hormone that regulates this?

A

Mainly by the kidneys; primarily through aldosterone action

113
Q

How do the kidneys regulate sodium?

A

Can hold sodium (therefore water too) back

OR excrete more sodium (therefore water too = more urination)

114
Q

Hormone that regulates sodium in conjunction with the kidneys

A

Aldosterone

115
Q

How is the sodium in the ECF affected by aldosterone?

A

Aldosterone secretion stimulates the renal tubules to reasorb Na

116
Q

Where is aldosterone secreted from?

A

The adrenal cortex

117
Q

Low chloride

A

Hypochloremia

118
Q

What causes hypochloremia?

A

Low sodium or a bicarbonate malfunction

119
Q

Too much chloride

A

Hyperchloremia

120
Q

*What causes hyperchloremia?

A

Too much sodium

Too little bicarbonate

121
Q

How would you treat hyperchloremia?

A

Lower sodium levels because if sodium lowers, so will chloride

122
Q

Symptoms of hyperchloremia

A

No specific symptoms

123
Q

3 ways potassium is regulated?

A
  • K and Na have reciprocal relationship (sodium/potassium pump)
  • When aldosterone secretion results in renal Na reabsorption, Kidneys excrete K
  • *Serum K level rises in acidosis and falls in alkalosis (respiratory effort)
124
Q

Explain why serum K levels may or may not reflect the total body potassium level

A

Serum potassium levels rise and fall with respiratory effort. So they are always fluctuating.

125
Q

Why is it important to keep in mind that serum K levels rise and fall with respiratory effort?

A

This is why we don’t use lab values to treat patients. Its trend value may or may not reflect total body use and storage

126
Q

Extremely high potassium

A

Hyperkalemia

127
Q

When would we treat a patient with hyperkalemia?

A

If levels were extremely high (above 7)

128
Q

Side effects of potassium levels above 7

A

Potassium directly affects cardiac muscle contraction and electrical conductivity. So high levels would result in heart rhythm abnormalities

129
Q

Which is more dangerous, potassium or sodium, and why?

A

Potassium because it affects heart rhythm

130
Q

What’s a “quick fix” to temorarly treat high potassium? Why?

A

Insulin and glucose, because insulin has a close relationship with potassium

131
Q

What facilitates K+ movement into muscle cells?

A

Catecholamines (have to do with fight or flight response)

132
Q

Where is calcium absorbed?

A

Small intestine (only in the presence of Vitamin D)

133
Q

What does the parathyroid hormone (PTH) do?

A

Promotes Ca transfer from bone to plasma

Aids intestinal and renal Ca absorption

134
Q

What happens if there is decreased Ca in ECF?

A
  • It directly stimulates PTH release from the parathyroid glands
  • This releases calcium phosphate from bone and indirectly activates mechanisms to increase Ca reabsorption from P excretion from the renal tubules and the GI tract
135
Q

What happens if someone has an issue with their parathyroid gland?

A

They will have an issue with calcium asorption

136
Q

What is calcium usually bound to before it’s used?

A

Albumin

Pathophysiology (14 decks)

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