Fluid Balance Flashcards

1 - Name the main hormones involved in water and electrolyte balance and describe their action to maintain homeostasis. 2 - Explain the causes and consequences of hypovolemia and hypervolemia. 3 - Describe how electrolyte concentrations are regulated.

1
Q

How do ions form?

A

When electrolytes dissolve and dissociate

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2
Q

4 Functions of electrolytes

A

Control osmosis of water between body fluid
compartments

Help maintain the acid-base balance

Carry electrical current

Serve as cofactors

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3
Q

Name 6 electrolytes

A

Sodium

Potassium

Calcium

Magnesium

Chloride

Phosphate

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4
Q

Causes of fluid and electrolyte imbalances

A

Patients with illness

Directly cause by illness/disease - Burns, heart failure, renal disease, liver disease, diabetes insipidus

Laxative abuse

Marathon runners

IV fluid replacement

Diuretics

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5
Q

Hormones involved with fluid/electrolyte balance

A

Antidiuretic hormone (ADH)

Aldosterone
- Secreted by angiotensin II

Atrial natriuretic peptide (ANP)

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6
Q

What cells secrete renin?

A

Juxtaglomerular cells of the kidneys

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7
Q

What secreted angiotensinogen?

A

The liver

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8
Q

What secretes angiotensin-converting enzyme (ACE)?

A

The lungs

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9
Q

What secretes aldosterone?

A

Adrenal cortex

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10
Q

Steps of renin-angiotensin aldosterone system

A

A decrease in blood volume and pressure

Kidneys secrete renin, the liver secretes angiotensinogen

Renin converts angiotensinogen into angiotensin I

Angiotensin I converted to angiotensin II by an angiotensin-converting enzyme found on the surface of the lungs

Angiotensin II is a vasoconstrictor, causing blood vessels to narrow, and increasing blood pressure

Angiotensin II also stimulates aldosterone secretion from the adrenal cortex

Aldosterone causes renal tubules to increase the reabsorption of sodium and water into the blood and causing excretion of potassium, causing increased blood volume which increases blood pressure

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11
Q

How does NaCl increase blood volume/pressure?

A

Increased intake of NaCl increases plasma concentrations of Na+ & Cl-

Increases osmosis of water from ICF to interstitial fluid and plasma

Blood volume increased

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12
Q

Term for high and low sodium levels

A

Hypernatremia

Hyponatremia

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13
Q

Term for high and low potassium levels

A

Hyperkalemia

Hypokalemia

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14
Q

Term for high and low calcium levels

A

Hypercalcemia

Hypocalcemia

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15
Q

Term for high and low magnesium levels

A

Hypermagnesemia

Hypomagnesemia

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16
Q

Term for high and low phosphate levels

A

Hyperphosphatemia

Hypophosphatemia

17
Q

Term for high and low chloride levels

A

Hyperchloremia

Hypochloremia

18
Q

What is hypovolemia

A

Low extracellular fluid (ECF) volume

19
Q

Causes of hypovolemia

A

GI sodium loss - vomiting, diarrohea

Skin sodium loss - sweating, burns

Renal sodium loss - diuretics, renal disease

Haemorrage

20
Q

Definition of dehydration

A

Loss of total body water

21
Q

What % of body weight reduction is mild-moderate dehydration? and symptoms

A

1-3% body weight reduction due to fluid loss

Thirst

Headache

Tirdness

Strong smelling urine

22
Q

What % of body weight reduction is moderate dehydration? and symptoms

A

3-5% body weight reduction due to fluid loss

Loss of strength and stamina

23
Q

What % of body weight reduction is severe dehydration? and symptoms

A

> 5% body weight reduction due to fluid loss

Severe thirst

Dry wrinkled skin

Inability to urinate

Low blood pressure

Weak pulse

Rapid heartbeat

24
Q

What % of body weight reduction is complete dehydration?

A

> 10% body weight reduction due to fluid loss

Can lead to death if not treated immediateley

25
Q

What is hypervolemia?

A

High extracellular fluid (ECF) volume

26
Q

Causes of hypervolemia

A

Intravenous therapy

Renal sodium retention in heart failure

Renal sodium retention in renal failure

27
Q

Steps of water intoxication

A

Hyponatremia

Decreased osmolarity of interstitial fluid and plasma

Osmosis of water from interstitial fluid into the intercellular fluid

Water intoxication (cells swell)

Convulsions, coma, possible death

28
Q

Clinical features of hypovolemia

A

Thirst

Dizziness

Confusion

Dry mouth

Reduced skin turgor

Reduced urine

Weight loss

29
Q

Clinical features of hypervolemia

A

Ankle swelling

Breathlessness

Oedema

Pulmonary precipitations (crackling sound)

Hypertension (sometimes)

Weight gain