FLUID ELECTROLYTE AND ACID BASE BALANCE II

Question 1

major electrolytes

(S,P,C,M,C,P,S,B)

Answer 1

sodium potassium calcium magnesium chloride phosphate sulphate bicarbonate

Question 2

normal plasma lvl = 135-145 mEq/L

predominant cation in the ECF
plays a crucial role in the excitability of muscles and neurons

important in regulating fluid balance

regulation at the cellular level is controlled by Na-K pump

Answer 2

sodium

Question 3

loss of sodium from fluid loss
excessive sweating, vomiting, diuretics, renal failure (inability to concentrate and save sodium)
fresh water drowning

water moves into cell such as brain cells causing brain expansion within limited space inside the cranium

Answer 3

hyponatremia

Question 4

renal failure
excessive salt ingestion
over administration of hypertonic IV fluids
salt water drowning
decreased fluid intake

water transfers from cell into the ECF causing cellular dehydration

Answer 4

hypernatremia

Question 5

normal plasma level = 3.5=5.5 mEq/L

major cation in the ICF
critical for electrical conduction of nerve impulses - particularly cardiac electrical conduction

kidneys can excrete K and in exchange for Na- controlled by aldosterone

Answer 5

potassium

Question 6

loss of K; excessive vomiting, diarrhea
acute alcoholism
medication: diuretics, laxative, insulin

hypotension, elevated pulse due to decreased cardiac output, weakness

Answer 6

hypokalemia

Question 7

use of K supplements
receiving old/improperly administered blood
inadequate potassium excretion
cell destruction; crushing injuries and burns

diarrhea, apathy, confusion, numbness in hands and feet, acidosis

Answer 7

hyperkalemia

Question 8

normal level: 4.0-5.5 mEq/L or 8.5 - 10mg/dl

required for normal skeletal, cardiac, and smooth muscle contraction

needed for blood clotting
intestinal absorption of dietary calcium requires vitamin D

regulated by PTH and vitamin D

Answer 8

calcium

Question 9

failre of normal regulatory mechanisms such as acute or chronic renal failure, malabsorption syndromes. acute pancreatitis, alkalosis

low serum levels —> bones release calcium —–> osteoporosis

(+) trousseau’s sign and chvostek’s sign

seizures arrhythmia and ECG changes

Answer 9

hypocalcemia

Question 10

disturbances in regulation, excess parathyroid hormone, excessive intake of calcium

polyuria (if kidney function is normal)
kidney stones

Homan’s sign

Answer 10

hypercalcemia

Question 11

normal value: 1.5-2.5 mEq/L
needed to prevent overexcitability of muscles

sedative effect on neuromuscular junction, inhibits acetylcholine release, and diminishes muscle cell excitability

acts as a cofactor in enzyme reactions

Answer 11

magnesium

Question 12

decreased GI absorption
hypoaldosteronism
high dose steroids
excessive intake of calcium, vitamin D

(+) chvostek’s and trousseau’s sign
confusion, agitation, seizures

Answer 12

hypomagnesemia

Question 13

combination of increased intake and decreased renal function, antacids and laxatives

lethargy and drowsiness, depressed respirations, low blood pressired

Answer 13

hypermagnesemia

Question 14

precise _______ is essential because the activities of almost all enzyme systems in the body are influenced by H+ concentration

Answer 14

hydrogen regulation

Question 15

normal ph of blood

Answer 15

7.4

Question 16

normal ph of venous blood

Answer 16

7.35

Question 17

normal ph of arterial blood

Answer 17

7.45

Question 18

a state of excess hydrogen ion

reduction in excitability especially in the brain
confusion, coma, death

Answer 18

acidosis

Question 19

results when the blood pH is less than 7.35

Answer 19

acidemia

Question 20

a state of excess bicarbonate (HCO3+)

overactivity, numbness, muscle spasm, convulsion as a result of excessive nervous activity in the brain

Answer 20

alkalosis

Question 21

results when the blood pH is greater than 7.45

Answer 21

alkalemia

Question 22

any compounds which can release hydrogen ions in solution
examples: HCl, H2CO3
proton donors

Answer 22

acids

Question 23

a compound that ionizes completely in solution to form hydrogen ions and a base (ex. HCl)

Answer 23

Strong acids

Question 24

compounds that are only partially ionized in solution

Answer 24

weak acids and bases

Question 25

ion or molecule that can accept an H+
proton acceptors
ex: bicarbonate; phosphate

Answer 25

bases

Question 26

a compound that limits the change in hydrogen ion concentration (and so pH) when the hydrogen ions are added or removed from the solution

either weak acids or basis, includes amino acids

Answer 26

buffers

Question 27

increased H+ concentration

Answer 27

reaction forced to the right

Question 28

decreased H+ concentration

Answer 28

reaction shifts to the left

Question 29

3 primary systems that regulate H+ concentration in body fluids

Answer 29

chemical acid-base buffer system
respiratory center
renal mechanism

Question 30

chemical acid-base buffer system includes

Answer 30

bicarbonate (CO2), protein (hemoglobin), phosphate

Question 31

immediately combines with acid/base to prevent changes in H+ concentration

reacts within seconds

Answer 31

chemical acid-base buffer system

Question 32

buffer systems in blood

Answer 32

bicarbonate buffer system
hemoglobin
phosphate
ammonia

Question 33

most important ECF buffer
chief buffer for fixed nonvolatile acids

sodium bicarbonate (alkali reserve of the body; deficiency: metabolic acidosis; excess: metabolic alkalosis)

Answer 33

bicarbonate buffer system