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patho final > fluid-electrolyte and acid-base imbalances > Flashcards

fluid-electrolyte and acid-base imbalances Flashcards

1
Q

FLUID=

A

water and electrolytes

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2
Q

anions=

A

anions=

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3
Q

cations=

A 
\+ 
calcium 
magnesium 
potassium 
sodium
hydrogen
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4
Q

what is CHP

A

capillary hydrostatic pressure
the PUSH pressure
-pressure fluid EXERTS on vessel walls OUT of capillaries

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5
Q

what is OP

A

osmotic pressure
-change in plasma protein concentration (amt of plasma protein or changes in H20 volume)
PULL pressure
-pressure coming from solutes drawing fluid IN to capillaries

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6
Q

NFP=

A

net filtration pressure (CHP-BCOP)

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7
Q

there is a net…

A

LOSS of fluid from capillaries into interstitial space

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8
Q

movement of fluid is _____

A

OUT OF capillaries

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9
Q

what returns the fluid from the interstitial tissues to blood?

A

LYMPHATIC system

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10
Q

what is edema?

A

extra fluid (excessive/abnormal) accumulation in interstitial space

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11
Q

where can edema be LIFE threatening?

A

BRAIN!, lungs! heart!

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12
Q

causes of edema? (4)

A
  1. increased capillary hydrostatic pressure
  2. decreased colloid osmotic osmotic pressure
  3. increased capillary permeability
  4. obstructed lymph flow
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13
Q

how does increased capillary hydrostatic pressure cause edema?

A
  • INCREASED vascular volume (HF, kidney disease, premenstrual sodium retention, pregnancy, envrionmental stress, thiazolidinedione therapy)
  • venous obstruction
  • decreased arteriolar resistance (calcium blocking drug response)
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14
Q

how does decreased colloid osmotic pressure occur?

A
  • increased loss of plasma proteins

- decreased production of plasma proteins

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15
Q

increased capillary permeability as a cause of edema?

A

-inflammation, allergic reaction, malignancy, issue injurys and burns cause INCREASED permeability

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16
Q

obstructed lymph flow occurs from?

A

malignant obstruction, surgical removal of lymph nodes

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17
Q

what is dehydration?

A

decreased interstitial and intravascular fluids

-KIDNEY not fx properly or losing fluid (draws from IS and cells)= DEHYDRATED cells

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18
Q

what is third spacing?

A

two NORMAL spaces for fluid= intravascular space and interstitial space
—-> continually exchange fluid
3rd space= ABNORMAL, transcellular space
example. ascites in abdomen, bleeding into a cavity or joint, pleural space
difficult to happen and just as difficult to get OUT

19
Q

measure of pH is a measure of

A

hydrogen ions

20
Q

normal pH of extracellular fluid

A

7.35-7.45

21
Q

pH is constantly changing because of?

A

reactions in body, generating H+

MANY compensatory mechanisms

22
Q

ABGs?

A

arterial blood gases= test blood from an artery for:

  • certain gases amt (CO2 and O2) dissolved in blod.
  • measures PH
23
Q

what is alkalosis?

A

increased BASE pH greater than 7.45

-LOW hydrogen

24
Q

what is acidosis?

A

increased ACID pH less than 7.35

-HIGH hydrogen

25
Q

4 types of metabolic imbalances?

A
  1. metabolic alkalosis
  2. respiratory alkalosis
  3. respiratory acidosis
  4. metabolic acidosis
26
Q

pH is dependent on?

A

BALANCE between bicarbonate and carbonic acid

27
Q

what is the homeostatic balance of bicarbonate ion and carbonic acid?

A

20:1 ratio 20 bases 1 acid

28
Q

NORMAL pH is maintained by what 3 systems?

A

BUFFERing system
LUNGS
KIDNEYS

29
Q

how does the buffer system work?

A
  • carbonic acid-bicarbonate buffer is used in the blood
  • chemicals in ICF and ECF providing IMMEDIATE response
  • weak base + conjugate acid pair, or weak acid + conjugate base pair (to prevent large changes in pH, system TRADES strong acid for weak acid or strong base for weak base)
  • pick up extra H+ if levels are HIGH
  • release H+ if levels are LOW
  • buffers cannot get RID of H+, so if buffering capacity exceeded, OTHER mechanisms needed!
30
Q

how do the lungs work to maintain pH?

A
  • CO2 exhaled by lungs
  • if lungs FAIL= BUILD up of C02, acidosis
  • CHEMORECEPTORS in brainstem and peripheral chemoreceptors sense change in pCO2 and ALTER ventilation rate to MAINTAIN acid-base balance
  • RAPID response (minutes)
  • only 50-75% as effective as buffer system
  • PREVENTS large pH changes while waiting for slower acting kidneys to respond
31
Q

how do the kidneys work to maintain pH?

A
  • SLOWEST response (hours to days)
  • EXCRETE more or less H+—> H+ from fixed acids resulting from protein and lipid metabolism
  • REABSORB more or less HCO3, filtered in glomerulus so that it is not lost in urine
  • generates new HCO3 and releases in blood
32
Q

equation

A

CO2 + H20 H2CO3 H+ + HCO3-

33
Q

the direction of the reaction is determined by?

A

concentration of reactants and products

moves TOWARD side with LOWER concentration (LE CHATELIERS principle)

34
Q

carbonic acid is volatile… which means

A

as soon as it forms it dissociates (so HARD to measure conc in blood)
only volatile acid in body

35
Q

how is ABG measured?

A

small volume of blood drawn from artery (most commonly radial artery on wrist)

  • interpreted to determine acid-base imbalances
  • can also measure lactate, hemoglobin, electrolytes and others
36
Q

metabolic imbalances occur when

A

any fixed acids involved lactic acid, HCl

37
Q

respiratory imbalances occur when

A

carbonic acid is involved

38
Q

metabolic acidosis=

A 
too much acid or too little base 
causes= severe diarrhea (lose HCO3), diabetes (ketones broken into acid, strenous exercise (lactic acid) or renal failure 
response: buffers PICK up extra H 
resp increases (H20 and CO2 exhaled) 
kidneys (secrete more H, reabsorption)
39
Q

metabolic alkalosis=

A

too much base or too little acid
causes= vomiting (lose H from stomach), excess intake of antacids (increase HCO3)
response: buffers drop off H
ventilation decreases (less Co2 lost)
kidneys secrete less H, reabsorb less HCO3

40
Q

what is respiratory acidosis=

A

lungs FAILING, not adequately ventilating! CO2 not exhaled and builds up
causes: lung disease, depression of resp centers due to drug, nerve/muscle disorders decrease resp, holding breath
results in increased PCO2, excess CO2 combined with water to form carbonic acid
response: buffers pick up excess H+
kidneys excrete H, reabsorb HCO3

41
Q

what is respiratory alkalosis=

A

hyperventilation, CO2 exhaled EXCESSIVELY, reactant conc drops so more H2CO3 converted into CO2
causes: fever, anxiety, aspirin positioning, high altitude
response: buffers drop off H
kidneys excrete less H, reabsorb more HCO3

42
Q

compensation is what?

A

LUNGS and KIDNEYS will compensate for each others FAILURE! to maintain pH

  • LUNGS failing not exhaling CO2, rxn moves right and kidneys excrete excess H+
  • KIDNEYS failing and retaining H not excreting, rxn moves left so carbonic acid formed and dissociated into CO2 to be exhaled by lungs
43
Q

treatment for acid-base imbalances?

A 
administer solutions (oral or IV) to normalize pH 
-must address underlying problem though!

patho final (40 decks)

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