Fluids and Electrolytes Flashcards
Water makes up ___% of total body weight
Water makes up 45 – 60% of total body weight
The intracellular water makes up __% of total body water.
The intracellular water compartment makes up 66% of total body water.
The extracellular water compartment makes up __% of total body water.
The extracellular water compartment makes up 34% of total body water.
The intravascular (plasma) compartment and interstitial compartments are found in the:
extracellular water compartment.
Remember that the hydrostatic pressure in capillary microcirculation drives
Remember that the hydrostatic pressure in capillary microcirculation drives fluid into the interstitium and fluid returns to plasma via LYMPHATICS
Na, Cl & HCO3 make up __% of the active osmoles in the ECW
Na, Cl & HCO3 make up 90% of the active osmoles in the ECW
the resting membrane potential is
the resting membrane potential is NEGATIVE and is essential for cell function/nerve conduct
60 – 70% of filtered Na and H2O is absorbed in the
60 – 70% of filtered Na and H2O is absorbed in the PROXIMAL CONVOLUTED TUBULE
The electrolytes absorbed and secreted at the distal convoluted tubule includes:
Sodium is absorbed, potassium & hydrogen is secreted.
The substance absorbed at the collecting duct is:
water is absorbed at the collecting duct.
PTH, angiotensin, and endothelin ALL influence function of the ___.
PTH, angiotensin, and endothelin ALL influence function of the PCT
Prostaglandins, glucagon, calcitonin and epinephrine work at the:
Loop of Henle
Aldosterone, natriuretic peptides and sympathetic tone all work at the:
distal collecting tubule.
during shock, fluid shifts from
during shock, fluid shifts from INTRAcellular water to EXTRAcellular water.
Shock results in expanded ECW, which is restored to normal volume via
is expanded ECW, which is restored to normal volume via renal function (natriuretic peptides such as ANP, BNP and CNP).
AVP increases the ECW in shock, as hypotension is a strong stimulus. AVP is an increase in response to:
AVP is an increase in response to plasma osmolarity > 280 mOsm/kg.
During shock, the function of ANP and BNP is:
ANP and BNP vasodilate and increase microvascular permeability.
The normal pH is 7.40. Daily metabolism provides
The normal pH is 7.40. Daily metabolism provides increase Hydrogen ions, making a positive daily balance. The excess is excreted in urine
- Low rates of survival: pH
- Low rates of survival: pH > 7.70 or < 7.00
Shock is defined as a:
Shock: rapid accumulation of H+ in ICW and ECW. The cell membrane is not readily permeable to H+ and the kidney cannot compensate for a sudden rapid increase.
CO2 is cleared from the body via the
CO2 is cleared from the body via the pulmonary system.
A major ECW & ICW buffer is:
(1) HCO3
(2) Proteins
(3) inorganic phosphate
(4) oxidative phosphorylation.
(1) HCO3 is a major ECW and ICW buffer.
Proteins are:
ICW buffers.
**HCO3 is absorbed and H+ is excreted, as well as production of ammonium in tubular filtrate in the nephron at the:
The distal convoluted tubule is essential for acidic urine.HCO3 is absorbed and H+ is excreted, as well as production of ammonium in tubular filtrate.
Which of the following is TRUE?
- A low GFR enhances the DCT’s ability to keep up with H+.
- Aldosterone: retains Na and HCO3, even if the pH is 7.40.
- Malnutrition: glutamine deficiency accelerates NH4+ excretion.
Aldosterone: retains Na and HCO3, even if the pH is 7.40.
Metabolic acidemia is defined as:
Metabolic acidemia: An abrupt addition of sufficient protons to reduce bicarbonate buffer by 50%.
Respiratory acidemia is defined as:
Respiratory acidemia: a sudden reduction in alveolar ventilation causes an increase in PaCO2 to 50 torr.
Metabolic alkalemia is defined as:
Metabolic alkalemia: an abrupt addition of sufficient bicarbonate to increase the buffer concentration to 30 mEq/L.
Respiratory alkalemia is defined as:
Respiratory alkalemia: a sudden increase in alveolar ventilation causes a decrease in PaCO2 to 20 torr.
- Hypoxia causes
- Hypoxia causes a rapid rise in ICW H+ and little change in ECW pH
T/F: in hypoxia, . Rapid infusion of HCO3 can worsen ICW pH (increased CO2).
True.
The result of lactic acidosis is:
anaerobic glycoslysis
Etiologies of lactic acidosis include:
hemorrhage, MI, alcholism and septic shock.
A patient presents with dilutional metabolic acidosis. There is a decreased anion gap. Treatment of this is:
renal correction via ammonium chloride excretion.
A patient with diarrhea experiences metabolic acidosis, which presents as reduciton in HCO3, Na and K. Treatment is:
IV fluids with NaCl and KCl
Treatment of metabolic acidosis involves:
Sodium bicarbonate SLOWLY infused, especially if the pH < 7.2
Diabetic ketoacidosis results in:
(1) Increased metabolism and insulin levels.
(2) An increase in beta-hydroxybutyric acid and acetoacetic acid.
(3) decreased anion gap and low hydrogen protons.
(2) An increase in beta-hydroxybutyric acid and acetoacetic acid.
Kussmaul’s respirations are seen in patients with diabetic ketoacidosis when PaCO2 is:
PaCO2 < 20 mmHg.
T/F: Ketoacidosis does occur in alcoholics due to decreased glucose intake.
False.
A patient presents with renal failure. They have a low GFR and an inability to clear extracellular water protons. The results is:
metabolic acidosis.
Renal tubular acidosis causes metabolic acidosis. Treatment is:
bicarbonate and dialysis.
Metabolic alkalosis occurs as a result of:
excess ECW HCO3.
Sodium bicarbonate perfusion can result in:
mechanical ventilation in hypoventilation syndrome.
Gastric outlet obstruciton causes metabolic alkalosis that has characteristics of:
hypochloremia, hypokalemic metabolic alkalosis.
Increased use of loop diuretics is associated with:
metabolic alkalosis and an increase in aldosterone.
Respiratory alkalosis occurs due to:
acute hypoxia and hyperventilation.
Respiratory acidosis results from:
Decreased alveolar ventilation.
T/F: giving supplemental oxygen to a patient in respiratory acidosis can suppress respiratory drive and cause death.
True.
T/F: Sodium only makes up 5% of the osmolarity of extracellular water compartment.
False.
Moderate hyponatremia is defined as:
(1) 120 meq/L
(2) 120 - 130 meq/L
(3) 130 - 138 meq/L
Moderate hyponatremia is defined as (2) 120 - 130 meq/L.
Severe hyponatremia results in
Severe hyponatremia results in seizures and coma, with < 110 meq/L causing death from cerebral edema.
Acute hyponatremia causes:
Na and H2O are lost and replaced by hypoosmotic fluid
Acute hyponatremia can be resuscitated with
Dilutional: resuscitation of losses with HYPOTONIC solution
Desalination in acute hyponatremia refers to
Desalination: an increase in AVP (due to stress, pain or anxiety) causes water retention despite isotonic resuscitation
The type of diuretics that cause obligatory sodium loss (and acute hyponatremia) are:
Furosemide and mannitol
Diabetic ketoacidosis is a cause of:
(1) acute hyponatremia
(2) chronic hyponatremia
Diabetic ketoacidosis is a cause of (1) acute hyponatremia.
Cerebral salt wasting is associated with:
acute hyponatremia
Cerebral salt wasting is treated via:
Check 24 hour urine sodium levels and treat with daily sodium replacement.