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ANPH 1105 > Fluids, Electrolytes, Acids, and Bases > Flashcards

Fluids, Electrolytes, Acids, and Bases Flashcards

1
Q

How much of our body fluid exists within cells?

A

About 2/3rds.

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2
Q

How much of our body fluid exists outside of cells?

A

About 1/3rd.

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3
Q

Of our extracellular fluid, how much is interstitial and how much is plasma?

A

80% interstitial, 20% plasma.

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4
Q

Describe why vessels may become leaky and why it may cause issues.

A

They become leaky when there is inflammation in order to allow WBCs to escape, but this is an issue because other substances can also escape and create pressure and edema in the tissues.

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5
Q

Define sensible fluid losses.

A

Loss of body fluid that is able to be measured such as urination, defecation, or wound drainage.

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6
Q

Define insensible fluid loss.

A

Unmeasurable body fluid loss such as evaporation from skin or breathing.

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7
Q

What is dehydration?

A

The loss of fluid without the loss of salts.

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8
Q

What role does angiotensin play in homeostasis?

A

The release of angiotensin constricts blood vessels to prevent blood loss and increases the water retention of the kidneys. It causes the body to HOLD ON to water (antidiuretic).

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9
Q

What is the difference between hydrostatic and osmotic pressure?

A

Hydrostatic pressure is the physical pressure of blood on the capillaries resulting from cardiac contraction, while osmotic pressure is dictated by the concentration gradient of solutes in the blood and interstitium.

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10
Q

Define oncotic pressure.

A

The colloid osmotic pressure; pressure of a colloid solution caused by the large, charged, insoluble particles such as proteins in the blood that cannot cross the vessel membrane, so they draw water into the vessels.

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11
Q

Which factors are the most important in fluid movement between the capillaries and the interstitium?

A

The oncotic pressure and the hydrostatic pressure (amount of solids in blood drawing water in and the force on the walls of the vessel pushing blood out)

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12
Q

Define the Net Filtration Pressure

A

NFP= (BHP+IFOP) - (BCOP+ IFHP) where:
BHP: blood hydrostatic pressure
IFOP: interstitial fluid hydrostatic pressure
BCOP: Blood colloid osmotic pressure
IFHP: Interstitial fluid hydrostatic pressure

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13
Q

If the BHP (blood hydrostatic pressure) were to increase, which direction would the fluid favor?

A

It would favor exiting the vessel.

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14
Q

If the BHP (blood hydrostatic pressure) were to decrease, which direction would the fluid favor?

A

It would favor entering the vessel.

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15
Q

If the IFOP (interstitial fluid osmotic pressure) were to increase, which direction would the fluid favor?

A

It would favor exiting the vessel.

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16
Q

If the IFOP (interstitial fluid osmotic pressure) were to decrease, which direction would the fluid favor?

A

It would favor entering the vessel.

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17
Q

If the BCOP (blood colloid osmotic pressure) were to increase, which direction would the fluid favor?

A

It would favor entering the vessel.

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18
Q

If the BCOP (blood colloid osmotic pressure) were to decrease, which direction would the fluid favor?

A

It would favor exiting the vessel.

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19
Q

If the IFHP (interstitial fluid hydrostatic pressure) were to increase, which direction would the fluid favor?

A

It would favor entering the vessel.

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20
Q

If the IFHP (interstitial fluid hydrostatic pressure) were to decrease, which direction would it favor?

A

It would favor exiting the vessel.

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21
Q

What is the easiest way to find the net filtration pressure?

A

Take the difference between the net filtration out of arteries and net reabsorption into veins.

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22
Q

What is the major ion outside of cells?

A

Na+

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23
Q

What is the major ion inside cells?

A

K+

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24
Q

Which ion does water follow?

A

Na+

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25
Q

What is the baroreceptor reflex?

A

A reflex triggered by a drop in arterial blood pressure that constricts afferent arterioles of the kidney resulting in fluid retention.

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26
Q

Where are baroreceptors located?

A

In the atrial walls, vena cava, aortic arch, and carotid sinus (in and very close around heart)

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27
Q

What are volume receptors?

A

They detect too much volume in vessels and create a renal response to increase urine output to lower the amount of fluid in the body.

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28
Q

What is Renin?

A

An enzyme secreted by kidneys when the arterial pressure or volume drops.

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29
Q

What substance does renin interact with and what does it do?

A

It converts angiotensin to angiotensin I which is a vasoconstrictor.

30
Q

What substance converts angiotensin I to angiotensin II and where is it located?

A

ACE (angiotensin converting enzyme) found in the lungs.

31
Q

What does angiotensin II do?

A

It produces vasoconstriction to elevate blood pressure and stimulates the adrenal cortex to produce aldosterone.

32
Q

What is aldosterone?

A

A mineralocorticoid that brings Na+ and K+ into the blood from the interstitial fluid of the kidneys, and increases Cl- and HCO3- concentrations and causes water retention; released from the adrenal cortex.

33
Q

What kind of feedback loop is aldosterone a part of?

A

It is a negative feedback loop where ACTH is released by the Ant. Pit. in response to low ECF and Na+ levels, causing release of aldosterone by adrenal cortex, leading to Na+ and fluid retention, which shuts of ACTH release.

34
Q

What are the four causes of edema?

A

An increase in blood hydrostatic pressure, a decrease in blood colloid osmotic pressure, an increase in interstitial fluid osmotic pressure, and obstruction of lymphatics that prevents fluid from being cleared away.

35
Q

Define electrolytes

A

A compound that dissociates into ions in solution, resulting in the solution being able to carry a current.

36
Q

What are the functions of electrolytes?

A

Control osmosis, maintain acid-base balance, carry electrical current, and serve as cofactors for enzymes.

37
Q

What are the main electrolytes found in plasma (ECF)?

A

High Na+ and low K+, Cl-, HCO3-, and plasma proteins

38
Q

What are the main electrolytes found in interstitial fluid?

A

High Na+ and low K+, Cl-, and HCO3-.

39
Q

What are the main electrolytes found in intracellular fluid (ICF)?

A

Low Na+ and high K+, Mg2+, HPO4- and proteins.

40
Q

What is the normal range of serum sodium?

A

135-145 mEq/L (milliequivalents per litre).

41
Q

How does the Na+/K+ pump work?

A

Uses ATP, Mg2+, and an enzyme to pump 3 Na+ out and 2 K+ in, which creates an electrical charge that allows neuromuscular contraction.

42
Q

What are the three factors in K+ balance?

A

The Na+/K+ pump, renal regulation (K+ is excreted by kidneys), and the pH level.

43
Q

What is acidosis?

A

Too much acid in the blood, caused by hyperkalemia (K+) moving out of the cells.

44
Q

What is alkalosis?

A

Blood is too basic, caused by hypokalemia (K+ moving into cells).

45
Q

What are some risk factors that contribute to hypomagnesemia?

A

Chronic alcoholism, malabsorption, GI/urinary disorders, sepsis, burns, and wounds needing debridement.

46
Q

What is the normal blood serum level of Mg2+?

A

1.5-2.5 mEq/L (milliequivalents per litre)

47
Q

What are some roles of calcium within the body?

A

Forms bones and teeth, plays a role in cell membrane and permeability, affects cardiac muscle contractions, and participates in blood clotting.

48
Q

What is the normal serum level of calcium?

A

8.9-10.1 mg/dl (milligrams per decilitre)

49
Q

What is the normal serum level of chorine?

A

96-106 mEq/L (milliequivalents per litre)

50
Q

What are some causes of hypochloremia?

A

Decreased intake or absorption, osmotic or thiazide diuretics and IMPORTANT: metabolic alkalosis

51
Q

What are some causes of hyperchloremia?

A

Dehydration, renal failure, respiratory alkalosis, hypernatremia.

52
Q

What is the normal pH range for a person?

A

7.35-7.45

53
Q

What are some sources of H+ within the human body?

A

Cellular respiration, incomplete combustion of glucose yielding organic acids like lactic acid and ketones, and ingestion of acid products such as in an overdose situation.

54
Q

What are the three parts of the acid-base regulatory system?

A

Buffers (bicarbonate-carbonic acid system) in the blood, the respiratory system regulating CO2 loss, and the kidneys secreting H+ and reabsorbing HCO3-

55
Q

Where are phosphate buffers found?

A

They are the intracellular buffer.

56
Q

Where are protein buffers found and what do they do?

A

They are both intracellular and plasma buffers and they have both a carboxyl terminal and an amino terminal so they can buffer both acids and bases.

57
Q

How does the respiratory system balance pH?

A

The rate of respiration will adjust to get rid of more or less CO2 (faster breaths=more CO2 being blown off).

58
Q

How is the body’s pH monitored?

A

It is monitored by chemoreceptors in the medulla, aortic arch, and carotid bodies which can send signals to the brainstem to alter respiration rate.

59
Q

How do kidneys regulate pH?

A

They excrete H+ (acidic) and reabsorb Na+. Ammonia and H2PO4 -2 both combine with H+ in the urine to prevent it from being too acidic.

60
Q

What are some causes of respiratory acidosis?

A

Emphysema, pulmonary edema, brainstem injury, airway obstruction, anything that prevents CO2 from leaving via the breath

61
Q

How does the body compensate for respiratory acidosis?

A

The kidneys will increase the secretion of H+ and reabsorption of HCO3- (base).

62
Q

How do the ABGs of a patient with compensated vs. uncompensated respiratory acidosis look?

A

Compensated: normal pH, paCO2 >45, HCO3 >26
Uncompensated: pH <7.35, PaCO2 > 45, HCO3 normal

63
Q

What are the causes of respiratory alkalosis?

A

Cerebrovascular accident (CVA), anxiety (hyperventilation), O2 deficiency, anything causing too much CO2 to be blown off.

64
Q

How does the body compensate for respiratory alkalosis?

A

The kidneys compensate by decreasing the secretion of H+ and HCO3- reabsorption.

65
Q

What does the ABG of an uncompensated vs. compensated patient with respiratory alkalosis look like?

A

Compensated: normal pH, PaCO2 <35, HCO3 <22
Uncompensated: pH >7.45, PaCO2 <35, HCO3- normal

66
Q

What are some causes of metabolic acidosis?

A

Severe diarrhea, renal dysfunction, overwhelmed buffer such as in overdose or ketosis.

67
Q

How does the body compensate for metabolic acidosis?

A

By hyperventilating

68
Q

What does the ABG for uncompensated vs. compensated metabolic acidosis look like?

A

Uncompensated: pH <7.35, PaCO2 normal, HCO3- <22
Compensated: normal pH, PaCO2 <35, and HCO3- <22

69
Q

What are some causes of metabolic alkalosis?

A

Excessive vomiting, alkaline drugs, too much HCO3- in IV.

70
Q

How does the body compensate for metabolic alkalosis?

A

The respiratory system compensates by hypoventilation to hold on to CO2.

71
Q

What are the ABG results for a patient with uncompensated vs. compensated metabolic alkalosis?

A

Uncompensated: pH >7.45, normal PaCO2, and HCO3- >26
Compensated: Normal pH, PaCO2 >45, HCO3- >26

ANPH 1105 (14 decks)

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