Fluids, Electrolytes, Acids, and Bases Flashcards
What does ADH stand for?
Antidiuretic Hormone
Where is ADH produced?
Hypothalamus
Where is ADH stored and secreted?
Posterior Pituitary
T or F:The hypothalamus stores ADH.
False. Stored and secreted by the posterior pituitary
What does ADH do?
Increases water reabsorption by renal tubules
What hormone increases water reabsorption by the renal tubules?
ADH
What are the physiological triggers for release of ADH?
Decreased blood volume,
Increased blood osmolarity,
Decreased blood pressure
What does decreased blood volume, increased blood osmolarity, and decreased blood pressure trigger?
Release of ADH
T or F:ADH decreases blood osmolarity.
True
Does ADH increase or decrease blood osmolarity?
Decrease
What is increased blood osmolarity?
Increase in blood glucose,
Loss of water, but no loss of sodium
Where is aldosterone produced and secreted?
Adrenal Cortex
What hormone is produced in the adrenal cortex?
Aldosterone
What does aldosterone do?
Increase sodium reabsorption by the renal tubules,
Increase in potassium and hydrogen secretion by the renal tubules
How is the release of aldosterone stimulated?
Via renin-angiotensin pathway
What does the renin-angiotensin pathway stimulate?
Release of Aldosterone
What hormone increases sodium reabsorption, increase potassium secretion, and increases hydrogen secretion by the renal tubules?
Aldosterone
What does decreased kidney perfusion stimulate?
Renin Release
What is the stimulus for renin release?
Decreased kidney perfusion
What does ECF stand for?
Extra-cellular Fluid
What does ICF stand for?
Intra-cellular Fluid
What is ECF?
All fluid outside of cells
T or F:ECF includes interstitial fluid and plasma?
True
What is ECF’s primary cation?
Sodium
What is ECF’s primary anions?
Chlorine and Bicarbonate
Is bicarbonate a cation or anion?
Anion
Is sodium a cation or anion?
Cation
What is ICF?
All fluid inside cells
What is ICF’s primary cation?
Potassium
What is ICF’s primary anions?
Hydrogen Phosphate and Proteins
T or F:Proteins have a positive charge.
False. Negative Charge
What is hypovolemia?
Isotonic Fluid Loss
What is another term for hypovolemia?
Dehydration
Dehydration is another term for what?
Hypovolemia
What causes hypovolemia?
Blood loss,
GI losses-vomiting, diarrhea
What does blood loss and GI losses cause?
Hypovolemia
What are some clinical manifestations of hypovolemia?
Decreased BP (can be normal for a while with vasoconstriction),
Tachycardia,
Decreased Urine Output,
Increased Hematocrit
Decrease BP, tachycardia, decreased urine output, and increased hematocrit are clinical manifestations of what?
Hypovolemia
What is hypervolemia?
Isotonic fluid gain
Isotonic fluid gain causes what?
Hypervolemia
Isotonic fluid loss causes what?
Hypovolemia
What causes hypervolemia?
Excessive IV fluids,
Hyperaldosteronism
What is hyperaldosteronism?
Sodium and water reabsorption
What is sodium and water reabsorption?
Hyperaldosteronism
What does excessive IV fluids and hyperaldosteronism cause?
Hypervolemia
What clinical manifestation does hypervolemia cause?
Increased BP, Weight Gain, Edema, Decreased Hematocrit, Jugular Vein Dystension
Increased BP, weight gain, edema, decreased hematocrit, and jugular vein distension are clinical manifestations of what?
Hypervolemia
What does BHP stand for?
Blood Hydrostatic Pressure
T or F:BHP opposes filtration.
False. Favors Filtration
What are two reasons BHP decreases along capillaries?
- more distance from heart
2. bc of filtration
What causes isotonic fluid gain?
Aldosterone
T or F:BHP is exerted by blood on vessel walls.
True
What does BOP stand for?
Blood Oncotic Pressure
T or F:BOP is exerted by blood on vessel walls.
False. Exerted by proteins in the blood
T or F:BOP stays constant along the length of the capillary.
True
T or F:BOP opposes filtration.
True
What does IFOP stand for?
Interstitial Fluid Oncotic Pressure
T or F:IFOP is exerted by proteins in the interstitium.
True
T or F:IFOP opposes filtration.
False. Favors Filtration
T or F:IFOP stays constant along the length of the capillary.
True
What does IFHP stand for?
Interstitial Fluid Hydrostatic Pressure
T or F:IFHP favors filtration.
True
T or F:IFHP is exerted by proteins in the interstitium.
False. Exerted by fluid in the interstitium
Is IFHP a positive or negative pressure?
Negitave Pressure
T or F:IFHP opposes filtration.
False. Favors Filtration
What pressure systems favor filtration?
BHP,
IFHP,
IFOP
What pressure system opposes filtration?
BOP
Does BHP, IFHP, IFOP favor filtration or oppose filtration?
Favor Filtration
Does BOP favor filtration or oppose filtration?
Opposes Filtration
What do alterations in water movement cause?
Edema
What causes decreased BOP?
Liver Disease-decreased synthesis of oncotic proteins,
Malnutrition-lack of AA to synthesize oncotic proteins,
Some types of kidney disease-increased loss of proteins in urine
What does AA stand for?
Amino Acids
What does liver disease, malnutrition, and some types of kidney disease cause?
Decreased BOP
Why does liver disease decrease BOP?
It decreases synthesis of oncotic proteins
Why does malnutrition decrease BOP?
There is a lack of AA to synthesize oncotic proteins
What is an example of oncotic proteins?
Albumins
Why do some types of kidney diseases cause BOP?
There is an increased loss of proteins in urine
What are some manifestations of decreased BOP?
Increased Filtration @ the arterial end of the capillary,
Decreased Reabsorption @ the venous end of the capillary
What causes increased BHP?
Hypertension,
Hypervolemia
Hypertension and hypervolemia cause what?
Increased BHP
What are some manifestations of increased BHP?
Increased Filtration @ the arterial end of the capillary,
Decreased Reabsorption @ the venous end of the capillary
Increased filtration @ the arterial end of the capillary and decreased reabsorption @ the venous end of the capillary are manifestations of what?
Decreased BOP,
Increased BHP,
Increases Capillary Membrane Permeability,
Lymphatic Obstruction
What causes increased capillary membrane permeability?
Anything that causes inflammation,
Decreased BOP-opposes filtration,
Increased IFOP-favors filtration
What happens to oncotic proteins when capillary membrane permeability increases?
Oncotic proteins shift from blood to the interstitium
What causes oncotic proteins to shift from blood to the interstitium?
Increased Capillary Membrane Permeability
What are some manifestations of increased capillary membrane permeability?
Increased Filtration @ the arterial end of the capillary,
Decreased Reabsorption @ the venous end of the capillary
What are some manifestations of lymphatic obstruction?
Increased Filtration @ the arterial end of the capillary,
Decreased Reabsorption @ the venous end of the capillary,
Decreased BOP,
Increased IFOP (Proteins collect in interstitium and aren’t drained by the lymphatic system)
What causes lymphatic obstruction?
Removal of lymph nodes,
Obstruction of lymph nodes
What obstructs lymph nodes?
Bacterial Infections,
Cancer,
Nematodes-small wormy parasites
Bacterial infections, cancer, and nematodes do what?
Obstruct lymph nodes
What are some metabolic roles of sodium?
Conduction of nerve impulses,
Maintenance of water content of cells
Conduction of nerve impulses and maintenance of water content in cells are metabolic roles of what?
Sodium
What is hyponatremia?
When the concentration of sodium in ECF is less than normal
What is it called when the concentration of sodium in ECF is less than normal?
Hyponatremia
T or F:Hyponatremia is isotonic.
False
What causes hyponatremia?
Excessive sodium loss (depletion hyponatremia)
-Sweating, Vomiting, diarrhea
Excessive Water Intake (dilutional hyponatremia)
What is depletion hyponatremia?
Excessive sodium loss
What kind of hyponatremia is caused by excessive loss of sodium?
Depletion Hyponatremia
What kind of hyponatremia is caused by excessive water intake?
Dilutional Hyponatremia
What manifestations cause depletion hyponatremia?
Sweating,
Vomiting,
Diarrhea
What do sweating, vomiting, and diarrhea cause?
Depletion Hyponatremia
What is a consequence of hyponatremia?
ECF becomes Hypotonic,
-Cells swell (esp. neurons)
What happens when ECF becomes hypotonic?
Cells swell
What are some clinical manifestations of hyponatremia?
Lethargy,
Generalized Weakness,
Confusion,
Coma
What is hypernatremia?
When sodium in ECF is greater than normal
What causes hypernatremia?
Sodium Gain -Sea water near drowning (sodium in lungs) -Excessive IV salts Water Loss -Fever -Burns -Lack of water intake
What is it called when sodium in ECF is greater than normal?
Hypernatremia
What does sodium gain or water loss cause?
Hypernatremia
What are ways water is lost?
Fever,
Burns,
Lack of water intake
What does fever cause?
Increased BMR,
Increased water usage,
Hyperventilation
What does BMR stand for?
Basal Metabolic Rate
Why do burns cause water loss?
The epidermis is where keratin is present and keratin helps keep water in or out.
What causes lack of water intake?
Altered consciousness-dementia
Lack of access
Choice to not consume water
What are consequences of hypernatremia?
ECF is Hypertonic,
Cells lose water (crenation)
What is crenation?
When cells lose water
What is it called when cells lose water?
Crenation
What cells are most affected by crenation?
Neurons
What are some clinical manifestations of hypernatremia?
Lethargy, Weakness, Seizures, Confusion, Coma
T or F:The clinical manifestations associated with hyponatremia and hypernatremia are almost identical.
True
Where is potassium stored?
Inside Cells
What releases potassium?
Damaged Cells
T or F:potassium uptake requires ATP and insulin.
True
How long does it take for a potassium deficit to occur without potassium intake?
2-3 day
How is potassium lost?
Through cells sloughing
Where does potassium secretion occur
In the Renal Tubules
What hormone promotes potassium secretion?
Aldosterone
What does aldosterone do to potassium?
Promotes Secretion
T or F:Potassium secretion is NOT flow dependant.
False
T or F:More potassium is lost with a faster flow rate of filtrate.
True
What is one way to increase flow rate?
Drinking too much water
What does drinking too much water do to flow rate of filtrate?
Increases Flow Rate of Filtrate
What is hypokalemia?
When potassium in ECF is less than normal
What is “actual” hypokalemia?
When potassium is lost from the body
What is “relative” hypokalemia?
When potassium shifts from ECF to ICF
What is it called when potassium shifts from ECF to ICF?
Relative Hypokalemia
When does ECF volume deficit occur?
When Kidney Perfusion Decreases
What does renin, angiotensin, and aldosterone do to potassium secretion?
Increases Potassium Secretion
What do diuretics do to flow rate in renal tubules?
Increases Flow Rate
What increases flow rate in renal tubules?
Diuretics
What potassium shift results from increased flow in renal tubules?
Increased Potassium Secretion
What does black licorice affect?
Potassium Secretion
Does black licorice decrease or increase potassium secretion?
Increase
T or F:Black licorice has no effect on potassium secretion?
False. Profound effects on potassium secretion
What does insulin administration do to potassium?
Promotes potassium uptake by cells
What chemical promotes potassium uptake by cells?
Insulin
What effect does new tissue formation have on potassium?
Increases potassium uptake by new cells
What are some causes of hypokalemia?
Decreased Kidney Perfusion, Diuretic Use, Black Licorice, Insulin Administration, New Tissue Formation
Decreased kidney perfusion, diuretic use, black licorice, insulin administration, and new tissue formation are causes of what?
Hypokalemia
What consequence does hypokalemia have?
Fewer action potentials will be generated
What causes fewer action potentials to be generated?
Hypokalemia
What manifestations does hypokalemia cause?
Skeletal Muscle Weakness, Depression of CNS, Decreased GI motility, -Nausea, Vomiting bc body doesn't want food Shallow Respirations, Cardiovascular Dysrhythmias -Shallow T wave -Prominent U wave
What cardiovascular dysrhythmias does hypokalemia cause?
Shallow T wave,
Prominent U wave
skeletal muscle weakness, depression of CNS, decreased GI motility, shallow respirations, and cardiovascular dysrhythmias are manifestations of what?
Hypokalemia
What is it called when potassium in ECF is less than normal?
Hypokalemia
What is it called when potassium in ECF is greater than normal?
Hyperkalemia
What is hyperkalemia?
When potassium in ECF is greater than normal
What causes hyperkalemia?
Decreased Potassium
-Renal Failure
-Aldosterone deficiency
Extensive Tissue Damage
-Potassium spills out of cells when damaged
Insulin Deficit
-Decreased potassium uptake y cells in absence of insulin
What decreases potassium in the body?
Renal Failure,
Aldosterone Deficiency
What happens to potassium when there is extensive tissue damage?
It spills out of cells
Decreased potassium, extensive tissue damage, and insulin deficit cause what?
Hyperkalemia
What consequences are associated with hyperkalemia?
Raise resting membrane potential,
action potentials are generated more easily
What are some manifestations of hyperkalemia?
Overstimulation causes muscle fatigue; weakness, Increased GI motility -Diarrhea Cardiovascular Dysrhythmias -High T wave -Ventricular Fibrillation -Can cause Cardiac Arrest
What is ventricular fibrillation?
When cells in the heart quiver and cannot pump blood
How does a defibrillator work?
It overrides the electrical impulses in the heart to try to get myocardiocytes to contract together again
What is it called when heart cells quiver?
Ventricular Fibrillation
What cardiovascular dysrhythmia is associated with hyperkalemia?
High T wave
What is a buffer?
A chemical system used to maintain a constant pH
What is a chemical system used to maintain a constant pH?
Buffer
Why are buffer systems important?
They help maintain a constant pH
What happens if pH changes?
Proteins will be denatured
What is the carbonic acid-bicarbonate system?
(CO2)+(H20)–(H2CO3)–(H+)+(HCO3-)
What is (CO2)+(H20)–(H2CO3)–(H+)+(HCO3-)?
Carbonic Acid-Bicarbonate System
Do strong acids or weak acids dissociate in water more easily?
Strong Acids
What does a pH scale measure?
Hydrogen Ion Concentration
T or F:Weak acids usually don’t dissociate completely.
True
What is the pH in the human body?
7.4
What is the ratio of bicarbonate:carbonic acid in the human body?
20:1
Where is carbonic acid regulated in the body?
Lungs
What is regulated in the lungs?
Carbonic Acid
Where is bicarbonate regulated in the body?
Kidneys
What is regulated in the kidneys?
Bicarbonate
What happens to carbonic acid if carbon dioxide increases?
Increases
What happens to carbonic acid during hyperventilation?
Decreases
What is compensation?
When pH is 7.4 and a 20:1 ratio of bicarbonate:carbonic acid is achieved, BUT the values aren’t normal
What is correction?
When pH is 7.4 and a 20:1 ratio of bicarbonate:carbonic acid is achieved, AND the values are normal
What happens to carbon dioxide and carbonic acid when respiration rate increases?
Carbon Dioxide Increases,
Carbonic Acid Increases
What happens to carbon dioxide and carbonic acid when respiration rate decreases?
Carbon Dioxide Decreases,
Carbonic Acid Decreases
T or F:Bicarbonate MUST bind with hydrogen before reabsorption.
True
T or F:Anything that increases hydrogen ions will increase bicarbonate reabsorption.
True
What is the phosphate buffer system?
(H2PO4–)–(HPO4)+(H+)
What is the equation for protein buffers?
(HHB)–(Hb-)+(H+)
Where are protein buffers most important?
In ICF
T or F:Protein buffers can NOT donate or accept protons.
False
What is metabolic acidosis?
Change in bicarbonate; pH is less than 7.35
What imbalance is a change in bicarbonate?
Metabolic
What causes metabolic acidosis?
Increase in non-carbonic acid -Lactoacidosis:tissue hypoxia -Ketoacidosis:excessive fat degradation -Ingestion of aspirin, antifreeze Excessive loss of bicarbonate -Diarrhea:decreased bicarbonate reabsorption in large intestine Decreased Hydrogen Ion Secretion -Renal failure -Hypoaldosteronism
Increase in non-carbonic acid, excessive loss of bicarbonate, and decreased hydrogen ion secretion causes what?
Metabolic Acidosis
