I K (no j or i): Water, electrolytes, acid-base balance Flashcards
what is insensible water loss? how much is it?***
skin, breathing; 0.8-1.2 L per day
intracellular vs. intercellular
- intracellular = within cells
- intercellular = type of extracellular fluid, between/around cells
what is sensible water loss?
urine = CAN COLLECT IT
insensible water loss- easy or difficult to measure?
difficult
electrolytes do what in water?
dissociate into ions: cations (+), anions (-)
mEq equation***
(mg/atomic weight) x valence
atomic weight of Na, K, Ca**
Na = 23 K = 39 Ca = 40
valence of Na, K, Ca***
Na = 1 K = 1 Ca = 2
concentration of electrolytes is expressed in what unit?***
milliequivalents (mEq)
extracellular electrolytes are?***
SODIUM, CALCIUM (also Cl, HCO3 aka bicarbonate)
sodium chloride is ___% sodium
40%
one tsp salt = 6g or NaCl or ___g sodium
2.4 (2400 mg = 1 tsp salt)
sodium is reabsorbed by __________ (hormone) and retained by ______
absorbed by aldosterone and retained by steroids
intracellular electrolytes?***
POTASSIUM, magnesium, phosphorous
sources of potassium*****
meat, fruits, vegetables (banana, orange, tomato, potato, cantaloupe)
sources low in potassium***
apple, cranberry, blueberry, carrot, corn
aldosterone (increases/decreases) excretion of potassium
increases
normal range for the following: ***
- sodium
- potassium
- calcium
- sodium = 136-145 mEq/L
- potassium = 3.5-5 mEq/L
- calcium = 4.4-5.5 mEq/L (9-11 mg/dL or 2xs the mEq)
normal range for the following –(FLIP)–>
- magnesium
- chloride
- phosphorous
- magnesium = 1.5-2.5
- chloride = 96-106
- phosphorous = 3-4.5
what is osmosis?***
fluid moves from LESS –> MORE CONCENTRATED SIDE OF MEMBRANE
what is diffusion?***
particles move from MORE –> LESS CONCENTRATED SIDE
osmosis vs. diffusion***
- osmosis = less to more
- diffusion = more to less
effect of protein on fluid balance
exerts colloidal osmotic pressure
relationship between albumin and fluid**
- albumin exerts pressure on blood vessel wall that keeps water within
- when ALBUMIN DROPS, PRESSURE DROPS, FLUID LEAKS OUT
- water goes from extracellular to between and around cells = edema + ascites
anasarca***
extreme, generalized edema and widespread swelling of skin due to effusion of fluid into extracellular space
anasarca is associated with?***
HEART, LIVER, RENAL FAILURE, EXTREME PRO/KCAL MALNUTRITION
generally with dehydration, what happens to lab values?***
most increase
causes of dehydration
- decreased water intake
- excessive water output
- heavy solute load
s/s of dehydration***
- NAUSEA
- DIZZINESS
- SUNKEN EYES
- INCREASE IN SOLUTES (BUN)
BEST ASSESSMENT parameter for fluid status?***
serum sodium
hypernatremia is associated with? hyponatremia is associated with?***
- hyper = dehydration
- hypo = overhydraton
with fluid status, what lab value should you look at first?***
serum sodium
what is acid-base balance?***
regulation of hydrogen concentration
acid does what? base does what?***
- ACID RELEASES H ions
- BASE TAKES UP H ions
what is a buffer?**
MIXTURE of acid and base components to protect against a strong acid or a strong base
major buffer***
carbonic acid (H2CO3) and sodium bicarbonate (NaHCO3)
body pH is?***
7.4
what do lungs control? what do kidneys control?***
- lungs = supply of carbonic acid (CO2, water)
- kidneys = bicarbonate (base)
hypoventilation does what? hyperventilation does what?***
- hypoventilation = retention of acid (carbonic acid or CO2)
- hyperventilation = loss of acid
what happens if kidneys retain bicarbonate? what happens if kidneys excrete excess bicarbonate?***
- retain bicarb = level of base increases
- excrete bicarb = level of base decreases
how does acid-base balance work?***
change in one side of the buffer = COMPENSATORY CHANGE ON THE OTHER SIDE to maintain balance and a PH OF 7.4
failure related to pulmonary system is called?***
respiratory
general guideline for acid-base disorders –>
- what is occuring = the condition
- compensatory response = opposite organ increases or decreases to balance out the pH
(ex: metabolic acidosis = low pH of the kidneys & they excrete too much base —> compensatory is for the lungs to hyperventilate to lose acid)
what happens in respiratory acidosis?
CO2 retention (or hypoventilation, retaining acid)
compensatory response of respiratory acidosis?***
kidneys increase absorption of base (bicarbonate)
what happens in respiratory alkalosis?
increased ventilation/loss of acid
compensatory response for respiratory alkalosis***
kidneys excrete base (bicarbonate)
what happens in metabolic acidosis?***
kidneys EXCRETE EXCESS BASE (or kidneys produce or retain too much hydrogen –> increase in production of carbonic acid)
compensatory response for metabolic acidosis***
lungs HYPERVENTILATE = YAWN & SIGH; respiration increases to EXPEL CO2 to decrease carbonic acid
what happens in metabolic alkalosis?***
ABNORMAL RETENTION OF BASE (or loss of H due to loss of acid)
compensatory response for metabolic alkalosis***
HYPOVENTILATION –> ventilation or respiration decreases to retain CO2 to increase carbonic acid
chemical makeup for bicarbonate vs. carbonic acid***
- bicarbonate = HCO3
- carbonic acid = H2CO3
blood gas readings for bicarbonate***
HCO3 = 24-28
blood gas readings for carbonic acid***
pCO2 = 35-45
associations: acid vs. base
- pCO2…carbonic acid…lungs
- HCO3…base…bicarbonate…kidneys
