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Patho > pH, Electrolyte, & Fluid Balance (exam 3) > Flashcards

pH, Electrolyte, & Fluid Balance (exam 3) Flashcards

1
Q

What is the total body water (TBW)?

A

All fluids 60% of weight

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2
Q

How much of the TBW is intracellular fluid (ICF)?

A

2/3 of the TBW

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3
Q

How much of the TBW is extracellular fluid (ECF)?

A

1/3 of the TBW

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4
Q

What makes up the ECF?

A 
Interstitial fluid (IF): between the cells
Intravascular fluid: blood plasma (primarily H20)
Lymph, synovial, intestinal, CSF, sweat, urine, pleural, peritoneal, pericardial, intraocular fluid
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5
Q

What is the normal pH of the body?

A

7.40

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6
Q

What is the normal pH range in the body?

A

7.35 - 7.45

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7
Q

What is pH a measure of?

A

H+ ions
Power of hydrogen
0-14

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8
Q

What pH is acidic (acidotic)?

A

7.34 and below

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9
Q

What pH is basic (alkadotic)?

A

7.46 and above

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10
Q

What is an anion?

A

Negative charged ion

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11
Q

What is a cation?

A

Positively charged ion

plussy cat

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12
Q

What is the primary ECF cation? Where is there more of it?

A

Sodium (Na+)

More outside the cell

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13
Q

What does Na+ do?

A

Regulates osmotic forces

Fluid Movement! water follows Na+

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14
Q

What is the primary ECF anion?

A

Chloride (Cl-)

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15
Q

What does Cl- do?

A

Provides electroneutrality

Moves with Na+

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16
Q

What does H20 do when Na+ levels are increased?

A

H20 levels increase

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17
Q

What does H20 do when Na+ levels are decreased?

A

H20 levels decrease

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18
Q

What is tonicity?

A

Change in concentration of solutes (salt) with relation to solvent (water)

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19
Q

What is an isotonic solution?

A

Equal concentrate in and outside the cell

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20
Q

What is a hypertonic solution? Which direction does water move?

A

Concentrate higher outside the cell

Water moves out of the cell (dehydrates cell)

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21
Q

What is a hypotonic solution? Which direction does water move?

A

Concentrate higher inside the cell

Water moves into cell (explodes/ lysis cell)

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22
Q

What is hypernatremia? What are the manifestations?

A 
Na+ > 145 mEq/ L 
High Na+ levels (outside cell)
Intracellular dehydration
Increase Na+ or decrease H20
Manifestations: increase cellular functions
Hypertension
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23
Q

What is hyponatermia? What are the manifestions?

A 
Na+ < 135 mEq/ L
Low Na+ levels
More H20 into cells
Decrease Na+ or increase H20
Manifestations: decrease cellular functioning, hypotension, tachycardia (try to bring up BP)
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24
Q

What is the most common electrolyte imbalance?

A

Hyponatremia

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25
Q

What is hypochloremia the result of?

A

Result of hyponatremia or

Increase HCO3

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26
Q

What is the major intracellular electrolyte?

A

Potassium (K+)

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27
Q

What does K+ do?

A

Think heart
Transmission and conduction of nerve impulses
Normal cardiac rhythm
Skeletal and smooth muscle contractions (“action potentials”)
Changes in K+= changes in heart functioning

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28
Q

What is acidosis? Causes of acidosis?

A

pH under 7.35

Increase H+ inside cell –> K+ moves out (hyperkalemia)

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29
Q

What is hyperkalemia? What are its manifestations?

A

K+ moves out
High K+ levels outside cell
Raises resting membrane potential
Increase excitability: take less to reach threshold
Manifestations: cardiac dyshythmias, PVC (premature ventricular contractions)

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30
Q

What is alkolosis? Causes of alkolosis?

A

pH above 7.46

Decrease H+ inside cell –> K+ moves into cell (hypokalemia)

31
Q

What is hypokalemia? What are its manifestations?

A

Low K+ outside the cell
Lowers resting membrane potential
Decrease excitability: need more to reach threshold
Manifestations: cardiac dysrhythmias (bradycardia, asystole)

32
Q

What is Ca++ function? Hypocalcemia? Hypercalcemia?

A

Think skeletal muscle function
Affects threshold potential
Hypocalcemia: decrease threshold potential= more excitable (increase skeletal muscle function)
Hypercalcemia: increase threshold potential= less excitable (decrease skeletal muscle function)

33
Q

What is the main driver of fluid balance?

A

Na+

34
Q

What primarily regulates fluid balance?

A

Kidneys and Hormones

35
Q

What regulates H20?

A

Hypothalamus–> posterior pituitary–> ADH

ADH causes kidneys to take H20 from the urine

36
Q

What regulates Na+/ Cl-?

A

Adrenal gland- releases aldosterone: reabsorbs Na+, H20, decrease urine, increase BP
Atrial muscle- releases natriuretic hormones (ANH): put Na+ into urine, H20 follows, increase urine, decrease BP

37
Q

What is osmolarity/ osmolality? What happens if increased?

A

Amount of electrolytes to H20

Increase osmolality: More electrolytes, less H20

38
Q

What does the RAAS system do?

A

Release aldosterone
Increase BP
Decrease urine

39
Q

How do we take in fluids?

A

Drinking
Food
Metabolism

40
Q

How do we output fluids?

A

Urine
Breathing
Skin
Feces

41
Q

What is hydrostatic pressure?

A 
Fluid pressure (main= BP)
PUSHing force (high to low)
42
Q

What is oncotic pressure? Osmotic pressure?

A

Oncotic= Proteins
Osmotic= Electrolytes
PULLing force

43
Q

What is capillary hydrostatic pressure (CHP)?

A

‘Fluid out’
#1 pressure (strongest)
Push out of capillary
Blood pressure is driving force out

44
Q

What is capillary oncotic pressure (COP)?

A 
'Fluid in'
#2 pressure
Water attraction to plasma proteins
Albumin is driving force into capillaries
Pull into capillary
45
Q

What is interstitial hydrostatic pressure (IFHP)?

A 
'Fluid in'
# 3 pressure
Interstitial fluid pressure
Push into capillaries
Driving force is interstitial fluid pressure
46
Q

What is interstitial oncotic pressure (IFOP)

A

‘Fluid out’
#4 pressure (weakest)
Water attraction to interstitial proteins
Proteins and electrolytes are driving force out
Pull into interstitial fluid

47
Q

What pressures work together?

A

CHP & IFOP

COP & IFHP

48
Q

What is edema?

A

Excessive accumulation of fluids in interstitial space

49
Q

What are the 4 major causes of edema?

A

Increase capillary hydrostatic pressure: Increase BP
Decrease plasma oncotic pressure
Increase capillary permeability: inflammation
Lymph obstruction: can’t drain obligatory load

50
Q

What pH range is the absolute range of life?

A

6.8-7.8
Acid pull K+ from cells- hyperkalemia
Base push K+ into cells- hypokalemia

51
Q

Are acids or bases produced more in the body?

A

Acids

52
Q

What constantly regulates acids in the body?

A

Lungs: increase or decrease CO2
Kidneys: bicarbonate & H+ ions

53
Q

What is the volatile acid? How is it eliminated? What carries out the volatile body acids?

A

Carbonic acid (H2CO3) only one
Eliminated as CO2
Carried out by the lungs

54
Q

What carries out the nonvolatile body acids

A

Eliminated by the kidneys

55
Q

When the blood pH is low, what is it called?

A

Acidemia

56
Q

When the blood pH is high, what is it called?

A

Alkalemia

57
Q

What is acidosis?

A

Low pH in general body tissues

58
Q

What is alkalosis?

A

High pH in general body tissues

59
Q

What is metabolic acidosis? Signs & Symptoms?

A

Low body pH
Kidney problem: retain to much H+ or get rid of to much bicarb
Hyperkalemia (high K+)
Kussmaul respirations (compensatory hyperventilation)

60
Q

What is metabolic alkalosis? Signs and Symptoms?

A

High body pH
Kidney problem: retain to much bicarb or get rid of to much H+
Compensatory hypoventilation
Hypokalemia (low K+)

61
Q

What is respiratory acidosis? Signs and Symptoms?

A

Low body pH
Lung problem: not getting rid of enough CO2
Hypoventilation–> hypoxia
Hyperkalemia (high K+)

62
Q

What is respiratory alkalosis? Signs and Symptoms?

A

High body pH
Lungs problem: blow off to much CO2
Hyperventilation
Hypokalemia (low K+)

63
Q

What is a buffer?

A

A chemical that binds to excess H+ or OH- without a significant change in pH

64
Q

What are the physiological pH control systems?

A

Chemical buffer systems: immediate (blood) response, ex: bicarbonate buffer system is main (produced by H2O & CO2)
Physiological buffer systems: minutes (lungs) response, hours (kidneys), ex: respiratory or renal response system

65
Q

What is compensation in reference to the buffering systems?

A

If lungs or kidneys aren’t working right the other compensates (after trying blood buffer)
Respiratory issue- kidney compensation
Kidney issue- lung compensation

66
Q

What is the normal range of pCO2?

A

35-45 mmHg
46 or high= acid
34 or below= base

67
Q

What is the normal range of HCO3?

A

22-26 mEq/ L

68
Q

What does acidosis do to CNS?

A

CNS depression

Stupor to confusion to coma

69
Q

What does alkylosis do to CNS?

A

CNS irritability

Restlessness to seizures

70
Q

What does it mean for fluid balance if:

CHP + IFOP > COP + IFHP?

A

More fluid into interstitial fluid from the blood

71
Q

What does it mean for fluid balance if:

CHP + IFOP < COP + IFHP?

A

More fluid pushes into the capillaries

72
Q

What pathologies are related to fluid balance errors?

A

4 causes of edema:
Increase capillary hydrostatic pressure: Increase BP
Decrease plasma oncotic pressure
Increase capillary permeability: inflammation
Lymph obstruction: can’t drain obligatory load

73
Q

What is the obligatory load?

A

During fluid balance process, 10% of fluid goes into tissues and can’t be reabsorbed due to BP
Fluid must be drained by lymphatics
Obligatory load= 10% of fluid that isn’t reabsorbed

Patho (17 decks)

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