Unit 1 - Fluids and Electrolytes Flashcards
what are the two types of body fluids?
intracellular fluid (ICF)-40% of body weight, approximately 28 L of body fluid extracellular fluid (ECF)-consistent interstitial fluid and intravascular fluid
liquid found between the cells of the body that provides much of the liquid environment of the body
interstitial fluid
fluid term used to refer to that part of the extracellular fluid that is within the blood vessels
intravascular fluid
what are the total body water percentages of body weight?
female adult-60%
male adult-50%
infants-70%
hormone secreted by the renal cortex that increases Na+ resorption from urine back to the blood at the distal tubules of the kidney
aldosterone
among released in response to low blood pressure that is secreted by the posterior pituitary and promotes water retention by the kidneys to regulate water balance
antidiuretic hormone
hormone secreted by the kidneys in response to low blood pressure and activates angiotensin to promote secretion of aldosterone
renin
peptide released from atria of the heart in response to high blood pressure, and acts as an antagonist to aldosterone
atrial natiuretic hormone
what is the impact of atrial natiuretic hormone on sodium concentrations in the blood
decreases blood sodium through the excretion of sodium in the urine, this reduces blood volume and blood pressure
water channel proteins in the lipid bilayer of the cell membrane that promotes permeability of the cell
aquaporins
blood pH is buffered by two mechanisms which are regulated by two body systems. The buffering reactions are rapid and slow reactions, which systems react to changes in blood pH?
rapid reactions-respiratory system
slow reactions-urinary system
accumulation of fluid within interstitial spaces is called…
edema
edema that is confined to traumatized areas is termed…
localized edema
edema that exhibits uniform distribution of fluid in the interstitial spaces is termed…
generalized edema
extracellular fluid loss or gain is accomplished by proportional changes of electrolytes, with no shrinkage or swelling in the fluids
isotonic imbalances
- losses seen in hemorrhage or excessive sweating
- gains occur in administration of normal saline or renal retention of sodium and water
imbalance in which water loss or solute gain occurs, cells shrink in these types of imbalances
hypertonic imbalances
-seen in administration of hypertonic saline, hyper aldosteroneism, Cushing syndrome, diabetes, diarrhea, or insufficient water intake
imbalances in which water gain and solute loss occurs, cells swell in these types of solutions
hypotonic imbalances
-these imbalances can be caused by vomiting, diarrhea, burns, diuretics, excessive sweating, renal failure, or failure to excrete water
excess Na +
hypernatremia
list conditions associated with hypernatremia
- central nervous system your ability
- convulsions
- tachycardia
- dry and flushed skin
- hypervolemia
- hypertension and rapid pulse
- thirst
- elevated temperature
- weight loss
- oliguria or anuria
Na + deficit
hyponatremia
this conditions associated with hyponatremia
- headache
- cerebral edema
- stupor orcoma
- peripheral edema
- polyuria
- absence of thirst
- hypovolemia
- hypotension
- temperature
- rapid pulse
- nausea and vomiting
- decreased urination
what is the treatment for hypernatremia?
give water slowly or intravenous replacement with 5% dextrose in water
what is the treatment for hyponatremia?
restrict water with cautious use of hypertonic seeming solution
Cl- deficit
hypochloremia
list the possible causes of hypochloremia
- hyponatremia
- elevated bicarbonate concentration
- vomiting and loss of HCl
K + excess
hyperkalemia
list conditions associated with hyperkalemia
- decrease conductivity of the heart muscle
- muscle cramping
- paresthesias
- oliguria
- nausea
- diarrhea
list causes of hyperkalemia
- increased intake of potassium from ICF into ECF
- decreased renal excretion
- insulin deficiency
- cellular trauma
K + deficit
hypokalemia
list conditions associated with hypokalemia
- cardiac irritability
- dysrhythmia
- vomiting
- paralytic ileus
- constipation,
- thirst
- inability to concentrate urine
list the causes of hypokalemia
- reduced intake of potassium
- increased entry of potassium into cells
- increased loss of potassium
Ca + + excess
hypercalcemia
list conditions associated with hypercalcemia
- decreased neuromuscular excitability
- muscle weakness
- central nervous system depression
- stupor to coma
- increased risk of bone fracture
- vomiting
- constipation
- kidney stones
list the causes of hypercalcemia
- hyperparathyroidism
- bone metastasis*
- sarcoidosis
- excess vitamin D
- tumors that produce parathyroid hormone
*be sure to check notes regarding specific tissues for bone metastasis
Ca ++ deficit
hypocalcemia
list conditions associated with hypocalcemia
- increased nerve muscular excitability
- skeletal muscle cramps
- tetany
- laryngeospasm
- asphyxiation
- cardiac arrest
list the causes of hypocalcemia
- in adequate intestinal absorption
- deposition of ionized calcium into the bone or soft tissue
- decreases in parathyroid hormone and vitamin D
- nutritional deficiencies with in adequate sources of dairy products were green leafy vegetables
PO4 - excess
hyperphosphatemia
list the conditions associated with hyperphosphatemia
same clinical manifestations as hypercalcemia
list the causes of hyperphosphatemia
- acute or chronic renal failure with significant loss of glomerular filtration
- treatment of metastatic tumors with chemotherapy that releases large amounts of phosphate into the serum
- long-term use of laxatives or enemas containing phosphates
- hyperparathyroidism
PO4 - deficit
hypophosphatemia
list conditions associated with hypophosphatemia
- anorexia
- weakness
- osteomalacia
- muscle weakness
- tremors and or seizures
- coma
- anemia and other bleeding disorders
- leukocyte alterations
list the causes of hypophosphatemia
- intestinal malabsorption
- malabsorption syndromes
- respiratory alkalosis
- increased renal excretion of phosphate associated with hyperparathyroidism
list conditions associated with
Mg ++ excess
- skeletal muscle depression
- muscle weakness
- hypotension
- bradycardia
- respiratory depression
list the causes of Mg++ excess
- renal insufficiency
- excess intake of magnesium containing antacids
- adrenal insufficiency
list conditions associated with
Mg ++ deficit
- hypokalemia and hypocalcemia
- neuromuscular irritability
- tetany
- convulsions
- tachycardia
- hypertension
list the causes of Mg++ deficit
- malnutrition
- malabsorption syndromes
- alcoholism
- urinary losses
normal blood pH range
7.35-7.45
list the major organs involved in the regulation of acid-based balance
- bones
- lungs
- kidneys
acids are formed by the release of H + ions, these ions are formed via the metabolism of…
- protein
- carbohydrate
- fats
a chemical that combined excesses H + or OH - without a significant change in pH
buffer
-buffering pair consists of the week acid and its conjugate base
most important plasma buffering system
carbonic acid-carbonate pair
what is the ratio of bicarbonate to carbonic acid to maintain a proper blood pH
20:1
if the amount of bicarbonate decreases the pH decreases resulting in what state?
acidosis
the mechanism by which pH can be returned to normal is the amount of carbonic acid increases or decreases to match increases or decreases of bicarbonate
compensation
-compensation mechanisms include respiratory compensation and renal system compensation
list the three other buffering systems discussed in class
- protein buffering system (hemoglobin), proteins are negatively charged and can act as buffers for H +
- renal buffering, secretion of H plus in the urine and reabsorption of HCO3 -
- Ion exchange between ICF and ECF, exchange of K +for H + in acidosis and alkalosis
systematic increase in H+ concentration or decrease in bicarbonate
acidosis
systematic decreased in H + concentration or increase in bicarbonate
alkalosis
list the four categories of acid-base imbalances
- Respiratory acidosis-elevation of pCO2 as a result of ventilation depression
- Respiratory alkalosis-depression of pCO2 as a result of alveolar hyperventilation
- Metabolic acidosis-depression of HCO3-or an increase in non-carbonic acids
- Metabolic alkalosis-elevation of HCO3-usually caused by an excessive loss of metabolic acids
occurs when your kidneys can get rid of acid buildup or when your body gets rid of too much bass
metabolic acidosis*
*be sure to look at the diagrams on page 113 concerning metabolic acidosis and alkalosis
occurs when your lungs do not properly eliminate CO2 which allows it to build up in the blood
respiratory acidosis*
*be sure to look at the diagrams on page 11 concerning respiratory acidosis and alkalosis
