Week 1 - Fluid and Electrolyte Balance, Blood pH and Metabolism Flashcards
List the relevant nursing actions?
- Administering prescribed medications and intravenous fluids
- Observing, managing oedema
- Assessment and recording of: BGL, HR, BP, temperature, fluid balance, urinalysis and patient weight.
List four ways water exits the human body
- Urine
- Sweat
- Faeces
- Insensible loss via skin and lungs
An excessive loss of water from the blood (extracellular fluid) through sweating would cause water to be moved by osmosis from where in the human body?
- Tissue fluid (interstitial)
- Intracellular
The movement of this water from the tissue fluid into the blood would cause water to move out of the cells. How would this affect the volume and osmotic concentration of these cells?
- Cells shrink
- Increase osmotic concentration (solute load)
Describe what the symbol pH defines (Figure 2.7).
- Hydrogen concentration (H+)
- Acidity or alkalinity (basic)
Would an isotonic or hypertonic intravenous solution be prescribed and administered to correct this dehydrated condition?
- Isotonic (0.9% NaCI)
- Hypotonic
Name the two major organs that help maintain the homeostatic pH of the blood.
- Lungs
- Kidneys
Comment on the effect of severe vomiting (hydrochloric acid, HCl loss) on blood volume, blood pressure and blood pH. As this condition has resulted from a non-respiratory cause it is classified as a metabolic condition.
- Blood pH increase (alkaline) due to H+ loss
- Concentration of body fluids increase
- Blood volume decreases
- Blood pressure decreases
How would this renal tubular reabsorption or secretion of H+ effect the pH of a patients’ urine?
pH of urine would change
Comment on the effect of diarrhoea (bicarbonate-rich, HCO3- loss) on blood volume, blood pressure and blood pH. This is also a metabolic condition.
- Blood pH decreases (acidic) due to HCO-3 loss (less HCO-3 to buffer H+)
- Concentration of body fluids increases
- Blood volume decreases
- Blood pressure decreases
Define metabolism
- Chemical reactions necessary to maintain life
- Enzymes required
- Catabolism and anabolism
Name the structure that takes water-soluble molecules like monosaccharides, amino acids and medications from the jejunum to the liver.
Hepatic portal vein
Name the structure(s) in a hepatocyte that metabolises toxins like medications (biotransformation).
Smooth endoplasmic reticulum (microsomal enzymes)
Once a medication has been metabolised by the hepatocytes where does it go?
Hepatic vein -> Inferior Vena Cava -> Circulation -> Kidneys -> Bile
The dominant electrolyte in the extracellular fluid is ______.
Sodium (Na+)
Gluconeogenesis is the ______.
Conversion of lipids and amino acids to glucose
Ammonia and urea accumulate in the blood because of ______ catabolism.
Protein
Ketone bodies accumulate in the blood because of ______ catabolism.
Lipid
______ generates the most adenosine triphosphate (ATP) from catabolism.
Aerobic Respiration
The human body has evolved to resist periods of starvation, not over consumption. In the absence of food, the glycogen of the liver and skeletal muscle provides ______ calories of fuel to maintain the production of ATP. Once this is exhausted, adipose tissue continues as the principal source with a potential to deliver ______ calories of fuel.
3000; 60000
The production of ATP by the mitochondria also generates CO2, H2O and heat. The hypothalamus will initiate ______ and ______ gland secretion to eliminate excess heat from the body.
Vasodilation; merocrine
High density lipoproteins (HDL) are associated with better health outcomes. HDLs transport cholesterol from the ______.
Body cells to the liver
List the five correct functions of the liver.
- Plasma protein production
- Synthesis of blood cholesterol (85%)
- Formation of bile
- Filtration of blood from the digestive tract
- Detoxification of medications
List the five correct functions of the liver.
- Storage of glycogen
- Storage of iron (Fe)
- Synthesis of prothrombin and fibrinogen
- Conversion of toxic ammonia to urea
Synthesis of lipoproteins (VLDL, HDL)
Describe how gastroenteritis could potentially influence the pH of a patients’ blood.
- Neutral ptt effect
- Fluid and electrolyte loss bigger problem
- Blood volume and blood pressure decreases
