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Pathophysiology > Week 6: Ch. 2- Fluid/Electrolytes > Flashcards

Week 6: Ch. 2- Fluid/Electrolytes Flashcards

1
Q

The major component of the body is __________ in
these compartments:
- Intercellular fluid (ICF) compartment
- Extracellular fluid (ECF) compartment

A

water

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2
Q

Balance of water in the compartments
essential for:

A

homeostasis

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3
Q

About ____ of an adult’s body weight is water.

About____ of an infant’s body weight is
water.

A

About 60% of an adult’s body weight is water.

About 70% of an infant’s body weight is
water.

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4
Q

Females―higher percentage of _______________,
lower water content than males

A

fatty tissue

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5
Q

Older adults and obese persons have lower
proportion of:

A

water

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6
Q

individuals with less fluid reserve are more likely to be adversely affected by: ?

A

any fluid or electrolyte imbalance.

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7
Q

The amount of water entering the body
should equal:

A

the amount of water leaving the
body

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8
Q

Fluid circulates throughout the body via:

A

filtration and osmosis.

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9
Q

Water moves between compartments via:
- _____________ pressure
- _____________ pressure

A

-Hydrostatic pressure
-Osmotic pressure

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10
Q

Thirst mechanism
- __________ in the hypothalamus

A

Osmoreceptors

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11
Q

Antidiuretic hormone
-Promotes resorption of water into :

A

blood from kidney tubules

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12
Q

Aldosterone
-Determines resorption of :

A

sodium ions and water

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13
Q

Atrial natriuretic peptide
-Regulates fluid, sodium, and __________ levels

A

potassium

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14
Q

Edema―excessive amount of fluid in the: __________________________
- Causes swelling or enlargement of tissue
- May be localized or throughout the body
- May impair tissue perfusion
- May trap drugs in ISF

A

interstitial compartment

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15
Q

Causes of Edema

A
  • Obstruction of lymphatic circulation
  • Increased capillary permeability
  • Swelling
  • Pitting edema
  • Increase in body weight
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16
Q

Effects of Edema

A
  • Functional impairment
  • Pain
  • Impaired arterial circulation
  • Dental
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17
Q

Causes of Dehydration

A
  • Vomiting and diarrhea
  • Excessive sweating with loss of sodium and water
  • Diabetic ketoacidosis
  • Loss of fluid, electrolytes, and glucose in the urine
  • Insufficient water intake in older adults/ unconscious persons
  • Use of concentrated formula in infants
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18
Q

Effects of Dehydration

A
  • Dry mucous membranes in the mouth
  • Decreased skin turgor or elasticity
  • Lower blood pressure, weak pulse, fatigue
  • Decreased mental function, confusion, loss of
    consciousness
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18
Q

Manifestations of Dehydration

A
  • Decreased skin turgor and dry mucous membranes
  • Sunken eyes
  • Sunken fontanelles in infant
  • Lower blood pressure, rapid weak pulse
  • Increased hematocrit
  • Increased temperature
  • Decreasing level of consciousness
  • Urine―low volume and high specific gravity
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18
Q

Attempts to Compensate for Fluid Loss

A
  • Increasing thirst
  • Increasing heart rate
  • Constriction of cutaneous blood vessels
  • Producing less urine
  • Concentration of urine
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19
Q

Primary cation in ECF:

A

sodium

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19
Q

Sodium diffuses between _____________________
fluids.

A

vascular and interstitial

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20
Q

Transport of sodium into and out of cells by:

A

sodium potassium pump

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21
Q

Sodium is a actively secreted into _____ and other secretions

A

mucus

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22
Q

Sodium exists in forms of sodium chloride and sodium:

A

bicarbonate

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23
Q

Hyponatremia is low

A

blood sodium

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24
Q

Casues of hyponatremia

A

-Losses from excessive sweating, vomiting, diarrhea
-Use of some diuretic drugs combo with low salt diet
-Hormonal imbalances
* Insufficient aldosterone
* Adrenal insufficiency
* Excess ADH secretion
-Diuresis
-Excessive water intake

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25
Q

Effects of Hyponatremia

A

Low sodium levels cause fluid imbalance in compartments
* Fatigue, muscle cramps, abdominal discomfort or
cramps, nausea, vomiting

Decreased osmotic pressure in ECF compartment
 Fluid shift into cells
* Hypovolemia and decreased blood pressure
 Cerebral edema
* Confusion, headache, weakness, seizures

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26
Q

Hypernatremia
-Cause is imbalance in:

A

sodium and water

  • Insufficient ADH (diabetes insipidus)
  • Results in large volume of dilute urine
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27
Q

Hypernatremia
- Loss of the _______ mechanism

A
  • Loss of the thirst mechanism
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28
Q

Hypernatremia

  • Watery __________
  • Prolonged periods of rapid ___________
  • Ingestion of large amounts of ________________________________
A
  • Watery diarrhea
  • Prolonged periods of rapid respiration
  • Ingestion of many sodium w/o enough water
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29
Q

Potassium is a major intracellular:

A

cation

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30
Q

Potassium is excreted primarily in:

A

urine

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31
Q

____________ promotes movement of potassium into cells

A

Insulin

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32
Q

Potassium level influenced by ___________ balance

A

acid-base

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33
Q

Excess potassium ions in interstitial fluid may lead to :

A

hyperkalemia.

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34
Q

Abnormal potassium levels cause changes in ______________________ and are life-threatening!

A

cardiac conduction

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35
Q

Definition of hypokalemia- Serum K+ < _____ mEq/L

A

3.5

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36
Q

Causes of Hypokalemia

A

-Excessive losses caused by diarrhea
-Diuresis associated with some diuretic drugs
-Excessive aldosterone or glucocorticoids
* Example: Cushing syndrome
-Decreased dietary intake
* May occur w/ alcoholism, eat. disorder, starvation
-Treatment of diabetic ketoacidosis with insulin

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37
Q

Effects of Hypokalemia

A

-Cardiac dysrhythmias caused by impaired repolarization leading to cardiac arrest
-Interference with neuromuscular function; Muscles less responsive to stimuli
-Paresthesias―“pins and needles”
-Decreased digestive tract motility

-Severe hypokalemia: Shallow respirations; Failure to concentrate urine―polyuria

38
Q

Effects of Hypernatremia

A
  • Weakness, agitation
  • Dry, rough mucous membranes
  • edema
  • Increased thirst (if thirst mechanism is functional)
  • Increased blood pressure
39
Q

Definition of hyperkalemia- Serum K+
> ____ mEq/L

A

5

40
Q

Causes of Hyperkalemia

A

-Renal failure
-Deficit of aldosterone
-“Potassium-sparing” diuretics
-Leakage of intracellular potassium into extracellular fluids
* In patients with extensive tissue damage
-Displacement of potassium from cells by prolonged or severe acidosis

41
Q

Effects of Hyperkalemia

A

-Cardiac dysrhythmias; may progress to cardiac arrest
-Muscle weakness common
—Progresses to paralysis
—May cause respiratory arrest
—Impairs neuromuscular activity
-Fatigue, nausea, paresthesias

42
Q

Calcium is an Important extracellular:

A

cation

43
Q

Calcium is

Ingested in :
Stored in :
Excreted in :

A

Ingested in food
Stored in bone
Excreted in urine and feces

44
Q

Calcium balance controlled by : 2 things

A

parathyroid hormone (PTH) and calcitonin

45
Q

Vitamin D promotes __________ absorption from
intestine
* Ingested or synthesized in skin in the presence of
ultraviolet rays
* Activated in kidneys

A

calcium

46
Q

Functions of Calcium

A

 Structural strength for bones and teeth
 Maintains stability of nerve membranes
 Required for muscle contractions
 Necessary for many metabolic processes &
enzyme reactions
 Essential for blood clotting

47
Q

Causes of Hypocalcemia

A
  • Hypoparathyroidism
  • Malabsorption syndrome
  • Deficient serum albumin
  • Increased serum pH level
  • Renal failure
48
Q

Effects of Hypocalcemia

A

Increase in the permeability and excitability of
nerve membranes
-Spontaneous stimulation of skeletal muscle
* Muscle twitching
* Carpopedal spasm
-Tetany

Weak heart contractions
-Delayed conduction
-Leads to dysrhythmias and decreased blood
pressure

49
Q

Causes of Hypercalcemia

A

Uncontrolled release of calcium ions from bones
-Neoplasms―malignant bone tumors

Hyperparathyroidism

Demineralization caused by immobility- decrease stress on bone

Increased calcium intake
-Excessive vitamin D
-Excess dietary calcium

Milk-alkali syndrome

50
Q

Effects of Hypercalcemia

A

Depressed neuromuscular activity
- Muscle weakness, loss of muscle tone
- Lethargy, stupor, personality changes
- Anorexia, nausea

Interference with ADH function
- Less absorption of water
- Decrease in renal function

increased strength in cardiac contractions
- Dysrhythmias may occur.

51
Q

Hypomagnesemia results from ____________ or ______________ ; often associated with alcoholism

A

malabsorption or malnutrition

52
Q

Hypomagnesemia is caused by

use of :
diabetic :
hyper:
hyper:

A

use of diuretics
diabetic ketoacidosis
hyperthyroidism
hyperaldosteronism

53
Q

Hypermagnesemia
* Occurs with _________ failure
* Depresses ______________ function
* Decreased ____________

A
  • Occurs with renal failure
  • Depresses neuromuscular function
  • Decreased reflexes
54
Q

Phosphate
- Bone and tooth _____________

A

mineralization

55
Q

Phosphate
 Important in ______________ ―ATP

A

metabolism

56
Q

Phosphate is an Integral part of the :

A

cell membrane

57
Q

Phosphate - Reciprocal relationship with serum ____________

A

calcium

58
Q

Hypophosphatemia

A
  • Malabsorption syndromes, diarrhea, excessive antacids
59
Q

Hyperphosphatemia
* From _______ failure

A

renal

60
Q

Chloride is a major extracellular _______

A

anion

61
Q

Chloride levels related to ___________ levels

A

sodium

62
Q

Chloride and bicarbonate ions can shift in
response to :

A

acid-base imbalances.

63
Q

Hypochloremia

  • Usually associated with ___________
    -Early stages of ____________ ―loss of hydrochloric acid
A
  • Usually associated with alkalosis
     Early stages of vomiting―loss of hydrochloric acid
64
Q

Hyperchloremia
* Excessive _______ __________ intake pH.

A

sodium chloride

65
Q

Respiratory system can alter carbonic acid
levels to change:

A

pH.

66
Q

Kidneys can modify the excretion rate of acids and absorption of bicarbonate ions to:

A

regulate pH.

  • Most significant control mechanism
  • Slowest mechanism
67
Q

Buffer Systems

A

Sodium bicarbonate–carbonic acid system
- Major ECF buffer
- Controlled by the respiratory system and kidneys

Other buffering systems:
- Phosphate
- Hemoglobin
- Protein

68
Q

Decompensation occurs when:
- Causative problem becomes:
- Additional:
- Compensation mechanisms are:

A
  • Causative problem becomes more severe
  • Additional problems occur
  • Compensation mechanisms are exceeded or fail
69
Q

Decompensation
Requires: ?

A

Requires intervention to maintain
homeostasis
- LIFE-THREATENING!

70
Q

Acidosis
 Excess:
 Decrease:

A

Excess hydrogen ions
Decrease in serum pH

71
Q

Alkalosis
 Deficit of:
 Increase:

A

Deficit of hydrogen ions
Increase in serum pH

72
Q

Respiratory Acidosis
 Acute problems

A
  • Pneumonia, airway obstruction, chest injuries
  • Drugs that depress the respiratory control center
73
Q

Chronic respiratory acidosis is common with chronic:

A

obstructive pulmonary disease

74
Q

________________ respiratory acidosis may develop if impairment becomes severe or if compensation mechanisms fail

A

Decompensated

75
Q

Metabolic Acidosis

Excessive loss of …
Increased use of …..

A

Excessive loss of bicarbonate ions to buffer
hydrogen
-Diarrhea―loss of bicarbonate from intestines

Increased use of serum bicarbonate

76
Q

Effects of Acidosis

A

Impaired nervous system function
-Headache, lethargy, weakness, confusion, coma and death

Compensation
-Deep rapid breathing
-Secretion of urine with a low pH

77
Q

Respiratory alkalosis

-Hyperventilation
* Caused by ?
* ______________ tumor

A

Hyperventilation
* Caused by anxiety, high fever, overdose of aspirin
* Head injuries
* Brainstem tumor

78
Q

Metabolic alkalosis - Increase in …?
* Loss of _____________ from stomach
* Hypokalemia
* Excessive ingestion of:

A

Increase in serum bicarbonate ion
* Loss of hydrochloric acid from stomach
* Hypokalemia
* Excessive ingestion of antacids

79
Q

Effects of Alkalosis

Irritability of the:

A

Increased irritability of the nervous system causes:

Restlessness
Muscle twitching
Tingling and numbness of the fingers
Tetany
Seizures
Coma

80
Q

Treatment of Imbalances

A

-Treatment of underlying cause
-Immediate corrective measures to include fluid and electrolyte replacement or removal
-Caution is required when adjusting fluid levels to
ensure appropriate electrolyte balance.
-Addition of bicarbonate to the blood to reverse acidosis
-Modification of diet to maintain better electrolyte balance

81
Q

Buffers are like hydrogen ion sponges-
they will

A

soak up or release hydrogen ions depending on pH

[resists changes in pH]

82
Q

Potassium’s function is to maintain :

A

heart and muscle contraction

83
Q

With hyperkalemia, heart will be:

A

tight and contracted

[as well as GI tract & neuromuscular]

84
Q

With hypokalemia, heart will be:

A

low and slow

[as well as muscular and GI]

85
Q

3 functions of sodium

maintain blood __________
maintain blood __________
___ balance

A

maintain blood pressure
maintain blood volume
pH balance

86
Q

Main signs of hypernatremia (high blood sodium) include

A

Flushed skin + edema
Polydipsia (thirst)
Late serious sign- swollen dry tongue, GI sx + increased muscle tone

87
Q

Main signs of hyponatremia (low blood sodium)

A

Depressed & Deflated

Neuro= Seizures/coma
Heart- Tachycardia/ weak pulse
respiratory arrest

88
Q

Symptoms of hyperchloremia (high chloride) are very similar to those of

A

high sodium

[same with hypo - low]

89
Q

Magnesium function is to maintain law and order in the :

A

muscles

90
Q

Calcium is important for: (3)

A

blood
bones
heart beat

91
Q

Phosphate works inversely to

A

calcium

92
Q

what are the 3 major triggers for renin release?

RAAS

A

decreased blood pressure
sympathetic nerves
low salt in DCT

93
Q

Angiotensinogen is a precursor for

A

angiotensin 1 > 2

94
Q

______________ is the final hormone that gets your blood pressure to go up

A

Aldosterone

95
Q

Aldosterone comes from the _________ glands

A

adrenal

[sits on top of kidneys]

96
Q

Triggers for aldosterone production

A

angiotensin 2

dehydrated > decreased urination
~low blood volume
~elevated potassium K+ (hyperkalemia)

Pathophysiology (23 decks)

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