Ch2 electrolytes Flashcards

(118 cards)

1
Q

the major component of the body is water in these compartments

A

intercellular fluid compartment and extracellular fluid compartment

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2
Q

balance of water in the compartments is essential for

A

homeostasis

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3
Q

What percent of a males body weight is water

A

60

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4
Q

what percent of an infants body weight is water

A

70

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5
Q

who has a higher % of fatty tissue, lower water content than the other sex

A

females

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6
Q

what type of people lower proportion of water

A

older adults and obese people

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7
Q

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

A

any fluid or electrolyte imbalance

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8
Q

what percent of a females body weight is water

A

50

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9
Q

where are transcellular fluids present

A

present in various secretions
pericardial cavity
synovial cavities of joints

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10
Q

the amount of water entering the body should equal the what

A

amount of water leaving the body

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11
Q

what ways is fluid balance controlled

A

thirst mechanisms
antidiuretic hormone
aldosterone
atrial natriuretic peptide

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12
Q

how is the thirst mechanism a control of fluid balance

A

osmoreceptors in the hypothalamus

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13
Q

how does the antidiuretic hormone control fluid balance

A

promotes resorption of water into blood from kidney tubules

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14
Q

how does aldosterone control fluid balance

A

determines resorption of sodium ions and water

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15
Q

how does atrial natriuretic peptide control fluid balance

A

regulates fluid, sodium, and potassium levels

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16
Q

how does fluid circulate throughout the body

A

filtration and osmosis

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17
Q

how does water move between compartments

A

hydrostatic pressure and osmotic pressure

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18
Q

push force

A

hydrostatic pressure

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19
Q

pull force

A

osmotic pressure

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20
Q

movement of water from low solute concentration to high concentration

A

osmosis

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21
Q

movement of water and solutes from blood to ISF area (high to low pressure)

A

filtration

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22
Q

excessive amount of fluid in the interstitial compartment

A

edema

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23
Q

causes swelling or enlargement of tissue
may be localized or throughout the body
may impair tissue perfusion
may trap drugs in ISF

A

edema

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24
Q

what are the four causes of edema

A

increased capillary hydrostatic pressure
loss of plasma proteins
obstruction of lymphatic circulation
increased capillary permeability

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25
what causes increased capillary hydrostatic pressure
by higher blood pressure or increased blood volume | forces increased fluid out of capillaries into tissues
26
increased capillary hydrostatic pressure is a cause for what type of edema
pulmonary
27
what is the result of the loss of plasma proteins
decreased plasma osmotic pressure
28
what is particularly lost in plasma proteins
albumin
29
obstruction of lymphatic circulation causes what type of edema
localized
30
excessive fluid and protein not being returned to the general circulation has to do with what type of cause of edema
obstruction of lymphatic circulation
31
increased capillary permeability can result from what and can lead to what
some bacterial toxins or large burn wounds and results in widespread edema can lead to shock
32
increased capillary permeability usually causes what type of edema
localized
33
may result from an inflammatory response or infection is what type of cause of edema
increased capillary permeability
34
what increases capillary permeability
histamines and other chemical mediators
35
effects of edema
``` functional impairment pain impaired arterial circulation dental practice edema in skin swelling pitting edema increased in body weight ```
36
pale or red in color
swelling
37
presence of excess interstitial fluid moves aside when pressure is applied by finger depression remains when finger is removed
pitting edema
38
restricts range of joint movement reduced vital capacity impaired diastole
functional impairment
39
edema exerts pressure on nerves locally headache with cerebral edema stretching of capsule in organs
pain
40
ischemia leading to tissue breakdown
impaired arterial circulation
41
difficult to take accurate impressions | dentures do not fit well
dental practice
42
susceptible to tissue breakdown from pressure
edema in skin
43
insufficient body fluid either inadequate intake or excessive loss
dehydration
44
fluid loss is often measured by a change in what
body weight
45
dehydration is more serious in who
infants and older adults
46
water loss may be accompanied by what
loss of electrolytes and proteins
47
causes of dehydration
vomiting and diarrhea excessive sweating with loss of sodium and water diabetic ketoacidosis insufficient water intake in older adults or unconscious persons use of concentrated formula in infants
48
loss of fluid, electrolytes, and glucose in the urine
diabetic ketoacidosis
49
effects of dehydration
dry mucous membranes in the mouth decreased skin turgor or elasticity lower blood pressure, weak pulse, and fatigue decreased mental function, confusion, loss of consciousness
50
body compensations for dehydration
increased thirst increased heart rate constrict cutaneous blood vessels-pale, cool skin concentrated urine or less urine
51
lab values of dehydration
increased hematocrit increased electrolytes urine is high specific gravity, low volume
52
lab values of edema
decreased hematocrit decreased serum sodium urine is low specific gravity, high volume
53
fluid shifts out of the blood into a body cavity or tissue and can no longer reenter vascular compartment like burns, inflammation and infection
third-spacing of fluid
54
primary cation in ECF sodium diffuses between vascular and interstitial fluids transport into and out of cells by sodium-potassium pump actively secreted into mucus and other secretions exists in form of sodium chloride and sodium bicarbonate ingested in food and beverages
sodium imbalance
55
causes of hyponatremia
losses from excessive sweating, vomiting, and diarrhea use of certain diuretic drugs combined with low-salt diet hormonal imbalances such as insufficient aldosterone, adrenal insufficiency, excess ADH secretion early chronic renal failure excessive water intake
56
effects of hyponatremia
low sodium levels and decreased osmotic pressure in ECF compartment
57
hyponatremia what effect has to do with fatigue, muscle cramps, abdominal discomfort or cramps, nausea, vomiting impair nerve conduction
low sodium levels
58
hyponatremia what effect has to do with cerebral edema (confusion, headache, weakness, seizures) and fluid shift into cells (hypovolemia and decreased blood pressure)
decreased osmotic pressure in ECF compartment
59
cause of the imbalance in sodium and water of hypernatremia
insufficient ADH results in large volume of dilute urine loss of thirst mechanism watery diarrhea prolonged periods of rapid respiration ingestion of large amounts of sodium without enough water
60
effects of hypernatremia
``` weakness agitation dry, rough, mucous membranes edema increased thirst increased blood pressure decreased urine output because ADH is secreted ```
61
major intracellular cation serum levels are low, with a narrow range ingested in foods excreted primarily in urine insulin promotes movement of this into cells level influenced by acid-base balance excess ions in interstitial fluid may lead to hyperkalemia abnormal levels cause changes in cardiac conduction and are life-threatening
potassium imbalance
62
signs of potassium imbalance in hypokalemia
cardiac arrhythmias, cardiac arrest anorexia, nausea, constipation fatigue, muscle twitch, weakness, leg cramps shallow respirations, parethesias postural hypotension, polyuria, and nocturia serum pH elevated
63
signs of potassium imbalance in hyperkalemia
arrhythmias, cardiac arrest nausea, diarrhea muscle weakness, paralysis beginning in legs paresthesias in fingers, toes, face, tongues oliguria serum pH decreased
64
resting state of semipermeable membrane
polarization
65
stimulates open Na+ channels Na+ moves into cell
depolarization
66
as impulse moves along membrane Na+ channels close and K+ channels open allowing K+ to move outward
repolarization
67
channels close. Sodium-potassium pump returns Na+ outside cell and K+ inside cell
resting state
68
causes of hypokalemia
excessive losses caused by diarrhea diuresis associated with some diuretic drugs excessive aldosterone or glucocorticoids decreased dietary intake such as alcoholism, eating disorders, starvation treatment of diabetic ketoacidosis with insulin
69
effects of hypokalemia
cardiac dysrhythmias caused by impaired repolarization leading to cardiac arrest interference with neuromuscular function paresthesias decreased digestive tract motility
70
effects of severe hypokalemia
shallow respirations | failure to concentrate urine
71
causes of hyperkalemia
renal failure deficit of aldosterone potassium-sparing diuretics leakage of intracellular potassium into extracellular fluids displacement of potassium from cells by prolongs or severe acidosis
72
effects of hyperkalemia
cardiac dysrhythmias muscle weakness: may cause respiratory arrest, progressive to paralysis, and impairs neuromuscular activity fatigue, nausea, paresthesias
73
important extracellular cation ingested in food stored in bone excreted in urine and feces balance controlled by parathyroid hormone and calcitonin Vitamin D promotes absorption from intestine (ingested or synthesized in skin in the presence of UV rays or activated in kidneys
calcium imbalance
74
functions of calcium
provides structural strength for bones and teeth maintenance of the stability of nerve membranes required for muscle contractions necessary for many metabolic processes and enzyme reactions essential for blood clotting
75
causes of hypocalcemia
``` hypoparathyroidism malabsorption syndrome deficient serum albumin increased serum pH level renal failure ```
76
effects of hypocalcemia
increase in the permeability and excitability of nerve membranes (carpopedal spasm and muscle twitching) weak heart contractions (delayed conduction and leads to dysrhythmias and decreased blood pressure)
77
causes of hypercalcemia
uncontrolled release of calcium ions from bones (neoplasms) hyperparathyroidism demineralization caused by immobility (decrease stress on bone) increased calcium intake milk-alkali syndrome
78
what increases calcium intake
excessive vitamin d | excess dietary calcium
79
associated with increased milk and antacid intake
milk-alkali syndrome
80
effects of hypercalcemia
depressed neuromuscular activity (muscle weakness, loss of muscle tone, lethargy, stupor, personality changes, anorexia, nausea) interference with ADH function (less absorption of water and decrease in renal function) increased strength in cardiac contractions (dysrhythmias may occur)
81
results from malabsorption or malnutrition; often associated with alcoholism
hypomagnesemia
82
causes of hypomagnesemia
use of diuretics diabetic acidosis hyperthyroidism hyperaldosteronism
83
hypomagnesemia leads to
neuromuscular hyperirritability, insomnia, personality changes and increased heart rate with arrhythmias
84
occurs with renal failure depresses neuromuscular function decreased reflexes
hypermagnesemia
85
``` bone and tooth mineralization important in metabolism (ATP) acid-base balance integral part of the cell membrane reciprocal relationship with serum calcium ```
phosphate imbalances
86
malabsorption syndromes, diarrhea, excessive antacids neurologic function is impaired blood cells function less effectively
hypophosphatemia
87
from renal failure and same manifestations as hypocalcemia
hyperphosphatemia
88
major extracellular anion | related to sodium levels
chloride
89
what ions can shift in response to acid-base imbalances
chloride and bicarbonate
90
usually associated with alkalosis | early stages of vomiting (loss of hydrochloric acid)
hypochloremia
91
excessive sodium chloride intake
hyperchloremia
92
increased H+ results in
acidosis
93
decreased H+ results in
alkalosis
94
what can modify the excretion rates of acids and absorption of bicarbonate ions to regulate pH
kidneys
95
respiratory system can alter what levels to change pH
carbonic acids
96
what pairs in the blood respond to pH changes immediately
buffer
97
which mechanism is the slowest regarding to controlling the pH
kidneys
98
carbonic acid system major ECF buffer controlled by the respiratory system and kidneys
sodium bicarbonate
99
buffering systems
sodium bicarbonate phosphate hemoglobin protein
100
when does decompensation occur
causative problem becomes more severe additional problems occur compensation mechanisms are exceeded or fail
101
decompensation requires what
intervention to maintain homeostasis
102
is decompensation life threatening
yes
103
is compensation long term or short term
short term
104
compensation occurs to what
balance the relative proportion of hydrogen ions and bicarbonate ions in circulation : buffers, change in respiration, and change in renal function
105
excess hydrogen ions | decrease in serum pH
acidosis
106
deficit of hydrogen ions | increase in serum pH
alkalosis
107
pneumonia, airway obstruction, chest injuries | drugs that depress the respiratory control center
acute problems
108
common with chronic obstructive pulmonary disease
chronic respiratory acidosis
109
may develop if impairment becomes severe or if compensation mechanisms fail
decompensated respiratory acidosis
110
excessive loss of bicarbonate ions to buffer hydrogen increased use of serum bicarbonate renal disease or failure decompensated metabolic acidosis
metabolic acidosis
111
additional factor interferes with compensation
decompensated metabolic acidosis
112
decreased excretion of acids | decreased production of bicarbonate ions
renal disease or failure
113
loss of bicarbonate from intestines
diarrhea
114
what are the effects of acidosis
compensation (deep rapid breathing and secretion of urine with a low pH) and impaired nervous system function (headache, lethargy, weakness, confusion, coma and death)
115
hyperventilation caused by anxiety, high fever, overdose of aspirin, head injuries, and brainstem tumor
respiratory alkalosis
116
increase in serum bicarbonate ion loss of hydrochloric acid from stomach hypokalemia excessive ingestion of antacids
metabolic alkalosis
117
what are the effects of alkalosis
increased irritability of the nervous system causes restlessness, muscle twitching, tingling and numbness of the fingers, tetany, seizures, and coma
118
treatments of imbalance
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