Flashcards in Chapter 3 Deck (50)
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1
The lower percentage of TBW in females correlates with higher percentage of _____?
Adipose tissue and lower muscle mass
2
Where can you find 80% water percentage in TBW?
Newborns
3
Extracellular water is ____%
And is divided into _____(5%) and ____(15%)
20% , plasma , interstitial fluid
4
Intracellular water makes up how many percent of the TBW? And where is the largest proportion found?
40% skeletal muscle mass
5
What are the principal anions of the intracellular compartment? And the principal cations?
Anion: K+ and Mg+
Cation: phosphates, proteins from muscles and sulfates
6
What is the principal anion of the ECF? What are the principal cations?
Anion: sodium
Cation: Cl- and HCO3-
7
Concentration gradient between the ICF and ECF compartments is maintained by???
ATP driven NA/K+ pump
8
The physiologic activity of electrolytes depends on?
Number of particles per unit volume
Number of electric charges per unit volume
Number of osmotically active ions per unit volume
9
What are the principal determinants of osmolality?
Sodium
Glucose
Urea
10
Daily water loss in the stool?
250ml
11
Daily water loss in the urine?
800-1500ml
12
Daily water insensible loss?
600ml
13
To excrete metabolic products, kidneys must excrete a minimum of _____ of urine per day
500-800ml, regardless of the amount of oral intake
14
Disorders in fluid balance? (Classification)
Disturbance in:
Volume
Concentration
Composition
15
Acute volume deficit is associated with?
Cardiovascular and central nervous system signs
16
Chronic deficits display what in addition to cardiovascular and central nervous signs?
Turgor, sunken eyes and tissue signs
17
What is the most common source of volume deficit in surgical patients?
Loss of GI fluids
18
Volume changes are senses by?
Osmoreceptors and Baroreceptors
19
Are specialized sensors that detect even the smallest changes in fluid osmolality and drive changes in thirst and kidney diuresis
Osmoreceptors
20
What are the cardiac signs that occur if there is a volume deficit?
Tachycardia
Orthostasis
Hypotension
Collapsed neck veins
21
What are the generalized signs that occur if there is an excess in volume?
Weight gain
Peripheral edema
22
Changes in serum sodium concentration is ____proportional to TBW
Inversely
23
An excess in extracellular water relative to sodium
Hyponatremia
24
For every 100mg/dl of glucose above normal, sodium decreases by how many mEq/L?
1.6 mEq/L
25
What causes pseudohyponatremia?
Extreme elevations in plasma lipids and proteins
26
In the absence of renal disease, this is associated with low urine sodium
Depletional cause of hyponatremia
27
This shows increased sodium levels in the urine
Renal sodium wasting
28
This type of cause related hyponatremia is associated with hypovolemia in circulation
Dilutional
29
Loss of free water or gain of sodium in excess of water
Hypernatremia
30
This type of hypernatremia is caused by iatrogenic administration of sodium containing fluids
Hypervolemic hypernatremia
31
Can result from renal causes, diabetes insipidus, diuretic use or renal disease
Normovolemic hypernatremia
32
Sodium concentration of
Hyponatremia
33
Average intake of potassium is?
50 to 100 mEq/day
34
Renal excretion of potassium?
10-700 mEq
35
Above the normal range of potassium which is 3-5 to 5 mEq/L
Hyperkalemia
36
ECG changes in hyperkalemia
High peaked T waves
Widened QRS complex
Flattened P wave
Prolonged PR interval
Sine wave formation
Ventricular fibrillation
37
Potassium decreases by _____ with ___ increase in pH
0.3 mEq/L , 0.1
38
ECG changes in hypokalemia
U waves
T-waves flattening
ST segment changes
Arrythmias
39
Water constitutes how many % of the total body weight?
50% to 60%
40
Earliest sign of volume overload is?
Weight gain
41
Should be considered in patients who are euvolemic and hyponatremic with elevated urine sodium levels and urine osmolality
SIADH
42
Manifests dilute urine in the case of hypernatremia
Diabetes insipidus
43
Lethal condition that can occur with rapid and excessive feeding of patient with severe underlying malnutrition
Refeeding syndrome
44
Serum calcium
Is distributed among 3 forms and how many %
Ionized form 60%
Attached to phosphate ions 10%
Protein found 40%
45
Adjust calcium levels down by ___ mg/dL for every ___ g/dL decrease of albumin
0.8
1
46
What is the daily calcium
Intake?
1-3 g/d
47
Compute for the total amount of fluid needed for fluid therapy of a 70 kg man
1000 for 1st 10 kilo
500 for 2nd 10 kilo
1000 for thr last 50 kilos
48
What is the mechanism
Of action of kayexelate
Secretes potassium
In exchange with sodium
For hyperkalemia
49
Common cause of severe acidosis is
Lactic acidosis
50
