Chapter 3 Review Q&A

Question 1

***Infants are more susceptible to significant losses in TBW

Answer 1

Kidney are not mature enough to deal with fluid losses

Question 2

Infants are more susceptible to change in water because they have

Answer 2

High metabolic rate

Greater total body surface area in proportion to total body size

Question 3

**Obesity creates a greater risk for dehydration in people because

Answer 3

Adipose cells contain little water because Fat is WATER REPELLANT

Question 4

There is a lot/little body water in adipose tissue

Answer 4

Little

Question 5

***Water movement between the intracellular fluid compartment and the extracellular fluid compartment is primarily function of

Answer 5

OSMOTIC forces

Question 6

***In addition to OSMOSIS, what is the force involved in the movement of water between the plasma and interstitial fluid space?

Answer 6

HYDROSTATIC PRESSURE

Question 7

Water moves between the plasma and interstitial fluid through the forces of ________and _______Accross the ________ ________

Answer 7

Osmosis
Hydrostatic pressure
Capillary membrane.

Question 8

What does oncotic pressure do?

Answer 8

encourage water to cross the barrier of capillaries to enter the circulatory system.

Question 9

**Venous obstruction is a cause of edema because of an increase in which pressure?

Answer 9

CAPILLARY HYDROSTATIC PRESSURE

Question 10

Venous obstruction can increase the hydrostatic pressure of fluid in the ________enough to cause fluid to escape into the ________Space

Answer 10

Capillaries; interstitial spaces

Question 11

***At the arterial end of capillaries , fluid moves from the intravascular space into the interstitial space because the

Answer 11

Capillary HYDROSTATIC pressure is HIGHER than the capillary ONCOTIC PRESSURE

Question 12

***Low plasma albumin causes edema as a result of a reduction in which

Answer 12

PLASMA ONCOTIC pressure

Question 13

What is the ONLY thing that leads to a decreased in plasma oncotic pressure?

Answer 13

Decrease ALBUMIN

Question 14

***Secretion of the ADH hormone and the perception of thirst are stimulated by?

Answer 14

INCREASED IN PLASMA OSMOLALITY

Question 15

***Thirst activates osmoreceptors by an increase in which in BLOOD PLASMA?

Answer 15

OSMOTIC PRESSURE

Question 16

Thirst is experienced when water loss equals ____% of body weight or when ______ ______Increases

Answer 16

2%; Osmotic pressure

Question 17

What are the osmo-receptors? what are they stimulated by ?

Answer 17

Neurons in the hypothalamus stimulated by INCREASED IN OSMOTIC PRESSURE

Question 18

***It is true that natriuretic peptides: { in/de BP, water and sodium retain/excrete)

Answer 18

Decreased BP and Increase sodium and water EXCRETION

Question 19

What are the 3 different natriuretic peptides and where are they produced?

Answer 19

Atria natriuretic peptide : atria of myocardium
BRAIN natriuretic peptide (BNP) produced in ventricles of myocardium
URODilatin: Produced in the kidneys.

Question 20

***When changes in total body water are accompanied by proportional change in electrolytes, what type of alteration occurs?

Answer 20

ISOTONIC

Question 21

**Which enzymes is secreted by the JUXTAGLOMERULAR Cells of the kidney when circulating blood volume is reduced?

Answer 21

RENIN

Question 22

RENIN is released in response to (para/symp) _________ nerve stimulation and (incre/decr) __________ perfusion to the renal vasculature.

Answer 22

Sympathetic

decreased

Question 23

**What mechanism cause hypernatremia?

Answer 23

HYPERSECRETION OF ALDOSTERONE

Question 24

Cushing syndrome can also cause hypernatremia because of the oversecretion of ________hormone which also leads to oversecretion of _________

Answer 24

ACTH; ALDOSTERONE

Question 25

For hypernatremia, during cardiac arrest, the inappropriate administration of ________Saline solution such as _____ ______may lead to ___________

Answer 25

Hypertonic Sodium bicarbonate Hypernatremia

Question 26

***What causes the clinical manifestations of confusion, convulsion, cerebral hemorrhage and coma in hypernatremia?

Answer 26

HIGH SODIUM in the blood vessels pulls water OUT OF THE BRAIN CELLS, causing BRAIN CELLS TO SHRINK.

Question 27

Water follows

Answer 27

SODIUM

Question 28

***Vomiting induced metabolic alkaloiss, resulting in the loss of chloride causes

Answer 28

RETENTION of sodium bicarbonate to maintain the anion balance

Question 29

When vomiting with the depletion of ECF and chloride causes ACID LOSS, renal compensation is

Answer 29

NOT effective

Question 30

Loss of electrolytes such as Na+, K+, H+ and Cl- stimulate a paradoxic response by the ______. What does the kidney do?

Answer 30

kidneys ; it increases sodium and bicarbonate reabsorption with the excretion of HYDROGEN

Question 31

***The PATHOPHYSIOLOGIC process of edema is related to which mechanism

Answer 31

LYMPHATIC OBSTRUCTION

Question 32

***Insulin is used to treat HYPERKALEMIA because it:

Answer 32

Transport potassium from the blood to the cell along with

Question 33

What does insulin do to regulate potassium?

Answer 33

stimulate the sodium-potassium pump.

Question 34

***A major determinant of the resting membrane potential necessary fro the transmission of nerve impulse is the ration between

Answer 34

INTRACELLULAR and EXTRACELLULAR POTASSIUM

Question 35

*** During acidosis (ELEVATED HYDROGEN IONS), the body compensates for the increase in serum HYDROGEN IONS by shifting hydrogen ions into the cell in exchange for which electrolyte

Answer 35

POTASSIUM

Question 36

therefore, because of the shift of electrolyte during acidosis: ACidosis and ______ often occur together

Answer 36

HYPERKALEMIA

Question 37

****2 Causes of hyperkalemia include?

Answer 37

Renal Failure and Addison disease

Question 38

*** In hyperkalemia, what change occurs to the cell's resting membrane

Answer 38

HYPOPOLARIZATION (depolarization)

Question 39

****The Calcium and phosphate balance is influenced by which three substances?

Answer 39

Parathyroid hormone Calcitonin Vitamin D

Question 40

**** It is true that kussmaul respiration indicate

Answer 40

a compensatory mechanism is needed to correct metabolic acidosis.

Question 41

****Chvostek and trousseau sing indicate which electrolyte imbalance

Answer 41

HYPOCALCEMIA

Question 42

*** An excessive use of magnesium-containing antacids and aluminum containing antacids can results in

Answer 42

HYPOPHOSPHOTEMIA

Question 43

What are the most common cause of hypophosphatemia

Answer 43

Intestinal malabsorption | Increased renal excretion of phosphate

Question 44

****the most common cause HYPERMAGNESEMIA is

Answer 44

Renal Failure

Question 45

***Physiologic pH is maintained at approximately 7.4 because bicarbonate (HCO3) and carbonic acid exist in a rtion of

Answer 45

20:1

Question 46

***Which arterial pH will initiate the formation of ammonium (NH4) from ammonia (NH3) referred to ACADEMIA, in the tubular lumen of the kidney

Answer 46

7.25

Question 47

***Two thirds of the body's water is found in its

Answer 47

INTRACELLULAR FLUID Compartments

Question 48

One third of the body's water is in

Answer 48

extracellular fluid

Question 49

What are the 2 main ECF compartments

Answer 49

Interstitial | Intravascular

Question 50

***It is true that when insulin is administered

Answer 50

the liver increases its potassium levels

Question 51

*** Increased capillary hydrostatic pressure results in edema because of

Answer 51

SODIUM and WATER RETENTION

Question 52

INCREASED CAPILLARY HYDROSTATIC PRESSURE is a result of

Answer 52

VENOUS OBSTRUCTION | SODIUM AND WATER RETENTION

Question 53

***The existence of hyperkalemia is likely to result in which changes to a patient's ECG?

Answer 53

Peaked T-waves

Question 54

ECG changes in hyperkalemia

Answer 54

Peaked Twaves Prolonged PR interval Absent p-wave widened QRS

Question 55

***Which groups are at risk for sodium imbalanced (select all that apply)

Answer 55

Infant Obese Older adults

Question 56

****3 Dehydration can cause which result?

Answer 56

Weak pulses Tachycardia weight loss

Question 57

*** 2 Causes of Hypocalcemia included

Answer 57

Repeated blood administration | Pancreatitis

Question 58

What is a common cause of hypocalcemia? Why?

Answer 58

Blood transfusion ; because the citrate solution used in storing whole blood binds with calcium.

Question 59

How does pancreatitis cause HYPOCALCEMIA?

Answer 59

it causes a release of lipase into the soft tissue spaces; the free fatty acids that are formed bind calcium, causes a decrease in ionized calcium.

Question 60

****The electrolyte imbalance called hyponatremia exhibits which clinical manifestations?

Answer 60

Headache Seizure Confusion Lethargy

Question 61

****The electrolyte imbalance called HYPERCALCEMIA exhibits which clinical manifestations?

Answer 61

Calcium based kidney stones Lethargy Bradycardia

Question 62

ECG changes with HYPERCALCEMIA

Answer 62

Shortened QT segment | Depressed widened T Waves

Question 63

******The electrolyte imbalance called HYPOKALEMIA exhibits which clinical manifestations? (PAS)

Answer 63

Paralytic Ileus SInus Bradycardia AV block

Question 64

****A third of the body's fluid is contained in the extracellular interstitial fluid spaces that include (select all that apply):

Answer 64

Urine Intraocular fluids Lymph Sweat

Question 65

****An imbalance of potassium can produce with dysfunction?

Answer 65

Weakness skeletal muscles Cardiac dysrhythmias Smooth muscle atony

Question 66

***Which statement regarding total body water are true? (select all that apply)

Answer 66

During childhood, TBW slowly decreases in relationship to body weight Men tend to have greater TBW as a result of their muscle mass Estrogen plays a role in female TBW Older adults experience a decrease in TBW as a result of decreased muscle mass

Question 67

****__________Regulates osmolality in the ECF space

Answer 67

Sodium

Question 68

****________Is inversely related to HCO3 concentration

Answer 68

Chloride

Question 69

****_________is a major determinant of resting membrane potention

Answer 69

Potassium

Question 70

Chloride levels are _______related to HCO3 concentration

Answer 70

Inversely

Question 71

***_________ an intracellular metabolic form is ATP

Answer 71

Phosphate

Question 72

****Changes in Hydrogen ion concentration affects this electrolyte

Answer 72

Potassium

Question 73

THE MOST DANGEROUS EFFECT OF HYPERKALMIA is on which organ

Answer 73

HEART

Question 74

Categorize causes of edema: Tumor grows in lymph node

Answer 74

Lymphatic obstruction

Question 75

Categorize causes of edema: Right HF

Answer 75

Increased Capillary hydrostatic pressure

Question 76

Categorize causes of edema: Infected wound

Answer 76

Increased CAPILLARY PERMEABILITY

Question 77

Categorize causes of edema: CLOT In vein

Answer 77

INCREASED HYDROSTATIC PRESSURE

Question 78

Categorize causes of edema: PROTEIN MALNUTRITION

Answer 78

Decreased Plasma oncotic pressure

Question 79

Categorize causes of edema: Bee sting

Answer 79

INCREASED CAPILLARY PERMEABILITY

Question 80

Categorize causes of edema: ESRD

Answer 80

INCREASED CAPILLARY HYDROSTATIC PRESSURE

Question 81

The renal compensation for an acid-base balance is

Answer 81

SLOW

Question 82

The pulmonary compensation for an acid-base balance is

Answer 82

FAST

Question 83

Acid-base imbalance correction

Answer 83

returns HCO3 and carbonic acid buffers to normal levels.

Question 84

Acid-base imbalance compensaiton

Answer 84

returns HCO3 and carbonic acid buffers to the 20:1 ratio but BOTH MAY STILL BE ABNORMAL.

Question 85

A buffer is a _____ and its _____

Answer 85

weak acid; conjugate base

Question 86

When pH is 7.40 , the bicarb to carbonic acid ratio is

Answer 86

20:1

Question 87

***paCO 2 is proportional to is proportional to

Answer 87

VCO2 / VA • where: VCO2 is CO2 production by the body VA is Alveolar ventilation

Question 88

Calculate AG with this formula

Answer 88

Na- (Cl+HCO3)

Question 89

Calcitonin, secreted with _____calcium and what does it do in bone?

Answer 89

HIGH; inhibits osteoclasts in bone.

Question 90

What stimulates increase secretion of ADH:

Answer 90

Increased plasma osmolality decreased arterial blood pressure INCREASES renal water reabsoprtion, vasoconstriction

Question 91

Angiotensin II and increased plasma potassium stimulates

Answer 91

increase renal sodium and water reabsorption | increase renal excretion of potassium and hydrogen ions.

Question 92

In adult female percentage of water is

Answer 92

50

Question 93

Not a component of ECF

Answer 93

RBCs

Question 94

In adult male percentage of water is

Answer 94

60

Question 95

Major INTRACELLULAR cation

Answer 95

Potassium

Question 96

Anions in HIGHEST concentration in the EXTRACELLULAR

Answer 96

Proteins Bicarbonate Chloride

Question 97

Which hormones plays a CENTRAL role in rate of SODIUM REABSORPTION and POTASSIUM SECRETION?

Answer 97

ALDOSTERONE>

Question 98

Which hormone MOST affects OSMOLARITY of BLOOD

Answer 98

ADH

Question 99

Hormones released by heart muscles in response to EXCESSIVE CHAMBER VOLUME

Answer 99

Natriuretic Peptides

Question 100

_____ECF fluid and __/3 ICF

Answer 100

1 third | 2 thirds

Question 101

The release of ATRIAL NATURETIC PEPTIDES from the heart will cause the body to

Answer 101

Excrete sodium ions and decreases ECF.

Question 102

Angiotensin II produces a coordinated elevation in ECF by: 4 mechanisms NOT BY : INcreasing

Answer 102

1.Stimulate thirst 2.Causing release of ADH 3.trigger production and secretion of Aldosterone 4.Stimulate kidney to conserve sodium NOT BY INCREASING PNS ACTIVITY.

Question 103

ALDOSTERONE does what?

Answer 103

promote sodium retention in the kidneys

Question 104

Principal ions in ECF are (3)

Answer 104

Sodium Chloride Bicarbonate

Question 105

Promotes WATER REABSORPTION at the kidneys and STIMULATES THIRST

Answer 105

ADH

Question 106

Principal ions in ICF are (3)

Answer 106

Potassium Magnesium Phosphate

Question 107

When water is lost, but electrolytes are retained?

Answer 107

OSMOSIS moves water from the ICF to the ECF.

Question 108

When pure water is consumed

Answer 108

OSMOLARITIES of the ICF and ECF fall.

Question 109

Exchanged between 2 main subdivisions of ECF occurs primarily at the

Answer 109

CAPILLARIES

Question 110

Typical water losses and gains each day

Answer 110

2500ml

Question 111

Calcium reabsorption by the kidneys is promoted by the hormone

Answer 111

PTH

Question 112

Chemical that minimizes changes in pH of a body by releasing or binding HYDROGEN ions

Answer 112

Buffer

Question 113

Excess hydrogen ions is eliminated from the body largely by

Answer 113

KIDNEYS

Question 114

Primary role of Carbonic acid bicarbonate buffer system

Answer 114

Limit pH changes caused metabolic and fixed acids

Question 115

Hypoventilation leads to

Answer 115

respiratory acidosis

Question 116

What does the kidney do in response to RESPIRATORY ALKALOSIS

Answer 116

Kidney retain more hydrogen ions.

Question 117

A person with emphysema with exhibit sings of

Answer 117

Chronic respiratory acidosis

Question 118

Poorly controlled DM- acid base balance

Answer 118

Metabolic acidosis

Question 119

Which best fits acid-base metabolic alkalosis

Answer 119

PROLONGED VOMITING

Question 120

A person consuming large amount of sodium bicarbonate to settle upset stomach is at risk for

Answer 120

METABOLIC ALKALOSIS

Question 121

Severe Kidney damage often leads to

Answer 121

Metabolic acidosis

Question 122

Which best fits acid-base RESPIRATORY ACIDOSIS

Answer 122

Reduced Alveolar ventilation

Question 123

When the pH of the ECF drops, kidney will

Answer 123

secretes more hydrogen ions, and fewer bicarbonate

Question 124

Which best fits acid-base RESPIRATORY ALKALOSIS

Answer 124

Cause by HYPERVENTILATION

Question 125

A drowinng victim will most likely experience

Answer 125

ACute RESPIRATORY ACIDSOSIS

Question 126

Excessive loss of bicarb such as diarrhea

Answer 126

Metabolic acidosis

Question 127

The elderly have ____water content in the body

Answer 127

less

Question 128

Potassium rise in ______ patients. As potassium rise, Hydrogen secretions rises

Answer 128

Acidosis

Question 129

In which body fluid do the phosphate and protein buffer system help regulate the ph

Answer 129

INTRACELLULAR

Question 130

What is the kidney response to alkalosis caused by the removal of H+? What is the lung response to Metabolic acidosis ?

Answer 130

CONSERVE H+ SECRETE HCO3 -Lung increase respiratory rate.