Chapter 6: Fluid, Electrolyte, and Acid–Base Homeostasis Flashcards
(94 cards)
1
Q
Intracellular fluid
A
inside the cells
2
Q
Extracellular fluid
A
fluid outside the cells
3
Q
Interstitial fluid
A
between the cells
4
Q
Intravascular fluid
A
inside the blood vessels
5
Q
Tonicity
A
osmotic pressure of two solutions separated by a semipermeable membrane
6
Q
Isotonic
A
equal solute concentrations, causes no fluid shifts
7
Q
Hypotonic
A
lower solute concentrations, cell swells
8
Q
Hypertonic
A
higher solute concentrations, cell shrinks
9
Q
Fluid movement
A
Isotonic, Hypotonic,
Hypertonic
10
Q
Fluid compartment
A
Intracellular fluid, Extracellular fluid, Interstitial fluid, Intravascular fluid
11
Q
Fluid Sources
A
Oral intake
12
Q
Intravenous solutions
A
Isotonic – 0.9% saline, lactated ringers, Hypotonic – 0.45% saline, Hypertonic – 5% dextrose in 0.9% saline, 3% saline
13
Q
Fluid Loses
A
In Urine, Feces, Insensible losses (Through skin, respiratory tract)
14
Q
Thirst mechanism
A
Triggered by decreased blood volume and increased osmolarity
15
Q
Antidiuretic hormone
A
Promotes reabsorption of water in the kidneys
16
Q
Aldosterone
A
Increases reabsorption of sodium and water in the kidneys
17
Q
Atrial natriuretic peptide (ANP)
A
Stimulates renal vasodilatation and suppresses aldosterone, increasing urinary output
18
Q
Edema
A
fluid in the interstitial space
19
Q
Hypervolemia
A
fluid in the intravascular space
20
Q
Water intoxication
A
fluid in the intracellular space
21
Q
Manifestations of Fluid Excess
A
peripheral edema, periorbital edema, anasarca, cerebral edema
22
Q
Treatment for Fluid Excess
A
administering diuretics
23
Q
Causes of Fluid Excess
A
Excessive sodium or water intake, and Inadequate sodium or water elimination
24
Q
Fluid Deficit
A
Dehydration, Decreased fluid in the intravascular space
25
Causes of Fluid Deficit
Inadequate fluid intake, and Excessive fluid or sodium losses
26
Manifestations of Fluid Deficit
thirst, altered level of consciousness, hypotension, tachycardia, weak pulse
27
Treatment for Fluid Deficit
fluid replacement
28
Electrolyte Balance
cations, anions
29
Cations
Positively charged electrolytes
30
Anions
Negatively charged electrolytes
31
Sodium
Most significant cation and prevalent electrolyte of extracellular fluid
32
Hypernatremia
Results in fluid shifts
33
Causes of Hypernatremia
Excessive sodium ingestion,
Hypertonic IV saline (3% saline) administration,
Cushing’s syndrome,
Corticosteroid use, Deficient water, Vomiting, Diarrhea
34
Manifestations of Hypernatremia
headache, seizures, lethargy, coma, blood pressure changes, tachycardia,
35
Treatment for Hypernatremia
fluid replacement, and diuretics
36
Hyponatremia
Sodium < 135 mEq/L
37
Manifestations of Hyponatremia
diminished deep tendon reflexes, muscle weakness, seizures, and coma
38
Causes of Hyponatremia
Deficient sodium, Insufficient aldosterone levels, Excessive water, Renal failure, Syndrome of inappropriate antidiuretic hormone
39
Chloride
Major extracellular anion, Found in gastric secretions, pancreatic juices, bile, and cerebrospinal fluid
40
Hyperchloremia
Increased chloride intake or exchange: hypernatremia, hypertonic intravenous solution, metabolic acidosis, and hyperkalemia
Decreased chloride excretion: hyperparathyroidism, hyperaldosteronism, and renal failure
41
Hypochloremia
Decreased chloride intake or exchange: hyponatremia, 5% dextrose in water intravenous solution, water intoxication, and hypokalemia
Increased chloride excretion: diuretics, vomiting, metabolic alkalosis, and other gastrointestinal losses
42
Potassium
electrical conduction
43
Hyperkalemia
Deficient excretion, and Excessive intake: oral potassium supplements
44
Manifestations of Hyperkalemia
paresthesia, flaccid paralysis, bradycardia, dysrhythmias, electrocardiogram changes, cardiac arrest, respiratory depression, abdominal cramping, nausea, and diarrhea
45
Diagnosis of Hyperkalemia
electrocardiogram
46
Hypokalemia
Increased shift into the cell: alkalosis and insulin excess, Excessive loss, Deficient intake
47
Manifestations of Hyperkalemia
muscle weakness, paresthesias, hyporeflexia
48
Calcium
Mostly found in the bone and teeth
49
Calcium regulated by
Vitamin K, Parathyroid hormone, Calcitonin
50
Calcium plays a role in?
blood clotting, hormone secretion, receptor functions, nerve transmission, and muscular contraction
51
Hypercalcemia
Increased intake or release, Deficit excretion
52
Manifestations of Hypercalcemia
electrocardiogram change, confusion, renal calculi
53
Hypocalcemia Excessive losses
hypoparathyroidism, renal failure, hyperphosphatemia
54
Manifestations of Hypocalcemia
dysrhythmias, electrocardiogram changes, increased bleeding tendencies, Trousseau’s and Chvostek’s signs
55
Acid-Base Balance
Normal serum pH 7.35-7.45, Body fluids, kidneys, and lungs maintain balance
56
Sodium and potassium relationship
have an inverse relationship; thus, when one goes up, the other goes down.
57
Calcium and phosphorus relationship
have an inverse relationship
58
Calcium and magnesium relationship
have a synergistic relationship, so one enhances the other.
59
pH reflects hydrogen concentrations
The more hydrogen, the lower the pH
60
3 systems work to maintain acid-base balance
the buffers, respiratory system, and renal system
61
4 major blood buffer mechanisms
The bicarbonate-carbonic acid system, The phosphate system, The hemoglobin system, The protein system
62
Key players in Bicarbonate-Carbonic Acid System
Carbonic acid and bicarbonate
63
Carbonic anhydrase causes?
carbonic acid to separate into hydrogen and bicarbonate
64
Carbonic anhydrase in the lungs allows for?
carbon dioxide excretion and in the kidneys allows for hydrogen excretion
65
Bicarbonate-Carbonic Acid System
Most significant in the extracellular fluid
66
Phosphate System
intracellular fluid, primarily occurs in the kidneys by accepting or donating hydrogen
67
Hemoglobin System
in the capillaries, taking up extra hydrogen, Binding with oxygen makes hemoglobin more prone to release hydrogen
68
Protein System
Most abundant buffering system
69
Albumin in plasma
is the primary buffer in the intravascular space
70
pH Regulation
Respiratory Regulation, Renal Regulation
71
Respiratory Regulation
Responds quickly, but is short-lived
72
Renal Regulation
Alters the excretion or retention of hydrogen or bicarbonate, Responds slowly, but longer lasting
73
CO2 is an?
acid
74
If the problem causing the pH imbalance originates in the lungs
the kidneys initiates efforts to correct it
75
If the problem causing the pH imbalance originates outside the lungs
the lungs initiate efforts to correct it
76
Metabolic Acidosis
Results from a deficiency of bicarbonate or an excess of hydrogen, pH below 7.35
77
Metabolic Acidosis causes
Bicarbonate deficit, Acid excess
78
Bicarbonate deficit
intestinal and renal losses
79
Acid excess
tissue hypoxia resulting in lactic acid
80
Manifestations of Metabolic Acidosis
Kussmaul’s respirations
81
Metabolic Acidosis treatment
Intravenous bicarbonate, correction of electrolyte disturbances, improving oxygenation
82
Metabolic Alkalosis
Results from excess bicarbonate or deficient acid or both (remember, this is opposite of metabolic acidosis)
83
Metabolic Alkalosis causes
Excess bicarbonate, Deficient acid
84
Treatment for Metabolic Alkalosis
adequate hydration, correcting electrolyte disturbances, Diamox, arginine hydrochloride, and administering a weak hydrochloric acid solution
85
Respiratory Acidosis
Results from carbon dioxide retention, which increases carbonic acid, result in hypoventilation
86
Respiratory Alkalosis
Results from excess exhalation of carbon dioxide, which leads to carbonic acid deficits (opposite of resp. acidosis), result in hyperventilation
87
Respiratory Alkalosis Treatment
breath into a paper bag, mechanical ventilation, and anxiety reduction strategies
88
pH
serum hydrogen concentration
89
PaCO2
partial pressure of carbon dioxide
90
HCO3
bicarbonate
91
PaO2
partial pressure of oxygen
92
Base excess/deficit
Indicates serum buffer concentration, particularly bicarbonate
93
Positive values
indicate an excess of base or a deficit of acid
94
Negative values
indicate a deficit of base or an excess of acid
