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Chemistry > Electrolytes and Acid Base Balance > Flashcards

Electrolytes and Acid Base Balance Flashcards

(72 cards)

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1
Q

Definition of Electrolytes

A

Substance that ionize (dissociates) in blood stream and body fluids

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2
Q

Examples of Electrolytes

A

Acids (H+)
Bases (HCO3-, PO4-2)
Inorganic Salts (K+, Na+, Cl-)
Mineral Ions (Mg2+, Fe2+, Fe3+, Ca2+)

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3
Q

Electrolytes Function

A

Maintain osmotic pressure of body fluid compartments
Regulate osmotic movement of H2O
Acid-Base Regulation
Found in tissues
Co-enzymes
Neuromuscular reactions

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4
Q

Imbalances in Electrolytes Caused By

A

Vomiting
Diarrhea
Sweating
Kidney Loss
Hormonal Imbalance
Acid-Base Imbalance
Tissue Destruction

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5
Q

Electrolyte Panel Ordered

A

Called “lytes”
Na+
K+
Cl-
HCO3- (noted as TCO2 on Blood Gas Report)
Calculated by Anion Gap

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6
Q

Sodium Function

A

Create Osmotic Pressure
Most Abundant in ECF - Major Extracellular cation
Essential for electrical activity of neurons and muscle cells

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7
Q

Hormonal Regulation of Na and H2O

A

Aldosterone
- controls Na+ reabsorption by kidneys
Juxtaglomerular apparatus turns on renin-angiotensin system

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8
Q

Decrease Aldosterone Production

A

Addison’s Disease

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9
Q

Increase Aldosterone Production

A

Cushing’s Disease

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10
Q

Hyponatremia

A

Decreased Plasma Na+
Associated with regulation of blood volume
Skin turgor, Venous Pressure, and Urine Na+ concentration

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11
Q

Hypovolemic Depletion Hyponatremia

A

Result of excess Na loss and excess H20 loss

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12
Q

Renal Loss Hypovolemic

A

Diuretics
Primary or secondary Addison’s disease

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13
Q

Non-renal loss Hypovolemic

A

GI loss from vomiting or diarrhea
Skin loss from burns or trauma

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14
Q

Hypervolemic Dilutional Hyponatremia

A

Relative change in measured Na+ due to increased H2O volume
- Syndrome of inappropriate ADH secretion
- Generalized edema (congestive heart failure, cirrhosis, nephrotic syndrome)
- Uncontrolled diabetes (high blood glucose) mellitus

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15
Q

Hypernatremia

A

Increased Plasma Sodium
Result of excess water loss or Na+ gain (rare)

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16
Q

Fluid loss of Hypernatremia

A

Loss of fluid by: GI tract, excessive sweating, hromone disorder
Diabetes insipidus

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17
Q

Absolute Na+ Gain Hypernatremia

A

Ingestion or infusion of NaCl or NaHCO3
Hyperaldosteronism
Acute Renal Failure

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18
Q

Function of Potassium

A

Creates Osmotic pressure in ICF
Must abundant cation in ICF
- Major Intracellular Cation
Electrical activity of neurons and muscle cells
Hydrogen Ion buffering

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19
Q

Kidney-Aldosterone Regulation Potassium

A

Decreased Plasma concentration by increasing rate of K+ secretion in the proximal convoluted tubules and duct
Cellular breakdown increase K+ released
Tied to H+ during metabolic acidosis

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20
Q

Effect of K+ on Heart

A

Increased plasma slows heart rate by decreasing resting membrane potential of heart
Decreased extracellular, causes myocardial excitability

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21
Q

Critical high K+ levels

A

Cause Cardiac shutdown
Too much Potassium

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22
Q

Critical low K+ levels

A

Causes arrythmia

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23
Q

Hypokalemia

A

Decreased plasma K+

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24
Q

Causes of Hypokalemia

A

Excessive GI loss, N-G tube, diarrhea, and laxative abuse
Renal losses hyperaldosteronism, renal tubular acidosis
Decreased dietary intake
Increased cellular uptake in alkalosis
Insulin excess

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25
Symptoms of Hypokalemia
Muscle weakness Cardia arrhythmia Paralysis
26
Hperkalemia
Increased plasma K+
27
Causes of Hyperkalemia
Increased dietary intake Increased tissue destruction Altered cellular uptake in acidosis Insuling deficiency Impaired renal excretion in renal problems & hypoaldosteronism
28
False Cause of Hyperkalemia
Hemolyzed blood sample
29
Symptoms of Hyperkalemia
Muscle weakness Slow or irregular pulse EKG changes Tingling
30
Chloride Function
Most abundant anion in ECG - Major extracellular anion Moves in and out of cells passively in association with Na+ Helps regulate osmotic pressure and thus H2O balance Helps regulate electric neutrality Component of HCl in gastric juice
31
Chloride balance
Passively follows Na+ Acid base balance and electric neutrality within the body - Cl- ion shift is secondary to Na+ and HCO3- movement Ingested in diet and absorbed in intestines
32
Hypochloremia
Decreased plasma Cl- levels
33
Causes of Hypochloremia
GI losses in prolonged comiting & nasogastric suction Loss from traumatized skin in burns Renal losses with diuretics Metabolic acidosis
34
Hyperchloremia
Increased Plasma Cl- levels
35
Causes of Hyperchloremia
Dehydration Renal Tubular Acidosis Metabolic acidosis from prolonged diarrhea Loss of NaHCO3 Salicylate Intoxication (Aspirin)
36
Sweat Chloride Test
Screening for Cystic Fibrosis Characterized by excessive mucus secretion causing lung and upper respiratory obstruction & blockage Increase of Na+ and Cl- in sweat
37
Sweat Chloride Test Measured
Pilocarpine Iontophoresis
38
Bicarbonate Function
Major component of bicarbonate buffer system - 2nd largest anion found in ECF Acid base balance as component of bicarbonate - Carbonic acid buffer system
39
Bicarbonate Balance
Kidney reabsorption Lungs - control through respiration
40
Decreased HCO3-
Results in Metabolic Acidosis
41
HCO3- Primary metabolic acidosis
Buffered during diabetes Renal disease Lactic acidosis Other acidic conditions
42
Increased HCO3-
Results in Metabolic Alkalosis
43
HCO3- Primary metabolic alkalosis
Due to medications
44
Anion Gap Formula
Na - (Cl + HCO3)
45
Anion Gap <7
Low anion gap Instrument error Patient Condition - Multiple myeloma w/ pos charged abnormal proteins - Very rare
46
Anion Gap >16
High anion gap Instrument error Patient Condition - Diabetic ketoacidosis - Lactic acidosis - Renal azotemia and retention of acids
47
Acid-Base Balance
State of equlibrium pH is maintained regardless of metabolic stressors on the body
48
Acid-Base Balance Maintained BY
Controlling hydrogen concentrations of body fluids pH within a narrow range 7.35 - 7.45
49
Hydrogen Ion homeostasis
Dependent on - Bod buffer systems - Respiratory mechanisms - Renal function
50
Acid Production Metabolism
Krebs Cycle - ATP +H2O +CO2
51
Acid Production Metabolic Pathways
H+ + Anions Excess H+ can be excreted or retained by kidneys
52
Body's Buffer Systems
Prevent rapid, drastic changes in pH Maintains pH consistancy Consists of a pair of chemicals
53
Carbonic Acid-Bicarbonate Buffer System
CO2 + H2O = H2CO3 = HCO3- + H+ Most abundant buffer system buffer system in the ECF
54
Chloride Shift
Occurs inside RBCs Way of buffering H+
55
Carbonic Acid-Bicarbonate Buffer Kidneys Role
HCO3- is reabsorbed along with Na+ for H+ under normal circumstances Acidosis - this exchange increases Alkalosis - this exchange is retained and more HCO3- is excreted
56
Phosphate Buffer System
Important in intracellular fluid and in urine Weak base is monohydrogen phosphate (HPO4)2- Weak Acid is dihydrogen phosphate (H2PO4-)
57
Protein Buffer System
Proteins are most important in buffering inside cells Hgb is especially good buffer Weak Base is Amine Group (NH2) Weak Acid of carboxyl group (-COOH)
58
Hendersohn Hasselbalch Equation
pH = pKa + log (HCO3-/H2CO3)
59
Respiratory Acidosis Signs
Increased pCO2 and decreased pH
60
Common Cause of Respiratory Acidosis
Hypoventilation - retention of CO2 in blood stream - Emphysema - Pulmonary edema - Trauma to respiratory center - Airway obstruction (choking or asthma) - Dysfunctional respiratory muscles - Pneumonia - Barbiturate poisoning
61
Metabolic Acidosis Signs
Decreased Bicarbonate and decreased pH
62
Common Cause of Metabolic Acidosis
- Loss of body bicarbonate due to diarrhea - Accumulation of acid from increased production - Retention due to decreased renal function - Diabetic ketosis - Lactic Acidosis - Renal failure -Ethylene glycol poisoning - Methanol ingestion
63
Respiratory Alkalosis Signs
Decreased pCO2 and increased pH
64
Common Cause of Respiratory Alkalosis
Anything that makes patient breath faster Hyperventilation - Oxygen deficiency - Pulomonary disease - Cerebral Vascular accident (CVA) - Anxiety - Fever - Aspirin Overdose
65
Metabolic Alkalosis Signs
Increased bicarbonate and increased pH
66
Common Cause of Metabolic Alkalosis
- Loss of acid (vomiting or Gastric suctioning) - Diuretic therapy - Hyperaldosteronism or Cushing's Disease - Excessive intake of alkaline drugs - Citrate toxicity after massive transfusion
67
Respiratory Compensation
Occurs in response to altered pH caused by metabolic changes
68
Respiratory Mechanisms for Compensation
Hypoventilation Hyperventilation -Occurs within minutes and maximized within hours
69
Blood Hydrogen Ion Concentration
Increase activates chemoreceptors in the medulla oblongata - stimulates respiratory center - Nerve impulses to respiratory muscles which contract more forcefully - increases exhalation of CO2
70
Metabolic Compensation
Occurs in response to altered pH caused by respiratory changes
71
Metabolic Mechanisms for Compensation
Kidney excretion Compensation begins in minutes but takes days to maximize
72
Renal Compensation
Renal tubules raised blood pH by - secretion and excretion of H+ - reabsorption of filtered HCO3- - synthesis and absorption of newly formed HCO3- - Formation of NH4+ (ammonium)

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