final: fluid balance Flashcards
(153 cards)
1
Q
what is total body water dependent on?
A
function of age, body mass, sex and amount of body fat
2
Q
does total water content decrease or increase throughout the lifetime
A
decrease
3
Q
what % of total body water is there for elderly
A
45
4
Q
total body water for infants
A
75
5
Q
for infants the total weight includes
A
water, low body fat, low bone mass
6
Q
total body water for males
A
60
7
Q
males have more what and less what
A
more skeletal muscle and less fat
8
Q
total body water for females
A
50
9
Q
why is females body water lower
A
due to higher body fat and smaller skeletal muscles
10
Q
what is the least hydrated tissue with low water content 20%
A
adipose
11
Q
what fraction of volume is intracellular fluid compartment
A
2/3
12
Q
what does the intracellular fluid contain
A
all fluid inside the body cells and cytoplasm
13
Q
what percent is the ICF of the body’s H2O
A
70
14
Q
ICF is what percent of the body’s total weight
A
40
15
Q
what fraction of volume is the ECF compartment
A
1/3
16
Q
what percent is the ECF of the body’s H2O
A
30
17
Q
what percent is the ECF if the body’s total weight
A
20
18
Q
what does the ECF include
A
plasma and interstitial fluid
19
Q
what is plasma
A
blood fluid and it links internal and external environments
20
Q
what is IF
A
between cells
21
Q
what does other ECF include
A
lymph
CSF
eye humors
synovial fluid
serous fluid
GI secretions
22
Q
what is compartmental exchange regulated by
A
osmotic and hydrostatic pressure
23
Q
what is hydrostatic pressure
A
pressure any fluid in a confined space exerts, due to force of gravity
24
Q
what is osmotic pressure
A
amount of force applied to solution that prevents solvent from moving across semipermeable membrane
25
what is osmosis
movement of solvent from lower concentration of solutes to more concentrated
26
is the total osmotic pressure in each compartment equal of unequal
=
27
since the osmotic pressure is equal in each compartment what does it allow for
continuous exchange of H2O and electrolytes between compartments
28
where is the exchange between plasma and IF
capillary walls
29
what of bloof forces plasma out of blood into interstitial space
hydrostatic pressure
30
once blood goes to interstital space, what happens
it is reabsorbed into bloodstream via colloid osmotic pressure of plasma proteins
31
what picks up IF and return it to blood
lymph capillaries
32
where is the exchange between IF and ICF
plasma membranes
33
the exchange between IF anf ICF is a 2 way what
osmotic flow of water
34
ions move via what across the plasma membranes
ative transport or channels
35
nutrients, resp gases, wastes move in what way
1 direction
36
water intake= water output to do what
maintain hydration
37
alteration in total water volume has effect on what?
body fluid solute
38
water intake can be from
fluids, food, cell metabolism
39
what is output of water
insensible water loss and sensible water loss
40
what is insenible water loss
expires air vapor
41
what is sensible water loss
measureable via urine, perspiration and feces
42
what detects ECF osmolality via PM stretch changes from gain/ loss of water
osmoreceptors
43
what happens when you have dry mouth
blood osmotic pressure increases because there is less saliva
44
decreased BV/BP triggers what
thirst by baroreceptors detecting changes in volume or pressure
45
when is the hypothalamus thirst center problematic
during athletic activity
elderly/ confused
renal/ CV patients (fluid overload)
46
what do you need in order to survive
water intake
47
obligatory water loss is from what
insensible and sensible water loss
48
what do kidneys do after ingestion
excrete xs water
49
there is a delay of fluid output why?
due to the time needed to inhibit ADH release
50
when does diuresis peak
1 hour after drinking
51
when does diuresis decrease
lowest at 3 hours
52
low ADH=
adequate diluted urine
53
high ADH=
small amount of concentrated urine produced
54
what other hormones are involved in fluid output
angiotensin, aldosterone, ANF role
55
what are water balance disorders
dehydration, edema, hypotonic hydration
56
can profuse sweating for xs time cause water balance disorders
yes
57
what is dehydration
when loss exceeds intake over time and creates a neg fluid balance
58
when can dehydration occur
after hemorrhage, severe burns, xs diarrhea, vomiting, profuse sweating, water deprivation, diuretic abuse, DI and DM
59
early signs of dehydration
cottony oral mucosa
thirsty
dry flushed skin
decreased urinary output
60
later signs of dehydration
weight loss
fever
mental confusion
hypovolemic shock
61
what is edema
swelling- atypical accumulation of fluid in interstitial space (tissue swelling)
62
what is hypotonic hydration
water intoxication
63
explain hypotonic hydration
overconsume water and electrolyte becomes xs diluted
64
when does hypotonic hydration occur
after overexertion in hot conditions (marthon runners)
65
plain water causes what
Na plasma to drop
66
sudden and sever drop of Na results in
hyponatremia
67
when a patient is unconscious with hypotonic hydration what do you need
IVF of hypertonic solutioins
68
what do you need in hypotonic hydration if xs vomit and diarrhea
fluid replacement
69
water into the cells and swell causing what
increased intracranial pressure
70
symptoms of hypotonic hydration
severe H/A
confused
nausea
muscle cramps
seizure
coma and death
71
prevention for hypotonic hydration
fluids with electrolytes
72
treatment for hypotonic hydration
administer IV hypertonic saline- reverse osmosis gradient pull H2O out of cells
73
what are the six essential electrolytes
k
PO
Ca2
Cl
Mg
Na
74
what are the functions of the 6 essential electrolytes
1. balance blood pH levels
2. facilitate waste excretion from cells
3. maintains fluid balance
4.promotes proper functioning of nerve, muscle, heart, and brain cells
5. transport nutrients into cells
75
what are electrolytes
chemical compounds that dissociate into ions in h2o
76
due to the ions being charged particles it ?
conducts electrical current
77
what are the category of electrolytes
inorganic salts
inorganic and organic acids and bases
some proteins
78
electrolytes have increases what?
osmotic power due to dissociation into at least 2 ions
79
what do electrolytes cause
fluid shifts, influences movement of h2o from lesser to high osmolality
80
how are electrolytes consumed
food and water we ingest
81
how are electrolytes removed
kidneys
liver
skin
lungs
82
when does the concentration of electrolytes change
when individual is growing and gaining weight
83
roles of electrolytes
control fluid movements
provide minerals for excitability
secretory activity
membrane permeability
84
sodium is the most abundant....
cation in the ECF
85
what is the primary role in sodium
control ECF volume and water distribution in the body
86
what follows NaCl
water
87
when ECF Na increases what happens to na and ecf volume
decrease Na
increase ECF volume
88
when BP is elevated what happens to na and ecf volume
they both decrease
89
when BP is low what happens to na and ecf volume
both increase
90
Overdilution of Blood due to xs H2O consumed post exercise
Mental Confusion, Seizures & Coma
Solute loss, Water retention (Vomit, Diarrhea, Burned skin, xs Diuretics)
If also Water loss = Decreased BV & BP
hyponatremia
91
Due to xs Aldosterone secretion Pulmonary Edema & Muscle Convulsions
May be caused by Dehydration. Causes thirst, Confusion, Lethargy, Coma
hypernatremia
92
chloride is the predominant...
anions of the ecf
93
what is the regulation for chloride
since Na is the predominant cation, Cl follows it in regulation
94
Due to xs sweat/diuresis/vomiting/diarrhea. Low salt intake/SIADH (xs retention).
May indicate Heart Failure or Addison’s
hypochloremia
95
Indication of Dehydration, Also with High blood Na+ (Cushing Syndrome),
Kidney disease
hyperchloremia
96
K is the chief what?
intracellular cation
97
K is tightly regulated meaning
it is critical in determining RMP for electrically excitable cells
98
K is regulated by aldosterone secretion which means
elevated k causes aldosterone secretion which increases Na reabsorption and K secretion (via sodium potassium pump in DCT)
99
Due to xs K+ Secretion due to xs Elevation of Aldosterone, Aldosterone increases
rate of K+ Secretion & decreases K+ in Blood. Also due to Insulin Administration,
which activates Na+ - K+ Pump, which decreases extracellular K+ Low K+ Levels
Fatigue, Muscle cramps or Temporary Paralysis. Due to water pills/diuretics
hypokalemia
100
Due to Renal disease = Less Renal Excretion Intestinal Cramping, Diarrhea & Temporary
paralysis.
hyperkalemia
101
what plays a role in exocytosis, muscle contraction, regulation AP in cardiac muscle and blood clotting
Ca
102
what are the three sites for ECF Ca regulation
kidney
gi tract
bones
103
99% calcium where
in the bone
104
how do u regulate Ca
deposit into and reabsorption from bone
105
what is long term regulation of calcium
maintaining balance between absorption across intestine wall and excretion by kidneys
106
Ca is regulated by what 3 hormones
PTH
vitamin d
calcitonin
107
what does PTH increase
blood calcium via osteoclasts
renal tubule resorption
vitamin d absorb in SI
108
what does calcitonin do
decrease blood calcium, inhibits osteoclasts, preventing bone breakdown
109
= Affects PM permeability to Sodium, causing Nerve & Muscle tissue to spontaneous AP- muscle tetany
hypocalcemia
110
Prevents depolarization of Nerve & Muscle cells. Deposit CaCO3 salts in soft tissues
Irritation & Inflammation. Can lead to Cardiac arrhythmias.
hypercalcemia
111
85% of phosphate is found where
bone and teeth
rest is in cells
112
role of phosphate
bind to lipids, proteins and carbs: components of DNA, RNA, ATP; regulate enzyme activity, and act as a buffer
113
Due to Vitamin D deficiency, Alcohol abuse Decreased Blood clotting & WBC function
hypophosphatemia
114
Due to Acute & Chronic Renal Failure, due to decreased Filtrate by Kidneys.
Also due to chronic laxative use, Prolonged elevation cause Calcium Phosphate
deposit in joints, lungs, kidneys.
hyperphosphatemia
115
where is Mg stored
bones or ICF
116
Due to Alcohol abuse Muscle weakness & muscle convulsions.
Also Insulin Resistance & Chronic Diarrhea, Severe malnutrition, Diuretic therapy. Cramps.
hypomagnesemia
117
Rare. Due to Renal Failure Nausea, Hypotension & Low RR.
Also due to chronic laxative use, xs ingestion of Antacids, OR Magnesium intake.
Prolonged elevation cause Calcium Phosphate deposit in joints, lungs, kidneys
hypermagnesemia
118
which is rare hyper or hypomagnesemia
hyper
119
consequences of hypermagnesemia
Consequences may include Lethargy, impaired CNS functioning, Coma, Respiratory
depression & Cardiac arrest.
120
lower pH is due to?
greater amounts of acidic metabolites and CO2, which combines with H2O to form H2CO3
121
acid-base balance regulates what
pH of fluid
122
relationship between pH level and H concentration are...
inverse
123
lower the pH the greater what?
H concentration
124
what do acids do
release H into solution
125
what do bases do
remove H from solution
126
what do buffers do
prevent extreme changes in pH of solution
127
hydrogen ion concentration in blood is regulated sequentially by?
1. chemical buffers
2. brain stem respiratory centers
3. renal mechanisms
128
1st line of defense to resist pH changes
is due to chemical buffers
129
what does the brain stem respiratory center do
change RR and depth to compensate for acidosis and alkalosis
130
what buffer is the respiratory and renal mechanism considered
physiological buffer
131
what is slower acting, chemical or respiratory and renal
respiratory and renal
132
what immediately resists pH changes in body fluids
chemical buffer systems
133
what system is a short term response to acid-base balance changes and usually takes a few minutes to correct pH abnormality
respiratory system
134
what system is long term, significant response to acid-base balance changes
hours to days to alter body fluid pH
renal system
135
what are the 3 chemical buffer systems
carbonic acid/ bicarbonate buffer
protein buffer
phosphate buffer
136
what is the ECF buffer
carbonic acid/ bicarbonate
137
what is the hemogloin and plasma protein buffer
protein buffer
138
what is the urine and ICF buffer
phosphate
139
chemical buffer systems have an important role in?
regulation of extracellular pH
140
chemical buffers have limited capacity to...
resist pH changes
141
is carbonic acid strong or weak
weak
142
when H is added to soltuion what happens
it adds to bicarbonate to form carbonic acid to prevent decrease in pH
143
when H is removed from the solution what happens
carbonic acids forms bicarb to resist change in pH when alkaline is added to body fluids
144
how does the protein buffer system work
it acts as a buffer due to the amino acid functional group and acts as a weak acid and base
as H concentration increases more H binds to func group but when it decreases more H is released
144
what is an important ICF buffer
phosphate
145
when pH decreases in phosphate what happens
ions bind H
146
when pH increases in phosphate what happens
opposite between gaining and losing H to balance pH
147
what system works with carbonic acids/ bicarbonate system
resp
148
as CO2 increases which way does it shift
right
149
as CO2 decreases which way does it shift
left
150
what system is regulated by renal tubule cells
renal
151
renal system increases when
pH of body fluids increase
152
when pH increases in renal system what happens
H secretion slows
