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Malnourishment and Obesity > Fluid and Electrolyte Requirements in Disease > Flashcards

Fluid and Electrolyte Requirements in Disease Flashcards

(52 cards)

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1
Q

What is the normal pH range of arterial blood?

A

7.35-7.45

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2
Q

What is the pH of extracellular fluid?

A

7.4

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3
Q

At what pH levels would death occur?

A

less than 6.8

more than 8.0

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4
Q

What pH level classifies as acidosis (acidemia)?

A

below 7.35

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5
Q

What pH level classifies as alkalosis (alkalemia)?

A

above 7.45

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6
Q

What would small changes in pH cause major disturbances to?

A
  • enzyme functions (only function at narrow pH ranges)
  • affect electrolytes (Na+, K+, CL-)
  • affect hormones
  • affect bone synthesis, re-absorption
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7
Q

Which organs help regulate pH and how?

A
  1. Lungs - through carbonic acid-bicarbonate buffer system
    - changing respiratory rates changes PCO2
  2. Kidneys - through renal compensation
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8
Q

Does the body produce more acid or more bases?

A

more acid

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9
Q

Why does the body produce more acid?

A
  • acid taken with food
  • acids produced by metabolism of lipids/proteins
  • cellular metabolism produces CO2
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10
Q

How to calculate pH?

A

pH = - log [H+]

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11
Q

What is buffering?

A

buffer system consist of weak acid and anion

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12
Q

What are the 3 buffering systems?

A
  1. Protein buffer system - amino acids, H+
  2. Carbonic acid-bicarbonate
    - buffer changes caused by organic and fixed acids
  3. Phosphate
    - buffer pH in the ICF
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13
Q

What are the common acids?

A
  • carbonic acid
  • sulfuric/phosphoric acid
  • organic acids
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14
Q

What happens when carbonic acid affects of ECF?

A
  • CO2 reacts with water to form carbonic acid

- inverse relationship between pH and conc of CO2

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15
Q

When is sulfuric/phosphoric acid generated?

A
  • during catabolism of amino acids
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16
Q

What are some organic acids?

A
  • lactic acid

- ketone bodies

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17
Q

Explain protein buffering in terms of pH increasing and decreasing:

A

pH climbs = carboxyl group of amino acid acts as weak base

pH drops = amino group acts as weak base

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18
Q

What does the haemoglobin buffer system do?

A

prevents pH changes when PCO2 is rising or falling

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19
Q

Explain what happens in the carbonic acid-bicarbonate buffer system:

A
  • classic chemical buffer
  • body eliminates chemicals from either end of chemical reaction to maintain pH
  • effective in converting carbonic acid to CO2 through carbonic anhydrase
  • then removes CO2 through respiration
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20
Q

What is the chemical reaction of carbonic-acid-bicarbonate buffer system

A

H+ + HCO3- H2CO3 H2O + CO2

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21
Q

How is the alkali removed when in access?

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A

through kidneys

22
Q

How fast does the buffer function work?

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A

almost instantaneously

23
Q

How fast does respiratory mechanism take to do corrections?

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A

several minutes to hours

24
Q

How fast does renal mechanism take to do corrections?

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A

several hours to days

25
What is the principle effect of acidosis?
depression of CNS through decrease in synaptic transmission
26
What generally happens in acidosis?
- weakness - deranged CNS function = greatest threat - severe state causes: disorientation, coma, death
27
What are the responses to acidosis? (alkalosis is opposite)
- increase respiratory rate to lower CO2 - other buffer systems absorb H+ - secrete H+ in kidneys
28
What does alkalosis cause?
- over excitability of central/peripheral nervous systems - numbness - lightheadedness - can cause: nervousness, muscle spasm, tetany, convulsions, loss consciousness, death
29
What does the Bohr effect observe?
the relationship of Oxyhaemoglobin and pO2
30
When do respiratory acid-base disorders occur?
when abnormal respiratory function cause rise/fall in CO2 in ECF
31
When do metabolic acid-base disorders occur?
- generation of organic or fixed acids - anything affecting concentration of bicarbonate ions in ECF - bicarbonate loss during chronic diarrhea
32
When does respiratory acidosis occur?
from excessive levels of CO2 in body fluids
33
When does respiratory alkalosis occur?
- relative rare condition | - associated with hyperventilation
34
what is hypercapnia?
high levels of CO2 in blood
35
What are chronic conditions of respiratory acidosis?
- depression of respiratory center in brain that controls breathing rate - drugs/head trauma - paralysis of respiratory/chest muscles - emphysema
36
what are the acute conditions of respiratory acidosis?
- adult respiratory distress syndrome - pulmonary edema - pneumothorax
37
What do the kidneys specifically elimate and retain to compensate respiratory acidosis?
eliminate H+, retain bicarbonate ion
38
Respiratory acidosis signs/symptoms:
- breathlessness - restlessness - lethargy, disorientation - tremors, convulsions, coma - respiratory rate rapid then gradually depressed - skin warm, flushed, due to vasodilation from excess CO2
39
Respiratory acidosis treatment?
- restore ventilation - IV lactate solution - treat underlying dysfunction/disease
40
What is hypocapnea?
when pCO2 is less than 35mmHg
41
What is the primary cause of respiratory alkalosis?
hyperventilation
42
What conditions stimulate respiratory centre in regards to respiratory alkalosis?
- oxygen deficiency at high altitudes - pulmonary disease + congestive heart failure by hypoxia - acute anxiety - fever, anaemia - early salicylate intoxication - cirrhosis - gram-negative sepsis
43
Respiratory alkalosis treatment?
- treat underlying cause - breath into paper bag - IV chloride containing solution (Cl- ions replace lost bicarbonate ions)
44
When does metabolic alkalosis occur?
- when HCO3- concentrations become elevated (by repeated vomiting)
45
What are the symptoms of metabolic acidosis?
- headache - nausea - vomiting - coma, death
46
What can be done to compensate metabolic acidosis?
- increase ventilation - renal excretion of H+ - K+ exchange with H+ in ECF - H+ into cells, K+ out of cells
47
Metabolic acidosis treatment?
IV lactate solution
48
What can cause metabolic alkalosis?
- excessive vomiting (lose stomach acid) - excessive use of alkaline drugs - certain diuretics - endocrine disorders - heavy ingestion of antacids - severe dehydration
49
What can be done to compensate metabolic alkalosis?
- can't count on kidneys since it usually occurs with renal dysfunction - hypoventilation limited by hypoxia BASICALLY, NOT MUCH CAN BE DONE???
50
What are the symptoms of metabolic alkalosis?
- respiration = slow/shallow - hyperactive reflexes, tetany - often related to depletion of electrolytes - atrial tachycardia - dysrhythmias
51
Metabolic alkalosis treatment?
- Electrolytes to replace lost ones - IV chloride containing solution - Treat underlying disorder
52
How to diagnose acid-base imbalances?
1. Note pH low or high 2. Decide which values (pCO2 or HCO3-) is outside normal ranges and is the cause of the problem 3. if its change in pCO2 = respiratory problem 4. If change in HCO3- = metabolic problem

Malnourishment and Obesity (21 decks)

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