Fluid, Electrolyte, And Acid-Base Balance Flashcards by Brody Nickels

K+, Mg2+, and PO43- are predominant electrolytes in…

Intracellular fluid

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Angiotensin 2 Functions

1)vasoconstriction (constricts BF to kidneys limits its ability ti excrete water)
-keeps more water in blood to ⬆️BV and ⬆️BP

2)➕ adrenal cortex to release aldosterone
-kidneys keep Na+ and H2O in blood
-⬇️ urination

3)➕ posterior pituitary gland to release ADH
-➡️ kidneys keep water and ⬆️BV
-➕ thirst mechanism

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Hypothalamus and ADH

Makes ADH

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Posterior pituitary and ADH

Stores and secretes ADH

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⬆️BV➡️ _ BP

⬆️BP

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RAAS mechanism

1) ⬇️BV➡️ ⬇️ BP
2) juxtaglomerular cells: release Renin into blood circulation
3) liver responds: activates angiotensinogen➡️ angiotensin 1
4) angiotensin-converting enzyme (ACE): turns angiotensin 1➡️ angiotensin 2
5)angiotensin 2
-major vasoconstriction (constricts BF to kidneys, limits its ability to excrete water)
-➕adrenal cortex to release aldosterone
-➕ posterior pituitary gland to release ADH

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Diuretic

Helps pt’s excrete excess fluids in the body

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Thirst mechanism

1) ⬆️osmolality (plasma)
-⬇️fluids, ⬆️solute

2) hypothalamus osmoreceptors respond
-➕ADH release
-thirst sensation experienced

3) kidneys respond
-sense ADH
-ADH causes DCT and CD to transport water
-water is put back into bloodstream and NOT excreted via urine

4) water is retained

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ANP

Hormone release by ♥️ cells due to atrial wall stretching
-works against angiotensin 2
-stops effects of aldosterone, ADH, and renin

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Fixed Acid

“Non-violate”

An acid that cannot be easily expelled from the body through the lungs as gas

Ex. HCl

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Normal pH range

7.35-7.45

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Hypernatremia

Na+ excess: > 145mEq/L

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Hypernatremia causes

-dehydration
-uncommon in healthy individuals
-may occur in infants, elderly, and any individual unable to indicate thirst
-may result from excessive intravenous NaCl administration

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Hypernatremia consequences

-thirst
-CNS dehydration
-confusion
-lethargy
-coma
-⬆️neuromuscular irritability
-twitching
-convulsions

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Hyponatremia

Na+ deficit: <135mEq/L

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Hyponatremia causes

-solute loss
-water retention
-vomiting
-diarrhea
-burned skin
-gastric suction
-⬆️⬆️⬆️use of diuretics
-⬇️aldosterone (Addison’s)
-renal disease
-⬆️⬆️⬆️ADH release
-⬆️⬆️⬆️ H2O ingestion

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Hyponatremia consequences

-neurological dysfunction due to brain swelling
-if body Na+ content is normal but water is excessive, the symptoms are the same as those of water excess
-mental confusion
-giddiness
-coma
-muscular irritability/twitching
-convulsions
-accompanied by water loss: ⬆️BV and ⬆️BP

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Hyperkalemia

K+ excess > 5.5mEq/L

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Hyperkalemia causes

-renal failure
-⬇️aldosterone
-⬆️⬆️⬆️intravenous infusion of KCl
-burns or severe tissue injuries that cause K+ to leave cells

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Hyperkalemia consequences

-nausea
-vomiting
-diarrhea
-bradycardia
-cardiac arrhythmias and arrest
-skeletal muscle weakness
-flaccid paralysis

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Hypokalemia

K+ deficit < 3.5mEq/L

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Hypokalemia causes

-GI tact distrurbances
-vomiting
-diarrhea
-gastric suctions
-cushings syndrome
-inadequate dietary intake (starvation)
-hyperaldosteronism
-diuretic therapy

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Hypokalemia consequences

-cardiac arrhythmias
-flattened T Wave
-muscular weakness
-metabolic alkalosis
-mental confusion
-nausea
-vomiting

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Hyperphosphatemia

HPO42- excess > 2.9mEq/L

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Hyperphosphatemia causes

-⬇️urine loss due to renal failure -Hypoparathyroidism -major tissue trauma -⬆️intestinal absorption

Hyperphosphatemia and hypo phosphatemia consquencds

Clinical symptoms arise b/c of reciprocal changes in Ca2+ levels rather than directly from changes in plasma [HPO42-]

Hypophosphatemia

HPO42- deficit <1.6mEq/L

Hypophosphatemia causes

-⬇️ intestinal absorption -⬆️ urinary output -hyperparathyroidism

Hyperchloremia

Cl- excess > 105mEq/L

Hypercholemia causes

-dehydration -⬆️retention or intake -metabolic acidosis -hyperparathyroidism

Hypochloremia

Cl- deficit < 95mEq/L

Hypochloremia causes

-metabolic alkalosis -due to vomiting or excess ingestion of alkaline substance - ⬇️aldosterone

Hypercalemia

Ca2+ excess > 5.2mEq/L

Hypercalemia cause

-hyperparathyroidism -⬆️⬆️⬆️ Vit D -prolonged immobilization -renal disease (⬇️excretion) -malignancy

Hypercalemia consequences

-⬇️ neuromuscular excitability leading to… -cardiac arrhythmias and arrest -skeletal muscle weakness -confusion -stupor -coma -kidney stones -nausea -vomiting

Hypocalemia

Ca2+ deficit <4.5mEq/L

Hypocalemia causes

-burns (Ca2+ trapped in damaged tissues) -Hypoparathyroidism -⬇️Vit D -renal tubular disease -renal failure -Hyperphosphatemia -diarrhea -alkalosis

Hypocalemia consequences

-⬆️neuromuscular excitability leading to -tingling fingers -tremors -skeletal muscle cramps -tetany -convulsions -depressed excitability of the ♥️ -osteomalacia -fractures

Hypermagnesemia

Mg2+ excess > 2.2 mEq/L

Hypermagnesemia cause

-rare -renal failure when Mg2+ is not excreted normally -⬆️⬆️⬆️ingestion of Mg2+-containing antacids

Hypermagnesemia consequences

-lethargy -impaired CNS functioning -coma -respiratory depression -cardiac arrest

Hypomagenesemia

Mg2+ deficit < 1.4mEq/L

Hypomagnesemia causes

-alcoholism -chronic diarrhea -severe malnutrition -diuretic therapy

Hypomagnesemia consequences

-tremors -⬆️ neuromuscular excitability -tetany -convulsions

The kidneys generate buffer that enter the bloodstream in…

DCT and CD

Avg. % of water in the adult body

60-70%

Suppose the ECF osmolality becomes too high. What hormone would most likely be release to correct this situation?

ADH

T or F: adh secretion can be stimulated by either blood osmolarity changes or bp changes in the heart or large vessels

True

Primary buffer in the plasma

HCO3- buffer system

⬆️in CO2 levels leads to what change in pH.

⬇️ pH

most important renal mechanism for regulating acid-base balance involves

Maintaining HCO3- balance: reabsorption of filtered HCO3- from urine back into blood

Which acid base imbalance would be cause by over accumulation of CO2 in the blood?

Respiratory acidosis

Which of the following does NOT serve as a source of acids in the body? a) aerobic breakdown of glucose b) CO2 in the blood c) fat metabolism d) ingesting of HCO3-

Ingesting of HCO3-

In order to buffer a strong acid into a weak acid, which has a less dramatic effect dramatic effect on pH, what chemical should be used as the buffer?

Weak base

Effects of PTH

-➕kidneys to transform Vit D to its active form -⬆️ intestinal absorption of Ca2+ -to activate bone-digesting osteoclasts

⬆️levels of what hormone would result in ⬇️ in reabsorption in CD in kidneys?

ANP

What results from ⬆️ levels of aldosterone?

⬆️Na+ reabsorption

What type of intravenous intravenous infusion would you give to a runner who has collapsed after drinking too much water during the course of her marathon and why?

Hypertonic saline solution to pull water out of cell

Under normal circumstances, what method does NOT lead to water intake? A) metabolism B) beverages C) osmosis D) food

C. Osmosis

Which of the following would NOT be expected to occur as a result of dehydration? A) edema B) reduced urine flow C) Hypovolemic shock D) shrinkage of body cells

A. Edema

ECF osmolality becomes too high. What hormone would most likely be released to correct this situation?

ADH

Where are signs of change in osmolality, stomach stretch, and thirst monitored?

In the hypothalamus

Which of the following is NOT involved in triggering the thirst mechanism? A) detection of ⬆️osmolality by osmoreceptors B) ⬆️BP C) ⬇️BV D) dry mouth

B. ⬆️BP

Major cation in ECF

Na+

Major anion in ECF

Cl- and HCO3-

Major cations in ICF

K+ and Mg2+

Hypertonic solution

⬆️[solute] outside the cell than inside -water leaves cell➡️cell shrivels -⬆️osmolality -⬇️H2O

Hypotonic solution

⬇️[solute] outside the cell than inside the cell -water enters the cell➡️ cell bloats -⬇️osmolality

Isotonic solution

= distribution of water

Why does the interstitial fluid have ⬇️proteins?

Capillary membrane has pores that allow solute through except for proteins➡️ proteins stay in plasma➡️⬇️proteins in interstitial fluid

Normal Arterial Blood Gas (ABG) values

-pH: 7.35-7.45 -PaCO2: 35-45 mmHg- respiratory -HCO3: 22-26 mEq/L- metabolic -PaO2: 80-100mmHg

Hyperventilation

⬇️CO2 Respiratory alkalosis

Hypoventilation

⬆️CO2 Respiratory acidosis

Fluid, Electrolyte, And Acid-Base Balance Flashcards

(73 cards)