Fluid Regulation and Electrolytes

Question 1

intake comes from 2 main sources

Answer 1

Ingestion (food and drink) – Obviously the main way
Metabolic byproduct of carbohydrate oxidation (small amount)

Question 2

There are 4 main sources of daily loss of body water

Answer 2

• Insensible loss – Diffusion through skin and respiratory evaporations
  Not precisely regulated
• Sweat
• Feces
• Urine

Question 3

For an average adult male (70 kg), total body water is ___% of total weight

Answer 3

60

Question 4

There are two main body compartments for fluid

Answer 4

Intracellular Fluid
Extracellular Fluid

Question 5

The Extracellular Fluid compartment can be further broken down into

Answer 5

Interstitial Fluid
Plasma

Question 6

The composition of the extracellular and intracellular compartments must be ____ in order for various cellular functions to occur

Answer 6

significantly different

Question 7

The Extracellular fluid has high concentrations in _____

Answer 7

Sodium, Chloride, and somewhat high in Bicarbonate

Question 8

The composition of the Extracellular fluid is carefully regulated by the ____ to ensure proper concentration for cell function

Answer 8

kidneys

Question 9

The Intracellular fluid has concentrations higher in ___

Answer 9

Potassium, Phosphate, Protein, and a little higher levels of Magnesium

Question 10

A very important feature of the fluid compartments is the ability of ____ between the intracellular and extracellular compartments

Answer 10

fluid exchange

Question 11

The forces that help to drive the fluid into or out of the cell is that of _____

Answer 11

osmolarity – maintaining an Osmotic Equilibrium

Question 12

Isotonic

Answer 12

When the osmotic pressure is the same outside the cell as it is inside, no fluid shift is necessary

Question 13

If there is a rapid increase in the water volume of the extracellular fluid, osmotic pressures drive some of that fluid into the cells, causing _____

Answer 13

cell swelling (hypotonic)

Question 14

If there is a rapid loss of water content in the extracellular fluid, osmotic pressures drive fluid from inside the cell to outside, causing the cell to _____

Answer 14

shrink (hypertonic)

Question 15

Managing the extracellular fluid volume is determined mainly by the balance between _____

Answer 15

sodium intake and output

Question 16

ADH is secreted during times of ____, which results in reabsorption of water in the nephron tubules

Answer 16

water deficits

Question 17

There are two main variables the kidney can use to manage sodium and water excretion

Answer 17

Glomerular Filtration
Tubular Reabsorption

Question 18

Essentially all of the intravascular sodium is filtered into the ____ system

Answer 18

tubular

Question 19

____ and ____ are two hormones that trigger increased sodium reabsorption when necessary

Answer 19

Angiotensin II; Aldosterone

Question 20

A laboratory measurement that is readily available to the clinician for evaluating a patient’s fluid status is the ____

Answer 20

serum Sodium concentration

Question 21

When plasma sodium concentration is less than 135 mEq/L, the patient is said to have ___

Answer 21

Hyponatremia

Question 22

On the other hand, if sodium is greater than 145 mEq/L, the patient is said to have ____

Answer 22

Hypernatremia

Question 23

Decreased serum sodium concentration can result from what two things

Answer 23

Loss of sodium from the extracellular fluid
Addition of excess water in the extracellular fluid

Question 24

A primary ____ of sodium usually results in hyponatremia and dehydration and is associated with ____ extracellular volume

Answer 24

loss; decreased

Question 25

What is Syndrome of Inappropriate Antidiuretic Hormone (SIADH) is common associated with?

Answer 25

Hyponatremia

Question 26

Signs and symptoms of brain swelling due to hyponatremia

Answer 26

Nausea with or without vomiting
Malaise and/or headache
Decreased level of consciousness
Seizures
Coma

Question 27

Increased serum sodium concentration in hypernatremia can result from

Answer 27

Loss of water from the extracellular fluid
Excess sodium in the extracellular fluid – more common

Question 28

A primary loss of water usually results in ____

Answer 28

hypernatremia and dehydration and can be associated with Diabetes Insipidus

Question 29

Commonly, hypernatremia occurs secondary to addition of ___ to extracellular fluid, which ultimately results in overhydration

Answer 29

excessive sodium

Question 30

During hypernatremia, the extracellular fluid is ____

Answer 30

hyperosmolar

Question 31

T/F Edema can be intracellular or extracellular

Answer 31

T

Question 32

Swelling within the cells of the body can occur with 3 conditions

Answer 32

Hyponatremia
Depression of the metabolic processes of the tissues
Lack of adequate nutrition to the cells

Question 33

What is Anoxic Brain Injury an example of?

Answer 33

Intracellular edema

Question 34

There are two means of extracellular edema development

Answer 34

Failure of lymphatics to return fluid back to the blood
Abnormal leakage of fluid from the plasma across capillaries

Question 35

Blockage of lymph return can result in _____ edema

Answer 35

non-pitting edema

Question 36

Abnormal leakage of fluid from the plasma into interstitial spaces across the capillaries can result from several disease processes and is often seen clinically as ____ edema

Answer 36

pitting

Question 37

Increased hydrostatic pressure, decreased oncotic pressure, and/or increased capillary permeability can lead to ____

Answer 37

edema

Question 38

_____ are those spaces that can occur between two adjacent anatomic structures that are normally pressed together

Answer 38

Potential spaces

Question 39

Examples of potential spaces

Answer 39

Pleural cavity
Synovial cavities
Pericardial cavity
Peritoneal cavity

Question 40

When fluid accumulates in potential spaces, we call it ____

Answer 40

Effusion
Except peritoneal (Ascites)

Question 41

There are two types of Effusions

Answer 41

Transudative
Exudative

Question 42

_____ are composed mostly of fluid from the plasma, with little to no protein

Answer 42

Transudative Effusions

Question 43

____ Effusions are composed of plasma with high levels of protein

Answer 43

Exudative

Question 44

____ is the predominant intracellular ion

Answer 44

Potassium

Question 45

Secretion of Potassium by special cells called ____ occurs in the late distal tubules and collecting ducts

Answer 45

Principal Cells

Question 46

Active secretion of potassium requires a 2-step process

Answer 46

• Sodium-Potassium pump on the basolateral membrane pulls potassium into the cell, creating a gradient
• Passive diffusion of potassium out of the cell into the tubule

Question 47

What hormone works on these Principal cells to increase Potassium secretion when needed, and also increases Sodium (and water) reabsorption

Answer 47

Aldosterone

Question 48

99% of Calcium is stored in ____

Answer 48

our bones

Question 49

Parathyroid hormone is an important regulator of serum _____

Answer 49

Calcium levels

Question 50

__% of filtered Calcium is reabsorbed from the tubules and __% excreted

Answer 50

99; 1

Question 51

About 85% of our total body ____is stored in the bones with calcium

Answer 51

phosphate

Question 52

Most filtered ____ is reabsorbed, but if necessary, large amount can be excreted

Answer 52

magnesium