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ASforP > Fluids electrolyte and acid base imbalances > Flashcards

Fluids electrolyte and acid base imbalances Flashcards

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1
Q

What substances can pass freely through the cellular membrane?

A

Water
Hydrogen ions
Carbon dioxide
Oxygen

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2
Q

What are the four main ways fluid and solutes can move across membranes?

A

Filtration - movement of water down pressure gradients
Diffusion - movement of solutes down concentration gradient
Osmosis - movement of water up solute concentration gradient
Active transport - Solute using carrier energy

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3
Q

What is tonicity?

A

The ability of an extracellular solution to make water move into or out of a cell by osmosis

Hypertonic solutions will cause a net flow of water out of the cell

Hypotonic solutions will cause a net flow of water in to the cell

Isotonic solutions will have no effect.

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4
Q

What is osmolarity?

A

Osmolarity describes the total concentration of solutes in a solution.

A solution with a low osmolarity has fewer solute particles per liter of solution, while a solution with a high osmolarity has more solute particles per liter of solution.

When solutions of different osmolarities are separated by a membrane permeable to water, but not to solute, water will move from the side with lower osmolarity to the side with higher osmolarity.

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5
Q

What is an electrolyte?

A

An atom which carries a charge when dissolved in water.

Inorganic molecules (which may have no charge) split into their constituent electrolytes when dissolved in water e.g. NaCl to Na+ and Cl-

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6
Q

What is the importance of sodium in fluid balance?

A

Sodium is one of the most abundant cations in the body, it regulates water exchange between intracellular and extracelluar spaces. “Where sodium goes, water follows”.

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7
Q

What is the importance of sodium in acid base balance?

A

It forms a component of the circulating buffer, sodium bicarbonate.

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8
Q

How do blood buffers regulate pH?

A

They are solutions that resist dramatic changes in pH when large amounts of solutes are added with a neutralising reaction taking place in the same solution.

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9
Q

What are the symptoms of hyponatraemia?

A

Anorexia, nausea, cramps
Fatigue, lethargy, muscle weakness
Headache confusion, seizures
Hypotension

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10
Q

What are the symptoms of hypernatraemia?

A

Thirst, dry and sticky tongue/mucosa
Weakness, lethargy, agitation
Oedema
Hypertension

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11
Q

Where is most potassium in the body found?

A

98% is found inside the cells

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12
Q

What are the functions of potassium?

A

Neuromuscular function and converting glucose into glycogen

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13
Q

What are cellular potassium levels regulated by?

A

Insulin

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14
Q

What is the sodium potassium pump assisted by?

A

Insulin and adrenaline

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15
Q

What can hypokalaemia cause?

A

Decrease in skeletal muscle function
GI disturbances
Alterations in cardiac rythym

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16
Q

What can hyperkalaemia cause?

A

Hyperstimulation of neural cell transmission potentially leading to cardiac arrest

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17
Q

What is the principle cation needed for bone growth?

A

Calcium

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18
Q

What are the function of calcium other than bone regulation?

A

Assists in the functioning of heart muscle, nerves and cell membranes
Assists with blood clotting

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19
Q

How does hypocalcaemia affect nerve cells?

A

Leads to overstimulation causing:
Skeletal muscle cramps
Abdominal cramps
Carpal-pedal spasms
Hypotension
Vasoconstriction

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20
Q

How does hypercalcaemia affect nerve cells?

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A

Understimulation leading to:
Skeletal muscle weakness
Lethargy
Ataxia
Vasodilation (flushed skin)

21
Q

What is the primary buffer used in all body fluids?

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A

Sodium bicarbonate

22
Q

What is the purpose of chloride?

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A

Mainly responsible for regulation of stmach pH
Also contributes to regulation of extracellular fluid balance

23
Q

Who is dehydration more of a problem for, why?

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A

Children and the elderly as they struggle to replace fluid volume as quickly

24
Q

Why are dehydrated patients not just given water?

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A

Water loss is often accompanied by electrolyte loss, replacing fluids alone is often insufficient.

25
What are the symptoms of moderate dehydration?
Dry mouth Lethargy Muscle weakness Headache Dizziness
26
What are the symptoms of severe dehydration?
Sunken eyes or shrivelled skin Hypotension Tachycardia Delerium Unconsciousness Ultimately death
27
What is acidity?
The acidity of a solution determines its ability to form a reaction with various metals and bases and to produce salts.
28
What is the difference between respiratory acidosis/alkalosis and metabolic acidosis/alkalosis?
Respiratory acidosis/alkalosis stems from an issue with the carbon dioxide produced from respiration i.e. too much or too little Metabolic acidosis/alkalosis stems from an issue with the bicarbonate and hydrogen ion levels in the body i.e. too much or too little In all cases the levels of CO2, HCO and H will change but the definition depends on the route of the cause.
29
How much of the male and female bodies are made of water, why is it different?
Men 63% Women 52% The differences between the sexes is due to the fact that females have more adipose tissue, which contains little water, while males have more muscle tissue, which contains a great deal of water
30
What are the two major compartments fluid is distributed into, and what makes them up?
Intracellular fluid compartment: Cells Extracellular fluid: Interstitial fluid, blood/plasma, lymph
31
What proportion of fluid is distributed in the intracellular and extracellular compartments?
Intracellular - 63% Extracellular - 37%
32
What drives fluid into lymphatic vessels?
Hydrostatic pressure
33
What regulates fluid movement in and out of cells?
Osmosis
34
How does the Na/K pump affect osmosis?
The Na+/K+ Pump results in sodium and potassium ions acting as impermeant solutes, and creates an osmotic pressure
35
What categorises organic molecules?
Carbon atoms (Carbon-hyrogen or carbon-carbon bonds)
36
What types of acids are present in the body?
Fixed acids (Do not leave solution) e.g. sufuric acid, phosphoric acid Organic acids
37
What causes respiratory acidosis?
A decrease in alveolar respiration i.e. an increase in PaCO2, resulting in a decrease in pH and a slight increase in HCO3- For example: Respiratory depression COPD Restrictive lung diseases Airway obstruction Pulmonary oedema Cardiac arrest Neuromuscular issues
38
What causes respiratory alkalosis?
An increase in alveolar respiration **relative to body CO2** i.e. a decrease in PaCO2, resulting in an increase in pH and a decrease in H+ For example: Hyperventilation (e.g. Anxiety) Hypoxaemia Pneumothorax Ventilation-perfusion inequality Hypotension High altitude
39
What causes metabolic acidosis?
A gain in H+ as fixed acid (or loss of HCO3-), resulting in a decrease in pH and HCO3- For example: Increased acid production Bicarbonate loss (e.g. diarrhea) Decreased ability of the nephron to excrete fixed acid
40
What causes metabolic alkalosis?
A loss of H+ as fixed acid (or gain in HCO3-), resulting in an increase in pH and HCO3- For example: Vomiting Loop and thiazide diuretics Barter and Gitelman syndromes (conditions characterized by renal salt-wasting) Intracellular shift of H+ Primary hyperaldosteronism
41
How do adjustments in ventilation create rapid changes to pH?
It produces quick changes in CO2 levels, CO2 can cross membranes rapidly resulting in quick change.
42
How do the kidneys regulate pH?
By changing the rate of H+ and HCO3- secretion and re-absorption in the kidneys (responding to pH changes in the plasma)
43
Why must the pH of the renal tubule be maintained above 4?
A lower pH would allow the H+ to rush back in as fast as it is pumped out
44
What are the dependant and independant variables of body pH?
The body is an almost limitless pool of H ions and bicarbonate ions, **these are not the causes of the change in acidity**. These are dependent variables. Independent variable include: CO2 Total weak acids present (most important one is albumin) Strong Ion difference
45
What is the function of albumin?
Oncotic pressure: Maintains oncotic pressure within the vessels Transport: Facilitates the transport of many other substances (bilirubin, metals, ions, amino acids, free fatty acids, hormones, phospholipids, enzymes) Antioxidant: Albumin is also a free radical scavenger
46
What can cause high albumin?
Infection Burns Stress to the system Dehydration
47
What can cause low albumin levels?
Malnutrition Poor absorption in the GIT Renal losses Inflammatory disorders Long term high dose corticosteroids use Pregnancy Dilution of the blood with IV fluids
48
What are strong ions?
Any anion or cations that completely dissociate in solution

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