I K (no j or i): Water, electrolytes, acid-base balance

Question 0

what is insensible water loss? how much is it?***

Answer 0

skin, breathing; 0.8-1.2 L per day

Question 1

intracellular vs. intercellular

Answer 1

• intracellular = within cells

- intercellular = type of extracellular fluid, between/around cells

Question 2

what is sensible water loss?

Answer 2

urine = CAN COLLECT IT

Question 3

insensible water loss- easy or difficult to measure?

Answer 3

difficult

Question 4

electrolytes do what in water?

Answer 4

dissociate into ions: cations (+), anions (-)

Question 5

mEq equation***

Answer 5

(mg/atomic weight) x valence

Question 6

atomic weight of Na, K, Ca**

Answer 6

Na = 23
K = 39
Ca = 40

Question 7

valence of Na, K, Ca***

Answer 7

Na = 1
K = 1
Ca = 2

Question 8

concentration of electrolytes is expressed in what unit?***

Answer 8

milliequivalents (mEq)

Question 9

extracellular electrolytes are?***

Answer 9

SODIUM, CALCIUM (also Cl, HCO3 aka bicarbonate)

Question 10

sodium chloride is ___% sodium

Answer 10

40%

Question 11

one tsp salt = 6g or NaCl or ___g sodium

Answer 11

2.4 (2400 mg = 1 tsp salt)

Question 12

sodium is reabsorbed by __________ (hormone) and retained by ______

Answer 12

absorbed by aldosterone and retained by steroids

Question 13

intracellular electrolytes?***

Answer 13

POTASSIUM, magnesium, phosphorous

Question 14

sources of potassium*****

Answer 14

meat, fruits, vegetables (banana, orange, tomato, potato, cantaloupe)

Question 15

sources low in potassium***

Answer 15

apple, cranberry, blueberry, carrot, corn

Question 16

aldosterone (increases/decreases) excretion of potassium

Answer 16

increases

Question 17

normal range for the following: ***

• sodium
• potassium
• calcium

Answer 17

• sodium = 136-145 mEq/L
• potassium = 3.5-5 mEq/L
• calcium = 4.4-5.5 mEq/L (9-11 mg/dL or 2xs the mEq)

Question 18

normal range for the following –(FLIP)–>

• magnesium
• chloride
• phosphorous

Answer 18

• magnesium = 1.5-2.5
• chloride = 96-106
• phosphorous = 3-4.5

Question 19

what is osmosis?***

Answer 19

fluid moves from LESS –> MORE CONCENTRATED SIDE OF MEMBRANE

Question 20

what is diffusion?***

Answer 20

particles move from MORE –> LESS CONCENTRATED SIDE

Question 21

osmosis vs. diffusion***

Answer 21

• osmosis = less to more

- diffusion = more to less

Question 22

effect of protein on fluid balance

Answer 22

exerts colloidal osmotic pressure

Question 23

relationship between albumin and fluid**

Answer 23

• albumin exerts pressure on blood vessel wall that keeps water within
• when ALBUMIN DROPS, PRESSURE DROPS, FLUID LEAKS OUT
• water goes from extracellular to between and around cells = edema + ascites

Question 24

anasarca***

Answer 24

extreme, generalized edema and widespread swelling of skin due to effusion of fluid into extracellular space

Question 25

anasarca is associated with?***

Answer 25

HEART, LIVER, RENAL FAILURE, EXTREME PRO/KCAL MALNUTRITION

Question 26

generally with dehydration, what happens to lab values?***

Answer 26

most increase

Question 27

causes of dehydration

Answer 27

- decreased water intake - excessive water output - heavy solute load

Question 28

s/s of dehydration***

Answer 28

- NAUSEA - DIZZINESS - SUNKEN EYES - INCREASE IN SOLUTES (BUN)

Question 29

BEST ASSESSMENT parameter for fluid status?***

Answer 29

serum sodium

Question 30

hypernatremia is associated with? hyponatremia is associated with?***

Answer 30

- hyper = dehydration | - hypo = overhydraton

Question 31

with fluid status, what lab value should you look at first?***

Answer 31

serum sodium

Question 32

what is acid-base balance?***

Answer 32

regulation of hydrogen concentration

Question 33

acid does what? base does what?***

Answer 33

- ACID RELEASES H ions | - BASE TAKES UP H ions

Question 34

what is a buffer?**

Answer 34

MIXTURE of acid and base components to protect against a strong acid or a strong base

Question 35

major buffer***

Answer 35

carbonic acid (H2CO3) and sodium bicarbonate (NaHCO3)

Question 36

body pH is?***

Answer 36

7.4

Question 37

what do lungs control? what do kidneys control?***

Answer 37

- lungs = supply of carbonic acid (CO2, water) | - kidneys = bicarbonate (base)

Question 38

hypoventilation does what? hyperventilation does what?***

Answer 38

- hypoventilation = retention of acid (carbonic acid or CO2) | - hyperventilation = loss of acid

Question 39

what happens if kidneys retain bicarbonate? what happens if kidneys excrete excess bicarbonate?***

Answer 39

- retain bicarb = level of base increases | - excrete bicarb = level of base decreases

Question 40

how does acid-base balance work?***

Answer 40

change in one side of the buffer = COMPENSATORY CHANGE ON THE OTHER SIDE to maintain balance and a PH OF 7.4

Question 41

failure related to pulmonary system is called?***

Answer 41

respiratory

Question 42

general guideline for acid-base disorders -->

Answer 42

- what is occuring = the condition - compensatory response = opposite organ increases or decreases to balance out the pH (ex: metabolic acidosis = low pH of the kidneys & they excrete too much base ---> compensatory is for the lungs to hyperventilate to lose acid)

Question 43

what happens in respiratory acidosis?

Answer 43

CO2 retention (or hypoventilation, retaining acid)

Question 44

compensatory response of respiratory acidosis?***

Answer 44

kidneys increase absorption of base (bicarbonate)

Question 45

what happens in respiratory alkalosis?

Answer 45

increased ventilation/loss of acid

Question 46

compensatory response for respiratory alkalosis***

Answer 46

kidneys excrete base (bicarbonate)

Question 47

what happens in metabolic acidosis?***

Answer 47

kidneys EXCRETE EXCESS BASE (or kidneys produce or retain too much hydrogen --> increase in production of carbonic acid)

Question 48

compensatory response for metabolic acidosis***

Answer 48

lungs HYPERVENTILATE = YAWN & SIGH; respiration increases to EXPEL CO2 to decrease carbonic acid

Question 49

what happens in metabolic alkalosis?***

Answer 49

ABNORMAL RETENTION OF BASE (or loss of H due to loss of acid)

Question 50

compensatory response for metabolic alkalosis***

Answer 50

HYPOVENTILATION --> ventilation or respiration decreases to retain CO2 to increase carbonic acid

Question 51

chemical makeup for bicarbonate vs. carbonic acid***

Answer 51

- bicarbonate = HCO3 | - carbonic acid = H2CO3

Question 52

blood gas readings for bicarbonate***

Answer 52

HCO3 = 24-28

Question 53

blood gas readings for carbonic acid***

Answer 53

pCO2 = 35-45

Question 54

associations: acid vs. base

Answer 54

- pCO2...carbonic acid...lungs | - HCO3...base...bicarbonate...kidneys