SODIUM AND POTASSIUM Flashcards by Unknown Unknown

____________is paramount to life for all
organisms.

Maintenance of water homeostasis

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In addition to water homeostasis, these electrolytes play an
important role: (4)

(1) In maintenance of pH;
(2) In proper heart and muscle function;
(3) In oxidation-reduction reactions; and
(4) As cofactors for enzymes

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Laboratory tests for evaluation of disorders of ___________ are the most common
procedures performed in clinical chemistry laboratories

renal,
water,
electrolyte,
and acid-base status

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____________ is one of the major sequelae of common
disorders such as diabetes and hypertension

Renal disease

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four major electrolytes:

sodium
potassium
chloride
bicarbonate

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__________ is classified as anion or cation

Electrocytes

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___________ is negatively charged
ions that move toward an anode

anions

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___________ is positively charged
ions that move toward a cathode

cations

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_____________= denotes the number of ______
Capacity of certain analyte to bind
to another chemical

valence

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Carries one valence
monovalent cation

SODIUM

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Positively charged [under electrophoresis
migration of charges] it will travel towards
the cathode region

● CATION ATOM

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Sodium Comprises ________ of all Extracellular Fluid
(ECF) cations

90% of ECF

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________is found
outside the red blood cell

ECF

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= test to determine the
hydration of patient/ body
■ A test that can help diagnose a
fluid/ electrolyte imbalances
including dehydration

Osmolality

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○ Major determinant of plasma osmolality

Sodium

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NORMAL VALUE OF OSMOLALITY

______ mmol/L
● With _______ mmol/L being the result of Sodium and
associated anion electrolytes

295 mmol/L
● With 270 mmol/L being the result of Sodium and
associated anion electrolytes

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Osmolality INCREASES if _________– and it will
also DECREASES if ___________ [too much fluid in
the blood].

dehydrated
overhydrated

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Sodium has high levels in Extracellular fluids(Blood
plasma and Interstitial fluid),________ for Blood
plasma and ________ for Interstitial fluid
● _______ ions follow, and ________, followed by
__________

142 mEq/L
145 mEq/L
Chloride, bicarbonate, calcium

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INTRACELLULAR FLUID

___________ = highest levels 140 mEq/L
_____________= 100 mEq/L

Potassium
Hydrogen phosphate

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__________is the major cation of extracellular fluid

Sodium

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___________is freely filtered by the glomeruli.

sodium

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The interval for serum Na+ is ____________
Urinary sodium excretion varies with dietary intake, but for
people on an average diet containing ___________ an
interval of __________ is typical

135 to 145 mmol/L
8 to 15g /day,
40 to 220 mmol/day

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SERUM INTERVAL

There is a large diurnal variation in Na
+ excretion,
with the rate of Na+ excretion during then ight
being only _______ of the peak rate during the day.

20%

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6 POSSIBLE SPECIMENS

SERUM
PLASMA
URINE
WHOLE BLOOD
SWEAT
CEREBROSPINAL FLUID

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Certain coagulants should be used

PLASMA (Lithium heparin, ammonium heparin, and lithium oxalate)

Increased sodium concentration in the serum[blood] ● Results from excess loss of water relative to Na + loss, decreased water intake, or increased Na + intake or retention

HYPERNATREMIA

It is LESS COMMONLY SEEN in hospitalized patients than in hyponatremia.

HYPERNATREMIA

___________ may occur either by the kidney or through profuse sweating, diarrhea or severe burns.

LOSS OF HYPOTONIC FLUID - HYPERNATREMIA

● May result from loss of water in diabetes insipidus

HYPERNATREMIA

___________ defined as an increased sodium concentration in plasma water, and is generally diagnosed a serum sodium levels __________

Hypernatremia >145 mmol/L

____________ may not be accompanied by hypoosmolality, hypernatremia is always associated with an increased effective plasma osmolality, and hence with a reduced cell volume.

hyponatremia

Hypernatremia can be due to the following: (3)

1. Excess water loss 2. Decreased water intake 3. Increased intake or retention

In excess water loss in hypernatremia

a. Diabetes insipidus b. Renal tubular disorder c. Prolonged diarrhea d. Profuse sweating e. Severe burns f. Vomiting

Increased intake or retention in hypernatremia

a. Hyperaldosteronism (Conn's disease) b. Sodium bicarbonate infusion

Characterized by copious production of dilute urine (3-20 L/day)

DIABETES INSIPIDUS

People w/ diabetes insipidus drink large volumes of water, Hypernatremia does not occur usually unless the ______________

thirst mechanism is impaired

Excess water loss may also occur in RENAL TUBULAR DISEASE, such as ____________

acute tubular necrosis,

____________ with a normal osmolality may be a result of a high increase in non-sodium cations

HYPONATREMIA

___________ may also be seen with in vitro hemolysis, considered the most common cause for a false decrease. When red blood cells (RBCs) lyse, Na+, K, and water are released, and since Na+ concentration is lower in RBCs, this results in a false decrease

Pseudohyponatremia

Hyponatremia with a high osmolality is associated with ___________

hyperglycemia

The elevated levels of glucose increase the serum osmolality and cause a shift of water from the cells to the blood, resulting in a ______

dilution of Na+ .

______________the most common electrolyte disorder, is defined as reduced plasma sodium less than __________ concentration to a value less than ____________

130 mmol/L. 135 mmol/L

Hyponatremia can be due to the following:

1. Increase Na+ loss 2. Increased water retention

Increase Na+ loss in hyponatremia

a. Thiazide diuretics in the presence of ADH b. Saline infusion in the presence of ADH

. Increased water retention in hyponatremia

a. Renal failure b. Nephrotic syndrome c. Aldosterone deficiency d. Cancer e. Syndrome of Inappropriate ADH Secretion (SIADH) f. Hepatic cirrhosis

ranges of serum

136-145 mmol/L

________, Hypernatremia _________, Hyponatremia

>145, Hypernatremia <136, Hyponatremia

PACKAGE INSERT in serum

● 128-160 mmol/L

reference range of sodium in Urine

40-220 mmol/day (varies with diet) 24h Urine: 120-240 mmol/day (varies with diet) Urine

reference range of CSF in sodium

136-150 mmol/L

linearity of sodium

**LINEARITY - 200 mmol/L

● REMEMBER THAT WHEN LINEARITY IS REACHED, THERE IS A RESULT PRODUCED BUT IT IS _____________

EXTREMELY HIGH

___________ are all acceptable for Na+ measurements

Serum, plasma, and urine

When plasma is used ___________ are suitable for anticoagulants

When plasma is used, lithium heparin, ammonium heparin, and lithium oxalate are suitable anticoagulants

_________ does not cause a significant change in serum or plasma values as a result of decreased levels of intracellular Na+.

hemolysis

______________ samples may be used with some analyzers.

Whole blood

. The specimen of choice in urine Na+ analyses is a _____________

24-hour collection

____________ are the most routinely used method in clinical laboratories.

Ion-Selective Electrode [ISE] (Glass Ion Exchange Membrane)

1.Serum, heparinized plasma, whole blood, sweat, urine, feces, or gastrointestinal fluids may be assayed for Na+ 2. When plasma is used, lithium heparin, ammonium heparin, and lithium oxalate are suitable anticoagulants. 3. Timed collections of urine, feces, or gastrointestinal fluids are preferred to allow comparison of values with reference intervals and to determine rates of electrolyte loss. 4. Serum, plasma, and urine may be stored at 2°C to 4°C or frozen. 5. Erythrocytes contain only one tenth of the Na* present in plasma, so hemolysis does not cause significant errors in serum or plasma Nat values. 6. Lipemic samples should be ultracentrifuged and the supernatant analyzed unless a direct ISE is used

SAMPLE CONSIDERATIONS

What are the four sodium ion determinations

1. Chemical Methods 2. Flame Emission Spectrophotometry (FES) 3. Atomic Absorption Spectrophotometry (AAS) 4. Ion-Selective Electrode [ISE] (Glass Ion Exchange Membrane)

a. Excitation of atoms

3. Atomic Absorption Spectrophotometry (AAS)

a. The sample is mixed up with flame to create vapor, and whatever color produced by the flame will be transmitted to the monochromator b. Then the prism, next to the photomultiplier tube and [leave] the device

2. Flame Emission Spectrophotometry (FES)

**Outdated methods because of large samples,

1. CHEMICAL METHODS

Sodium (Na) [from the blood] is made to react with zinc uranyl acetate (reagent) to produce a sodium uranyl acetate precipitate

ALBANESE LEIN METHOD

ALBANESE LEIN METHOD ___________is mixed with water and a _______ solution is formed which is then measured _______________

Precipitate (SUN) yellow spectrophotometrically.

ALBANESE LEIN METHOD Test Tube 1 ➔ Precipitation test ■ Sodium is precipitated in a form of _____________ ■ Precipitates will be transferred to TT2 ○ Test Tube 2 ➔ Precipitate will mix with water and there is formation of ________ which is measured spectrophotometrically for Sodium

sodium-uranyl acetate yellow color

ALBANESE LEIN METHOD REAGENT → ______________ PRODUCT → ______________

zinc uranyl acetate sodium uranyl acetate

**Followed by AGAPPE

MAGNESIUM-URANYL METHOD

MAGNESIUM-URANYL METHOD Sodium is precipitated with ________; the uranyl ions remaining in suspension form a __________ with thioglycolic acid ● The difference between reagent blank and analysis is ___________ to the sodium concentration

magnesium-uranyl acetate yellow-brown complex PROPORTIONAL

MAGNESIUM-URANYL METHOD ➔ Protein precipitant: ______________ ● Test Tube 1 ➔ ___________ ● Test Tube 2 ➔ __________

Uranyl acetate and magnesium acetate Suspension /supernatant Precipitate

**UTILIZES GLASS-TYPE MEMBRANE WHICH IS MORE PREFERRED THAN CHEMICAL METHODS**

ION SELECTIVE ELECTRODES (GLASS ION EXCHANGE MEMBRANES)

● The _____ method uses a ___________- to develop an _________produced by having different ion concentrations on either side of the membrane

ISE semipermeable membrane electrical potential

ISE In this type of system, ________- are used.

two electrodes

_________ are selective for the ion but are not absolutely specific because other monovalent cations may react with the electrode but not in the physiologic range.

ION-SELECTIVE ELECTRODES

ISE ___________ has a constant potential, making it the__________, and the difference in potential between the reference and measuring electrodes can be used to CALCULATE THE “CONCENTRATION” of the ion in teh solution. ○ However, it isthe ACTIVITY OF THE ION, not the concentration that is being measured

One Electrode REFERENCE ELECTRODE

There are two types of ISE measurement, based on sample preparation:

DIRECT AND INDIRECT

measurement provides an undiluted sample to interact with the ISE membrane ■ Used in blood gas analyzers

DIRECT

The INDIRECT measurement uses whole (diluted) blood samples Used in most automated chemistry analyzers

INDIRECT

● Uses a single-use, direct ISE potentiometric system ● Each disposable slide contains a reference and measuring electrode. ● A drop of sample fluid and a drop of reference fluid are simultaneously applied to the slide and the potential difference between the two is measured, which is proportional to the Na + concentration.

VITROS ANALYZERS

Protein buildup on the membrane through continuous use

SOURCES OF ERROR

SODIUM AND POTASSIUM Flashcards

(81 cards)