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Flashcards in Unit 8 Deck (75):
1

Isotonic Solutions Percent Salt:

0.9% NaCl

2

Isotonic Solutions Other names

-D5W (5% dextrose)
-Saline, NS, PS, PSS
-Ringer’s
-Lactated Ringer’s
-Milliosmoles: 300 milliosmoles/Liter (mOsm/L)
-Milliequivalents: 325 milliequivalents/Liter (mEq/L)

3

Hypertonic Solutions Percent Salt:

>0.9% NaCl
-Milliosmoles: >300 milliosmoles/Liter (mOsm/L)
-Milliequivalents: >325 milliequivalents/Liter (mEq/L)

4

Hypertonic Solutions other name

D10W (>5% dextrose)


5

Hypotonic Solutions Percent Salt

<300 milliosmoles/Liter (mOsm/L)

6

Hypotonic Solutions other name

D2W (<5% dextrose)

7

Definition of osmosis

H2O moves toward the region of higher solute concentration

8

Isotonic Solution movement:

-causes no net water movement (cell is in equilibrium)
-cells in an isotonic solution show no change in size & function

9

Hypertonic Solution movement:

-draws H2O out of the cell
-cells crenate in a hypertonic solution; size + function both decrease

10

Hypotonic Solution movement:

-draws H2O into the cell
-cells in a hypotonic solution swell & may lyse; size increases, function decreases

11

Blood sodium levels drop from 325 mEq/L to 124 mEq/L
What is the danger?

-↓Sodium in the blood allows H2O to move into cells (osmosis)
-Less fluid in blood
-↓Blood volume
-↓Blood pressure
To correct this:
↑Heart rate will ↑blood pressure

12

What does electrolytes ionize into?

particles
Ex: NaCl --> Na+ + Cl-

13

Does glucose ionize?

Nonelectrolytes (Glucose), do not ionize

14

Organs That Regulate Fluid & Electrolyte Balance:

Brain, Adrenal Glands, Kidneys

15

List the steps of the thirst mechanism

DECREASED ECF VOLUME OR INCREASED ECF OSMOLALITY --->HYPOTHALAMUS----> ↓SALIVA ---->THIRST--->DRINK--->↑ ECF VOLUME




16

About Aldosterone

-Hormone (mineralocorticoid)
-Secreted by: adrenal cortex
-Stimulates kidneys to:
Reabsorb Na+, Cl–, H2O
Secrete K+

17

Estrogen

-Female hormone from the ovaries mimics aldosterone
-Stimulates kidneys to reabsorb sodium, chloride, water
-↑Fluid retention (edema)

18

How does estrogen affect calcium?

Calcium Moves Into Bone

19

Cortisol

-Hormone (glucocorticoid) from the adrenal cortex that mimics aldosterone
-Converts lipids & protein to glucose (gluconeogenesis)
-Anti-inflammatory (vasoconstrictor)

20

What does ↑Cortisol causes:

Edema, ↑visceral fat deposition, ↓memory storage, ↓memory retrieval

21

What does Antidiuretic Hormone (ADH) do?

Saves water at the collecting duct

22

Calcitonin Increases! In which direction will calcium move?

blood ---> bone

23

Parathyroid Hormone Increases! In which direction will calcium move?

bone ---> blood

24

A person is in the hot sun for many hours resulting in water lost through perspiration
How does the body maintain homeostasis?

-Hypothalamus makes ↑Aldosterone & ↑ADH
-Kidneys produce ↓urine
-Hypothalamus will cause ↑thirst (thirst center)

25

A person urinates many times during the day but is able to sleep all night w/o the need to urinate
How is this explained?

Hypothalamus secretes ↑ADH during sleep (↑ADH prevents urination)

26

A person has had diarrhea for two days
Body potassium level is only 25% of normal value
Why is potassium level so low?

-Body has lost fluid & w/ this fluid, has lost potassium
-Patient must be given potassium immediately or the heart may develop arrhythmias (stop efficient pumping)

27

A patient has been unable to eat anything following surgery
The physician has ordered an IV of D5W
Why was this done?

-Fluid in the D5W will replace fluid that will naturally be lost due to not eating
-Dextrose (glucose) will provide an energy source for the body

28

Dr. Feelgood has told a patient that they need to flush the toxins & poisons out of their body
The patient has been given an IV of distilled water twice a week
What are the risks to the patient w/ this treatment?

-Distilled water is hypotonic to cells
-Red blood cells will lyse & release hemoglobin, creating a burden on the liver to cleanse the blood
-↓Red blood cell count could make the patient anemic

29

A patient has had severe head trauma & there is swelling around the brain
The physician has ordered an IV of 20% glucose (D20W)
Why was this done?

20% Glucose is hypertonic
It will attract fluid from the brain into the blood, reducing the swelling around the brain

30

A patient has a history of hypertension
The physician has placed the patient on a ↓sodium diet
What is the reason for the ↓sodium diet?

-Salt makes the blood hypertonic
-Fluid will move by osmosis into the blood
-↑Blood volume → ↑blood pressure
-Sodium ↑BP in ⅓ of patients (sodium sensitivity)

31

What is blood pH and its range

Blood pH = 7.40 (7.35 - 7.45)

32

What is blood pH regulated by?

Kidneys, Lungs, Blood Buffers

33

Response to acidosis:

Kidneys Secrete H+ and Reabsorb HCO3–

34

Response to alkalosis:

Kidneys Reabsorb H+ and Secrete HCO3–

35

What does the kidney secrete if the pH is too low?

Secrete hydrogen ions & reabsorb bicarbonate ions

36

What does the kidney reabsorb if the pH is too high?

Reabsorb hydrogen ions & secrete bicarbonate ions

37

Brethe FASTER or SLOWER to get rid of excess carbon dioxide if ↓pH ?

FASTER
-Carbon dioxide forms carbonic acid in the blood

38

Breath FASTER or SLOWER to retain carbon dioxide if ↑pH?

SLOWER
-Carbon dioxide combines w/ water to form carbonic acid in the blood

39

Equation of Carbon Dioxide + Water → Carbonic Acid

CO2 + H2O H2CO3 H+ + HCO3–

40

Breathing _______ will retain CO2 & pH will _______ (↑acidity & ↑H+)

slower, decrease
↑Carbon Dioxide → ↑Acidity → ↓pH

41

Breathing ______ will eliminate more CO2 & pH will ______ (↓acidity & ↓H+)

faster,increase
↓Carbon Dioxide → ↓Acidity → ↑pH

42

If blood pH decreases to 7.3 how does the body compensate?

-Breath faster to get rid of carbon dioxide, ↓acidity
-Hyperventilation

43

If blood pH increases to 7.5 how does the body compensate?

-Breath slower to retain more carbon dioxide, ↑acidity
-Hypoventilation

44

A patient takes narcotics for pain which have decreased breathing rate…what happens to blood pH?

pH will decrease because carbon dioxide is retained, which will ↑blood acidity & ↑H+

45

A person takes caffeine for energy which has increased breathing rate…what happens to blood pH?

pH will increase because carbon dioxide is not retained, which will ↓blood acidity & ↓H+

46

Definition of Buffers

-Buffers resist changes in pH
-Prevent excessive pH changes in the body if an acid or base is added to the body

47

Definition of Strong Acid

-Acid that releases many hydrogen ions
-Hydrochloric acid
-HCl → H+ + Cl–

48

Defintion of Weak acid

-Acid that releases few hydrogen ions
-Carbonic acid
-H2CO3 → H+ + HCO3–

49

Buffers change ______ acids to ______ acids: strong acid + buffer → weak acid + salt

strong, weak
HCl (strong acid) + NaHCO3 (buffer) ---> H2CO3 (weak acid) + NaCl (salt)

50

Bicarbonate Ion:Carbonic Acid Ratio

20:1 = pH 7.4
21:1 = pH more than 7.4
19:1 = pH less than 7.4
NOTE: THESE ARE RATIOS

51

Define & give the cause of Acidosis

-pH falls below 7.35
-↓Nervous system function
-Coma
-Acidotic shock

52

Define & give the cause of Alkalosis

-pH climbs above 7.45
-↑Nervous system function
-Convulsions
-Alkalotic shock

53

Define & give the cause of Respiratory Acidosis

-Decrease in respiratory rate (hypoventilation)
-↑Carbon dioxide in the blood
-↑Carbon dioxide level → ↓pH

54

Define & give the cause of Respiratory Alkalosis

-Increase in respiratory rate (hyperventilation)
-↓Carbon dioxide in the blood
-↓Carbon dioxide level → ↑pH

55

Define & give the cause of Metabolic Acidosis

-NOT caused by breathing or carbon dioxide imbalance
-↑Acid (↑H+) in blood:
*Renal disease (unable to secrete H+)
*Diabetes mellitus, ↑fat diet, starvation, ↑ketones (ketosis → ketoacidosis)
-↓Bicarbonates in blood
-↑Hydrogen ions in blood
-↑Acids in food
-↓Bases in food
- Diarrhea

56

Define & give the cause of Metabolic Alkalosis

-NOT caused by breathing or a carbon dioxide imbalance
-↓Acid (↓H+) in blood:
*Vomiting
*Diuretics
-↑Bicarbonate in blood
-↑Sodium bicarbonate ingestion
-↑Bases in food
-↓Acids in food

57

Name the 4 ECF ions

↑Na+ (Sodium),↑Cl– ( Chloride),↑Ca+2 (Calcium), ↑HCO3– (Bicarbonate)

58

Name the 4 ICF Ions

↑K+ (Potassium), ↑Mg+2 (Magnesium), ↑SO4–2 (sulfate), ↑HPO4–2 (phosphate)

59

Sodium Functions

-Attracts water to the ECF
-Nerve impulses
-Muscle contractions

60

Hypernatremia:

-↑Sodium in the blood
-Hypertension
-Muscle twitching
-Mental confusion
-Coma

61

Hyponatremia:

-↓Sodium in the blood
-Hypotension
-Tachycardia
-Muscle weakness

62

Potassium Functions

-Attracts water into the ICF
-Nerve impulses
-Muscle contractions

63

Hyperkalemia:

-↑Potassium in the blood
-Cardiac arrhythmias
-Cardiac arrest
-Elevated T-wave (ECG)
-Muscle weakness

64

Hypokalemia:

-↓Potassium in the blood
-Cardiac arrhythmias
-Cardiac arrest
-Depressed T-wave (ECG)
-Muscle weakness

65

Calcium Functions

-Bones & teeth
-Blood clotting
-Nerve impulses
-Muscle contraction

66

Hypercalcemia:

-↑Calcium in the blood
-Renal calculi (kidney stones)
-Cardiac arrhythmias

67

Hypocalcemia:

-↓Calcium in the blood
-Muscle tetany
-Weak cardiac muscle contractions
-↑Clotting time

68

Aldosteronism:

-↑Aldosterone production
-↑Blood sodium levels
-↓Blood potassium levels
-Hypertension

69

Addison’s Disease

-Hyposecretion of the Adrenal Cortex
-↓Aldosterone (mineralocorticoid)
-↓Cortisol (glucocorticoid)
*Cortisol converts protein → glucose)
-Hypotension (↓sodium)
-Hypoglycemia (↓glucocorticoids)

70

Cushing’s Disease

-↑Glucocorticoids
-Adrenal gland tumor
-Side effect of cortisol
-Hyperglycemia
-Abdominal fat accumulation
-Posterior neck hump

71

True or false: Addison is similar to Cushing's Disease.

FALSE! They are basically opposites! (check powerpoint on slide 93)

72

↑Antidiuretic Hormone (ADH) in a hypertonic interstitial fluid

↑ADH goes in collecting duct, ↑H2O comes out, and ↓Urine output


73

↓Antidiuretic Hormone (ADH) in a Hypertonic Interstitial Fluid
:

↓ADH goes into the collecting duct, ↓H2O comes out, and ↑Urine output


74

Cause of Diabetes Insipidus

-↓ADH secretion
-↓ADH receptors (at kidneys)

75

Effect of Diabetes Insipidus

-↑Urination
-Dehydration