Water, Electrolyte and Acid-Base Balance

Question 1

Between ___% and ___% of a body weight is water.

In the average man, water makes up ___% of weight (about 40 L); in the average woman, water makes up about ___%.

An infant is composed of even more water—up to ___%.

Because adipose tissue contains less water than muscle tissue, ___ persons have less water than thin persons.

(Herlihy, 2020, p. 477)

Answer 1

50, 70

60, 50

75

obese

(Herlihy, 2020, p. 477)

Question 2

Water and its dissolved electrolytes are distributed into two major compartments: an ___ compartment and an ___ compartment.

(Herlihy, 2020, p. 477)

Answer 2

intracellular

extracellular

(Herlihy, 2020, p. 477)

Question 3

Which compartment includes the water located in all the cells of the body?

(Herlihy, 2020, p. 477)

Answer 3

Intracellular

(Herlihy, 2020, p. 477)

Question 4

Most water, about ___%, is located in the intracellular compartment.

(Herlihy, 2020, p. 477)

Answer 4

63

(Herlihy, 2020, p. 477)

Question 5

The extracellular compartment includes the fluid located outside all the cells and represents about ___% of the total body water.

(Herlihy, 2020, p. 477)

Answer 5

37

(Herlihy, 2020, p. 477)

Question 6

Which compartment includes the water located between cells, called interstitial fluid, water within blood vessels (plasma), and water within lymphatic vessels (lymph)?

(Herlihy, 2020, p. 477)

Answer 6

Extracellular

(Herlihy, 2020, p. 477)

Question 7

Water within the blood vessels and lymphatic vessels is also called ___ fluid.

(Herlihy, 2020, p. 477)

Answer 7

intravascular

(Herlihy, 2020, p. 477)

Question 8

Which fluid is extracellular fluid and includes cerebrospinal fluid, the aqueous and vitreous humors in the eyes, the synovial fluids of joints, the serous fluids in body cavities, and the glandular secretions?

(Herlihy, 2020, p. 477)

Answer 8

Transcellular

(Herlihy, 2020, p. 477)

Question 9

___ ___ and ___ are the largest extracellular compartments.

(Herlihy, 2020, p. 477)

Answer 9

Interstitial fluid

plasma

(Herlihy, 2020, p. 477)

Question 10

(Herlihy, 2020, p. 478)

Answer 10

(Herlihy, 2020, p. 478)

Question 11

Intracellular and extracellular fluids vary in concentration of various ___.

(Herlihy, 2020, p. 478)

Answer 11

electrolytes

(Herlihy, 2020, p. 478)

Question 12

Extracellular fluids contain high concentrations of ___ (___), ___ (___), and ___ (___) ions.

The plasma portion contains more ___ than do other extracellular fluids.

(Herlihy, 2020, p. 478)

Answer 12

sodium (Na+), chloride (Cl −), bicarbonate (HCO3 −)

protein

(Herlihy, 2020, p. 478)

Question 13

Intracellular fluid contains high concentrations of ___ (___), ___ (___), and ___ (___) ions.

(Herlihy, 2020, p. 478)

Answer 13

potassium (K+), phosphate (PO4 3−), magnesium (Mg2+)

(Herlihy, 2020, p. 478)

Question 14

The ___ of an ion is indicated when it appears in brackets; thus, [H+] means the ___ of the hydrogen ion.

(Herlihy, 2020, p. 478)

Answer 14

concentration x 2

(Herlihy, 2020, p. 478)

Question 15

Smaller ___ of other ions are present in both intracellular and extracellular fluids.

Although distributed across the fluid compartments, water and electrolytes can move from one compartment to another.

The movement of fluid and electrolytes between compartments is well regulated.

However, many clinical conditions are associated with shifts of water and electrolytes between compartments.

(Herlihy, 2020, p. 478)

Answer 15

concentrations

(Herlihy, 2020, p. 478)

Question 16

Normally, the quantity of water taken in, which is ___, equals the amount of water eliminated from the body, which is ___.

(Herlihy, 2020, p. 478)

Answer 16

intake

output

(Herlihy, 2020, p. 478)

Question 17

Water ___ exists when intake equals output.

(Herlihy, 2020, p. 478)

Answer 17

balance

(Herlihy, 2020, p. 478)

Question 18

Although water intake can vary considerably, the average adult takes in about ___ mL every day.

About ___% comes from drinking liquids, an additional ___% comes from water in foods, and ___% comes from the breakdown of foods.

This latter portion is called the water of ___.

(Herlihy, 2020, p. 478)

Answer 18

2500

60

30

10

metabolism

(Herlihy, 2020, p. 478)

Question 19

What is the primary regulator of water intake?

(Herlihy, 2020, p. 478)

Answer 19

Thirst

(Herlihy, 2020, p. 478)

Question 20

The thirst center is in the ___ of the brain.

(Herlihy, 2020, p. 478)

Answer 20

hypothalamus

(Herlihy, 2020, p. 478)

Question 21

As the body loses water, the thirst center in the ___ is stimulated, thus causing a person to drink.

(Herlihy, 2020, p. 478)

Answer 21

hypothalamus

(Herlihy, 2020, p. 478)

Question 22

What restores the water content of the body, so both thirst and the hypothalamus are satisfied?

(Herlihy, 2020, p. 478)

Answer 22

Drinking

(Herlihy, 2020, p. 478)

Question 23

Older adults have a diminished thirst mechanism and are therefore prone to ___.

(Herlihy, 2020, p. 478)

Answer 23

dehydration

(Herlihy, 2020, p. 478)

Question 24

In a healthy person, 24-hour intake and output are approximately equal; the individual who takes in 2500 mL of water should therefore eliminate ___ mL.

(Herlihy, 2020, p. 478)

Answer 24

2500

(Herlihy, 2020, p. 478)

Question 25

Water can leave the body through several routes: ___, ___, ___, and ___ ___. ## Footnote (Herlihy, 2020, p. 478)

Answer 25

kidneys skin lungs digestive tract ## Footnote (Herlihy, 2020, p. 478)

Question 26

The kidneys eliminate about ___% of the water as urine. About ___% is lost from the skin and lungs; ___% is eliminated in the feces, and another ___% is lost as sweat. The amount lost by ___ can vary considerably, depending on the level of exercise and environmental temperatures. ## Footnote (Herlihy, 2020, p. 478)

Answer 26

60 28 6 6 sweat ## Footnote (Herlihy, 2020, p. 478)

Question 27

Water loss through the skin and lungs (decreases/increases) in a hot, dry environment. ## Footnote (Herlihy, 2020, p. 478)

Answer 27

increases ## Footnote (Herlihy, 2020, p. 478)

Question 28

What are the primary regulators of water output? ## Footnote (Herlihy, 2020, p. 478)

Answer 28

Kidneys ## Footnote (Herlihy, 2020, p. 478)

Question 29

Water regulation occurs mainly through the action of ___ ___ (___) on the collecting duct. ## Footnote (Herlihy, 2020, p. 478)

Answer 29

antidiuretic hormone (**ADH**) ## Footnote (Herlihy, 2020, p. 478)

Question 30

What does the posterior pituitary gland release when body water content is low? ## Footnote (Herlihy, 2020, p. 478)

Answer 30

Antidiuretic Hormone (ADH) ## Footnote (Herlihy, 2020, p. 478)

Question 31

What stimulates the collecting duct to reabsorb water, thereby decreasing water in the urine and increasing blood volume? ## Footnote (Herlihy, 2020, p. 478)

Answer 31

Antidiuretic Hormone (ADH) ## Footnote (Herlihy, 2020, p. 478)

Question 32

When body water content is high, the secretion of antidiuretic hormone (ADH) (decreases/increases). As a result, less water is reabsorbed from the collecting duct, and the excess water is eliminated in the urine. ## Footnote (Herlihy, 2020, p. 478)

Answer 32

decreases ## Footnote (Herlihy, 2020, p. 478)

Question 33

Water Balance ## Footnote (Herlihy, 2020, p. 479)

Answer 33

## Footnote (Herlihy, 2020, p. 479)

Question 34

Fluid may shift as part of a normal homeostatic mechanism as in the prevention of ___ due to dehydration. Fluid may also shift in response to various diseases and disorders. ## Footnote (Herlihy, 2020, p. 480)

Answer 34

hypovolemia ## Footnote (Herlihy, 2020, p. 480)

Question 35

Fluid shifts because of a change in the “pushing and pulling” forces affecting the capillaries. The forces include the ___ ___ pressure, ___ ___ pressure, effect of ___ ___, and effects of ___ ___ that becomes trapped in the tissue space. Alteration of any of these factors affects water movement. ## Footnote (Herlihy, 2020, p. 480)

Answer 35

capillary filtration plasma oncotic lymphatic drainage plasma protein ## Footnote (Herlihy, 2020, p. 480)

Question 36

What is the clinical term that refers to the distribution of body water? ## Footnote (Herlihy, 2020, p. 480)

Answer 36

Fluid Spacing ## Footnote (Herlihy, 2020, p. 480)

Question 37

Which spacing refers to the normal distribution of water? ## Footnote (Herlihy, 2020, p. 480)

Answer 37

First ## Footnote (Herlihy, 2020, p. 480)

Question 38

___ spacing refers to the accumulation of water in the interstitial spaces (as in pedal edema). Generally, with adequate treatment, this water can be reabsorbed and excreted. ## Footnote (Herlihy, 2020, p. 480)

Answer 38

Second ## Footnote (Herlihy, 2020, p. 480)

Question 39

Which spacing refers to the accumulation of water in spaces from which it is not easily absorbed? ## Footnote (Herlihy, 2020, p. 480)

Answer 39

Third ## Footnote (Herlihy, 2020, p. 480)

Question 40

Which spacing includes the water that accumulates in the abdominal cavity as ascites that is not easily reabsorbed? ## Footnote (Herlihy, 2020, p. 480)

Answer 40

Third ## Footnote (Herlihy, 2020, p. 480)

Question 41

Excess water that accumulates within the digestive tract as a result of a paralytic ileus is unavailable for easy reabsorption. The amount of water in “___ ___” can be large and life threatening. Monitoring of water distribution is a common clinical concern. ## Footnote (Herlihy, 2020, p. 480)

Answer 41

third spaces ## Footnote (Herlihy, 2020, p. 480)

Question 42

The daily measurement of body weight provides a reliable estimate of fluid ___. For example, if a person with heart failure suddenly gains 4.4 lb, fluid ___ should be suspected. ## Footnote (Herlihy, 2020, p. 480)

Answer 42

balance retention ## Footnote (Herlihy, 2020, p. 480)

Question 43

One liter of water weighs 2.2 lb (1 kg). If a person has a sudden weight gain of 4.4 lb, it is assumed that person has retained ___ L of fluid. Another example is when a patient is given a diuretic and loses 2.2 lb overnight. It is assumed that the patient excreted ___ L of fluid. ## Footnote (Herlihy, 2020, p. 480)

Answer 43

2 1 ## Footnote (Herlihy, 2020, p. 480)

Question 44

Electrolyte ___ exists when the amounts of the various electrolytes gained by the body equal the amounts lost. ## Footnote (Herlihy, 2020, p. 480)

Answer 44

balance ## Footnote (Herlihy, 2020, p. 480)

Question 45

Electrolyte imbalances are (uncommon/common), serious clinical challenges. Electrolytes are important components of the body fluids. The ___ control the composition of body fluids by regulating the renal excretion of electrolytes. ## Footnote (Herlihy, 2020, p. 480)

Answer 45

common kidneys ## Footnote (Herlihy, 2020, p. 480)

Question 46

An ___ is an element or compound that carries an electrical charge. Common ___ are Na+, Cl − , K+, Ca2+, and Mg2+. ## Footnote (Herlihy, 2020, p. 480)

Answer 46

ion ions ## Footnote (Herlihy, 2020, p. 480)

Question 47

A ___ is a positively charged ion, such as Na+, K+, and Ca2+ ## Footnote (Herlihy, 2020, p. 480)

Answer 47

Cation ## Footnote (Herlihy, 2020, p. 480)

Question 48

An ___ is a negatively charged ion, such as Cl − and HCO3 − (bicarbonate). Most ___ (such as albumin) carry a negative charge. ## Footnote (Herlihy, 2020, p. 480)

Answer 48

Anion proteins ## Footnote (Herlihy, 2020, p. 480)

Question 49

What are the substances that form ions when they dissolve in water, such as NaCl (salt)? ## Footnote (Herlihy, 2020, p. 480)

Answer 49

Electrolyte ## Footnote (Herlihy, 2020, p. 480)

Question 50

What refers to the chemical reaction caused when an electrolyte splits into two ions? ## Footnote (Herlihy, 2020, p. 480)

Answer 50

Ionization ## Footnote (Herlihy, 2020, p. 480)

Question 51

___ (___) is the chief extracellular cation, accounting for almost ___% of the positively charged ions in the extracellular fluid. ## Footnote (Herlihy, 2020, p. 480)

Answer 51

Sodium (**Na+**) 90 ## Footnote (Herlihy, 2020, p. 480)

Question 52

Sodium plays a key role in the regulation of water balance. The primary mechanism regulating sodium concentration is ___. ## Footnote (Herlihy, 2020, p. 480)

Answer 52

aldosterone ## Footnote (Herlihy, 2020, p. 480)

Question 53

What stimulates the distal tubule and upper collecting duct of the nephron unit to reabsorb sodium? ## Footnote (Herlihy, 2020, p. 480)

Answer 53

Aldosterone ## Footnote (Herlihy, 2020, p. 480)

Question 54

Usually, “when ___ (___) moves, water moves”; this means that aldosterone causes the reabsorption of both ___ (___) and water. ## Footnote (Herlihy, 2020, pp. 480, 481)

Answer 54

sodium (**Na+**) x 2 ## Footnote (Herlihy, 2020, pp. 480, 481)

Question 55

What is the chief intracellular cation? ## Footnote (Herlihy, 2020, p. 481)

Answer 55

Potassium (K+) ## Footnote (Herlihy, 2020, p. 481)

Question 56

What is the primary hormone regulating potassium (K+) concentration? ## Footnote (Herlihy, 2020, p. 481)

Answer 56

Aldosterone ## Footnote (Herlihy, 2020, p. 481)

Question 57

What stimulates the distal tubule and upper collecting duct of the nephron unit to excrete potassium (K+) into the urine? ## Footnote (Herlihy, 2020, p. 481)

Answer 57

Aldosterone ## Footnote (Herlihy, 2020, p. 481)

Question 58

What are the primary organs responsible for the excretion of excess potassium (K+)? ## Footnote (Herlihy, 2020, p. 481)

Answer 58

Kidneys ## Footnote (Herlihy, 2020, p. 481)

Question 59

The monitoring of serum ___ (___) levels is an important clinical responsibility. Whereas only 2% of the ___ (___) is located in the extracellular space, ___ (___) is important for normal muscle function, especially cardiac function. Changes in plasma levels of ___ (___) cause serious cardiac dysrhythmias. ## Footnote (Herlihy, 2020, p. 481)

Answer 59

potassium (**K+**) potassium (**K+**) x 2 potassium (**K+**) ## Footnote (Herlihy, 2020, p. 481)

Question 60

What is necessary for bone and teeth formation, muscle contraction, nerve impulse transmission, and blood clotting? ## Footnote (Herlihy, 2020, p. 482)

Answer 60

Calcium ## Footnote (Herlihy, 2020, p. 482)

Question 61

Of the body’s calcium, ___% is in the bones and teeth. ## Footnote (Herlihy, 2020, p. 482)

Answer 61

99 ## Footnote (Herlihy, 2020, p. 482)

Question 62

___ ___ is the primary regulator of plasma levels of calcium. ## Footnote (Herlihy, 2020, p. 482)

Answer 62

Parathyroid hormone ## Footnote (Herlihy, 2020, p. 482)

Question 63

Next to potassium (K+), ___ (___) is the most abundant cation in the intracellular fluid. ## Footnote (Herlihy, 2020, p. 482)

Answer 63

magnesium (**Mg2+**) ## Footnote (Herlihy, 2020, p. 482)

Question 64

What is important in the function of the heart, muscles, and nerves? ## Footnote (Herlihy, 2020, p. 482)

Answer 64

Magnesium (**Mg2+**) ## Footnote (Herlihy, 2020, p. 482)

Question 65

Kidney disease is the major cause of ___. Other causes include overuse of magnesium-containing antacids. ___ is often seen in critically ill persons. ## Footnote (Herlihy, 2020, p. 482)

Answer 65

hypermagnesemia Hypomagnesemia ## Footnote (Herlihy, 2020, p. 482)

Question 66

___ (___) is the chief extracellular anion, and it usually follows sodium (Na +). That is, when sodium (Na +) is actively pumped from the tubules into the peritubular capillaries, ___ (___) follows the sodium passively. ## Footnote (Herlihy, 2020, p. 482)

Answer 66

Chloride (**Cl −**) chloride (**Cl −**) ## Footnote (Herlihy, 2020, p. 482)

Question 67

Changes in the plasma levels of chloride (Cl −) affect acid–base balance through its effect on ___ (___). For example, when the plasma chloride (Cl −) level decreases (___), the plasma ___ (___) level increases and causes alkalosis. ___, on the other hand, causes a decrease in the plasma ___ (___) level and a state of acidosis. Like sodium, chloride (Cl −) is greatly affected by diuretic therapy. ## Footnote (Herlihy, 2020, p. 482)

Answer 67

bicarbonate (**HCO3 −**) hypochloremia, bicarbonate (**HCO3 −**) Hyperchloremia, bicarbonate (**HCO3 −**) ## Footnote (Herlihy, 2020, p. 482)

Question 68

The plasma contains other ions, such as sulfate (SO4 2− ) and ___ (___) ## Footnote (Herlihy, 2020, p. 482)

Answer 68

sulfate phosphate (**PO4 3−**) ## Footnote (Herlihy, 2020, p. 482)

Question 69

## Footnote (Herlihy, 2020, p. 482)

Answer 69

## Footnote (Herlihy, 2020, p. 482)