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63 Cards in this Set
- Front
- Back
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How much water comes from metabolism?
from food? beverages |
200ml - 8%
700ml - 28% 1600ml - 64% |
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Fluid output from feces?
lungs? skin? urine? |
150ml (15%)
300ml (11%) 550ml - 25% 1500ml - 59% |
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How much ECF in the adult human body? how much ICF?
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ECF: 1/3
ICF:2/3 |
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What is another word for oncotic?
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colloid osmotic pressure
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Where is hydrostatic pressure greatest?
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At the arterial end, water filters across capillary membrane into interstitial space
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What pressure is greatest at venous end? why?
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oncotic pressure is greatest which means fluids are attracted back into circulation (reabsorption)
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What hormone is released to result in Volume Excess of ECF?
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aldosterone causes kidneys to retain saline
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What are some clinical manifestations of ECV excess??
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-bounding pulse
-dyspnea -orthopnea sudden weight gain edema |
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What is volume defecit?
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removal of sodium-containing fluid from extracellular compartment
-gi excretion -renal excretion |
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What are some clinical manifestations for volume deficit?
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-sudden weight loss
-postural blood pressure decrease with increase in heart rate -light headedness -dizziness -decreased skin tugor -dry mucosal membrane |
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What is Hyponatremia?
What syndrome is this? |
serum sodium concentration is below normal level
ECF contains relatively more water than sodium ions present -known as hypotonic sydnrome |
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What are the 2 primary causes for hyponatremia?
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A gain of more water than salt:
prolonged release of ADH Excessive drinking A loss of salt: diuretics -salt wasting renal disease |
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What are signs and symptoms cause from in hyponatremia?
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-caused by swelling of neurons and glial cells as a result of decreased osmolaity
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What is hypernatremia?
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serum concentration of sodium is above upper limit of normal
cells shrivel -hypertonic syndrome |
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What are the two causes of hypernatremia?
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- gain of more salt than water
•tube feed •iv with hyper tonic soln •increased salt -loss of water compared to salt: -perspiration fever diabetes insipidus |
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What is clinical dehydration comprised of? (2)
What can it occur from? |
-ECV deficit, hypernatremia
-vommitting, diarrhea |
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What is edema?
What can it occur from? |
-excess fluid in the interstitial compartment
-increased capillary hydrostatic pressure increased interstitial osmotic pressure (proteins leak in) -blockage of lymphatic drainage -decreased capillary osmotic pressure: malnutrition, liver disease |
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What are electrolytes?
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ionized salts dissolved in water
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What are the most clinically important electrolytes?(5)
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-sodium
-potassium -chloride -calcium -phosphate |
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What is sodium good for? (6)
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-cellular fluid maintainence
-muscle contraction -acid base balance -cell permeability -fluid distribution -nerve impulse transmission |
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Pottassium ? 7
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-cardiac rhythm,
-muscle contraction -nerve impulse transmission -rapid growth -fluid distribution -osmotic pressure balance -acid base balance |
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Chloride? 4
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-maintenance of fluid
-electrolytes -acid base balance -osmotic pressure balance |
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calcium? 6
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-blood clotting
-bone and tooth formation -cardiac rhythm -cell membrane permeability -muscle growth and contraction -nerve impulse transmission |
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Phosphate?
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bone and tooth formation
-cell growth and repair -energy production |
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What is hypokalemia?
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- decreased potassium ion concentration in ECF
- a decrease in plasma pottassium concentration may not neccessarily mean decrease in total body potassium |
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What is hypokalemia associated with?
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compensaed heart failure and cirrhosis that accompanied by increased aldosterone levels
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What effect does aldosterone have with hypokalemia?
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-it promotes loss of K+ in urine for exchange of sodium since it acts on kidney and promotes water and sodium retention
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What are some clinical manifestation of hypokalemia?
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abdominal distention
obstruction SI bilateral muscle weakness that usually begins in legs dysrhythmias polyuria |
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What is hyperkalemia?
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rise of serum potassium above 5mEq/l
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How is hyperkalemia caused? 2 reasons
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shift of K cells to ECF: acidosis, crushing injuries (massive cell death)
Decreased potassium excretion: oliguria potassium sparing diuretics drugs that reduce aldosterone effects |
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What are some clinical manifestations of hyperkalemia?
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-smooth and skeletal muscles become hypopolarized leading to:
-intestinal cramping -diarrhea -muscle weakness cardiac dysryhtmias |
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how is calcium present in the plasma?
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bound to proteins (albumin)
bound to organic ions (citrate) are free and unbound |
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Which form of calcium is physiologically active?
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free ionized calcium
-about half of total calcium |
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What causes hypocalcemia?
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can be caused by pancreatitis when the pancreas does not secrete enough lipase to digest fats, calcium binds to fat and is excrete through feces
-hypoparathyroidism |
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what are some clinical manifestations for hypocalcemia?
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carpal and pedal spasms
tetany cardiac dysrhythmias parasethias |
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What can cause hypercalcemia?
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-milk-alkali syndrome
-Vitamin D overdose Hyperparathydroidism |
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Some clinical manifestation for hypercalcemia?
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muscle weakness
diminished reflexes cardiac dysrhythmias fatique polyuria constipation |
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What are ABG measures
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arterial blood gas measures are useful indicators of acid base status of ECF
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What are the 3 mechanisms that regulate acid base system in the body?
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HCO3 renal buffers
PaCO2- respiratory system Buffers: pH indicates any abnormal ph regulation |
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Where are bicarbonate buffers?
Phosphate buffers? haemoglobin buffers? protein buffers? |
ECF
ICF , urine erythrocytes -ICF, blood |
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What is the primary defence again acid base disorders?
-most important buffer in ECF |
Bicarbonate buffer system
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What are the components of the bicarbonate buffer system?
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HCO3-(bicarbonate) and H2CO3 (carbonic acid)
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What enzyme is needed so H2CO3 can excrete through respiratory system as CO2 and water?
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carbonic anhydrase
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What ratio is needed of bicarbonate to carbonic acid?
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20:1
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What is the second contribution to acid base disorders?
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Respiratory system
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What happens if theres an increase in carbonic acid, decreasing pH?
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Hyperventilation
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What happens if there is a decrease in carbonic acid, rise in pH?
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hypoventilation
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Decrease in pH from excess metabolic acids?
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Hyperventilation
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Increase in pH from deficit of metabolic acids?
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hypoventilation
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What is the third line of defence against acid base disorders?
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Renal contribution
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What happens if there is a decreased bicarbonate in blood?
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excess of metabolic acids
-buffered by bicarbonate |
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what does it mean if there is an increase in bicarbonate in the blood?
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deficit of metabolic acids: relative excess base
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For high carbonic acid levels what occurs? (compensation)
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increase excretion of metabolic acids and H+
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For low carbonic acid levels what occurs? (compensation)
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excretion of HCO3-
decrease excretion of metabolic acids and H+ |
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What is metabolic acidosis?
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relative excess of any acid that is not H+
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Respiratory acidosis?
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condition that tends to cause an excess in carbonic acid
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What are some causes of respiratory acidosis?
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impaired gas exchange
COPD pneumonia |
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How is respiratory acidosis compensated?
What do ABG show |
- increased renal excretion of metabolic acids
-retention of bicarbonate -primarily imbalance of paCO2, then increased bicarbonate concentration |
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What is metabolic alkalosis?
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a condition that leads to a deficit of any acid (except H+)
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What can cause metabolic alkalosis?
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-hyperventilation (secreting too much carbonic acid)
-increase in bicarbonate -decrease in acid - |
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What is the compensatory response to metabolic alkalosis?
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-decreased renal excretion of metabolic acid
-retention of H+ by kidneys -decreased bicarbonate ion concentration -kidneys excrete HCO3 |
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What are the compensated ABG show?
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-decreased PaCO2 (primary imbalance)
-decreased bicarbonate concentration (compensation) -increased pH |
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What is a mix acid-base imbalance?
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-dysfunction of respiratory system and kidneys
-bacterial pneumonia related to respiratory acidosis and develops severe diarrhea and concurrent metabolic acidosis |
