Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/140

Click to flip

140 Cards in this Set

  • Front
  • Back
total body water for an adult
45-70% of body weight (avg. 60)
Variations in fluid balance result from __, __, and __.
age, sex and fat vs. lean body mass
How does age affect fluid balance?
Infants have more body fluid and estracellular fluid than adults and are at higher risk for fluid deficit.
Which gender has higher fluid per body weight and why?
Men, because they have more water than females. Females have more fat which carries less water.
Name the two body fluid compartments.
Intracellular fluid

Extracellular fluid.
a. intersitial
b. intravascular fluid
Intracellular fluid facilitates++ and accounts for approximately __% of total body weight or __L (__%) of total body water.
facilitates chemical reactions...40% of body weight or 28L(70%) of total body water.
Fluid between cells and within the blood vessels is called__. Interstitial fluid:_(def.) and is about (__%) of the ECF. Intravascular is also called ___, and includes __(7)it makes up about (__%) of the ECF.
Extracellular fluid (ECF)
between cells and between vessels...it acts as transport medium between the vascular system and cells.
it is 75% of the ECF.
2. Plasma; includes transcellular fluids, i.e. cerebrospinal fluid, synovial, pleural, abdominal, G.I. and lympathic fluids (about 25%).
Fluid that doesn't generally change day to day.
Transcellular fluids
Blood volume is normally __-__ L, __L of which are plasma.
5-6L, 3L plasma
The ___fluid is usually protected at the expense of the ___ and ___ fluids.
intravascular
interstitial and extracellular
What is the most common fluid and electrolyte imbalance?
Dehydration
Intracellular fluids are separated from interstitial and intravascular fluids by __and__
capillary walls and membranes
Body composition:
Infant: __%water, __%solids
Adult: __% water, __%solids
Older adult: __water, __solids.
Infant: 20-30% water, 70-80% solids.

Adult: 50-60% water, 40-50% solids

Older Adult: 45-55% water, 45-55% solids
Def. fluid spacing
the term used to classify the distribution of body water.
1. First spacing
2. Second spacing
3. Third spacing
4. Why is third spacing a concern?
1. Normal distribution. Extra cellular and intracellular.
2. Abnormal interstitial fluid accumulation (edema)
3. "sequestration"...fluid into a place that's not a normal fluid compartment.
4. It's unavailable for exchange...takes fluid away from the other compartments...measures as weight but is absolutely useless.
When is body fluid in a state of balance?
a. H2O/electrolytes balanced
b. fluid between compartments is normal
c. losses of H2O/electrolytes are replaced.
d. Excess H2O/electrolytes are eliminated.
Name six mechanisms for maintaining fluid equilibrium.
1. Hypothalamus
2. Pituitary - Antidiuretic Hormone (ADH)
3. Adrenal Regulation
4. Renal Regulation
5. Gastrointestinal Regulation
6. Insensible Water Loss
(**Almost every organ and system in the body helps in some way to maintain fluid homeostasis.)
How does the hypothalamus help regulate fluid balance?
Primary protection against hyperosmolality. Thirst control center. Senses decreased blood volume and increase in blood plasma concentration. Osmo receptors monitor how concentrated blood is. Hypotension triggers hypothalamus.
Hypotension triggers the :
hypothalamus
How does the pituitary regulate fluid balance?
Posterior pituitary stores and releases ADH, which makes body retain water. Helps control water retention by the kidneys and maintains osmotic pressure of cells.
Effect of serum osmolality on ADH release and urine output.
^osmolality stimulates hypothalamus which stimulates the posterior pituitary to secrete ADH which causes water loss by the kidneys. Urine volume goes ^ and Urine concentration goes down.
Describe Renal Regulation of fluids.
"The Master Chemist" of the body. Most critical mechanism. Maintains osmoloality by selective retention. Extracellular fluid volume and osmolality is maintained. Also regulates electrolyte and acid base balance. Excretes metabolic waste and toxic substances.
Normal urine output is __
__-__L of plasma get filtered daily.
1500ml/day
170-180L
How does Gastrointestinal regulation maintain fluid balance?
Absorbs H2O and nutrients. Sole intake mechanism for fluid and electrolytes.
How does insensible water loss maintain fluid balance.
Rapid breathing excretes H2O in breath; H2O evaporated from the skin.
What three things are needed for water balance?
Free access to H2O
Normal thirst and ADH mechanisms.
Normal functioning kidneys
Hypervolemia inhibits_(3)___. How does this restore fluid volume?
ADH release, Aldosterone release, and thirst. ADH and Aldosterone inhibition contribute to Increased Urination (dilute urine) which restores fluid volume.
Hypovolemia stimulates (3): how does this restore normal fluid volume?
Thirst, ADH release, and Aldosterone release. ADH and Aldosterone release contribute to DECREASED urination (concentrated urine) which restores fluid volume.
Will and increased intake of fluids cause hypervolemia?

What is the best indicator of fluid loss/gain? 1 liter of water retained is ___lb. gained
Yes when renal or cardia disease is a factor.

Daily weights.
2.2
1. When a state of water balance exists, water intake equals the __.

2. Greatest intake source of fluids is_. Second source is_.
3. Intake of fluids is regulated by
4. Source of water in the body
5. the breakdown of fat in the body produces ____water than protein.
1. Output.
2. ingested fluids~water in flood.
3. thirst mechanism
4. end product of metabolic oxidation.
5. more
Name 4 routes of water loss that help regulate fluid volume
kidneys
bowel (very small amount)
skin
lungs
Minimum urinary output

How much urine output is needed just to get rid of waste products in the body?
20ccs/hr

400ml/day
1.What is the site of all normal fluid gain?
1.Intestinal tract
How much is the avg. adult intake of:
1. ingested water
2. ingested food
3. metabolic oxidation
4. total
1. 1300 ml
2. 1000ml
3. 300 ml
4. 2600 ml
What is the average adult fluid output of each?:
1. kidneys
2. Skin
a. insensible
b. sensible
3. lungs
4. gastrointestinal
5. total
1. 1500 ml
2. a.600-900 ml
b. 0-5000 ml
3. 400 ml
4. 100 ml
5. 2600-2900ml
5.
Name 5 factors that increase risks for fluid imbalance & describe each.
1. life span (child/infants), adolescents (increased hormone production and growth), pregnancy, elderly.
2. body size: high fat =greater risk. Females have more body fat.
3. environmental temperature: body responds to increased temperature by promoting heat loss/sweating
4. lifestyle: availability of food; stress; elderly living alone
5. alterations in health (d/v/fever, edema, hemorrhage, draining wounds, cardiovascular probs,burns, trauma)
Possible causes of water deficit (HYPOVOLEMIA)(5)
1. increased water output
2. decreased water intake
3. impaired concentration of urine as in renal disease
4. iatrogenic solute loading: excessive hypertonic IVs or tube feedings
5. third-space loss (ascites, peritonitis, pancreatitis)
What might cause increased water OUTPUT?
v/d
fever
gastric/intestinal suction
ileostomy
fistulas
burns
hyperventilation
diuretics
hyperthyroidism
hemorrhage
decreased ADH
Addison's disease
diabetes insipidus
diabetes mellitus
Causes of decreased water intake? (4)
1.decreased level of consciousness
2.decreased thirst
3.dysphagia
4.unavailability of water
Possible causes of water EXCESS (HYPERVOLEMIA)(4)
1.excessive intake
2. decreased excretion through the kidney (renal disease, increased ADH
3.increased retention at the plasma level
4. increased capillary permeability
Causes of excessive water intake. (2)
1.iatrogenic-excessive electrolyte-free IVs or excess saline IVs (osmotic pull of Na+ causes increased water in the plasma)
2. increased oral intake after loss of sodium-containing fluids (e.g., diarrhea, vomiting, suction)
Causes of increased water retention at the plasma level
(7)
1. Cushing's syndrome
2. hyperaldosteronism
3. increased venous pressure
4. lymphatic obstruction
5. congestive heart failure,
6. excess tap-water enemas,
7. cortisone therapy
Causes of increased capillary permeability (2)
sepsis
inflammatory responses
1. Body fluids are composed of: (3)
2. Body fluids are distributed and moved by (4)
3. body fluids also contain non-ionizing substances, such as (4)
1. electrolytes, minerals and cells.
2. diffusion, osmosis, filtration, and active transport
3. urea, glucose, creatinine, and bilirubin
Define:
1. electrolytes
2. ionized substances are measured in __.
3. cations
4. anions
5. solvent
6. solute
7. mEq
1. substances capable of breaking into electrically charged ions when dissolved in a solution.
2. milliequivalents
3. ions that develop a positive charge
4. ions that develop a negative charge.
5. liquids that hold a substance in solution
6. substances that are dissolved in a solution
7. unit of measure used to describe electrolytes in terms of their chemical combining power or activity.
1. What is the solvent in the body that makes up solutions with solutes?
2.One mEq is chemically equivalent to the activity of 1 mg. of __.
1. saline & water
2. hydrogen
Functions of electrolytes (4)
1. promote neuromuscular irritability
2. Maintain body fluid volume and osmolarity
3. distribute body water between fluid compartments
4. regulate acid/base balance.
Normal ECF concentrations of:
1. Na+
2. K+
3. Ca++
4. Mg++
1. 142 mEq/L
2. 4 mEq/L
3. 5 mEq/L
4. 2 mEq/L
Normal ECF concentrations of anions:
1. HCO3-
2. Cl-
3. HPO4-
4. Proteinate
5. Organic acids
1. 25 mEq/L
2. 103 mEq/L
3. 2 mEq/L
4. 18 mEq/L
5. 4 mEq/L
When their combining power is expressed in milliequivalents, the cations and anions of ECF____.
approximately balance
The most abundant cation in ECF is __ which is (__%).
Na+, 90
Basic Functions of Sodium (8)
1. regulates extracellular fluid volume
2. increases cell membrane permeability
3. maintains blood volume (attracts H2O)
4. controls water distribution between ECF and ICF spaces
5. provides necessary mechanism for normal nerve impulse conduction
6. helps maintain neuromuscular irritability
7. assists in controlling muscle contractility
8. provides necessary mechanism for buffer system as cation that combines with bicarbonate and phosphate.
5.
Hyponatremia (Na+ loss or water gain)also known as __ is reflected in serum Na+ level of ___.
Saline deficit
<135 mEq/L
Possible causes of HYPOnatremia (3)
1. increased loss
2. overdilution of sodium
3. decreased intake
Causes of increased Na+ loss (10)
1. vomiting
2. diarrhea
3. fistulas
4. wound drainage
5. gastric or intestinal suction
6. irrigating NG tube with hypotonic solution or overingestion of plain ice chips or H2O when NG to suction
7. increased diaphoresis
8. low salt intake while on diuretics
9. renal disease
10 Addison's disease
What might cause overdilution of Na+ in the body?
increased ADH
excessive tap-water enemas
1. Causes of decreased intake of sodium
2. Na+ levels of less than ___lead to death.
1.low-sodium diets
excessive electrolyte-free or low-Na+ IV solutions.
2. <110 mEq/L
Causes of HYPERnatremia (Na+ gain or water loss)(4)
1. increased Na+ intake
2. Diseases causing failure of homeostatic fluid regulation
3. Conditions in which H2O loss is greater that sodium
4. Decreased water intake
Causes increased Na+ intake (3)
1. excessive salt intake in presence of renal disease
2. excessive IV saline solutions
3. hypertonic feedings
Diseases that cause failure of homeostatic fluid regulation (5)
1. heart disease
2. renal failure
3. liver disease,
4 Cushing's syndrome
5. hyperaldosteronism
Conditions in which water loss is greater than sodium (4)
diabetes melitus
diabetes insipidus
hyperventilation
diaphoresis
1. Drugs may cause HYPOnatremia by:
potentiating the action of antidiuretic hormone (ADH) or by causing syndrome of inapporpriate antidiuretic hormone secretion, or by inhibiting sodium reabsorption in the kidney.
Drugs that may cause hypOnatremia:(6 classes)
diuretics
antineoplastics
antidiabetics
sedatives
antipsychotics
anticonvulsants
Diuretics that may cause hyponatremia (4)
Furosemide
Ethacrynic acid
Bumetanide
thiazides
Antineoplastics that may cause hyponatremia (2)
Vincristine
Cyclophosphamide
Antidiabetics that may cause hyponatremia (2)
Chlorpropamide
Tolbutamide (rarely)
Sedatives that may cause hyponatremia (2)
barbiturates,
morphine
1.Antipsychotics that may cause hyponatremia (3)
2. Anticonvulsant that may cause hyponatremia
1. Fluphenazine
Thioridazine
Thiothixene
2. carbamazapine
When serum osmolality decreases because of decreased sodium concentration, fluid moves _________.
by osmosis from the extracellular area to the intracellular.
1. Who is at risk for hyponatremia?
1. Healthy athletes, outdoor workers, ill (altered thirst mechanism), older adults r/t decreased total body weight.
Signs and symptoms of hyponatremia (9)
decreased bp
headaches
nausea
abdominal cramps
muscle twitch
tremors
weakness
orthostatic hypotension
confusion
How do you intervene in hyponatremia?
isotonic normal salin
restrict fluids
give high Na+ foods
in extreme cases, give hypertonic 3-5% saline.
1.Hypernatremia is Na+ above __.
2. What to look for in pt.that may indicate hypernatremia
1.145 meq/L
2. skin flushed
agitation (seizures/conf.)
low grade fever
thirst
(SALT)
Also look for signs of hypervolemia with sodium gain, which are high bp and bounding pulse.
Drugs associated with hypernatremia (6)
1. antacids with sodium bicarbonate
2. sodium bicarbonate injections (such as those given during cardiac arrest)
3. I.V. sodium chloride preparations
4. sodium polystyrene sulforate (Kayexalate)
5. antibiotics such as ticacillin disodium/ clauvulanate potassium .
1. Signs of hypervolemia (with sodium gain).
2. signs of hypovolemia (with water loss)
1. high bp, bounding pulse
2. Body fluids becoming more hypertonic, dry mucus membranes, decreased urinary output (oliguria)
Name 4 routes of water loss that help regulate fluid volume
kidneys
bowel (very small amount)
skin
lungs
Minimum urinary output

How much urine output is needed just to get rid of waste products in the body?
20ccs/hr

400ml/day
1.What is the site of all normal fluid gain?
1.Intestinal tract
How much is the avg. adult intake of:
1. ingested water
2. ingested food
3. metabolic oxidation
4. total
1. 1300 ml
2. 1000ml
3. 300 ml
4. 2600 ml
What is the average adult fluid output of each?:
1. kidneys
2. Skin
a. insensible
b. sensible
3. lungs
4. gastrointestinal
5. total
1. 1500 ml
2. a.600-900 ml
b. 0-5000 ml
3. 400 ml
4. 100 ml
5. 2600-2900ml
5.
Name 5 factors that increase risks for fluid imbalance & describe each.
1. life span (child/infants), adolescents (increased hormone production and growth), pregnancy, elderly.
2. body size: high fat =greater risk. Females have more body fat.
3. environmental temperature: body responds to increased temperature by promoting heat loss/sweating
4. lifestyle: availability of food; stress; elderly living alone
5. alterations in health (d/v/fever, edema, hemorrhage, draining wounds, cardiovascular probs,burns, trauma)
Possible causes of water deficit (HYPOVOLEMIA)(5)
1. increased water output
2. decreased water intake
3. impaired concentration of urine as in renal disease
4. iatrogenic solute loading: excessive hypertonic IVs or tube feedings
5. third-space loss (ascites, peritonitis, pancreatitis)
What might cause increased water OUTPUT?
v/d
fever
gastric/intestinal suction
ileostomy
fistulas
burns
hyperventilation
diuretics
hyperthyroidism
hemorrhage
decreased ADH
Addison's disease
diabetes insipidus
diabetes mellitus
Causes of decreased water intake? (4)
1.decreased level of consciousness
2.decreased thirst
3.dysphagia
4.unavailability of water
Possible causes of water EXCESS (HYPERVOLEMIA)(4)
1.excessive intake
2. decreased excretion through the kidney (renal disease, increased ADH
3.increased retention at the plasma level
4. increased capillary permeability
Causes of excessive water intake. (2)
1.iatrogenic-excessive electrolyte-free IVs or excess saline IVs (osmotic pull of Na+ causes increased water in the plasma)
2. increased oral intake after loss of sodium-containing fluids (e.g., diarrhea, vomiting, suction)
Causes of increased water retention at the plasma level
(7)
1. Cushing's syndrome
2. hyperaldosteronism
3. increased venous pressure
4. lymphatic obstruction
5. congestive heart failure,
6. excess tap-water enemas,
7. cortisone therapy
Causes of increased capillary permeability (2)
sepsis
inflammatory responses
1. Body fluids are composed of: (3)
2. Body fluids are distributed and moved by (4)
3. body fluids also contain non-ionizing substances, such as (4)
1. electrolytes, minerals and cells.
2. diffusion, osmosis, filtration, and active transport
3. urea, glucose, creatinine, and bilirubin
Define:
1. electrolytes
2. ionized substances are measured in __.
3. cations
4. anions
5. solvent
6. solute
7. mEq
1. substances capable of breaking into electrically charged ions when dissolved in a solution.
2. milliequivalents
3. ions that develop a positive charge
4. ions that develop a negative charge.
5. liquids that hold a substance in solution
6. substances that are dissolved in a solution
7. unit of measure used to describe electrolytes in terms of their chemical combining power or activity.
How is hypernatremia treated?
Replace fluid intake slowly because rapid replacement causes fluid shift into cells too quickly causing them to lyse/also crosses blood brain barrier causing cerebral edema.
Nursing interventions for hypernatremia
Monitor vitals, I&Os, electrolytes; urine specific gravity; increase fluid intake if possible; restrict Na+ intake.
1. Major cation of ICF is __, which is only __% in ECF but __% in ICF.
1. Postassium (K+), 4% in ECF, 96% in ICF
Basic functions of Potassium (6)
1. regulates water and electrolyte content of intracellular fluid
2. promotes nerve impulses, especially in heart muscle
3. promotes skeletal muscle function
4. assists in transforming carbohydrates into energy and restructuring amin acids into proteins
5. provides necessary mechanism for glycogen deposition in liver
6. assists in regulation of acid/base balance by cellular exchange with hydrogen.
Signs of Hypokalemia (9)
EKG changes
aryghmias
cardiac arrest
respiratory arrest
skeletal muscles affected first - weakness
constipation (ileus)
dig. tox.
irregular/weak pulse
decreased reflexes
1.Signs of hyperkalemia
2. __-__% of K+ is excreted by the kidneys.
3. ___ secretions contain high amounts of K+.
4. 1L of urine contains _-_mEq of K+
1.Muscle irritability
bounding irregular pulse
paresthesias
2. 80-90%
3. GI
4. 20-40
Causes of Potassium Deficit (<__mEq/L)
<3.5 mEq/L
1. Decreased intake: alcoholism, decreases\d intake through diet or IV solutions without k+
2. Increased loss: vomiting, diarrhea, fistulas, would drainage, osmotic diuresis (diabetes mellitus), during severe stress/trauma/burns in healing phase (after third day), diuretic phase of renal failure, cushing's syndrome, hyperaldosteronism, metabolic and respiratory alkalosis, high carb intake (K+ moves into cell with increased insulin)
1. Need __-__meq/day of K+
2. Potassium excess (>__meq)
1. 40-80
2. >5 mEq/L
Causes of Potassium Excess:
1. Increased intake:__
1. excessive oral intake in presence of renal disease; excessive IV K+; transfusion of stored blood (cells in blood break down over time and release the intracellular contents, including large amounts of K+)
Causes of K+ excess:
1. decreased output:
2. Cell destruction in ICF
3. Gain from K+ moving out of cells
1. renal failure, postoperative oligurea, Addison's disease.
2. Gain fro ICF excessive cellular destruction: first 3 days after severe burns or severe trauma.
3. Gain from intracellular movement of K+ outward in exchange for H+, which moves into cell: metabolic and respiratory acidosis (axcept diabetic acidosis)
1. ___% of Ca++ is in bones,teeth; __% is free ionized Calcium.
2. Basic functions of Ca++ (10)
1. 99,1

1. nonionized form required for building strong bones and teeth
2. acts as essential component for blood coagulation
3. decreases neuromuscular irritability
4. promotes normal nerve impulse transmissin
5. strengthens and thickens cell membrane
6. assists in absorption and utilization of vitamin B12
7. activates enzymes that in turn activate chemical reactions within body
8. inhibits cell membrane permeability to sodium
9. moves into cell with sodium during depolariztion, binding troponin
10. results in actin- and myosin-promoting muscle contraction
Causes of Hypocalcemia
decreased intake:
1. decreased intake: poor dietary intake of calcium or vitamin d, especially when need higher (pregnancy and lactation), IV solutions without Ca++ after several days of infusion.
Causes of Hypocalcemia:
increased loss
1. diarrhea, wound drainage, diuresis, alcoholism, Cushing's syndrome, renal failure (high PO4-, Mg++), high-protein diets.
Causes of Hypocalcemia:
Decreased availability
Burns (trapped in eschar), pancreatitis, metablic alkalosis (decreased ionizaton), excess citrated blood (Ca++ binds to citrate)
Causes of Hypocalcemia:
1. Diminished regulatory hormone
2. Abnormal _____ levels influence interpretation of Ca++ levels. When ___levels are elevated, serum Ca++ is ____ than the lab reading.
1. Removal or damage to parathyroids.
2. serum albumin; when elevated, serum Ca++ is lower than the lab reading
Causes of hypercalcemia:
1. increased intake
2. increased loss
3. Increased intestinal___
4. Increased ionization:
5 Addison's disease:
1. excess milk or vit. D
2. Loss of Ca++ from bone; immobilization, cancers (breast, lung, kidney, multiple myeloma, leukemia), hyperparathyroidism
3. increased intestinal absorption and skeletal mobilization in hypophosphatemia
4. metabolic acidosis (bound calcium displaced from albumin)
5. Addison's disease (decreased Na+) mechanism uncertain.
Nursing assessment for hypercalcemia:
Trousseau's sign
Chvostek's sign
Carpal spasm
1.The most abundant cation in ICF after K+ is __
2. Foods high in Magnesium (10)
1.Magnesium (Mg++)
2.
green, leafy veg
meat
seafood
nuts and seeds
wheat bran
dairy products
soy flour
legumes
chocolate
molasses
Causes of Hypomagnesemia (3)
1. decreased intake: decreased diet intake, softened water, refined foods, alcoholism, IV solutions over long time without Mg++
2. increased loss: gastric suction, v/d, diuretic phase of renal failure, alcoholism, diabetic acidosis, toxemia
3. Decreased absorption: Crohn's disease, celiac disease, pancreatitis, hyperparathyroidism (ca++ inhibits), Cushings syndrome, and hyperaldosteronism (Na+ inhibits).
Causes of Hypermagnesemia (3)
1. increased intake: overdoss of Mg++ or ingestion of Mg++ in presence of renal disease
2. decreased output: renal disease.
3. decreased oppositon: Addison's disease and hypoaldosteronism (less Na+)
1. Most abundant anion in ECF
2. Basic functions of above (3)
3. Where produced?
4. Can be unbalanced by...
1. Chloride (CL-)
2. regulates extracellular fluid volume; serves as blood buffer - chloride shift; digestion--required for secretion of hydrochloric acid (necessary for activation of protease)
3. in the stomach as HCL-
4. disruption in the GI tract
1. normal CL- level
2. CL- deficit
3. causes of CL- def.
4. ___loss is usually greater than ___loss.
1. 98-106 mEq/L
2. <98 meq/L
3. Increased loss: loss through vomiting, diarrhea, suction, diuretics, interstitial fluid loss, excess bicarbonate; Addison's disease.
4. upper GI/Lower GI
1. Causes of CL- excess
1. Nonspecific - related to cation excess, usually Na+ or K+ imbalances; CL- imbalances are often listed as saline imbalances
1. Primary anion in ICF
2. Basic Functions of above
1. Phosphate (HPO4-)
2. nonionized form promotes bone and teeth rigidity; promotes acid-base balance (buffer system); provides necessary mechanism for production of adenosine triphosphate.
Causes of Phosphate deficit
1. decreased intake
2. increased loss
3. increased opposition
4. chronic respiratory alkalosis (shift of phosphorus to cell occurs when PaCO2 is decreased) leads to severe loss
5. Metabolic alkalosis (increased renal loss of phosphate) leads to mild loss
1. Causes of decreased intake of phosphate
2. Causes of increased phosphate loss
3. causes of increased opposition to HPO4-
1. Decreased diet intake, IV solutions long term without HPO4-.
2. osmotic diuresis of diabetic acidosis, malabsorption (colitis, decreased vitamin d)
3. Cushing's syndrome (increased Na+); hyperparathyroidism (increased Ca++); lead poisoning
Causes of Phosphate Excess
1. increased intake: excess dietary intake of high-phosphate foods (milk and milk products), increased absorption; excess vitamin D
2. decreased output; renal failure
3. decreased opposition: hypoparathyroidism (decreased Ca++); Addison's disease (decreased Na+)
High/low levels of HPO4- are best treated how?
By prevention. Eat high phopsphate foods (meat, fish, poultry, seeds, nuts, eggs.)-
1. Basic functions of hydrogen bicarbonate (HCO3-)
2. normal HCO3- levels
3. HCO3 reflects...
1. ratio of the concentration of each determines acidity or alkalinity of body fluids.; acid-base balance promotes efficient enzyme funtioning; acid/base balance is ned\cessary for binding of oxygen by hemoglobin
2. 7.35-7.45
3. serum pH
1. bicarbonate deficit in ECF also known as...
2. Causes of above
1. metabolic acidosis
2. Increased loss of HCO3-: severe diarrhea, loss of biliary, pancreatic, or lower bowel fluid.
Overproduction of metabolic acids: diabetic acidosis, shock (anaerobic metabolism increases blood lactic acid levels), starvation, prolonged fasting
Excessive ingestion of metabolic acids: high-fat, low-carb diets; salicylate toxicity; overingestion of certain medications cause H+ overload
Decreased ability to excrete overload of acid: renal disease
Conditions leading to increase in serum K+ as result of compensatory chloride shift (Cl- moves out of cell to combine with K+, HCO3- moves into cell)
1. bicarbonate excess in ECF also known as...
2. causes of above
1. metabolic alkalosis
2. increased HCO3-: ingestion of large amounts of alkali (baking soda).
Loss of acid: loss of HCL acid from the stomach (by vomiting or gastric suctioning).
Decreased loss: diuretic therapy, can result in loss of K+ and CL- with compensatory increase in HCO3-
1. pH and bicarbonate levels seen in metabolic acidosis
2. pH and bicarbonate levels seen in metabolic alkalosis
1. pH<7.35; HCO3-<25 mEq/L
2. pH>7.45; HCO3->29 mEq/L
1. Electrolytes help ___ ___ ___, __ __ ___, and __ __ __.

2. They also contribute to __ __ and __ __.
1. regulate water distribution, govern acid-base balance, and transmit nerve impulses.

2. energy generation and blood clotting.
Summary information:
Potassium (K)(4)
1. the dominant cation in ICF
2. Regulates cell excitability
3. Permeates cell membranes, thereby affecting the cell's electrical status.
4. Helps to control ICF osmolality and, consequently, ICF osmotic pressure.
Summary Information:
Magnesium (Mg)(3)
1. a leading ICF cation
2. Contributes to many enzymatic and metabolic processes, particularly protein synthesis.
3. Modifies nerve impulse transmission and skeletal muscle response. (Unbalanced Mg concentrations dramatically affect neuromuscular processes>)
Summary Information:
Phosphorus (P) (3)
1. The major ICF anion
2. Promotes energy storage and carbohydrate, protein, and fat metabolism
3. Acts as a hydrogen buffer
Summary Information:
Sodium (Na) (5)
1. The main ECF cation
2. Helps govern normal ECF osmolality (A shift in Na concentrations triggers a fluid volume change to restore normal solute and water ratios.)
3. Helps maintain acid-base balance
4. Activates nerve and muscle cells
5. Influences water distribution with chloride
Summary Information:
Chloride (Cl) (4)
1. The main ECF anion
2. Helps maintain normal ECF osmolality
3. Affects body pH
4. Plays a vital role in maintaining acid-base balance; combines with hydrogen ions to produce hydrochloric acid.
Summary Information:
Calcium (Ca) (5)
1. A major cation in teeth and bones; found in fairly equal concentrations in ICF and ECF.
2. Also found in cell membranes, where it helps cells adhere to one another and maintain their shape
3. Acts as an enzyme activator within cells (muscles must haave Ca to contract.)
4. Aids coagulation
5. Affects cell membrane permeability and firing level.
1. When we take in water and electrolytes through diet, they are then________.
2. in ICF, __is the major cation and __is the major anion.
3. in ECF, __is the major cation, and __ is the major anion.
1. distributed throughtout the body's fluid compartments. The compartments contain the same electrolytes but in different amounts.
2. potassium, phosphate
3. Sodium, Chloride
Na+ levels in different compartments:
1. a. ECF/Intravascular (plasma)
b. ECF/Interstitial
2. Intracellular (skeletal muscle cell)
3. Transcellular:
a.Gastric juice
b. pancreatic juice
c. Sweat
1. a. 142
b. 145
2. 12
3. a. 60
b. 130
c. 45
K+ levels in different compartments:
1. ECF:a. Intravascular (Plasma)
b. Interstitial
2. Intracellular (skel. muscle cell)
3. Transcellular:
a. Gastric juice
b. Pancreatic juice
c. Sweat
1. a. 4.5
b. 4.4
2. 150
3. a. 7
b. 7
c. 5
Cl- levels in different compartments:
1. ECF a. intravascular
b. interstitial
2. Intracellular (skeletal muscle cell)
3. Transcellular
a. Gastric juice
b. Pancreatic juice
c. Sweat
1. a. 104
b. 117
2. 4.0
3. a. 100
b. 60
c. 58
HCO3- levels in different compartments:
1. ECF a. intravascular
b. interstitial
2. Intracellular (skeletal muscle cell)
3. Transcellular
a. Gastric juice
b. Pancreatic juice
c. Sweat
1. a. 24
b. 27
2. 12
3. a. 0
b. 100
c. 0
HPO4- levels in different compartments:
1. ECF a. intravascular
b. interstitial
2. Intracellular (skeletal muscle cell)
3. Transcellular
a. Gastric juice
b. Pancreatic juice
c. Sweat
1.a. 2.0
b. 2.3
2. 40
3. a. 0
b. 0
c. 0
Water and electrolytes move where?
Between one compartment to another, between ICF and ECF and interstitial and vascular compartments.
1. Diffusion
2. Hydrostatic pressure
3. osmosis
4. osmotic pressure
1. Movement of molecules from area of high concentration to area of low concentration.
2. Force exerted by a fluid against the walls of its container.
3. Flow of water between two compartments seperated by a membrane that's permeable to water but not to a solute, from an area of low concentration to an area of high concentration.
4. The force used to describe the movement of water.
1. osmolality
2. osmolarity
1. used to measure a solution's ability to effect the movement of water.
2. The measure of total solute volume. Also called tonicity.
1. Solutes move from areas of higher concentration ot areaas of lower concentration until their concentration is equal in both areas.
2. Fluid moves passively from an area with more fluid ( and fewer solutes) to one with less fluid (and more solutes).
1. Diffusion
2. Osmosis
1. isotonic IV solutions.
2. hypertonic IV solutions
3. hypotonic IV solutions
1. similar to body fluid. Normal saline, D5, lactated ringer; Same concentration of particles as ECF.
2. More concentrated than ECF. Pulls fluid into the bloodstream from the cells. D50, higher dextrose solns.
3. Less concentrated than ECF. Moves water out of blood into cells causing them to swell. D5 in .25 saline; half normal saline.