Fluid, Electrolyte, & Acid-Base Dynamics

Front 1

Isotonic Solutions

Back 1

Percent Salt: 0.9% NaCL
Milliosmoles: 300 mOsm/L
Milliequivalents: 325 mEq/L
D5W (5% dextrose)
Saline, NS, PS, PSS
Ringer's and Lactated Ringer's

Front 2

Hypertonic Solutions:

Back 2

Higher than isotonic solutions
Percent Salt: >0.9% NaCL
Milliosmoles: >300
Milliequivalents: >325
D10W (>5% dextrose)

Front 3

Hypotonic Solutions

Back 3

Lower than isotonic solutions
Percent Salt: <0.9% NaCL
Milliosmoles: <300
Milliequivalents: <325
D2W (<5% dextrose)

Front 4

OSMOSIS:

Back 4

H20 moves toward the region of higher solute concentration (into the cell)
H20 moves toward the region of higher solute concentration (out of cell)

Front 5

OSMOSIS:
Isotonic Solutions:

Back 5

causes no net water movement (cell is in equilibrium)
no change in size or function

Front 6

OSMOSIS:
Hypertonic Solutions:

Back 6

draws H20 out of the cell
cells crenate and size and function both decrease

Front 7

OSMOSIS:
Hypotonic Solutions:

Back 7

Draws H20 into the cell
cells swell and may lyse, size and function decreases

Front 8

OSMOSIS:
2 calorie burning reactions

Back 8

Hydrolysis
Dehydration
very high water = too dilute
too much water or not enough water = lowered reaction

Front 9

Thirst Mechanism:

Back 9

Decreases ECF Volume OR Increased ECF Osmolality -------> Hypothalamus ----->Lowered Saliva ------>thirst ------>drink------->higher ecf volume

Front 10

Hyperosmotic solution:

Back 10

shriveled cells

Front 11

Hypoosmotic solution:

Back 11

cells swell and eventually burst

Front 12

Quiz: H20 moves to 300 mOsm/L or to 310 mOsm/L?

Back 12

to 310 mOsm/L

Front 13

Excessive Perspiration.
Blood sodium levels drop from 325 mEq/L to 124 mEq/L. What is the danger?
How is it corrected?

Back 13

Low sodium in blood allows h20 to move into cells (osmosis)
less fluid in blood, lower blood volume and pressure
Raise the heart rate will raise BP

Front 14

Electrolytes ionize into particles; Nonelectrolytes (glucose), do NOT ionize. Electrolytes are separated by what?

Back 14

water

Front 15

Hormone mineralocorticoid match with....

Back 15

Aldosterone

Front 16

Estrogen:

Back 16

female hormone from the ovaries mimics aldosterone.
Stimulates kidneys to reabsorb sodium, chloride, water
high fluid retention (edema)

Front 17

Cortisol:

Back 17

hormone (glucocorticoid) from the adrenal cortex that mimics aldosterone.
anti-inflammatory (vasoconstrictor)

Front 18

Cortisol converts lipids and proteins to:

Back 18

glucose (gluconeogenesis)

Front 19

High Cortisol causes:

Back 19

edema, high visceral fat deposition, lower memory storage, low memory retrieval.

Front 20

4 importances of Calcium

Back 20

Nerve impulse transmission
muscle contraction
blood clotting
bone structure

Front 21

Calcitonin:
Release is stimulated by

Back 21

High blood Ca++

Front 22

Calcitonin acts on:

Back 22

bone (osteoblast cells deposit Ca++)
Kidneys (secrete Ca++)
Intestines (excrete Ca++)
Lowers blood Ca++ levels

Front 23

PTH release is stimulated by

Back 23

Low blood Ca++

Front 24

PTH acts on:

Back 24

Bone (osteoclast cells remove Ca++)
Kidneys (reabsorb Ca++)
Intestines (absorb Ca++)
Raises blood Ca++ levels

Front 25

Calcitonin increases....which direction will calcium move?

Back 25

from blood into bone

Front 26

Parathyroid Hormone increases....in which direction will calcium move?

Back 26

from the bones into blood

Front 27

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

Back 27

Hypothalamus makes high aldosterone and ADH
Kidneys produce less urine
Hypothalamus will cause high thirst (thirst center)

Front 28

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?

Back 28

Hypothalamus secretes more ADH during sleep (high ADH prevents urination)

Front 29

A person has had diarrhea for 2 days.
Body potassium level is only 25% of normal value
Why is potassium level so low?

Back 29

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)

Front 30

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

Back 30

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.

Front 31

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?

Back 31

Distilled water is hypotonic to cells.
Red blood cells will lyse and release hemoglobin, creating a burden on the liver to cleanse the blood.
Low red blood cell count could make the patient anemic.

Front 32

A patient has had severe head trauma and there is swelling around the brain.
the physician has ordered an IV of 20% glucose (d20W)
Why was this done?

Back 32

20% glucose is hypertonic.
it will attract fluid from the brain into the blood, reducing the swelling around the brain.

Front 33

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

Back 33

Salt makes the blood hypertonic
Fluid will move by osmosis into the blood which will raise blood volume and blood pressure

Front 34

Blood pH is regulated by:

Back 34

Kidneys, Lungs, Buffers in Blood

Front 35

Response to acidosis:

Back 35

Kidneys secrete H+ and reabsorb HCO3-

Front 36

Response to alkalosis:

Back 36

Kidneys reabsorb H+ and secrete HCO3-

Front 37

Kidneys regulate pH by:

Back 37

secrete hydrogen ions and reabsorb bicarbonate ions, if pH is too LOW
Reabsorb hydrogen ions and secrete bicarbonate ions, if pH is too HIGH

Front 38

Respiratory/Lungs regulate pH by:

Back 38

breath faster to get rid of excess carbon dioxide if low pH
Carbon dioxide forms carbonic acid in the blood
breath slower to retain carbon dioxide if high pH
carbon dioxide combines w/ water to form carbonic acid in the blood

Front 39

__________ + _______ = Carbonic Acid

Back 39

Carbon dioxide + Water = Carbonic Acid

Front 40

high carbon dioxide ------> ___ acidity ------> _____pH

Back 40

high acidity, low pH

Front 41

Breathing slower will

Back 41

retain Co2 & pH will decrease (high acidity and high H+)

Front 42

LOW carbon dioxide =

Back 42

low acidity, high pH

Front 43

Carbon dioxide:
Breathing faster will

Back 43

eliminate more Co2 and pH will increase (low acidity & high H+)

Front 44

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

Back 44

breath faster to get rid of Co2, lower acidity
Hyperventilation

Front 45

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

Back 45

breath slower to retain more Co2, raise acidity
Hypoventilation

Front 46

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

Back 46

pH will decrease because carbon dioxide is retained, which will raise blood acidity and H+

Front 47

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

Back 47

pH will increase because Co2 is NOT retained, which will lower blood acidity and H+

Front 48

Circulatory buffers:

Back 48

regulate pH

Front 49

Buffers:

Back 49

resist changes in pH.
prevent excessive pH changes in the body if an acid or base is added to the body.

Front 50

Strong acid:

Back 50

Acid that releases many hydrogen ions

Front 51

Strong acid = hydrochloric acid equation

Back 51

HCI ----> H+ + CI -

Front 52

Weak acid:

Back 52

Acid that releases FEW hydrogen ions

Front 53

Weak Acid: Carbonic acid equation

Back 53

H2Co3---->H+ + HCo3-

Front 54

Buffers change strong acids to weak acids: (equation)

Back 54

strong acid + buffer -----> weak acid + salt

Front 55

Bicarbonate Ion: Carbonic Acid Ratio

Back 55

20:1 = pH 7.4
21:1 = pH more than 7.4
19:1 = pH less than 7.4

Front 56

Acidosis:

Back 56

pH falls below 7.35
low Nervous system function
coma
Acidotic shock

Front 57

Alkalosis:

Back 57

pH climbs above 7.45
high nervous system function
convulsions
alkalotic shock

Front 58

Respiratory acidosis:

Back 58

Decrease in respiratory rate (hypoventilation)
increased Co2 in the blood = low pH

Front 59

Respiratory Alkalosis:

Back 59

increase in respiratory rate (hyperventilation)
decreased Co2 in blood = high pH

Front 60

Metabolic Acidosis:

Back 60

high acid (high H+) in blood
low bicarbonates in blood
high hydrogen ions in blood
high acids in foods
low bases in food
diarrhea

Front 61

Metabolic Acidosis:
high acid in blood caused by:

Back 61

renal disease (unable to secrete H+)
Diabetes Mellitus, high fat diet, starvation, high ketones (ketosis ----> ketoacidosis)

Front 62

Metabolic Alkalosis: low acid in blood caused by:
leads to:

Back 62

vomiting
diuretics
____________
High bicarbonate in blood
high sodium bicarbonate ingestion
high bases in foods, low in acids

Front 63

ECF Ions:

Back 63

HIGH
Na+, CI-, Ca+2, HCO3-
(sodium, chloride, calcium, bicarbonate)

Front 64

ICF Ions:

Back 64

K+, Mg+2, SO4-2, HPO4-2
(potassium, magnesium, Sulfate, Phosphate)

Front 65

Sodium Functions

Back 65

attracts water to the ECF
nerve impulses
muscle contractions

Front 66

Hypernatremia:

Back 66

high Na+ in the blood
hypertension
muscle twitching
mental confusion
coma

Front 67

Hyponatremia:

Back 67

Low Na+ in blood
hypotension
tachycardia
muscle weakness

Front 68

Potassium functions:

Back 68

attracts water into the ICF
nerve impulses
muscle contractions

Front 69

Hyperkalemia:

Back 69

high K+ in blood
cardiac arrhythmias
cardiac arrest
elevated T-wave (ECG)
muscle weakness

Front 70

Hypokalemia:

Back 70

low K+ in blood
cardiac arrhythmias
cardiac arrest
depressed T-wave (ECG)
Muscle weakness

Front 71

Calcium functions:

Back 71

bones & teeth
blood clotting
nerve impulses
muscle contraction

Front 72

Hypercalcemia:

Back 72

high Ca in blood
renal calculi (kidney stones)
cardiac arrhythmias

Front 73

Hypocalcemia:

Back 73

Low Ca in blood
muscle tetany
weak cardiac muscle contractions
increase in clotting time

Front 74

Aldosteronism:

Back 74

high Aldosterone production
high blood sodium levels
low blood potassium levels
hypertension

Front 75

Addison's Disease:

Back 75

hyposecretion of the adrenal cortex
low aldosterone (mineralocorticoid)
low cortisol (glucocorticoid)
(cortisol converts protein into glucose)
hypotension (low Na+)
Hypoglycemia (low glucocorticoids)

Front 76

Cushing's Disease:

Back 76

High glucocorticoids
adrenal gland tumor
side effect of cortisol
hyperglycemia
abdominal fat accumulation
posterior neck hump

Front 77

Addison's vs. Cushing's Disease:
Addison's:

Back 77

Low glucocorticoids & mineralcorticoids
hypoglycemia & hypotension
skin discoloration (sun-tanned)
high ACTH levels stimulate high melanocyte levels

Front 78

Addison's vs. Cushing's Disease:
Cushing's Disease:

Back 78

High glucocorticoids and mineralcorticoids
hyperglycemia and hypertension
edema (moon face)
abdominal visceral deposition
"buffalo hump"
low I.Q.

Front 79

Increase in Antidiuretic (ADH):

Back 79

recovery of H2O at collecting duct

Front 80

Decrease in Antidiuretic (ADH):

Back 80

recovery of H2O at collecting duct

Front 81

Diabetes Insipidus:
Cause:

Back 81

Low ADH secretion
Low ADH receptors @ kidneys

Front 82

Diabetes Insipidus:
Effect:

Back 82

Increased urination
dehydration