Patho Week 2- Fluid Electrolyte And Acid-Base Balance

Front 1

diffusion

Back 1

particles move from higher concentration to lower concentration. Smoke. Particles are in constant motion, providing energy for diffusion.

Front 2

osmosis

Back 2

movement of water across a semipermiable membrane

Front 3

osmotic pressue

Back 3

the pressure to oppose osmosis

Front 4

tonicity

Back 4

the tension or effect that the effective osmotic pressure of a solution with impermeable solutes exerts on a cell size because of water movement across the cell membrane.

Front 5

edema

Back 5

palpable swelling produced by expansion of interstitial fluid volume

Front 6

effects of edema

Back 6

interfere with movement by limiting joint motion
increases the distance for oxygen, nutrients and waste.

Front 7

3rd space accumulations

Back 7

when fluids accumulate in the transcellular space, such as the pericardial sac, the pleural sac, or peritoneal cavity.

Front 8

where are 3rd space locations

Back 8

serous cavity, pericardial sac, peritoneal cavity (ascites), and the pleural cavity.

Front 9

Mechanisms in which sodium is gained or lost

Back 9

fever-metabloci rate increases-greater demand for water

respiratory rate increases-additional loss of water vapor through the lungs.

Oral intake

gi absorption and IV fluids

Front 10

What causes isotonic fluid volume deficit

Back 10

when water and electrolytes are lost in isotonic proportions

Almost always caused by a loss of body fluids

often accompanied by a decrease in fluid intake

vomiting, diarreha, excessive sweating

Front 11

Signs and symptoms of isotonic fluid volume deficit

Back 11

thirst
water conservation by the kidney
loss of body weight
impaired temperature regulation
signs of reduced interstitial and vascular volume
postural hypotension
dehydration
sunken eyeballs
dry mucous membranes

Front 12

isostonic fluid excess

Back 12

Can be pathological or compensatory.

Increase in total body sodium that is accompanied by a proportionate increase in body water

Excessive sodium intake

Most commonly caused by a decrease in sodium and water elimination by the kidney

Front 13

isotonic fluid excess manifestations

Back 13

weight gain over short amount of time
edema
jugular vein distention
BUN and hematocrit decreased
edema-lungs
shortness of breath, difficulty breathing, respiratory crackles,
and productive cough

Front 14

Who is most at risk for hyponatremia and why?

Back 14

the elderly b/c they have a decrease in renal function

They have a more difficult time maintaining body fluid homestasis

Front 15

hyponatremia

Back 15

fluid volume excess. cells swell

Front 16

HYPERNATREMIA

Back 16

causes celullar dehydration (fluid volume deficit)

Front 17

Causes of hypernatremia

Back 17

net gain of sodium or net loss of water

defect in thirst or inability to drink water

rapid infusion of sodium with insufficient time for water ingestion

Front 18

hyponatremia

Back 18

Decrease in renal function
Difficulty to maintain body fluid homeostasis

Fluid Volume Excess

lethargy
headache
disorientation
confusion
motor weakness
seizure
coma
loss of appetite

muscle cramps
weakness
fatigue

GI: nausea vomiting abdominal cramps, diarrhea, anorexia

Front 19

Dibetes Insipidus

Back 19

Deficiency of or a decreased response to ADH.

Results in polyuria. Usu. balanced by excess thirst.

Hypernatria (fluid excreted leaving a higher concentration of sodium

dehydration

Front 20

Syndrome of inappropriate ADH (SIADH)

Back 20

too much ADH is released; negative feedback system fails. Results in marked water retention and dilutional hyponatremia

Front 21

Manifestations of SIADH

Back 21

stress or chronic conditions
dilutional hyponatremia (retaining too much fluid-lowers concentration of sodium

Urine output decreases
urine osmolality high

serum osmolality low

hematocrit and serum sodium decreases

BUN levels decrease

Front 22

hypovolemia

Back 22

when the effective circulating blood is compromised
Reduced fluid- Trauma with massive blood loss
Burns
Dehydration- GI tract vomiting diarrhea

Front 23

Where is most of the body's sodium?

Back 23

In the extra cellular fluid compartment

Front 24

calcium is a

Back 24

membrane stabilizer

Front 25

What could you give a pt with hyperkalemia?

Back 25

insulin

Front 26

#1 issue with potassium problems

Back 26

heart-conducting nerve/ muscular impulses

Front 27

PTH regulation on serum calcium

Back 27

1) Promotes the release of calcium from the bone
2) Increases the activation of Vitamin D
3) Stimulates calcium retention and phosphate elimination from the kidneys

DOES NOT INCREASE HUNGER FOR CALCIUM PRODUCTS

Front 28

Major Postive ions

Back 28

Na
K
Ca
MG

Front 29

Major negative IOns

Back 29

Cl
HCO3 (bicarbonate)
Phospahate ions (HPO4)
Sulfate SO4

Front 30

functions of electrolytes

Back 30

cofactors for enzymes
action potentials in neuron and muscle cells
secretion of hormones and neurotransmitters
muscle contraction

Front 31

capillary hydrostatic (filtration) pressure (CHP)

Back 31

pushes water out of the capillary and into the interstitial spaces
movement of water through capillary pores because of a mechanical force
A rise in the arterial or venous pressure idependent parts of the body.
Results from the weight of the water-hydrostatic pressure

Front 32

Capillary Colloidal Osmotic Pressure

Back 32

Pulls water back up into the capillary. The osmotic pressure generated by lasma proteins that are too large to pass through the pores of the capillary wall
o Because plasma proteins do not normally penetrate the capillary pores and because their concentration is greater in the plasma than in the interstitial fluids, it is the capillary colloidal osmotic pressure that pulls fluid back into the capillary

Front 33

Interstitial hydrostatic pressure (THP)

Back 33

Force of fluid in the interstitial spaces. The interstitial pressure is slightly negative, contributing to the outward movement of fluid from the capillary

Front 34

Tissue cuboidal osmotic pressure (TCOP)

Back 34

o Pulls water out of the capillary into the interstitial spaces
o Reflects the small amount of plasma proteins that normally escape into the interstitial spaces from the capillary
o Also pulls water out of the capillary into the tissue spaces

Front 35

Increased Capillary Filtration Pressure:

Back 35

o The movement of vascular fluid into the interstitial spaces increase
o Factors that increase capillary pressure:
 A decrease in the resistance to flow through precapillary sphincters
 An increase in venous pressure or resistance to outflow at the postcapillary sphincters
 Capillary distension caused by increased vascular volume
Causes-
Increased vascular volume, such as
 Heart failure
 Kidney disease
 Premenstrual sodium retention
 Pregnancy
 Environment
 Heat stress
Venous obstruction, such as
Liver disease with portal vein obstruction
Acute pulmonary edema
Venous thrombosis (thrombo phlebitis)

Front 36

Decreased Capillary Colloidal Osmotic Pressure

Back 36

o If there is a decrease, there are less Protein-pulling magnets tking fluid out of the capilaries.

This causes inadequate osmotic force

Increased loss of plasma proteins, such as
 Protein-losing kidney disease
 Extensive burns
Decreased production of plasma proteins, such as
 Liver disease
 Starvation
 Malnutrition

Front 37

Increased Capillary Permeability:

Back 37

o The capillary pores become enlarged or the integrity of the capillary wall is damaged, capillary permeability is increased
o Plasma proteins and other osmotically active particles leak into the interstitial spaces, increasing the tissue colloidal osmotic pressure and contributing to the accumulation of interstitial fluid
Causes-
 Inflammation
 Allergic reactions
 Malignancy
 Tissue injury and burns

Front 38

Obstruction of Lymphatic Flow:

Back 38

Obstruction of Lymphatic Flow:
o Osmotically active plasma proteins and other large particles that cannot be reabsorbed through the pores in the capillary membrane rely on the lymphatic system for movement back to the circulatory system
o Fluid in the interstitial spaces is not being returned to the circulatory system properly
Causes-
 Malignant obstruction of lymphatic structures
 Surgical removal of lymph nodes

Front 39

What does obesity do to total body water?

Back 39

Reduces amount of body water

Front 40

Identify the mechanisms by which water is gained and lost

Back 40

 What happens with fever?
o Metabolic rate increases-greater demand for water
o Respiratory rate increases-additional loss of water vapor through the lungs
 What is the main source of water gain?
o Oral intake and metabolism of nutrients
 GI absorption and IV
 What organ is responsible for the largest water loss?
o Kidneys
 GI tract and sweating
 What is obligatory urine output? What is the volume?
o The urine production required to eliminate metabolic wastes
o 300-500mL/day
 What is insensible water loss?
o Evaporative water losses from the respiratory tract and skin-occur without a person’s awareness

Front 41

Most of the body’s sodium is in the __________ compartment.

Back 41

extra cellular fluid

Front 42

Sodium regulates extracellular fluid volume through....

Back 42

osmotic activity, involved in acid-base balance, and contributes to function of the nervous system and other excitable tissues.

Front 43

How is sodium lost?

Back 43

Kidneys-regulating sodium output

Front 44

The physiological mechanisms that regulate sodium excretion/conservation

Back 44

 Sympathetic Nervous System
o Responds to changes in arterial pressure and blood volume by adjusting the glomerular filtration rate and the rate at which sodium is filtered from the blood
o Regulates tubular reabsorption of sodium and renin release
 Renin-angiotensin-aldosterone System
o Angiotensisn II
 Acts directly on the renal tubules to increase sodium reabsorption
 Acts to constrict renal blood vessels, thereby decreasing the glomerular filtration rate and slowing renal blood flow so that less sodium is filtered and more is reabsorbed
 Regulator of aldosterone
o Aldosterone
 Acts at the level of the cortical collection tubules of the kidney to increase sodium reabsorption while increasing potassium elimination

Front 45

What are the 2 stimuli for true thirst based on water need?

Back 45

 Cellular dehydration caused by an increase in extracellular osmolarity
 A decrease in blood volume which may or may not be associated with a decrease in serum osmolality

Front 46

Hypodipsia

Back 46

is a decrease in the ability to sense thirst while polydipsia represents excessive thirst.

Front 47

ADH levels are controlled by what?

Back 47

 Extracellular volume and osmolaltiy
 Osmoreceptors in the hypothalamus sense changes in extracellular osmolality and stimulate production and release of ADH

Front 48

What can cause an abnormal increase in ADH synthesis?

Back 48

 Stress situations
 Sever pain
 Nausea
 Trauma
 Surgery
 Certain anesthetic agents
 Some narcotics (morphine)

Front 49

Diabetes insipidus (DI):

Back 49

a deficiency of or a decreased response to ADH. Results in excretion of large volume of urine. Usually balanced by excessive thirst.

Front 50

Manifestions of Diabetes insipidous

Back 50

 Complaints of polyuria and intense thirst
 Hypernatremia (fluid excreted, higher concentration of sodium)
 Dehydration

Front 51

Syndrome of inappropriate ADH (SIADH):

Back 51

too much ADH is released; negative feedback system fails. Results in marked water retention and dilutional hyponatremia.

Front 52

What are some causes and manifestations of SIADH?

Back 52

 Stress or chronic conditions
 Dilutional hyponatremia (retaining too much fluid-lower concentration of sodium)
 Urine output decreases
 Urine osmolality-high
 Serum osmolality-low

 Hematocrit and serum sodium decreases due to blood dilution
 BUN (Blood, Urea, and Nitrogen) levels decrease due to blood dilution

Front 53

DISORDERS OF SODIUM AND WATER BALANCE

Back 53

isotonic fluid volume deficit and isotonic fluid volume excess.

Front 54

Isotonic Fluid Volume Deficit

Back 54

What is meant by isotonic fluid volume deficit?
 Differentiates this type of fluid deficit in which there are proportionate losses in sodium and water from water deficit and the hypersmolar state associated with hypernatremia

Front 55

What are the usual causes of isotonic fluid volume deficit?

Back 55

 When water and electrolytes are lost in isotonic proportions
 Almost always caused by a loss of body fluids
 Often accompanied by a decrease in fluid intake

Front 56

Manifestations. What are the signs and symptoms of isotonic fluid volume deficit?

Back 56

 Thirst
 Signs of water conservation by the kidney
 Loss of body weight
 Impaired temperature regulation
 Signs of reduced interstitial and vascular volume
 Postural hypotension (reduced blood volume)
 Dehydration

Front 57

Isotonic Fluid Volume Excess can be caused by

Back 57

 Increase in total body sodium that is accompanied by a proportionate increase in body water
 Excessive sodium intake
 Most commonly caused by a decrease in sodium and water elimination by the kidney

Front 58

Manifestations of Isotonic Fluid Volume Excess. What are the signs and symptoms?

Back 58

 Weight gain over a short amount of time
 Presence of edema
 As vascular volume increases the jugular veins become distended, pulse becomes full and bounding, central venous pressure is elevated
 BUN and hematocrit decreased as a result of the expanded plasma volume
 Edema-lungs
o Shortness of breath, complaints of difficult breathing, respiratory crackles, and productive cough

Front 59

Which population is most at risk for hyponatremia and why?

Back 59

 Elderly
o Decrease in renal function-causing the kidney to fall behind on conserving sodium
o Difficulty to maintain body fluid homeostasis due to environmental, drug-related, and disease associated stress

Front 60

hyponatremia:

Back 60

 The sodium in ECF becomes diluted as water moves out of cells in response to the osmotic effects of elevated blood glucose levels
 Water retention
 Loss of water and sodium-excess sweating
 When water is used to replace fluids lost in sweating-should use electrolytes
 Loss of sodium in gastrointestinal tracts
 Retention of water with dilution of sodium in normal ECF volume
 Edema associated disorders…heart failure, cirrhosis, nephritic syndrome, and advanced renal disease

Front 61

Manifestations hyponatremia

Back 61

 Muscle
o Muscle cramps
o Depression of deep tendon reflexes
o Weakness
o Fatigue
 (Heavy exercise and hot water)
 Central Nervous
o Lethargy
o Headache
o Disorientation
o Confusion
o Gross motor weakness
o Seizure (severe)
o Coma (severe)
 Gastrointestinal
o Nausea
o Vomiting
o Abdominal cramps
o Diarrhea
o Anorexia

Causes. List some causes of hypernatremia.
 Net gain of sodium or net loss of water
 Rapid ingestion or infusion of sodium with insufficient time or opportunity for water ingestion-disproportionate gain in sodium
 Defect in thirst or inability to obtain or drink water-can interfere with water replacement

Most likely to occur in what age groups?
 Infants and people who cannot express their thirst or obtain water to drink

Front 62

Hypernatremia causes...

Back 62

Results in hypertonicity of the ECF and causes cellular dehydration.

Front 63

Hypernatremia Causes:

Back 63

 Net gain of sodium or net loss of water
 Rapid ingestion or infusion of sodium with insufficient time or opportunity for water ingestion-disproportionate gain in sodium
 Defect in thirst or inability to obtain or drink water-can interfere with water replacement

Front 64

Hypernatremia, Most likely to occur in what age groups?

Back 64

Infants and people who cannot express their thirst or obtain water to drink

Front 65

Manifestations hypernatremia

Back 65

Mostly associated with dehydration. What are they?
 Increased thirst
 Increased ADH with oliguria and high urine-specific gravity
 Dry skin and mucous membranes
 Decreased tissue turgor
 Decreased salivation and lacrimation
 Headache
 Disorientation and agitation
 Decreased reflexes
 Seizures (severe)
 Coma (severe)
 Weak, rapid pulse
 Impaired temperature regulation with fever
 Decreased blood pressure
 Vascular collapse (severe)

Front 66

Potassium Balance. 98% of the body’s potassium is which…..intracellular or extracellular?

Back 66

intracellular

Front 67

The body stores most of the potassium where?

Back 67

muscles

Front 68

Describe the physiologic mechanisms that regulate potassium.

Back 68

RENAL REGULATION:
What does aldosterone do to potassium?
 In the presence of aldosterone, sodium is transported back into the blood
 Potassium is secreted into the tubular filtrate for elimination in the urine

How does the potassium-hydrogen exchange system work?
 When serum potassium levels are increased, potassium is secreted into the urine and hydrogen is reabsorbed into the blood, producing a decrease in pH and metabolic acidosis
 When potassium levels are low, potassium is reabsorbed and hydrogen is secreted into the urine, leading to metabolic alkalosis

Extracellular-Intracellular Shifts:
Metabolic acidosis >>> H+ ions move into cells >>> potassium leaves the cells.
Metabolic alkalosis >>> H+ ions leave the cells >>> potassium enters the cells.
Serum osmolality increases cause potassium to move out of cells into the ECF.

Front 69

Repeated muscle exercises causes potassium to what?

Back 69

To be released into the ECF

Front 70

Potassium is a super important electrolyte that does what?

Back 70

REGULATES ELECTRICAL MEMBRANE POTENTIALS (esp important for Cardiac, Skeletal, and smooth muscles)

 Maintenance of the osmotic integrity of cells
 Acid-Base balance
 Kidney’s ability to concentrate urine
 Necessary for growth
 Contributes to the chemical reaction that transforms carbohydrates into energy
 Changes glucose into glycogen
 Convert amino acid and proteins

Front 71

Since hypokalemia (decreased potassium) moves the resting membrane potential (RMP) further from the threshold for excitation, it requires a ___________ stimulus to reach the threshold.

Back 71

greater

Front 72

Hyperkalemia (increased potassium) moves the RMP closer to the threshold causing an initial increase in membrane _____________

Back 72

excitability

Front 73

3 causes of Hypokalemia

Back 73

 Inadequate intake
o Inability to obtain or ingest food
o Diet that is low in potassium-containing foods
 Excessive losses through the kidney, skin, or gastrointestinal tract
o Diuretic use
o Metabolic alkalosis
o Magnesium depletion
o Trauma and stress
o Increased levels of aldosterone
o Vomiting
o Loss of protective skin surface
o Sweating
o Burns
 Redistribution between the ICF and ECF compartments
o β2-adrenergic agonist drugs (decongestants)
o Insulin

Front 74

K+ has a critical role in conducting nerve impulses and the excitability of skeletal, cardiac, and smooth muscle … how does it do this? Describe the 3 ways:

Back 74

o Regulates Resting Membrane Potential

 The opening of the sodium channels that control the flow of current during the action potential
o A decrease in serum potassium causes the resting membrane potential to become more negative(hyperpolarization), moving further from the threshold for excitation. Therefore, it would take a greater stimulus to reach threshold and open the sodium channels that are responsible for the action potential

o An increase in serum potassium has the opposite effect; it causes the resting membrane potential to become more positive (hypopolarized), moving closer to the threshold
 It would take a lesser stimulus to reach the threshold and open the sodium channels that are responsible for the action potential
• Persistent depolarization inactivates the sodium channels
 The rate of repolarization

Front 75

Manifestations. Hypokalemia alters the membrane potentials and excitability on cardiovascular, neuromuscular, and gastrointestinal function. List these symptoms.
Notice … in general, things are sloooooowed down, right?

Back 75

 Cardiovascular
o Postural hypotension
o Predisposition to digitalis toxicity
o Electrocardiogram changes
o Cardiac arrhythmias
 Neuromuscular
o Muscle weakness, flabbiness, fatigue
o Muscle cramps and tenderness
o Paresthesias
o Paralysis (severe)
 Gastrointestinal
o Anorexia, nausea, vomiting
o Abdominal distention
o Paralytic ileus (severe)
 Increased thirst
 Inability to concentrate urine
 Polyuria
 Urine with low specific gravity

Front 76

Hyperkalemia is a serum potassium level greater than 5.0 mEq/L.
Causes. List the 3 categories of causes and give examples of each.

Back 76

o ******Decreased renal function-renal failure******* (Most common cause)
 Decreased renal elimination
o Decrease in aldosterone-mediated potassium
o Depression of aldosterone release caused by a decrease in renin or angiotensin II
o Impaired ability of kidneys to respond to aldosterone
 Excessively rapid administration
o Kidneys control potassium elimination, therefore IV solutions should not be administered until urine output has been assessed and renal function is adequate
 Movement of potassium from the ICF to ECF compartments
o Tissue injury-causes release of intracellular potassium into the ECF-diminish renal function

o Decrease in aldosterone-mediated potassium
o Depression of aldosterone release caused by a decrease in renin or angiotensin II
o Impaired ability of kidneys to respond to aldosterone
 Excessively rapid administration
o Kidneys control potassium elimination, therefore IV solutions should not be administered until urine output has been assessed and renal function is adequate
 Movement of potassium from the ICF to ECF compartments
o Tissue injury-causes release of intracellular potassium into the ECF-diminish renal function

Front 77

Manifestations. What are the effects of hyperkalemia on neuromuscular, gastrointestinal, and cardiovascular systems?

Back 77

Notice things are slow again … one would think the effects would be the opposite of hypok+ and initially they are, but the later effects differ because persistent depolarization inactivates the sodium channels and produce a decrease in excitability (p. 124).
 Cardiovascular
o Electrocardiogram changes
o Risk of cardiac arrest (severe)
 Neuromuscular
o Weakness, dizziness
o Muscle cramps
o Paresthesias
o Paralysis (severe)
 Gastrointestinal
o Nausea, vomiting
o Intestinal cramps
o Diarrhea
 Transient hyperkalemia may be induced by exercise or seizures when muscle cells are permeable to potassium

Front 78

Ionized calcium, which leaves the vascular space, serves what functions?

Back 78

 Many enzyme reactions
 Exerts an important effect on membrane potentials and neuronal excitability
 Necessary for contraction of skeletal, cardiac, and smooth muscle
 Participates in the release of hormones, neurotransmitters, and other chemical messengers
 Influences cardiac contractibility and automaticity by way of slow calcium channels
 Essential for blood clotting

Front 79

Describe the physiologic mechanisms that regulate calcium.

Back 79

Calcium enters the body through the gastrointestinal tract, is absorbed from the intestine, thanks to Vitamin D. Calcium is stored in bone and is excreted by the kidney.

What hormone is the major regulator of serum calcium?
 Parathyroid Hormone (PTH)

Front 80

Mechanisms involved in PTH’s regulation of serum calcium.

Back 80

1. Promotes the release of calcium from the bone.
2. Increases activation of Vitamin D.
3. Stimulates calcium retention and phosphate elimination in the kidneys.

Front 81

Describe the Renin-angiotensin, aldosterone system

Back 81

Regulates sodium excretion and absorption.

Front 82

What is Angiotensin II?

Back 82

Acts directly on renal tubules to increase sodium reabsorption.

Acts to constrict renal blood vessels, thereby decreasing the glomerular filtration rate and slowing renal blood flow so that less sodium is filtered and more is reabsorbed.

Front 83

Functions of Aldosterone

Back 83

Acts at the level of the cortical collection tubules of the kidney to increase sodium reabsorption and while increaing potassium elimination.

Front 84

SIADH

Back 84

Marked water retention, and dilutional hyponatremia

Urine output decreases
Serum sodium decreases
BUN levels dcrease
Dilutional hyponatremia (retaining too much fluid, lower concentration of sodium)

Front 85

Isotonic Fluid Volume deficit

Back 85

proportionate loss of sodium and water

Front 86

hypovolemia

Back 86

when the effective circulating blood is compromised

Front 87

Causes of isotonic fluid volume deficit

Back 87

when water and electrolytes are lost in isotonic proportions.
Almost always accompanied by a loss of body fluids
Pften accompanied by a decrease in fluid intake.

Front 88

Signs and symptoms of isotonic fluid volume deficit

Back 88

dehydration and related symptoms
postural hypotension
shock
weak pulse
decreased blood pressure
signs of water conservation by the kidney
dry mucous membranes
skin turgur

Front 89

Isotonic fluid volume excess

Back 89

Can be pathological or compensatory
Most commonly caused by a decrease in sodium and water elimination by the kidney
Caused by proportional increase in sodium and water

Front 90

Manifestations of Isotonic Fluid volume excess

Back 90

weight gain over short time
edema
distended jugular veins
full pulse
elevated central venous pressure
BUN and hematocrit decreased
Lung edema-shortness of breath productive cough

Front 91

For low sodium, think ________

Back 91

brain (cerebral swelling)

Hyponatremia aka fluid volume excess

water retention

edema related disorders (conjestive heart failure)

DISORIENTATION
Seizure
Coma
headache
Lethargy

Front 92

for high sodium (hypernatremia), think _______

Back 92

dehydration
aka fluid volume deficit

Caused by rapid ingestion of sodium, defect in thirst, or inability to drink.

Most likely in infants and people who cannot express their thirst or obtain a drink

Front 93

s/s hypernatremia

Back 93

dehydration
decreased reflexes
seizures coma
weak rapid pulse

Front 94

In metabolic acidosis, what happens to H+?

Back 94

H+ ions move into cells >>>> potassium leaves the cell, making the cells more acidic

Front 95

What happens to H+ in metabolic alkalosis

Back 95

H+ ions leave the cells>>>> potassium enters the cells

Front 96

Insulin and catecholamines

Back 96

decrease serum potassium levels by increasing cellular uptake of potassium

Front 97

What does aldosterone do to potassium?

Back 97

In the presence of aldosterone, sodium is transported back into the blood

Potassium is secreted into tubular filtrate for elimination through the urine

Front 98

How does thee Potassium hydrogen exchange system work?

Back 98

When serum potassium levels are increased, potassium is secreted into the urine and hydrogen is reabsorbed into the blood, leading to a decrease pH and metabolic acidosis

When potassium levels are low, potassium is reabsorbed and hydrogen is secreted into the urine, leading to metabolic alkalosis

Front 99

_________ __________ causes potassium to move out of cell into the ECF

Back 99

serum osmolality

Front 100

98% of the body's potassium is _____

Back 100

intracellular

Front 101

The body stores potassium where?

Back 101

muscles

Front 102

K+ critical role is...

Back 102

assisting in nerve impulses and the excitability of skeletal, cardiac, and smooth muscle

Front 103

3 ways potassium assists in nerve impulses

Back 103

Regulates Resting Membrane Potential

Regulates the opening of the sodium channels that control the flow of current during an action potential

Regulates the rate of repolarization

Front 104

Since hypokalemia moves the resting membrane potential further from the threshold for excitation , it requires a _______ stimulus to reach the threshold

Back 104

greater

Front 105

Hyperkalemia moves out of the RMP closer to the threshold causing an initial increase in membrane excitability, but with severe hyperkalemia, sodium channels become inactivated resulting in a net _________ in excitability

Back 105

decrease

Front 106

Hypokalemia ________ the rate of repolarization, whereas hyperkalemia ________ the rate of replorization

Back 106

decreases

increases

Front 107

When calcium goes up, ________ goes down

Back 107

PHOSPHATE LEVELS and PTH

Front 108

When PTH goes up, what goes down?

Back 108

calcium

Front 109

caused by increase in ADH

Back 109

hyponatremia

Front 110

Most likely to affect brain cells and cause altered personality and behavior

Back 110

hyponatremia and fluid volume excess

Front 111

SIADH involves....

Back 111

over production of ADH, causing fluid retention and edema. Dilution of solutes such as sodium (which causes hyponatremia) and dilution of RBC, which leads to Anemia.

Front 112

Hormones such as insulin and epipenephrine facilitate movement of K+ _________ the cells.

Back 112

into

Front 113

Severe excercise and cell trauma (burns, or excessive GI activity for example) can cause K+ to move ____ the blood.

Back 113

into