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34 Cards in this Set

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Excess sodium in the blood

Two main causes of hypernatremia:

1. Dehydration
2. Over-retention of sodium

Clinical manifestations of hypernatremia:

1. Hypovolemia (decreased blood volume from dehydration).
2. Tachycardia (increased HR) due to hypovolemia (need faster HR for blood to reach tissue).

3. Hypervolemia (increased blood volume).
4. Increased blood pressure due to hypervolemia.

What happens to a cell with hypernatremia?

Crenation (shrinking) of RBC


Decreased sodium in the blood

Two causes of hyponatremia:

1. DILUTIONAL HYPONATREMIA - Replacing body fluid with electrolyte-free fluid (i.e., H2O) or replacing with the wrong electrolytes.

2. SIADH (Syndrome of Inappropriate [Secretion of] ADH) - Loss of sodium through kidneys due to decreased aldosterone secretion.

Clinical manifestations of hyponatremia:

1. Hypervolemia due to over-hydration (from dilutional hyponatremia).
2. Hypovolemia due to under-retention of sodium (from SIADH).

What happens to a cell with hyponatremia?

Hemolysis (swelling leading to bursting)

What happens to H+ when potassium leaves a cell?

When potassium leaves a cell, H+ enters.

How does insulin affect potassium levels?

Insulin causes K+ uptake INTO cells. This causes decreased K+ in the extracellular fluid, which is HYPOKALEMIA.


Increased potassium in the blood

Four causes of hyperkalemia:

1. Renal disease - Nephron causes too little potassium to leave the body, meaning there will be TOO MUCH potassium in the extracellular fluid.

2. Shift from intracellular to extracellular
- Burn injury causes cells to burst, releasing potassium into the extracellular fluid.
- Acidosis of the ECF causes K+ to leave the cell, and H+ to enter the cell. This relieves the original acidosis but causes hyperkalemia

3. Insulin deficit - insulin causes K+ uptake so if there is too little insulin, minimal K+ is taken up by cells, resulting in hyperkalemia of ECF.

4. Undersecretion of aldosterone (aldosterone causes secretion of K+ from the body into the urine, so if there isn't enough, not a lot of aldosterone will leave ECF).


Decreased potassium in the blood

Four causes of hypokalemia:

1. Diuretics
2. Alkalosis
3. Increased aldosterone secretion
4. Insulin excess


Disorder marked by muscular twitching, cramps, and convulsions, and caused by hypocalcemia.


<7.35 pH


>7.45 pH

What is the main acid and base of the body?

ACID - Hydrogen ions (H+)
BASE - Bicarbonate (HCO3-)

Metabolic acidosis

A condition occurring when the kidneys are not removing enough acid from the body, or when not enough bicarbonate is being produced. Marked by a pH of <7.35.

Two causes of metabolic acidosis

1. Increase in non-carbonic acid acids (i.e., metaboic acids such as ketones or lactic acid from anaerobic respiration)
2. Decrease in HCO3- in extracellular fluid (may be due to kidney problem)

Effect of acidosis/alkalosis on the nervous system

Low pH (acidosis) depresses the nervous system, while a high pH (alkalosis) stimulates the nervous system.

Respiratory pH calculation

CO2 + H2O <--> H2CO3 (carbonic acid) <--> H+ (very strong acid) + HCO3- (bicarbonate, weak base)

How does hyperventilation affect the pH-respiratory system?

1. Hyperventilate
2. Decreased CO2 (due to hyperventilation)
3. Decreased H2CO3 (due to less CO2 binding to H2O)
4. Decreased H+ ions (due to less H2CO3)
5. Increased ph (alkalosis due to less H+)

How does acidosis affect the pH-respiratory system?

1. Acidosis
2. Increased breathing (due to lungs wanting to fix acidosis)
3. Decreased CO2 (due to increased breathing)
4. Decreased H2CO3 (due to less CO2 binding to H2O)
5. Decreased H+ (due to less H2CO3)
6. Increased pH (alkalosis due to less H+)

What systems regulate the balance of pH?

The respiratory system regulates CO2 (acid) levels, while the excretory system regulates HCO3- (base) levels.
- Respiratory system utilizes the lungs.
- Excretory system utilizes the kidneys.

Define "compensation"

What is done to maintain the pH in response to disturbances

Define "partially compensated"?

When one of the systems (respiratory or excretory) is attempting to rectify the disturbance, but has not yet been successful, resulting in values for that system that are outside normal ranges.

Define "fully compensated"?

When pH levels are back within normal limits, but values for both systems are outside of normal limits.

Define "corrected"

When all values are within normal limits.

Interprete these values:

pH 7.35
PaCO2 64 mmHg
PaO2 60 mmHg
HCO3- 33 mmol/L

- pH is normal
- PaCO2 is too high, indicating that their breathing has decreased.
- PaCO2 is too low, indicating that the person has decreased breathing or problems with gas exchange.
- HCO3- is too high, indicating that their kidneys have increased bicarbonate to fix previous acidosis.

Fully compensated, respiratory acidosis.

Interprete these values:

pH 7.32
PaCO2 32 mmHg
PaO2 86 mmHg
HCO3- 17 mmol/L

- pH is too low, acidosis
- PaCO2 is too low to cause acidity, indicating that this is metabolic acidosis.
- PaO2 is normal, indicating that it is trying to fix metabolic acidosis.
- HCO3- is too low, confirming that it is metabolic acidosis.

Partially compensated, metabolic acidosis.

Interprete these values:

pH 7.55
PaCO2 28 mmHg
PaO2 80 mmHg
HCO3- 24 mmol/L

- pH is too high (alkalosis)
- PaCO2 is too low, meaning it is respiratory alkalosis
- PaO2 is normal.
- HCO3- is normal.

Since HCO3- value is normal, this respiratory alkalosis isn't even partially compensated.

Interprete these values:

pH 7.33
PaCO2 55 mmHg
PaO2 57 mmHg
HCO3- 29 mmol/L

- pH is too low (acidosis)
- PaCO2 is too high, indicating that it is respiratory acidosis.
- PaO2 is too low, confirming that it is respiratory acidosis. This person has decreased breathing.
- HCO3- is higher than normal, indicating that is trying to fix the respiratory acidosis.

Partially compensated respiratory acidosis.

Interprete these values

pH 7.52
PaCO2 49 mmHg
PaO2 90 mmHg
HCO3- 40 mmol/L

- pH is too high (alkalosis)
- PaCO2 is too high, indicating that it is trying to fix the low pH.
- PaO2 is normal.
- HCO3- is too high, indicating that this is metabolic alkalosis.

Partially compensated metabolic alkalosis.