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Electrolyte Friends
Balancing electroltyes
Question | Answer |
---|---|
Substances that when in solution dissociate into ions | Electrolytes |
A change in sodium will probably affect _______ | chloride |
A change in calcium will probably affect _________ | phosphorous |
Positively charged ions | cations |
Negatively charged ions | anions |
A test used for distinguishing types and causes of acid-base imbalances | anion gap |
Electro-neutrality | the balance between positively and negatively charged ions |
Which type of ions do most electrolytes in the body interact with to maintain acid-base balance? | Hydrogen ions |
Name the major extracellular electrolytes. | sodium, chloride, calcium and bicarbonate |
What are the major electrolytes in extracellular fluid? | Sodium and Chloride |
Name three things sodium does. | affects serum osmolality and extracellular fluid volume; helps nerves and muscle interact |
What does chloride do? | helps maintain osmotic pressure and is a component of hydrochloric acid (stomach acid) |
Which fluid compartment is the main home for calcium and bicarbonate? | Extracellular |
Give 5 functions of calcium. | stabilizes the cell membrane and reduces its permeability to sodium; transmit nerve impulses; contract muscles; coagulate blood; form bone and teeth |
What is the function of bicarbonate? | acid-base balance |
Name the most abundant intracellular electrolytes. | Potassium, phosphate, and magnesium |
What intracellular electrolyte plays an important role in cell excitability, nerve impulse conduction, resting membrane potential, muscle contraction and myocardial membrane responsiveness, and intracellular osmolality control? | Potassium |
What intracellular electrolyte is needed in addition to calcium for the formation of teeth and bone? | Phosphate |
What intracellular electrolyte is essential for energy metabolism and also helps with acid-base balance? | Phosphorus |
What would we find elevated in plasma if cells are dying (from trauma or chemotherapy)? | Intracellular electrolytes like potassium, phosphate, and magnesium |
Do intracellular and extracellular electrolytes stay in their neighborhoods? | No, they like to travel around to maintain balance and electro-neutrality. |
Name the organs that are involved in the renin-angiotensin-aldosterone system. | kidneys, liver, lungs, adrenal glands |
What electrolytes are influenced by the renin-angiotensin-aldosterone system? | sodium, potassium, and hydrogen |
When aldosterone causes the kidneys to reabsorb sodium what electrolytes are sacrificed in its place? | potassium or hydrogen |
What hormone causes sodium to be reabsorbed? | aldosterone |
What hormone causes sodium to be excreted? | atrial natriuretic peptide |
What hormone causes the body to retain water and where does in come from? | antidiuretic hormone made in the hypothalamus and stored in the pituitary gland |
How does antidiuretic hormone affect electrolytes? | Increased water volume affects solute concentration in the blood |
Why are babies at higher risk for electrolyte imbalance? | because their kidneys cannot concentrate urine like adult kidneys until about age two |
Why are older folks at higher risk for electrolyte imbalance? | Their kidneys have fewer functional nephrons and a decreased glomerular filtration rate and a diminished ability to concentrate urine. |
What happens to the fluid level in the body when too much sodium is released? | It drops. |
_______ and fluid balance are closely related. | Sodium |
High levels of potassium can be fatal. The failure of what organ would lead to high levels of potassium in the blood? | the kidneys |
Name four conditions for which a diuretic might be prescribed. | hypertension, heart failure, electrolyte imbalances, kidney disease |
A ______ causes electrolyte loss, whereas __ _____ causes electrolyte gain. | diuretic; IV fluid |
What is the amount of required sodium and Chloride that we should keep in mind when administering IV fluids to a patient? | 1 to 2 mEq/kg/day |
What is the amount of required potassium that we should keep in mind when administering IV fluids to a patient? | 0.5 to 1 mEq/kg/day |
What gets left behind in the glomerulus if the kidney is healthy? | red blood cells, platelets, and protein |
K+ | potassium ion |
Na+ | Sodium ion |
Cl- | Chloride ion |
HPO42- | Phospate ion |
HCO3- | Bicarbonate ion |
H+ | hydrogen |
How do the kidneys keep the PH of the blood balanced? | They excrete variable amounts of H+ and conserve bicarbonate to buffer hydrogen |
Name 5 important ions regulated by the kidneys. | sodium, potassium, calcium, chloride, and phosphate |
What part of the kidney tubule is responsible for the most water reabsorption? | proximal tubule |
Which part of the kidney tubule concentrates urine by losing water to by osmosis and has a side that is not permeable to water but loses salt? | loop of Henle |
On what part of nephron do aldosterone and ADH work? | the distal tubule |
How does dopamine act like a diuretic? | it dilates the afferent arterioles in the glomerulus increasing blood flow, thereby increasing filtration ->urine production |
What kind of diuretics work in the proximal tubule? | osmotic diuretics: mannitol, glucose, carbonic anhydrase inhibitors (acetazolamide [Diamox]) |
How does mannitol cause diuresis? | since it isn’t reabsorbed in the tubule it increases osmotic pressure (water magnet) in the filtrate inhibiting reabsorption of water and salt |
How does glucose cause diuresis? | Extra glucose spills into the tubule causing an osmotic effect |
What kind of diuretic that works in the proximal tubule causes diuresis by reducing hydrogen ion (acid) concentration leading to excretion of bicarbonate, water, sodium, and potassium? | Carbonic anhydrase inhibitors (acetazolamide [Diamox]) |
What kind of diuretics work at the loop of henle? | loop diuretics |
How do loop diuretics work? | They prevent the reabsorption of water and sodium in the ascending loop of henle. |
Name some loop diuretics. | Lasix, Bumex, and Edecrin |
What kind of diuretics work in the distal tubule? | Thiazide diuretics and potassium sparing diuretics |
How do thiazide diuretics work? | They work by inhibiting reabsorption of sodium (Na+) and chloride (Cl−) ions from the high end of the distal convoluted tubules in the kidneys by blocking the thiazide-sensitive Na+-Cl− symporter. (Wikipedia) |
How much sodium chloride is in 5% sodium chloride IV fluid? | 855 mEq/L |
How much sodium chloride is in 3% sodium chloride IV fluid? | 513 mEq/L |
How much sodium chloride is in 0.9% sodium chloride IV fluid? | 154 mEq/L |
How much sodium chloride is in 0.45% sodium chloride IV fluid? | 77 mEq/L |
What electrolytes are in Ringer’s solution? | Chloride, sodium, calcium, potassium |
What does lactated Ringer’s solution have in addition to Ringer’s solution? | lactate |
Three questions we should ask to evaluate IV treatment. | Right amount of electrolytes? How long has the patient been getting them? Is the patient getting oral electrolyte supplements as well? |
Electrolyte that helps nerve and muscle cells interact | sodium |
Electrolyte that maintains osmotic pressure and helps gastric mucosal cells produce stomach acid | Chloride |
Stabilizes cell membrane, reducing its permeability; transmits nerve impulses; contracts muscle; coagulates blood; forms bones and teeth | Calcium |
Regulates acid-base balance | bicarbonate |
Regulates cell excitability, nerve impulse conduction, resting membrane potential, muscle contraction, myocardial membrane responsiveness, and intracellular osmolality | Potassium |
Controls energy metabolism | phosphate |
Influences enzyme reactions, neuromuscular contractions, normal functioning of nervous and cardiovascular system, protein synthesis, sodium and potassium ion transportation | magnesium |
What electrolyte is likely to be lost when a patient is on diuretics? | potassium |
What electrolyte level would be increased in serum if a patient had suffered a severe burn? | potassium |
Where are most electrolytes reabsorbed in the nephron? | proximal tubule |
Which intracellular ion causes ions to shift in and out of cells allowing electrical impulses to be conducted from cell to cell? | potassium |