Acid Base, Electrolytes, and Fluids - Part 1

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____ balances within the body maintain health and function in all body systems.

Fluid, electrolyte, and acid-base

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Fluid, electrolyte, and acid-base are maintained by __.

the intake and output of water and electrolytes, their distribution in the body, and regulated by the renal and pulmonary systems.

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Imbalances in fluids, electrolytes and acid-base result from?

illnesses, altered fluid intake, or prolonged episodes of vomiting or diarrhea.

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Acid-base balance is necessary for many physiological processes. Imbalances alter __.

respiration, metabolism, and cardiovascular, renal, and central nervous system function.

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__ of the average adult's weight is fluid.

60%

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Fluid imbalance is evaluated based on the amount of __ lost or gained in relationship to water.

sodium

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Body fluids are distributed into two distinct compartments.

intracellular fluids and extracellular fluids.

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Intracellular fluid (ICF) comprises

all fluid within the cells of the body, about 42% of total body weight.

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Extracellular fluid (ECF) is

all the fluid outside a cell, which is divided into three smaller compartments: interstitial fluid, intravascular fluid, and transcellular fluid.

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Interstitial fluid, intravascular fluid, and transcellular fluid

Extracellular fluid (ECF)

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Interstitial fluid

contains lymph, is the fluid between the cells and outside the blood vessels.

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Transcellular fluid

fluid separated from other fluids by a cellular barrier and consists of cerebrospinal, pleural, gastrointestinal (GI), intraocular, peritoneal, and synovial fluids.

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The area within the cell is called the ___ space

intracellular

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The tissue spaces between blood vessels and cells and the area within blood vessels are known as the ___ space.

extracellular

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An ___ is an element or compound that, when dissolved or dissociated in water or another solvent, separates into ions that are electrically charged.

electrolyte

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Cations

positively charged ions

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Anions

negatively charged ions

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Shift from compartment to compartment and are separated by

semi-permeable membranes. These are ways fluids move through our body.

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___ maintain physiological processes.

Minerals

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Minerals also act as catalysts in

nerve response, muscle contraction, and metabolism of nutrients in foods.

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Minerals regulate ___ and strengthen skeletal structures.

electrolyte balance and hormone production - iron and zinc.

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Osmosis

Movement of a solvent from an area of lesser to one of greater concentration.

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Diffusion

Random movement of a solute through a semipermeable membrane from higher to lower concentration. – Affected by size of molecules or solutes – large=slower. Filtration

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Active transport

Movement of ions against osmotic pressure to an area of higher pressure.

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Crystalloids

solutes comprised of salts and large molecule colloids that do not easily dissolve.

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In the body, water is the ___ and the solutes are ___.

solvent, electrolytes, oxygen, carbon dioxide, glucose, and proteins

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Fluids and electrolytes constantly shift from compartment to compartment to facilitate body processes such as

tissue oxygenation, acid-base balance, and urine formation.

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Osmolality is the measure used to evaluate serum and urine in clinical practice and reflects the

total solute concentration in a fluid compartment.

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Albumin exerts colloid osmotic or oncotic pressure, which tends to

keep fluid in the intravascular compartment by pulling water from the interstitial space back into the capillaries (vascular compartment).

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When there is increased hydrostatic pressure on the venous side of the capillary bed (as in congestive heart failure (CHF)), reversal in the normal movement of water occurs from interstitial space into intravascular space by filtration and results in ___

.edema - an accumulation of excess fluid in the interstitial space.

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As sodium diffuses into the cell and ___ out of the cell, active transport delivers sodium back to the extracellular compartment and ___ to the intracellular compartment.

potassium

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Examples of active transport are the

sodium-potassium-ATPase pump.

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The sodium-potassium-ATPase pump does what?

keeps a higher concentration of potassium in the ICF and a higher concentration of sodium in the ECF.

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The thirst-control center is located within

the hypothalamus in the brain.

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The __ continually monitor the serum osmotic pressure, and when osmolality increases, the hypothalamus is stimulated.

osmoreceptors

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ABG

tells us their pH levels – Arterial Blood Gas

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I/O

Intake and Output of fluids, etc, including stools.

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CMP

Complete metabolic panel – sodium, pot, cal, mag, etc. But your electrolytes.

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BMP

basic metabolic pane

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Too much fluid intake backs up into the lungs and we hear

crackles

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Avenues for daily water loss

Lungs (breathing), skin (perspiration), urine, feces.

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Average water intake is about

2200 mL to 2700 mL per day.

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Water oxidation (oxidative metabolism) is the by-product of

cellular metabolism of ingested solid foods.

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Antidiuretic hormone (ADH) is stored in the ___ and is released in response to changes in blood osmolarity.

posterior pituitary gland

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ADH prevents

diuresis, thus causing the body to save water.

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An increase in osmolarity stimulates the osmoreceptors in the hypothalamus to release the hormone

ADH.

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ADH works directly on the

renal tubules and collecting ducts to make them more permeable to water causing it to return to the systemic circulation, diluting blood and decreasing its osmolarity.

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As ADH causes the body to compensate, there will be a temporary ___ in urinary output.

decrease

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When the blood becomes __, the osmoreceptors stop the release of ADH and urinary output is restored.

diluted

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Changes in renal perfusion initiate the

renin-angiotensin-aldosterone mechanism.

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A proteolytic enzyme secreted by the kidneys, responds to decreased renal perfusion secondary to a decrease in extracellular volume.

Renin

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Renin Secreted from the kidneys in response to

low kidney perfusion

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Renin produces __ produced which is a vasoconstrictor.

Angiotension 1

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Angiotension 1 is converted to ___ which is also a selective vasoconstrictor which increases blood flow to the kidneys causing improved kidney function.

Angiotension 2

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The adrenal cortex releases ___ in response to increased plasma potassium levels or as a part of the renin-angiotensin-aldosterone mechanism to counteract hypovolemia.

aldosterone

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Atrial natriuretic peptide

secreted from atrial cells in the heart.

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ANP acts as a

diuretic that causes sodium loss and inhibits the thirst mechanism.

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Because sodium retention leads to water retention, the release of aldosterone acts as a

volume regulator.

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Fluid is lost through

kidneys, skin, lungs, and GI tract

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Insensible loss

skin and lungs and GI tract – breathing allows water to evaporate from our breath. 200 ml lost in GI tract and about 500mL through lungs.

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Sensible loss

perspire through skin

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Major cations within the body fluids include

sodium (Na+), potassium (K+), calcium (Ca2+), and magnesium (Mg2+).

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Cations interchange when one cation leaves the cell and is replaced by another. This occurs because cells tend to maintain

electrical neutrality.

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Sodium is the most abundant cation __% in ECF.

(90%)

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Sodium intake is regulated by

dietary intake and aldosterone secretion.

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Potassium is the major electrolyte and principal cation in the

intracellular compartment

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Potassium is regulated by?

Dietary intake and renal excretion - body conserves potassium poorly, so any condition that increases urine output decreases the serum potassium concentration.

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Magnesium is essential for

enzyme activities, neurochemical activities, and cardiac and skeletal muscle excitability.

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Serum magnesium is regulated by

dietary intake, renal mechanisms, and actions of the parathyroid hormone (PTH).

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The three major anions of body fluids are

chloride (Cl-), bicarbonate (HCO3-), and phosphate (PO43-) ions.

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___ is the major anion in ECF.

Chloride

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The transport of chloride follows

sodium.

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Bicarbonate

(HCO3-) - the major chemical base buffer within the body.

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The __ regulate bicarbonate.

kidneys

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Phosphate is a buffer anion found primarily in

ICF, with a small amount found in ECF.

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Calcium and phosphate are inversely proportional

if one rises, the other falls.

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___ is normally absorbed through the GI tract. It is regulated by dietary intake, renal excretion, intestinal absorption, and PTH.

Phosphate

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Arterial pH is

an indirect measurement of the hydrogen ion (H+) concentration.

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pH is also a reflection of the balance between

carbon dioxide (CO2), which is regulated by the lungs, and bicarbonate (HCO23), a base regulated by the kidneys.

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The three general types of acid-base regulators in the body are?

chemical (the carbonic acid–base buffer system), biological (the absorption and release of hydrogen ions by cells), and physiological buffering systems (the lungs and kidneys).

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The largest chemical buffer in ECF is the

carbonic acid and bicarbonate buffer system

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The carbonic acid–bicarbonate buffer system is the first buffering system to react to

change in the pH of ECF, and it reacts within seconds.

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Whenever carbon dioxide increases, there is an increase in

hydrogen ions produced

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Whenever hydrogen ions are produced, there is

more carbon dioxide produced.

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The __ primarily control the excretion of carbon dioxide resulting from metabolism.

lungs

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The __ control excretion of hydrogen and bicarbonate ions.kidneys

(blank)

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Biological buffering occurs when

hydrogen ions are absorbed or released by cells.

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Biological buffering occurs after

chemical buffering.

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The hydrogen ion has a positive charge and must be exchanged with

another positively charged ion, frequently potassium (K+).

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Created by: Ladystorm