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MLT Electrolytes
Electrolytes
| Question | Answer |
|---|---|
| Electrolytes dissociate into __________ when placed in a solution | Ions |
| Ions have a(n) _____________ charge | electrical |
| Anions have a(n) _____________ charge | negative |
| Cations have a(n) ___________ charge | positive |
| Main contributors to osmotic pressure | potassium (intracellular) sodium (extracellular) proteins (plasma) |
| total number of anions equals | total number of cations |
| reactivity measurements are expressed as | mEq/L or mmol/L |
| Major Cations | sodium Na+ potassium K+ |
| Major Anions | Chloride Cl- Bicarbonate HCCO3- |
| Sodium (Na) function/process | Blood Volume Osmotic Regulation |
| Potassium (K) function/process | Blood volume osmotic regulation myocardial rhythm acid-base balance neuromuscular excitability |
| Chloride (Cl) function/process | blood volume osmotic regulation acid-base balance |
| Bicarbonate (HCO3) function/process | acid-base balance |
| Magnesium (Mg) function/process | myocardial rhythm enzyme elevation blood coagulation neuromuscular excitability |
| Calcium (Ca) function/process | myocardial rhythm enzyme activation blood coagulation neuromuscular excitability production and use of ATP by glucose regulation of ATPase ion pump |
| Phosphate (PO4) function/process | production and use of ATP by glucose |
| Intracellular Water Cation amount = Na+ = _______mmol/L K+ = __________ mmol/L Mg++ = ___________ mmol/L Which is the major cation | cations = 205 Na+ = 10 mmol/L K+ = 160 mmol/L Mg++ = 35 mmol/L K+ is the major intra cellular cation |
| Intracellular water Anion amount = Cl- = _______ mmol/L HCO3- =______ mmol/L HPO4- =________mmol/L Protein- _________ mmol/L Which is the major anion | Anions= 205 Cl- = 2mmol/L HCO3- = 8mmol/L HPO4- =140 mmol/L Protein- = 55 mmol/L HPO4 is the major intracellular anion |
| Extracellular Water (plasma) Cation amount= Na+ = ________mmol/L K+ = _________mmol/L Ca++ = __________mmol/L Which is the major extracellular cation | Cation amount = 152 Na+ = 140 mmol/L K+ = 5 mmol/L Ca++ = 5 mmol/L Sodium is the major extracellular cation |
| Extracellular water (plasma) Anion amount = Cl- = ______ mmol/L HCO3 = _______mmol/L HPO4 = ___________ mmol/L SO4 = __________mmol/L Organic acids _________ mmol/L Protein __________ mmol/L What is the major extracellular anion? | Anion amount = 152 Cl- = 105 mmol/L HCO3 = 25 mmol/L HPO4 = 2 mmol/L So4 = 1 mmol/L organic acids = 6 mmol/L protein = 15 mmol/L Chloride is the major extracellular anion |
| Sodium function | fluid distribution maintain cell shape transmits nerve impulses |
| Sodium regulates/regulations | Renin-ADH Aldosterone (increase sodium, and decrease potassium) controlled by kidneys |
| A decreased serum sodium (hyponatremia) can be caused by | GI Loss Addison's disease (hypoaldosteronism) Renal loss Dilutional -edema diabetic acidosis |
| A serum sodium of less than ______ can cause seizures, and coma | < 110 mmol/L |
| An increased serum sodium (hypernatremia) can be caused by | Excess water loss (dehydration) Cushing's syndrome (hyperaldosteronism) Iantrogenic -caused by medications such as diuretics |
| A serum sodium higher than __________ can cause muscular weakness, and seizures | >170 mmol/L |
| What is considered the most important of the four major electrolytes | Potassium |
| Potassium function | cell metabolism cardiac muscular excitation pH |
| Potassium regulates/regulation | aldosterone H+ enter cells to be buffered and force K+ out of cells Dietary intake |
| Decreased serum potassium (hypokalemia) can be caused by | increased cellular uptake renal loss GI loss Hyperaldosteronism decreased dietary intake insulin injections (forces K+ into cells) |
| Increased serum potassium (hyperkalemia) can be caused by | trauma, crush injuries, blood transfusions altered cellular uptake impaired excretion hypoaldosteronism |
| What can cause a FALSE increase in potassium | hemolysis |
| a serum potassium of less than ________ mmol/L can cause irregular heartbeat | <2.5 mmol/L |
| a serum potassium of more than ________mmol/L can cause an irregular heartbeat | >6.5 mmol/L |
| Chloride function/regulation | maintains hydration along with sodium enzyme activator concentration of chloride varies inversely with HCO3 As bicarbonate increases, chloride decreases |
| Decreased serum chloride (hypochloremia) can be caused by | prolonged vomiting due to loss of HCL Diabetic ketoacidosis Renal failure Metabolic alkalosis |
| Increased serum chloride (hyperchloremia) can be caused by | dehydration decreased renal blood flow excessive loss of HCO3 through GI tract or renal loss |
| Bicarbonate function/regulation | major buffering system of plasma for acid-base balance CO2+H2O <---> H+ + HCO3 regulated by the kidneys through increased and decreased tubular reabsorption concentration varies inversely with chloride (chloride shift) |
| Decreased serum bicarbonate can be caused by | metabolic acidosis renal failure diarrhea |
| Increased serum bicarbonate can be caused by | metabolic alkalosis |
| Anion gap is | the difference between values of measured cations and measured anions |
| Purpose of anion gap | to get an estimation of undetermined anions in electrolyte determinations such as sulfates and organic acids such as ketoacids and lactic acid |
| anion gap is most useful in | determining degree o metabolic acidosis quality control of electrolyte analyses |
| anion gap determination calculation is and it should equal approximately | (sodium+potassium) - (chloride+bicarbonate) 12-20mmol/L |
| An elevated gap can indicate | in increase in unmeasured anions such as organic acids diabetic acidosis lactic acidosis |
| if several patient anion gaps are decreased | check possible issues with electrodes, clean them, run controls and rerun patients |
| ADH (antidiuretic hormone) is synthesized | in the hypothalmus |
| ADH (antidiuretic hormone) is stored in | the posterior pituitary gland |
| ADH (antidiuretic hormone) increases water.... | reabsorption in the distal tubules |
| Renin is secreted by ________ in response to | the kidney decreased renal blood flow |
| renin stimulates the | secretion of aldosterone |
| angiotensin is secreted by in response to | the liver renin |
| angiotensin acts on the to stimulate the secretion of it I salso a powerful vasoconstrictor that increases | adrenal cortex aldosterone blood pressure |
| aldosterone is a hormone that is secreted from the it enhances followed by and excretion of | cortex of the adrenal gland distal tubular reabsorption of sodium water potassium and hydrogen ions |
| Methods of measurement: Sodium | ion selective electrodes |
| Methods of measurement potassium | ion selective electrodes |
| methods of measurement chloride | ion selective electrodes |
| methods of measurement Bicarbonate or total CO2 | manometric (change in pressure) colorimetric enzymatic CO2 electrode = modified pH electrode |
| ISE (ion selective electrodes) method sodium | glass ion exchange membrane electrode |
| ISE (ion selective electrodes) method potassium | valinomycin membrane electrodes |
| ISE (ion selective electrodes) method chloride | ion exchange electrode to selectively bind Cl- ions |
| ISE (ion selective electrodes) method bicarbonate | usually measured using blood gas analysis |
| iontophoreses the sweat inducing drug used in this process is | pilocarpine |
| sodium and chloride content of sweat in individuals with cystic fibrosis is usually | 60 mmol/L or greater |
Created by:
Mwortman
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