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MLT Electrolytes


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