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TL electrolytes
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 anions |
| 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 |
| 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 old 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, protein, and platelets |
| 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 |
| What is the most common cause of hyponatremia? | SIADHs |
| What is the most common cause of Hypernatremia? | Diabetes Insipidus |
| What are the most common causes of hypokalemia (DVD)? | Diarrhea, Vomiting, Diurectics |
| What are the most common causes of hyperkalemia? | Burns and Renal Failure |
| What is the most common cause of hypocalcemia (serum level)? | Acute pancreatitus |
| What is the most common cause of hypercalcemia (serum level)? | Hyperparathyroidism |
| What is the most common cause of hypocalcemia (ionized level)? | Massive Transfusion |
| What is the most common cause of hypercalcemia (Ionized level)? | Acidosis |
| What is the most common cause of hypophospahtemia? | Diabetic ketoacidosis |
| What is the most common cause of hyperphosphatemia? | Renal insufficiency |
| What is the most common cause of hypomagnesemia? | Malnutrition |
| What is the most common cause of hypermagnesemia? | Renal Failure |
| What is the most common cause of hypochloremia? | Prolonged vomiting |
| What is the most common cause of hyperchloremia? | hypernatremia |
| What kind of drug works as a diurectic in the glomerulus and how? | Dopamine relaxes/dilates the tiny blood vessels that bring blood to the glomerulus which increases the amount of blood filtered = more filtrate |
| What kind of diuretics work in the proximal tubule? | Osmotic diurectics, mannitol and glucose |
| What kind of diuretics work in the loop of henle? | Loop diuretics, Lasix, Bumex, and Edecrin |
| What kind of diuretics work in the distal tublule? | Thiazide and potassium sparing (spironolactone Aldactone) |
| Name four parts of the Nephron where diuretics my cause diuresis in sequence. | Glomerulus, Proximal tubule, Loop of Henle, Distal Tubule |
| Name four conditions for which diuretics may be prescribed. | hypertension, heart failure, electrolyte imbalance, kidney disease |
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Perseverandovercome
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