CHAPTER 27: FLUID, ELECTROLYTE, AND ACID-BASE BALANCE

Which of the following would NOT be associated with a sensation of increased thirst?

- A DECREASE IN THE PRODUCTION OF ADH

In a protein buffer system, if the pH increases, the carboxyl group (COOH) of the amino acid dissociates and releases __________.

- A HYDROGEN ION

As a result of the aging process, the ability to regulate pH through renal compensation changes as a result of __________.

- A REDUCTION IN THE NUMBER OF FUNCTIONAL NEPHRONS

The elderly have an increased risk of respiratory acidosis because of __________.

- A REDUCTION IN VITAL CAPACITY

Physiological adjustments affecting fluid and electrolyte balance are mediated primarily by __________.

- ALDOSTERONE -ANTIDIUERETIC HORMONE (ADH) - ATRIAL NATIURETIC HORMONE (ANP) ***ALL OF THE LISTED RESPONSES ARE CORRECT***

The concentration of potassium in the ECF is controlled by adjustments in the rate of active secretion __________.

- ALONG THE DISTAL CONVOLUTED TUBULE OF THE NEPHRON

Deviations outside of the normal pH range due to changes in hydrogen ion concentrations __________.

- ALTER PROTEIN STRUCTURE - DISRUPT THE STABILITY OF CELL MEMBRANES - CHANGE THE ACTIVITIES OF IMPORTANT ENZYMES ***ALL OF THE ABOVE***

The most common problems with electrolyte balance are caused by __________.

- AN IMBALANCE BETWEEN SODIUM GAINS AND LOSSES

Under normal circumstances, during respiratory acidosis the chemoreceptors monitoring the PCO2 of the plasma and CSF will eliminate the problem by calling for __________.

- AN INCREASE IN PULMONARY VENTILATION RATES

After a person consumes a meal, the levels of which ion rise in the blood in response to increased acid production in the stomach?

- BICARBONATE

Sodium levels are figured as a balance between __________.

- BOTH ABSORPTION OF SODIUM ACROSS THE DIGESTIVE EPITHELIUM AND SECRETION AT THE KIDNEY AND OTHER SITES

Which of the following conditions could cause muscle cramps or spasms?

- BOTH HYPERKALEMIA AND HYPOCALCEMIA

Acidosis is a more common problem than alkalosis because many acids are by-products of metabolic reactions. Which of the following acids fits that description?

- CARBONIC ACID (when water gets dissolved with carbon dioxide) - SULFURIC ACID - LACTIC ACID ***ALL OF THE LISTED RESPONSES ARE CORRECT***

Angiotensin II produces a coordinated elevation in the extracellular fluid volume by __________.

- CAUSING THE RELEASE OF ADH - TRIGGERING THE SECRETION OF ALDOSTERONE - STIMULATING THIRST ***ALL OF THE LISTED RESPONSES ARE CORRECT***

Extracellular fluids in the body consist of __________.

- CEREBROSPINAL FLUID, SYNOVIAL FLUID, AND SEROUS FLUIDS - AQUEOUS HUMOR, PERILYMPH, AND ENDOLYMPH - INTERSTITIAL FLUID, BLOOD PLASMA, AND LYMPH ***ALL OF THE LISTED RESPONSES ARE CORRECT***

Which of the following does NOT affect fluid levels in the blood?

- CHLORIDE SHIFT (CORRECT ANSWER) - DIARRHEA -FEVER -HYPOALOSTERONISM

Sodium ions enter the ECF by crossing the digestive epithelium via __________.

- DIFFUSION AND ACTIVE TRANSPORT

All of the homeostatic mechanisms that monitor and adjust the composition of body fluids respond to changes in the __________.

- EXTRACELLULAR FLUID

When the amount of water you gain each day is equal to the amount you lose to the environment, you are in __________.

- FLUID BALANCE

If the ECF is hypertonic with respect to the ICF, water will move __________.

- FROM THE CELLS INTO THE ECF UNTIL OSMOTIC EQUILIBRIUM IS RESTORED

How does fever affect blood fluid levels?

- Fever increases perspiration due to high respiratory rate, mucus secretion, and excretion, which leads to rapid loss of fluids and electrolytes from the body.

When pure water is consumed, the extracellular fluid becomes __________.

- HYPOTONIC WITH RESPECT TO THE ICF

The major causes of metabolic acidosis include which of the following?

- IMPAIRED ABILITY TO EXCRETE H+ AT THE KIDNEYS - PRODUCTION OF A LARGE NUMBER OF FIXED OR ORGANIC ACIDS - A SEVERE BICARBONATE LOSS ***ALL OF THE LISTED RESPONSES ARE CORRECT***

When a normal pulmonary response does NOT reverse respiratory acidosis, the kidneys respond by __________.

- INCREASING THE RATE OF HYDROGEN ION SECRETION INTO THE FILTRATE

The body content of water or electrolytes will rise if _______.

- INTAKE EXCEEDS OUTFLOW

Potassium ions are found in the highest concentrations in which of the following fluid compartments?

- INTRACELLULAR FLUIS (ICF)

how does hyperaldosteronism affect fluid balance?

- Increases water retention by retaining too much sodium and loosing too much potassium

Whenever the rate of sodium intake or output changes, there is a corresponding gain or loss of water that tends to __________.

- KEEP THE SODIUM CONCENTRATION CONSTANT

Which of the following body organs has the greatest measure of control over body fluid and composition levels?

- KIDNEYS

The activity that occurs in the body to maintain calcium homeostasis occurs primarily in the __________.

- KIDNEYS - DIGESTIVE TRACT - BONE ***ALL OF THE RESPONSES ARE CORRECT***

Increasing or decreasing the rate of respiration can have a profound effect on the buffering capacity of body fluids by __________.

- LOWERING OR RAISING THE PCO2

Respiratory alkalosis develops when respiratory activity __________.

- LOWERS PLASMA PCO2 TO BELOW NORMAL LEVELS

Chronic diarrhea causes a severe loss of bicarbonate ions, resulting in __________.

- METABOLIC ACIDOSIS

The exchange between plasma and interstitial fluid is determined by the relationship between the __________.

- NET HYDROSTATIC AND NET COLLOID OSMOTIC PRESSURES Definition Hydrostatic pressure: is a force generated by the pressure of fluid on the capillary walls either by the blood plasma or interstitial fluid. Net colloid osmotic pressure: is a form of osmotic pressure induced by the proteins, notably albumin, in a blood vessel's plasma (blood/liquid) that causes a pull on fluid back into the capillary.

Disorders that have the potential for disrupting pH balance in the body include __________.

- NEURAL DAMAGE AND CNS DISEASE - EMPHYSEMA AND RENAL FAILURE -HEART FAILURE AND HYPOTENSION ***ALL OF THE LISTED RESPONSES ARE CORRECT***

When water is lost but electrolytes are retained, the osmolarity of the ECF rises and osmosis then moves water __________.

- OUT OF THE ICF AND INTO THE ECF UNTIL ISOTONICITY IS REACHED

Which of the following occurs when an individual loses body water?

- PLASMA VOLUME INCREASES, AND ELECTROLYTE CONCENTRATIONS RISE

Important homeostatic adjustments occur in response to changes in __________.

- PLASMA VOLUME OR OSMOLARITY

The primary role of the carbonic acid-bicarbonate buffer system is to __________.

- PREVENT CHANGES THE IN pH CAUSED BY ORGANIC AND FIXED ACIDS IN THE ECF

A metabolic alkalosis can be due to __________.

- PROLONGED VOMITTING

Atrial natriuretic peptide hormone __________.

- REDUCES THIRST - BLOCKS THE RELEASE OF ADH - BLOCKS THE RELEASE OF ALDOSTERONE ***ALL OF THE RESPONSES ARE CORRECT***

What are the two important effects of increased release of ADH

- REDUCTION OF URINARY WATER LOSSES AND STIMULATION OF THE THIRST CENTER

Which of the following does NOT cause hypokalemia?

- RENAL FAILURE

A mismatch between carbon dioxide generation in peripheral tissues and carbon dioxide excretion at the lungs is a __________.

- RESPIRATORY ACID-BASE DISORDER ***Causes of respiratory acidosis include: Diseases of the airways, such as asthma and COPD***

Pulmonary and renal mechanisms support the buffer systems by __________.

- SECRETING OR GENERATING HYDROGEN IONS - GENERATING ADDITIONAL BUFFERS WHEN NECESSARY -CONTROLLING THE EXCRETION OF ACIDS AND BASES ***ALL OF THE LISTED RESPONSES ARE CORRECT***

What are the major contributors to the osmolarities of the ECF and the ICF?

- SODIUM AND POTASSIUM

What are the principal ions in the extracellular fluid (ECF)?

- SODIUM, CHLORIDE, AND BICARBONATE

Ketone bodies accumulate in the blood during conditions of __________.

- STARVATION

The hemoglobin buffer system helps prevent drastic alterations in pH when __________.

- THE PLASMA PCO2 IS RISING OR FALLING

Treatment for hyperkalemia includes the __________.

- USING APPROPRIATE DIURETICS - ADMIN OF BUFFERS SUCH AS SODIUM BICARBONATE - INFUSION OF HYPOTONIC SOLUTION ***ALL OF THE LISTED RESPONSES ARE CORRECT***

Blood pH is normally measured at __________.

- pH 7.35-7.45