fluid and electrolyte and acid base balance

The average daily diet contains how much salt?

100 mEq

Normal blood sodium levels

136-145 mEq

Normal blood potassium levels

3.8-5.1 mEq

Normal blood calcium levels

8.4-10.5 mg

A pH 7.0 solution indicates what?

A nuetral reaction and contains equal number of hydrogen and hydroxide ions. It is neither acid or base

Describe a base

A solution higher than 7, it contains more hydroxide ions than hydrogen. The more hydroxide ions the solution contains, the more alkaline the solution

Describe an acid

A solution with a pH level less than 7, contains more hydrogen ions than hydroxide. The more hydrogen ions the solution contains the more acidic the solution

The term pH followed by a number, indicates what?

A solutions relative hydrogen ion concentration compared to hydroxide concentration

A solution with a high concentration of hydrogen ions is said to be

An acid with a low pH

Negatively charged Ions

Anion

Normal pH or arterial blood? Venous blood

Arterial blood - 7.45, Venous blood - 7.35, both are slightly alkaline

Buffer system that is a weak acid that reacts with a strong base, producing a weaker base. Or a weak base reacts with a strong acid, producing weaker acid

Bicarbonate Buffer system

List three types of buffer systems

Bicarbonate buffer system, phosphate buffer system, protein buffer system

Concentration of what contribuites to osmostic pressure

Blood plasma protein

Chemical substances that prevent a sharp change in the pH of a fluid when an acid or base is added to it.

Buffer

Which pH control mechanism uses chemical pH control mechanics

Buffers

List three mechanisms that control normal pH of body fluids.

Buffers, Respiratory Mechanisms, Urinary mechanism

Positively charged Ions

Cations

Dominant Anion in the blood

Chloride (Cl-)

List the common important anions found in the body.

Chloride(Cl-), bicarbonate(HCO3-)

Total volume of body fluids is smaller than normal, fluid output exceeds input

Dehydration

Low levels of protein in the blood can cause what

Edema

Substances that dissolve or break apart in water solution

Electrolytes

Two major fluid compartments where total body fluid can be subdivided.

Extracellular and intracellular

Total volum of water in the body or amounts in one or more of its compartments have increased or decreased beyond normal limits

Fluid imbalance

Which does the body primarily adjust, fluid intake or fluid output?

Fluid intake

Increased capillary blood pressure transfers fluid from blood to IF

Fluid shift

What is the most acidic substance in the body?

Gastric juice - pH1.6

Maintaining the acid-base balance means keeping the concentration of what type of ions in the body fluids relatively constant?

Hydrogen

Causes of this electrolyte imbalance include excessive output, increased absorption, shifts from the bone to ECF, Paget disease, bone tumors, and hyperparathyroidism

Hypercalcemia - calcium above 10.5mg

Causes of this electrolyte imbalance include increased intake, shifts from ICF to blood caused by tissue trauma and burns; and renal failure

Hyperkalemia - Potassium levels over 5.1 mEq

Sodium imbalance, blood sodium levels in excess of 145 mEq

Hypernatremia

This electrolyte imbalance can occur when there is too much water in the extracellular fluid compartment for the amount of sodium prresent. (too much water, not enough salt)

Hypernatremia - sodium level over 145 mEq

Causes of this electrolyte imbalance include dietary defieciency, decreased absorption, increased excretion, pancreatitis, hypoparathyroidism, rickets, renal insufficiency.

Hypocalcemia - calcium below 8.4mg

Causes of this electrolyte imbalance include diets, abuse of laxatives, certain diuretics, extreme weight loss programs, vomiting and gastric suction

Hypokalemia - low potassium below 3.8 mEq

Sodium imbalance, blood sodium levels less than 136 mEq

Hyponatremia

Electrolyte imbalance caused by excessive salt loss resulting from burns or certain diuretics

Hyponatremia - sodium level below 136 mEq

During dehydration, which fluid levels decrease first, second, third?

IF decreases first, ICF 2nd, and plasma volume will finally decrease if treatment is not given

Approximate percentage of water in newborn infant, adult male, and adult female.

Infant - 80%, Male - 60%, Female - 50%

Loss of fluid that can not be measured

Insensable loss

Of the three main body fluids, which one varies the most?

Interstitial fluid (IF) volume

Volume of body fluids larger than normal, fluid intake exceeds output.

Overhydration

Buffer System that begins as a weak acid that reacts with a strong base and produces a product that has not effect on the pH and a weak base

Phosphate Buffer System

Buffer System that begins as a weak base that reacts with a strong acid and produces a product that has not effect on the pH and a weak acid

Phosphate Buffer System

Fluctuations in relatively small amounts of this electrolyte will cause serious illness.

Potassium (K+)

Intracellular fluid electrolytes

Potassium (K+), Phosphates (HPO4-2)

Buffer system that is found in red blood cells and works immediately

Protein buffer system

What is the most important factor in determining urine volume?

Renal tubule regulation of salt and water

Dominant Cation in the blood

Sodium (Na+)

Imbalance of this electrolyte whether high or low can cause muscle weakness as well as impairment of CNS function, headaches, confusion, seizures, coma, and death.

Sodium (Na+)

Extracellular fluid electrolytes

Sodium (Na+), Chloride(Cl-), Bicarbonate(HCO3-)

List the common important cations found in the body.

Sodium (Na+), potassium (K+)

Which control mechanism is the most effect regulator of blood pH.

Urinary

A decrease in respirations will, in time produce a pH condition called

acidosis

what is called the salt and water retaining hormone

aldosterone

What hormones regulate electrolytes?

aldosterone regulates Na+ & Cl- ANP - Na+ PTH - Ca++

Excessive increase in respirations will, in time produce a pH condition called

alkalosis

List causes of metabolic alkalosis

antacids, loss of gastric juices, potassium wasting diuretics

Explain the respiratory mechanism of pH control

as carbon dioxide increases so does hydrogen. With increased hydrogen, the pH level decreases causing the blood to be more acidic. Receptors in the brain detect the drop in pH signaling the need to inhale.

This is known as a "water pushing force"

capillary blood pressure

Syptoms of hyercalcemia

decreased neuromuscular activity, fatigue, muscle weakness, diminished reflexes, cardiac problems

Causes for repiratory acidosis

drug overdose, copd, chest trauma, pulmonary edema,

Potassium imbalance, blood potassium levels in excess of 5.1 mEq

hperkalemia

H+

hydrogen ions

OH-

hydroxide ions

Calcium imbalance, blood calcium levels in excess of 10.5 mg

hypercalcemia

Sodium imbalance that may result from overuse of salt tablets, dehydration, or prolonged diarrhea.

hypernatremia - sodium level over 145mEq

List some causes of respiratory alkalosis

hyperventilation, anxiety, high altitude, pregnancy, hypoxia, fever

Calcium imbalance, blood calcium levels below 8.4 mg.

hypocalcemia

Potassium imbalance, blood potassium levels below 3.8 mEq

hypokalemia

Fluid output from the body occurs through what four organs

kidneys, lungs, skin, and large intestines

Three sources of fluid intake

liquids we drink, food we eat, water formed by catabolism of foods

transcellular fluid

lymph; joint fluids; cerebrospinal fluid; eye humors

Bicarbonate deficicit

metabolic acidosis

Bicarbonate excess

metabolic alkalosis

Symptoms of hyperkalemia

muscle malfunction including skeletal muscle weakness, paralysis, and cardiac arrest

Symptoms of hypocalcemia

neuromuscular - cramping, muscle twitching, hyperactive reflexes, abnormal cardiac rhythms.

A number that indicates the relative hydrogen ion concentration of a fluid

pH

Large pH fluctuations may appear small. Why?

pH scale is a logarithmic scale and represents a tenfold difference. Each change is based on multiples of 10

Extracellular fluid (ECF) includes fluids from where

plasma, interstitial fluid& transcellular fluid

Which buffer system is most important for intracellular fluid

protein buffer system

If buffers are unsuccessful which is the mechanism used to control the pH of body fluids

respiratory

Causes for metabolic acidosis

shock, sepsis, severe diarrhea, renal failure

Syptoms of hypokalemia

skeletal and cardiac muscular problems as well as smooth muscle of the GI tract does not contract causing abdominal distention and reduced rate of passage of intestinal contents

What are complications of overhydration

too much burden on pumping of heart

Which type of fluid output changes most

urine volume

How does fluid leave the body?

urine, feces, sweat, expired air (lungs) and diffusion through the skin

Neurological impairment caused by sever overhydration and accompanying electrolyte imbalance

water intoxication