FLUID ELECTROLYTE AND ACID-BASED BALANCE WORKSHEET (CHAPTER 19)

WHEN THERE IS TOO LITTLE WATER IN THE BODY, THE SECRETION OF THE HORMONE ______ INCREASES, AND THE URINARY OUTPUT ______.

ADH DECREASES

HOW IS OSMOLARITY RELATED TO THE FLUID BALANCE IN THE BODY?

BLOOD IS MORE CONCENTRATED IN COMPARISON TO FLUID.

THE pH-REGULATING MECHANISMS, IN ORDER FROM MOST RAPID TO SLOWEST, ARE THE ______, ______ AND ______.

BUFFER SYSTEMS RESPIRATORY RENAL

THE ELECTROLYTE THAT IS ESSENTIAL FOR BLOOD CLOTTING IS _______.?

CALCIUM

WHAT DOES INSENSIBLE LOSS MEAN?

CAN'T BE MEASURED DIRECTLY

WHAT IS THE DIFFERENCE BETWEEN A CATION AND AN ANION?

CATION: POSITIVELY CHARGED ION ANINON: NEGATIVELY CHARGED ION

THE RESPIRATORY SYSTEM IS IMPORTANT FOR pH REGULATION BECAUSE IT CONTROLS THE AMOUNT OF ______ IN BODY FLUIDS, WHICH IN TURN AFFECTS THE NUMBER OF ______ PRESENT IN BODY FLUIDS.

CO2 HYDROGEN IONS

A SUBSTANCE THAT IN WATER DISSOCIATES INTO ITS POSITIVE AND NEGATIVE IONS IS CALLED ______?

ELECTROLYTE

HOW DOES THE BODY LOSE WATER?

EXCRETION (urine / feces) INSENSIBLE LOSSES

WHAT IS EDEMA?

ABNORMAL INCREASE IN THE AMOUNT OF TISSUE FLUID (edema is a *symptom* not a* disease* )

WATER WITHIN BLOOD VESSELS IS CALLED ______?

PLASMA

THE BICARBONATE BUFFER SYSTEM IS IMPORTANT FOR THE REGULATION OF pH IN THE BODY FLUIDS ______ AND ______.

PLASMA TISSUE FLUID

MAGNESIUM (Mg+3)

PLASMA LEVEL: 1.3-2.1 ROLE IN BODY: *MOST FOUND IN BONES *MORE ABUNDANT IN ICF THEN ECF *ESSENTIAL FOR ATP PRODUCTION AND ACTIVITY OF NEURONS AND MUSCLE CELLS

SODIUM (Na+)

PLASMA LEVEL: 136-142 ROLE IN BODY: *CREATES OSMOTIC PRESSURE OF THE ECF *MOST ABUNDANT CATION IN ECF *ESSENTIAL FOR ELECTRICAL ACTIVITY OF NEURONS AND MUSCLE CELLS.

BICARBONATE (HICO3-)

PLASMA LEVEL: 28 ROLE IN BODY: *PART OF BICARBONATE SYSTEM

POTASSIUM (K+)

PLASMA LEVEL: 3.8-5.0 ROLE IN BODY: * CREATES OSMOTIC PRESSURE OF ICF *MST ABUNDANT CATION IN ICF *ESSENTIAL FOR ELECTRICAL ACTIVITY OF NEURONS AND MUSCLE CELLS (****ESPECIALLY CARDIAC****)

BLOOD PLASMA BECOMES TISSUE FLUID BY THE PROCESS OF ______.?

FILTRATION

THE MOVEMENT OF WATER THROUGH A MEMBRANE FROM AN AREA OF HIGHER PRESSURE TO AN AREA OF LOWER PRESSURE IS CALLED _______.

FILTRATION

WHAT ARE THE TWO PROCESSES BY WHICH WATER MOVES IN THE BODY?

FILTRATION OSMOSIS

INTRACELLULAR FLUID IS? (ICF)

FLUID WITHIN THE CELL (about two-thirds of total body water)

CALCIUM (Ca+2)

PLASMA LEVEL: 4.6-5.5 ROLE IN BODY: * MOST FOUND IN BONES AND TEETH *MAINTAINS NORMAL EXCITABILITY OF NEURONS AND MUSCLE CELLS. *ESSENTIAL FOR BLOOD CLOTTING

CHLORIDE (Cl-)

PLASMA LEVEL: 95-103 ROLE IN BODY: *MOST ABUNDANT ANION IN ECF *HELPS REGULATE OSMOTIC PRESSURE *PART OF HCL IN GASTRIC JUICES

A CATION IS A ______ SUCH AS _____.

POSITIVE ION *SODIUM *POTASSIUM *CALCIUM

IN INTRACELLULAR FLUID, THE MAJOR CATION IS ______ AND THE MAJOR ANION IS ______.

POTASSIUM PHOSPHATE

NAME THE MAJOR ELECTROLYTES OF THE BODY.

POTASSIUM (k+) SODIUM (Na+) CHLORIDE (Cl-) MAGNESIUM (Mg+2) CALCIUM (Ca+2)

THE pH-REGULATING MECHANISM THAT HAS THE GREATEST CAPACITY TO BUFFER AN ONGOING pH IMBALANCE IS THE ______.

RENAL (kidney's)

WHAT WOULD THE *RENAL* SYSTEM DO IF THE BLOOD pH WERE 7.2?

RENAL TUBULES WOULD EXCRETE H+ IONS RETAIN BICARBONATE IONS

WHAT WOULD THE *RESPIRATORY SYSTEM* DO IF THE BLOOD pH WERE 7.2?

RESPIRATORY RATE /DEPTH WOULD INCREASE WHY? * BLOW OFF MORE CO2

WHAT IS THE DEFINITION OF ALKALOSIS?

pH GREATER THAN 7.45 (more bicarb than H+ ions) INCREASE SYNAPTIC TRANSMISSION IN THE PERIPHERAL AND CNS. RESULT: *MUSCLE SPASMS *CONVULSIONS

WHAT IS THE DEFINITION OF ACIDOSIS?

pH LESS THAN 7.35 (excess of H+ ions) DEPRESSES SYNAPTIC TRANSMISSION IN THE CNS. RESULT: *CONFUSION *DISORIENTATION *DECREASES LOC *COMA

AN ANION IS A ______ SUCH AS ______.

NEGATIVE ION *CHLORIDE *SULFATE *BICARBONATE

WHY IS IT IMPORTANT FOR THE BLOOD pH TO BE MAINTAINED WITHIN NORMAL RANGE?

NORMAL RANGE IS REQUIRED FOR THE BODY TO PERFORM THE REQUIRED CHEMICAL REACTIONS REQUIRED FOR LIFE.

HOW DOES THE BODY INTAKE WATER?

ORAL INTAKE FOOD FLUIDS

THE CONCENTRATION OF DISSOLVED SUBSTANCES IN A SOLUTION IS CALLED ____?

OSMOLARITY

THE MOVEMENT OF WATER THROUGH A MEMBRANE TO AN AREA OF GREATER DISSOLVED MATERIAL IS CALLED ______?

OSMOSIS

TISSUE FLUID BECOMES INTRACELLULAR FLUID BY THE PROCESS OF ______?

OSMOSIS

WATER LOCATED BETWEEN CELLS IS CALLED ______?

TISSUE FLUID (interstitial fluid)

SYSTEMIC EDEMA

* CAN BE INFLAMMATORY PROCESS (histamine release causing fluid leaks into tissue all over body) *LOW LEVELS OF PROTEINS (proteins are responsible for maintaing *oncotic pressure* therefore holding fluid in vascular space) *INCREASED VENOUS PRESSURE (due to intravascular fluid volume)

WHY ARE CHILDREN MORE SUSCEPTIBLE TO ALTERATIONS IN FLUID BALANCE?

* HAVE A GREATER PERCENTAGE OF TOTAL BODY WATER THAN ADULTS. *INFANTS AND YOUNG CHILDREN- DIETARY INFLUENCES.

WHAT ARE THE THREE BODY MECHANISM FOR MAINTAINING ACID-BASE BALANCE?

*BUFFER SYSTEM (blood) *RESPIRATORY *RENAL

LAB VALUES TO MEASURE FLUID VOLUME STATUS...

*BUN: if high=(with normal creatinine) fluid vol low. *Na: high= low fluid vol. low: =fluid vol excess *HEMOGLOBIN/ HEMATOCRIT: if low=vol loss; high= plama vol. low *SERUM OSMOLARITY *URINE SPECIFIC GRAVITY *BNP

WHY ARE ELDERLY MORE SUSCEPTIBLE TO ALTERATIONS IN FLUID BALANCE?

*DECREASED SENSITIVITY OF OSMORECEPTORS WHICH DECREASES THIRST SENSATIONS. *CHANGE IN RENAL , CARDIAC AND PULMONARY SYSTEM FUCTION *DIETARY INFLUENCES.

LOCAL EDEMA

*EDEMA THAT FOLLOWS INJURY *IS DUE TO INFLAMMATORY PROCESS (histamine release) *HISTAMINE INCREASES PERMEABILITY OF CAPILLARIES *RESULTING IN TISSUE SWELLING AT THE SITE OF INJURY

EXTRA CELLULAR FLUID IS DIVIDED INTO WHAT TWO AREAS?

*INTRAVASCULAR *INTERSTITIAL

EXPLAIN WHERE THE FLUID IS IN THE TWO EXTRA CELLULAR FLUID AREAS (intravascular and interstitial)

*INTRAVASCULAR: WITHIN THE BLOOD VESSELS *INTERSTITIAL: WITHIN THE TISSUES (between cells)

HOW DOES ANP INFLUENCE FLUID BALANCE IN THE BODY?

-ANP IS RELEASED "FROM" ATRIAL FIBERS WHEN THE ATRIA ARE OVERFILLED. (over stretched) -ANP THEN PROMOTES WATER EXCRETION FROM THE KIDNEYS TO REDUCE FLUID VOLUME STATUS. (aka I need to pee)

WHAT TYPE OF FLUID BALANCE CHANGE WOULD STIMULATE THE RAAS SYSTEM AND WHY? HOW WOULD THE RAAS SYSTEM HELP RESTORE FLUID BALANCE?

-DECRESAED FLUID VOLUMN= DECREASED BLOOD PRESSURE >>> -STIMULATES RENIN RELEASE >> -STIMULATES ANGIOTENSIN I >> -CONVERTS TO ANGIOTENSIN II >> -WHICH STIMULATES THE RELEASE OF ADH ( water retention) AND ALDOSTERONE (water and Na+ retention) -WHICH INCREASES FLUID VOLUME!

WHY IS FLUID BALANCE IMPORTANT TO THE BODY?

-PRE-LOAD IS FLUID VOLUME:(needed to ensure good) *STROKE VOLUME *CARDIAC OUTPUT *TISSUE PERFUSION

HOW DOES ALDOSTERONE INFLUENCE FLUID BALANCE IN THE BODY?

-STIMULATES THE KIDNEY'S TO RETAIN SODIUM AND WATER. -CAUSES THE EXCRETION OF POTASSIUM

WHAT IS THE BLOOD'S NORMAL pH RANGE?

7.35-7.45

OSMOLARITY

A MEASURE OF CONCENTRATION OF THE BLOOD

THE HORMONE THAT INCREASES REABSORPTION OF WATER BY THE KIDNEYS FOLLOWING REABSORPTION OF SODIUM IONS IS ______.

ALDOSTERONE

WHAT ARE THE HORMONES INVOLVED IN ELECTROLYTE REGULATION?

ALDOSTERONE ANP PARATHYROID HORMONE CALCITONIN: (hormone produced by thyroid gland. maintains dense strong bone matrix and regulates calcium levels)

THE HORMONE THAT INCREASES EXCRETION OF WATER BY THE KIDNEYS FOLLOWING EXCRETION OF SODIUM IONS IS ______?

ANP

LENGTH OF TIME IT TAKES FOR THE KIDNEYS TO COMPENSATE FOR A CHANGE IN BLOOD pH?

DAYS (3-5) (kidneys are better at long term compensation)

TO COMPENSATE FOR METABOLIC ALKALOSIS, RESPIRATIONS WILL ______ IN ORDER TO ______ CARBON DIOXIDE.

DECREASE RETAIN

IF THE OSMOLARITY OF A SOLUTION INCREASES, THIS MEANS THAT THE RELATIVE AMOUNT OF WATER HAS ______.?

DECREASED

THE THREE SOURCES OF DAILY WATER INTAKE FOR THE BODY, FROM GREATEST TO LEASE, ARE______, ______ AND ______.

DRINK FOODS MEATABOLIC WATER

WHAT STIMULATES THE THIRST CENTER?

HIGH OSMOLARITY SENSED BY THE OSMORECEPTORS

TO COMPENSATE FOR ACIDOSIS, THE KIDNEYS WILL EXCRETE MORE ______ IONS AND RETAIN MORE ______IONS.

HYDROGEN BICARBONATE

THE THIRST CENTER FOR THE BODY IS LOCATED IN WHICH PART OF THE BRAIN?

HYPOTHALAMUS

THE PART OF THE BRAIN THAT REGULATES THE WATER CONTENT OF THE BODY IS THE ______?

HYPOTHALMUS

TO COMPENSATE FOR METABOLIC ACIDOSIS, RESPIRATIONS WILL ______ IN ORDER TO ______ CARBON DIOXIDE

INCREASE EXHALE

WATER WITHIN CELLS IS CALLED ______?

INTRACELLULAR FLUID

HOW IS EDEMA CATEGORIZED?

LOCAL SYSTEMIC

LENGTH OF TIME IT TAKES FOR THE LUNGS TO COMPENSATE FOR A CHANGE IN BLOOD pH?

MINUTES (lungs are better at short term compensation)

IN BLOOD PLASMA, THE MAJOR CATION IS _____ AND THE MAJOR ANION IS ______.

SODIUM CHLORIDE

THE ELECTROLYTES THAT ARE ESSENTIAL FOR NORMAL** NERVE IMPULSE TRANSMISSION** ARE_____?

SODIUM POTASSIUM

THE ELECTROLYTES THAT ARE ESSENTIAL FOR NORMAL** MUSCLE CONTRACTION** ARE ______,______ AND _____.

SODIUM POTASSIUM CALCIUM

HOW DOES ADH INFLUENCE FLUID BALANCE IN THE BODY?

STIMULATES THE KIDNEY'S TO RETAIN WATER.

MOST OF THE LOSS OF BODY WATER IS BY THE WAY OF ______, AND SECONDARY LOSSES ARE BY WAY OF ______ AND ______.

URINE SWEATING BREATHING

WHAT DOES HIGHER SPECIFIC GRAVITY MEAN?

URINE IS MORE CONCENTRATED (kidneys are retaining fluid)

WHAT ARE THE BODY'S MECHANISMS FOR INSENSIBLE WATER LOSS?

WATER LOSS FROM: *SWEATING *BREATHING *FECES

EXPLAIN HOW WATER MOVES BY OSMOSIS?

WATER MOVES FROM A LOW CONCENTRATION TO A HIGH CONCENTRATION THROUGH A SEMIPERMEABLE MEMBRANE.

EXPLAIN HOW WATER MOVES BY FILTRATION?

WATER MOVES FROM AN AREA OF HIGH PRESSURE TO AN AREA OF LOW PRESSURE THROUGH A MEMBRANE. (think coffee pot...you put all the water (high) in the top and it comes out a small (low) hole "through" a coffee filter (aka membrane)

EXTRACELLULAR FLUID (ECF)

WATER OUTSIDE CELLS: *TISSUE FLUID *PLASMA *LYMPH *SPECIALIZED FLUIDS