Chapter 2 study questions

Describe how a deficit of vitamin D would affect the following: -bone -serum calcium level

-a vitamin D deficiency would lead to to bone demineralization and decreased bone density -a vitamin D deficiency would lead to a low serum calcium level

State the normal range of pH for the following: 1. Blood 2. Urine

1. Blood: 7.35-7.45 2. Urine: 4.5-8

A diabetic client is producing excess amounts of ketoacids. 1. Describe the effects of his excess on serum bicarbonate levels and serum pH 2. Explain the possible compensations for this imbalance 3. Describe the signs of this compensation

1. Ketoacids bind with bicarbonate ions, decreasing serum bicarbonate and serum pH 2. Respiration increases. Kidneys excrete more acids and increase bicarbonate production and reabsorption 3. Rate and depth of breathing increase, and urine has a low pH (5)

A person is found unconscious. He is wearing a medic-alert bracelet for diabetes, and his breath has the typical odor of acetone (ketocids) 1. Predict his serum pH and the rational for this prediction 2. Predict his serum potassium level

1. Serum pH is less than 7.35 because acidosis depresses CNS function. Bicarbonate raises serum pH to normal by combining with ketoacids. 2. The serum potassium level is elevated because of acidosis

Describe how very slow, shallow respiration are likely to affect the following: 1. PCO2 2. Serum pH

1. Very slow, shallow respiration's would increase PCO2 2. Decrease serum pH (increase carbonic acid)

How are sodium and potassium levels controlled in the body?

Aldosterone and the kidney control sodium and potassium levels through the exchange of Na+ and K+ in the renal tubules

Why does dehydration affect cell function?

Because the transport of nutrients into the cell and removal of wastes from the cell are decreased, impairing cell metabolism and function.

The respirations that accompany metabolic acidosis are frequently called Kussmaul respirations or "air hunger". What is the purpose of such respiration's?

Carbons dioxide or carbonic acid levels in the blood decrease, resulting in decreased total acid levels in the body

Describe the effect of hypernatremia on extracellular fluid volume and on intracellular fluid volume

Hypernatremia tends to increase extracellular fluid volume by drawing water out of the cells, thus decreasing intracellular volume.

Explain how hypochloremia affects acid-base balance

Hypochloremia leads to increased serum bicarbonate levels as bicarbonate moves out of the RBC to maintain electromechanical neutrality by making up for a low chloride level. Increased serum bicarbonate results in higher serum pH or alkalosis.

How does insulin administration affect serum potassium?

Insulin reduces serum potassium by promoting the movement of potassium into cells.

State the primary location (compartment) of potassium

Intracellular compartment

Describe the locations of intracellular and extracellular fludis

Intracellular fluid is fluid contained within the cells. Extracellular fluid includes all fluids oitside the cells, such as blood, interstitial fluid, CSF, digestive tract secretions, pleural fluid, and lymph.

Which makes up the higher proportion of body fluid, intracellular fluid or extracellular fluid?

Intracellular fluid makes up the higher proportion of body fluid

State the three possible causes of metabolic acidosis

Metabolic acidosis may occur with infection (increased BMR), renal disease (retention of acids), severe vomiting or diarrhea (loss of bicarbonate and increased acids), starvation, or diabetic ketoacids (increased acid production)

Prolonged strenuous exercise usually leads to an increase in lactic acid. Given your knowledge of normal circulation, explain why it is helpful to have a cool-down period with mild exercise rather than total rest immediately after strenuous exercise.

Mild exercise promotes continued circulation to remove lactic acid from muscle tissue, decrease acidosis, and restore oxygen reserves.

Describe the signs and symptoms of hypocalcemia

Skeletal muscle twitches and tetany, numbness and tingling in the face and fingers, and weak cardiac contraction

General anesthetics, the presence of pain, and narcotic analgesics for pain often lead to slow, shallow respiration's after surgery, circulation is frequently slow, and oxygen levels are somewhat reduced. Predict the effects on the partial pressure of carbon dioxide and how this would affect serum pH.

Slow, shallow respirations lead to increased carbon dioxide in the blood. Reduced oxygen and sluggish circulation contribute to more anaerobic metabolism and increased lactic acid levels. Therefore, the serum pH is decreased, and acidosis is common during and following surgery.

What is the function of sodium ion in the body?

Sodium ions (Na+) help maintain extracellular fluid volume (as the major cation exerting osmotic pressure), contribute to neuromuscular function, and play a role in acid-base balance and metabolic processes.

How does the proportion of fluid in the body change with age?

The proportion of fluid in the body decreases throughout the life span

A person will probably become very dehydrated as ketoacidosis develops. What heart rate and pulse characteristics would you expect to be present in this dehydrated condition?

The pulse would be weak and thready because of hypovolemia. When CNS function is decreased, the heart rate is slow or irregular.