Disease Ch 24

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Water Electrolyte and Acid-Base Balance
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1

body water contains _____ that _____ in a solution yielding _____ and ____

dissolved mineral salts aka electrolytes

dissaciate

cations

anions

2

body fluids are

electrically neutral

sum of anions and cations are balanced

3

disturbances in body water are associated with what?

a corresponding change in electrolytes

4

if electrolyte concentration changes then ?

there is a corresponding change in body water

5

body consists of ___% water

60

6

rule of thirds

2/3 of body weight is water

2/3 of water is in cells

1/3 of water is in extracllular tissue surrounding cells

7

chief intracellular ions

K+

PO4

8

chief extracellular ions

Na+

Cl-

9

differences in concentration are a result of what?

metabolic activity of cell

10

amount of ___ in body determines the volume of extracellular fluid

sodium

water follows salt

11

ultimate regulation of body fluid and electrolyte concentration comes down to what organ?

kidneys

specifically aldosterone and ADH

12

what does aldosterone regulate?

Na and K

13

what does ADH regulate

water

14

dehydration

deficiency of body water

15

cause of dehydration

insufficient water intake

excessive water loss

16

severity of dehydration categorization

mild-2% loss

moderate-5% loss

severe-8% loss

17

symptoms of dehydration

headache

loss of tissue elasticity

increase in thirst-this is slow however

18

who is at greatest risk of dehydration

elderly-less water to begin with

babies and children-higher turn over of water

19

overhydration

less common

water intoxification

20

overhydration leads to what?

hyponatremia-ie cell swelling especially of neurons

21

symptoms of overhydration

nausea and vomitting

headache

disorientation and confusion

seizures

death

22

pH of extracellular fluid

7.4

23

pH of blood

7,35-7.45

differences outside of this range can lead to death

24

blood pH below 7.35 is considered

acidosis

25

blood Ph above 7.45 is considered

alkalosis

26

intracellular buffering system

H+ + HPO4 <-> H2PO4-

binds hydrogen to keep hydrogen ion out of cell

stops blood from becoming too acidic

27

blood buffers

plasma-carbonic acid-bicarbonate pair

protein buffer-proteins have negative charge so can serve as buffer to H+ ions

28

renal buffering

ultimate corrector

seretion of H+ in urine = decrease in acidity

reabsorption of HCO4- decrease in basic

29

lung buffering

ventilation of carbon dioxide

CO2 +H20 <-> H2CO2 <-> H+ +HCO3-

30

4 categories of acid base imbalance

respiratory acidosis

respiratory alkalosis

metabolic acidosis

metabolic alkalosis

31

respiratory acidosis

elevation of pCO2 as a result of ventilation depression

corrected by kidneys

32

respiratory alkalosis

depression of pCO2 as a result of alveolar hyperventilation

corrected by kidneys

33

metabolic acidosis

depression of HCO3- or an increase in noncarbonic acids

lungs will correct

34

metabolic alkalosis

elevation of HCO3- usually caused by excessive loss of metabolic acids

lungs will correct

35

principal effect of acidosis

depression of the CNS through a decrease in synaptic transmission

show a generalized weakness

deranged CNS function is the greatest threat

36

severe acidosis can cause what?

disorientation

coma

death

37

hypercapnia

high levels of CO2 in blood

38

cause of hypercapnia

depression of respiratory center in brain that controls breathing rate-ie drugs or head trauma

paralysis of respiratory or chest muscles

emphysema

more H+ ions in body = more CO2 in body

39

hypoventilation keeps ___ in the body

CO2

40

how is respiratory acidosis corrected?

kidneys eliminate hydrogen ions in urine and retain bicarbonate ion

41

causes of metabolic acidosis

renal failure= los of bicarbonate

accumulation of acids ie lactic acids or ketones-ie type 1 diabetic

42

how is metabolic acidosis corrected?

increased ventilation

renal excretion of hydrogen ions if possible

43

hyperventilation removes ____ which does what to H+ production?

CO2, eliminates

44

symptoms of alkalosis

causes over excitability of central and peripheral nervous systems

numbness

lightheaddness

45

alkalosis can cause

nervousness

muscle spasms or tetany

convulsions

loss of consciousness

death

46

respiratory alkalosis

hypocapnia=too little H+ ions

primary cause is hyperventilation

hyperventilation causes too much CO2 to be exhaled which leads to a loss of H+ ions

47

how is respiratory alkalosis corrected?

kidneys reabsorb H+ ions and excrete bicarbonate ions

48

metabolic alkalosis

increase in plasma bicarbonate relative to concentration of carbonic acid

49

causes of metabolic alkalsis

excessive vomitting=lose stomach acid

excessive use of alkaline drugs

certain diuretics

endocrine disorders

heavy ingestion of antacids

50

how is metabolic alkalosis corrected

hard to correct

kidneys probably arent functioning properly

lungs will hypoventilate but can only breath so little before hypoxia

51

rates of correction

buffers-first and fastest-instantaneously

respiratory-take minutes to hours

metabolic-take several hours or days

52

clinical evaluation of acid base balance

blood test to determine concentration of bicarbonate in plasma as index of patients overall status

can also test:

blood ph

PCO2

bicarbonate levels