Acid-Base, Fluid and Electrolytes Flashcards

pH
Terms Definitions
OH-
a base
Pure water
neutral
Blood pH
7.35 - 7.45
Food Products
sauerkraut and yogurt
The chief intracellular cation is
potassium
ADH
stiumulates water conservation at kindeys, and causes thirst at CNS released due to increased osmolarity of ECF.
osmoreceptors
hypothalamus,
ADH inhibits urine production which in turns reabsorb water is issued back into the body
Bicarbonate
22 to 26 mEq/L arterial
The chief extracellular cation is
sodium
If plasma (aldosterone) increases, Na+ excretion will ___
decrease
Hyperventilation
leads to eliminating excessive amounts of carbon dioxide, increased loss of CO2 from the lungs at a rate faster than it is produced, decrease in hydrogen ions
electrolytes
carry an electrical charge when dissolved in fluid
phlebitis
inflammation of vein - symptoms include: pain, edema, erythema, and increased skin temp over vein
anions
negatively charged electrolytes - Cl, Mg--, phosphate
Normal ratio of HCO3- to H2CO3
20:1
Derangements of hydrogen and bicarbonate concentrations in body fluids are common in
disease processes
H+ ion
has special significance because of the narrow ranges that it must be maintained in order to be comptible with living systems
Physiologically important acids
carbonic acid, phosphoric acid, pyruvic acid and lactic acid
Protein anions are most abundant in
the cytosol
Hyperkapnia
an accumulation of carbon dioxide in extracellular fluids
Metabolic Alkidosis
Is caused by elevated HCO3 concentrations, Bicarbonate ions interact with H+ in solution, Forming H2CO3, Reduced H+
causes alkalosi
Overhydration
if water is gained, but electrolytes are lost ECF volume increases but becomes hypoosmotic to ICF causing water to move into cells.
baroreceptors
stretch receptors in the aortic arch and carotid sinus
Aerobic Respiration
CO2 diffuses into the bloodstream where the reaction occurs in red blood cells
The area taht stimulates teh conscious desire to drink water is .located in the
hypothalamus
Respiratory Acidosis
caused by hyperkapnia due to hypoventilation characterized by a pH decrease and an increase in PCO2
The primary intracellular ions are
sodium and chloride
Cellular metabolism
of carbohydrates release CO2 as a waste product, aerobic respiration
Sources of hydrogen ions
cellular metabolism, food products, medications, metabolic intermediate by products
renal response acidosis
secrete H+, increase buffering, remove CO2, reabsorb NaHCO3-
Phosphate Ions
in ICF required for formation of bonds, in plasma reabsorbed along PCT,
extracellular fluid
90% water, outside of cells. Consists of Na,K,Ca.HCO3-,Cl-,organic, proteins,HPO4,SO4-. Found in plasma, lymph,interstitial fluid
dehydration
when the volume of body fluid is significantly reduced in both extra and intracellular compartments
isotonic saline
0.9% sodium chloride - ECF vol replacement
The cation that is necessary for generation and conduction of action potentials and that contributes nearly half of the osmotic pressure of extracellular fluid is
sodium ion
If lactic acid is injected iv, then plasma bicarbonate ion levels will immediately
decrease
What two solutions can increase potassium in hyperkalemic patients?
Plasma-lyte and LR
The direction of water movement between fluid compartments is determined by
the concentration of solutes
ADH saves water by
enhancing passive movement of water out of the collecting ducts
Protein buffer System
most buffering capacity comes from R groups that can act as weak acids o bases, when pH rises act as weak base accepting H+, when pH lowers act as weak acid donating H+
metabolic alkalosis
pH >7.45, PaCO2 normal or >45 mmHg (compensated), PaO2 normal
Cannont help protect against PH changes caused by respiratory problems in which there is an excess or shortage of carbon dioxide
bicarbonate ion/carbonic acid buffers
Bicarbonate Secretion
cells of the gastric mucosa secrete H+ ions into the lumen of the stomach in exchange for the diffusion of bicarbonate ions into blood
Bicarbonate ions diffuse into
the bloodstream to maintain electrical neutrality in the parietal cell in pancreatic epithelial cells the direction of ion movement is reversed
Hormonal control of urinary excretion primarily affects
DCTs and collecting ducts
What quantitative fluid calculations are made in the perioperative period?
Existing fluid deficits, maintenance fluids, and surgical fluid loss/3rd spacing
What are enzymes, hormones and ion distribution affected by
hydrogen ion concentrations maintenance of an acceptable pH range in the extracellular fluids is accomplished by three mechanisms, chemical buffers, respiratory regulation and renal regulation
Water ionizes to
a limited extent to form equal amounts of H+ ions and OH- ions
Buffers in Urine
th ability to eliminate H+ depends on buffer amounts in urine, carbonic acid, phosphate, and ammonia systems. Glomular filtration proved carbonic acid and phosphate buffer system, PCT generates ammonia while generating HCO3- which is retained for plasma buffering
Calcium
1% ECF = serum Ca = 4.5 to 5.5 mg/dl
Metabolic Acidosis
occurs when there is a decrease in the normal 20:1 ratio, decrease in blood pH and bicarbonate level, excessibe H+ or decreased HCO3
What is the effect of succinylcholine on plasma potassium concentration?
When Succinlycholine depolarizes muscles that have been previously traumatized or denervated, myoneural receptors proliferate over the cell membrane, and a depolarizing drug binding to the increased numbers of receptors can produce large increases in serum potassium leading to life-threatening arrhythmias and cardiac arrest
If ECF osmotic concentration increases
fluid becomes hyperosmotic to ICF, H2O moves from cells to ECF
7.0 is the normal pH of the
fluid within a typical cell
What negative outcomes can occur with large volumes of LR?
Metabolic alkalosis because of increased bicarbonate production due to lactate metabolism
A decrease in angiotensin II leads to
decreased blood volume due to increased GFR
What information is necessary for the accurate interpretation of a blood gas sample?
Source of sample, temperature of sample, ventilator settings, FiO2
A stron acid plus a weak base yields a
salt puls a weak acid
What are two common and clinically relevant causes of metabolic alkalosis?
Loss of gastric fluid and loss of acidic urine with diuretic therapy
What is the renal mechanism to correct for respiratory alkalosis
B type intercalated cells in the DCT and cortical CD will increase bicarbonate secretion and H+ reabsorption
What happens to PaCO2 and PaO2 with increased temperatures?
Both gases enter the gas phase so they increase
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