Sol. BD fluids & electrolytes.txt

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Sol. BD fluids & electrolytes.txt
2011-12-06 18:09:29
RESP 130

RESP 130
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  1. Water makes up to as much as _____ of your weight.
  2. The easiest way to track water gain and loss is to ______.
    weigh the patient.
  3. What are the three ways that substances or particles combine in our body with water.
    Colloids, Suspensions, and solutions.
  4. Dispersions or gels, consist of large molecules that attreact and hold water. they remain uniformly distributed throughout the dispersion and usually do not settle.
  5. Example of colloid.
    protoplasm w/in a cell
  6. Comprise large particles that float in a liquid. mixing of them depends on agitation
  7. Example of suspension.
    RBC in blood
  8. is a stable mixture of two substances. The substance that dissolves is called the solute and the medium in which it dissolves is called the solvent.
  9. Substance being dissolved.
    • Solute
    • '
    • Medium used to dissolve.
    • Solvent
  10. refers to the ease in which a solute dissolves in a solvent.
  11. The four factors that influence solubility.
    Nature of solvent, nature of solute, temperature, and pressure.
  12. The ease with which substances go into a solution in a given solvent varies widely due to its physical characteristics of matter.
    Nature of a solute
  13. Factor that influences solubility based on the idea that solvents vary widely in their ability to dissolve substances.
    Nature of the solvent
  14. Solubility of most solids increases with temp., but varies inversely w/ ______.
  15. Solubility of gases in liquids varies directly w/ _______.
  16. Is when the amount of solute is small in proportion to its solvent.
    Dilute solution
  17. has the max. amount of solute that can be held be a solvent, at a given temp.
    Saturated solution
  18. If there is excess solute in a solution or the temp cools, what will happen?
    a precipitate will form.
  19. The rate that precipitate forms i the same as the particles ________
    go into the solution.
  20. A solution that contains more solute than a sturated solution, at the same temp and pressure is said to be.
  21. Most of the solutions of physiological imprtance in the body are _____
  22. Solutes in dilute solution demonstrate many of the properties of gases due to?
    The large spaces between molecules.
  23. The most important physiological characteristic of solutions is their?
    ability to exert pressure.
  24. is the force produced by the mobility of solvent particles under certain conditions.
    Osmotic pressure
  25. Osmotic pressure can be a ________ or _______.
    driving force or an attractive force.
  26. Membrane that permits passage of solvent molecules, but not solute.
  27. The number of molecules passing in one directionn must _____ the number of solvent molecules passing in the opposite direction.
  28. Pure solvent is placed on one side of the membrane and a solution on the other. The solvent molecules will move ________ due to the osmotic prssure trying to equalize the concentration on both sides of the membrane.
    Into the solution
  29. If a stronger solution (50%) is placed across a semipermeable membrane from a dilute solution (30%) the attractive osmotic forces will__________.
    pull the solvent until both solutions have the same concentration.
  30. Osmotic pressure depends on ?
    the number of particles in a solution.
  31. Whe effect would increasing the temperature have on osmotic pressure?
    It would also increase.
  32. For every 1C increase, osmotic pressure goes up by?
  33. is the degree of osmotic pressure exerted by a solution.
  34. are sol. that have osmotic pressures equal to the average intracellular pressure in the body.
  35. Sol. that has higher osmotic pressure or more tonicity. This will draw water out of cells.
  36. sol. that has lower osmotic pressure or less tonicity. This will cause water to be absorbed from the sol. into the cells.
  37. There are three basic types of physiological solutions that coexist in the body:
    Ionic, Polar Covalent, Nonpolar Covalent
  38. Some of the solute ionizes into separate particles know as ions. this makes it an electrolyte
    Ionc solution ( electrovalent)
  39. Some solutes create ions and it is also an electolyte.
    Polar Covalent solution
  40. no ionization of solute takes place, they carry no electrical charge and are called nonelectrolytes.
    Non-polar covalent solutions.
  41. Are positive charged ions that migrate to a negative electrode called a cathode
  42. are negative charged ions that will migrate to a positive electrode callen an anode.
  43. What are the two ways to quantify the amount of solute in a solution:
    By actual weight or by chemical combining power.
  44. Are the amounts of substances that have equal chemical combining power.
    Equivalent weights
  45. What are the two values or equivalent weights that are used to cal chemical power?
    Gram and milligram equivalent.
  46. gEq and mEq
    gram equivalent and milligram equivalent.
  47. formula for gEq
    = atomic weight/ valence
  48. How do you calc. gEq for an acid.
    divide the atomic weight by the nuber of hydrogen atoms that are replaceable in its formula.
  49. The relationship of the solute to the solvent is expressed as a proportion. These are used often in describing concentrations os drugs or pharmaceuticals.
    Ratio solution
  50. this is used for solids dissolved in liquids.Not a true percent solution
    weight per volume W/V
  51. this solution is the weight of solute per weight of solution. It is a true percent solution
    percent solution
  52. are compounds that increase the hydrogen ion concentraion when placed in an aqueous solution.
  53. An acid is any compound that is a proton donor. This includes substances other than traditional acids such as the ammonium ion.
    Bronsted-Lowry's deinition
  54. is a compound that gives up a hydroxyl ion when placed into an aqueous solution.
  55. Are composed of amino acids bound together by peptide links. react mildly in the body like alkaline.
  56. Call and blood proteins acting a bases are transcribed as
  57. effect is produced by imidazole group of the amino acid histidine ( cyclic crystalline base)
    Hemoglobin Buffering Group
  58. The O2 carrying component of hemoblobin is attached to a histidine residue. What is it called?
  59. The ability of hemoglobin to accept H+ ions depends on the?
    Oxygenation state of the molecule.
  60. Which is a stronger base: Deoxigenated (reduced) or oxygenated hemoglobin
  61. These also act as buffers, but with less buffering power than hemoglobin, which contains more histidine.
    Plasma Proteins
  62. Pure water can be used as a reference point for determining:
    Acidity or alkalinity
  63. The concentration of both H+ and OH- is pure water is:
    10^7 mmol/L
  64. Any solution that has a greater H+ concentration or lower OH- concentration than water acts as:
  65. Any solution that has a lower H+ concentration or a greater OH- concentration than water is
  66. Acidity or alkalinity is determined by variations of the [H+] above or below
  67. what are the two ways to record pH of a substance:
    [H+] in nanomoles per liter or logarithmic pH scale
  68. How many nanomoles per liter of water is there when its neutral/
  69. If a solution has more nanomoles than water it is?
  70. If a solution has less nanomoles than water it is?
  71. Normal physiological range of [H+] in healthy people is.
  72. pH lower than 7
  73. pH higher than 7
  74. A pH change of 0.3 units equal a ____fold change in [H+].
  75. a pH change of 1 unit equals a __fold change in [H+].
  76. Water withing the cells makes up how much of the total body water?
  77. Water outside the cells makes up how much of the water in the total body water/
  78. Extracellular water is found in three places:
    Intravascular, Interstitial, and transcellular
  79. Intravascular water makes up what percentage of body weight?
  80. Interstitial water makes up what percentage of the body weight.
  81. Predominant extracellular electolytes:
    Na, Cl, HCO3
  82. Main intracellular electolytes are
    K, Mg, Phosphate, SO3, protein
  83. Plasma contain more protein than interstitial fluid. What mainly gives it its high osmotic pressure.
  84. Control of total body water occurs through regulation of?
    water intake and water excretion (urine, stool, and insensible)
  85. These are mainly responcible for water excretion.
  86. two mechanisms allow the kidneys to maintain the volume and concentraiton of body fluid despite variations in salt and water intake.
    filtration and reabsorption of sodium adjust urinary sodium excretion to match changes in dietary intake and water excretion is regulated by secretion of antidiuretic hormone
  87. Water loss from the skin and lungs (vaporization)
  88. Water loss from urine, intestinal, and sweat.
  89. These are such losses that may occur during vomiting, diarrhea, or suctioning from the intestines. Fever, with sweating, is another cause.
    Additive losses
  90. For each degree of temp >99F that persists for 24hrs, an additional _______ of fluid will be required.
    1000mL or 1L
  91. Water is replenished in two major ways:
    Ingestion and metabolism
  92. This is the main form of water replacement. Avg. drinks 1.5-2Lpday H2O and 500-600mL from food
  93. This water comes from the oxidation of fats, carbs., proteints in the body from the destruction of cells.
  94. Norm. H2O prduced from metabolism.
  95. In starvation or post-op. water prod. from metabolism can be as high as
    1-2 Lpday of H2O
  96. Gastro. tract makes 8-10 L of fluid per day, but more than 98% is reclaimed where?
    in the large intestine
  97. vomiting or diarrhea can cause substantial ____
    water loss
  98. ventillation will increase water losses. Artificial airways increased evaporation. This deficit could be ~ 700mL. How can we minimize this loss?
  99. Interstitial fluid moves into the lymphatics due to _______. Lymph. lower than interstitial.
    pressure gradients
  100. Colloid osmotic pressure of the intravascular fluid is constant at?
  101. Electrolytes are essential to life. they make chemical and physiological events possible. What are the 7 major ones?
    Na+, Cl-, HCO3-, K+, Ca2+, Mg2+, and HPO42-
  102. Norm. Na conc. in serum is?
    136-145 mEq/L
  103. Norm. Na conc. in intracellular?
    4.5 mEq/L
  104. Na reabsorbtion is govern by ______, which is secreted by the adrenal cortex.
  105. % Na in extracellular, bone, and cells
    50, 40, 10
  106. Adults ingest and excrete about _____ Na every day
  107. Kids ingest and excrete about ____Na every day
  108. Infants excrete about ____ Na every day.
  109. what % of Na is reabsorbed in proximal tubules and rest in distal tubules of the kidneys?
  110. Caused by gastrointestinal loss, sweating, fever, diurestics, ascites, congestive heart failure, kidney failure. Sympts. waekness, lassitude, apathy, headache, orthostatic hypotentsion, tachycardia.
  111. caused by net sodium gain, net water loss, increased aldosterone, steoid therapy. Smypt. tremulousness, irritability, ataxia, confusion, seizures, and coma.
  112. Norm. Cl serum levels range.
    98-106 mEq/L
  113. This is the most prominent anion in the body.
  114. what ratio of Cl is extracellular, rest is in the cells
  115. Cl is inversely proportional to major anion
  116. Cl is regulated by
  117. Cl is excreted w/ K as
  118. caused by gastrointedtinal loss, and diuretics. Sympts. include meta. alkalosis, muscle spasm, and coma
  119. caused by dehydration, meta. acidosis, resp. alk.. Sympts. are negligible
  120. Norm. serum K is
    3.5-5.0 mEq/L
  121. what percent of K is in the cells?
  122. adults excrete how much K in urine and how much in stool?
    40-75mEq and 10mEq
  123. Controls renal K excretion by inhibiting enzyme responsible for K transport in distal renal tubular cells
  124. Meta. acidosis inhibits trans. system as Na and H ions enter cells at the expense of?
    increased K excretion
  125. this stimulates cellular retention of K
  126. Caused by diuretics, steroid therapy, renal tubular disease, vomiting, diarrhea, malnutrition, trauma. Symps. muscle weakness, paralysis, ECG abnormalities, supraventricular, arrhythmias, circulatory failure, cardiac arrest.
  127. Hypokalemia treat, involves replacement of K often w/ Cl. Admin of IV K must be cautious because?
    cardiac muscles are sensitive to exracellular K
  128. caused by chronic renal disease, hemorrhage, tissue necrosis, nonsteroid anti-inflammatory drugs, ACE inhibitors, cyclosporine, K sparing diuretics. Sympts. ECG changes, ventricular arrhythmias, cardiac arrest.
  129. Hyperkalemia treatment involves the restriction of
    K intake
  130. Norm serum Ca is
    4.5-5.25 mEq/L
  131. Ca is maintained by humral factors such as?
    Vitamin D and parathyroid hormone
  132. is an important mediator of neuromuscular function and cellular enzyme processes. most of it is in the bones
  133. Ca is carried in the blood three ways;
    ionized, pretien-bound, and complex
  134. percent Ca2+ is nonionized and bound to plasma albumin
  135. percent Ca2+ in anion complex
  136. percent Ca2+ is ionized
  137. is physiologically active in processes such as enzyme activity, blood clotting, neuromuscular irritability, and bone calcification
  138. Acidemia does what to Ca2+ in serum?
  139. Alkalemia does what to Ca2+ in serum
  140. caused by hypoparathyroidism, pancreatitis, renal failure, and trauma. Sympts. fatigue, depression, muscle weakness, anorexia, nausea, vomiting, constipation
  141. causes hyperthyroidism, hyperparathyroidism, metastatic bone cancer, sarcoidosis. Sympts. fatugue, depression, muscle weakness, anorexia, vomiting, and constipation
  142. If serum Ca2+ rises above 17mg/L (8.3mEq/l) what may occur
  143. norm serum Mg2+
    1.7-2.1 mg/L
  144. fatty acids and excess phosphates impair
    Mg2+ uptake
  145. what percentage of Mg2+ is ionized or bound to other ions?
  146. What percentage of Mg2+ is bound to proteins?
  147. this is important for muscle function, neural conduction, particulary in the cardiac conduction system.
  148. causes inadequate intake/impaired absorbtion of Mg2+, pancreatitus, alcoholism. Sympts. muscle weakness, irritability, tetany, ECG changes, arrhythmias, delirium, and convulsions.
  149. causes dehydration, renal insufficiency, tissue trauma, lupus erythematosus. Sympts. ECG changes, hyperkalemia,cardiac arrest, respiratory muscle paralysis, and diaphragmatic weakness
  150. Norm Phosphate serum level
    1.2-2.3 mEq/L
  151. what percentage of the body HPO42- is contained in bone and teeth
  152. what percentage of phosphate is combined with proteins, carbs, and lipids in muscle tissue and blood, and the rest is incorporated into complex organic compounds.
  153. is the main anion in the cells.
    organic phosphate
  154. plays a primary role in the metabolism of cellular energy, being the source from which ATP is sythesized
    inorganic phosphate
  155. Phosphate is the main urinary buffer for titratable acid excretion in/
    Acid-Base homeostasis
  156. Causes starvation, malabsorption, hyperparathyoidism, hyperthyroidism, uncontrolled diabetes mellitus. Sympts. diaphragmatic weakness
  157. cases are endocrine disorders, acromegaly, chronic renal insufficiency, acute renal failure, tisse trauma. Sympts are minimal
  158. Normal HCO3 level in arterila blood.
  159. is the primary means for transporting CO2 from the tissues to the lungs.
  160. In acid base disorders, ____ regulate HCO3- levels to maintain near normal pH
    the kidneys
  161. In normal persons more than 80% of blood HCO3- is reabsorbed in _______ of the kidneys
    the proximal tubules
  162. In respiratory acidosis kidneys.....
    retain or produce HCO3-
  163. In repiratory alkalosis kidneys......
    get rid of HCO3-