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5% dextrose in water (D5W)
Isotonic
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10% dextrose in water D10W
Hypertonic
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5% dextrose in 0.9% saline
Hypertonic
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5% dextrose in 0.45% saline
Hypertonic
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5% dextrose in 0.225% saline
Isotonic
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Ringer's lactate
Isotonic
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5% dextrose in Ringer's lactate
Hypertonic
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Obligatory urine output
minimum amount of urine per day needed to excrete toxic waste products is 400 - 600 mL
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Diffusion,moment
from an area of higher concentration to lower concentration
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Osmosis,movement
of water only through a selectively permeable membrane
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Osmolarity,number
of milliosmoles in a liter of solution
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Osmolality,number
of milliosmoles in a kilogram solution
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Aldosterone,secreted
acts on the kidney, triggering them to reabsorb sodium and water from urine back to the blood
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Antidiuretic hormone (ADH)
acts directly on kidney tubules and collecting ducts, making them more permeable to water
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Natriuretic peptides (NPs)
secreted by special cells that line the atria of the heart & ventricles of the heart
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Hypovolemia
Circulating blood volume is decreased
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Hypoxia
decreased oxygen levels
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pH normal values
7.35 - 7.45
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PaO2 normal values
80 - 100 mm Hg
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PaCO2 normal values
35-45 mm Hg
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HCO3 (bicarbonate) normal values
21 - 28 mEq/L
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Lacate normal values
3-7 mg/dL
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Base is
- A substance that binds free hydrogen ions in solution
- Acid is
- A substance that release hydrogen ions when dissolved in H2O
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The lower the pH value of a fluid
the higher the level of free hydrogen ions in that fluid
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pH increased metabolic alkalosis
loss of gastric fluids, decreased K+ intake, diuretic therapy, fever, salicylate toxicity
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pH decreased, metabolic or respiratory acidosis
detosis, renal failure, starvation, diarrhea, hyperthyroidism
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PaO2 increased
increased ventilation, oxygen therapy, exercise
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PaO2 decreased
respiratory depression, high altitude, carbon monoxide poisoning, decreased cardiac output
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PaCO2 increased
respiratory acidosis, emphysema, pneumonia, cardiac failure, respiratory depression
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PaCO2 decreased
respiratory alkalosis, excessive ventilation, diarrhea
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HCO3 increased
bicarbonate therapy, metabolic alkalosis
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HCO3 decreased,metabolic acidosis
diarrhea, pancreatitis
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Chemical Regulatory Mechanisms
- Protein buffers (albumin, globulins, hemoglobin)
- Chemical buffers (bicarbonate, phosphate)
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Chemical Characteristics
Very rapid response
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Respiratory Regulatory Mechanisms
- Increased hydrogen ions or increased CO2 increased rate and depth of breathing
- Decreased hydrogen ions or decreased carbon dioxide
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Respiratory Characteristics
Primarily assist buffering systems when the fluctuation of hydrogen ion concentration is acute
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Renal Regulatory Mechanisms
- to Decrease pH: increased renal excretion of bicarbonate & reabsorption of hydrogen ions
- to Increase pH: decreased renal excretion of bicarbonate & reabsorption of hydrogen ions
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Renal Characteristics
- Most powerful regulator of acid-base balance
- Slowest response
- Longest duration
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Respiratory opposite (acidosis or alkalosis)
- pH up PaCO2 down
- pH down PaCO2 up
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Metabolic equal (acidosis or alkalosis)
- pH up HCO3 up
- pH down HCO3 down
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