Electrolytes and Acid-Base Regulation

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jgething
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270157
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Electrolytes and Acid-Base Regulation
Updated:
2014-04-10 22:46:15
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  1. fluid balance
    involves regulating content and distribution of body water in ECF and ICF
  2. electrolyte balance
    involves balance of rates of absorption of electrolytes across digestive tract with the rates of loss at the kidneys and other sites
  3. acid-base balance
    precisely balances production and loss of H+ ions
  4. the ions formed when electrolytes dissolve and dissociate serve four main functions
    • control osmosis of water between fluid compartments
    • maintain acid-base balance for normal cell activities
    • production of action and graded potentials
    • serve as cofactors for optimal enzyme activities
  5. cations in body fluids
    • ECF, plasma: Na+
    • ECF, interstitial fluid: Na+
    • ICF, intracellular fluid: K+
  6. anions in body fluids
    • ECF, plasma: Cl-
    • ECF, interstitial fluid: Cl-
    • ICF, intracellular fluid: HPO4 -2
  7. primary regulatory hormones
    • antidiuretic hormone: water retention; released with low blood pressureand Na ions
    • aldosterone: retain Na ions and enchance K excretion
    • natriuretic peptides: when bp is high and high levels of Na ions
  8. fluid shifts from one compartment to another
    rapid water movements between ECF and ICF in response to osmotic gradient
  9. electrolyte balance: sodium
    • dominant cation in ECF
    • provide 90% ECF osmotic concentration
  10. electrolyte balance: potassium
    • dominant cation in ICF
    • processes of K balance:
    • rate of gain across digestive epithelium
    • rate of loss into urine
    • factors involved in tubular secretion of k:
    • changes in k conc in ECF
    • changes in pH
    • aldosterone levels
  11. hypernatremia >145
    • thirst, dryness, and wrinkling of skin
    • reduced blood volume and pressure 
    • dehydration, loss of hypotonic fluid 
    • ingest water
    • intravenous infusion of hypotonic sodium
  12. hyponatremia <135
    • disturbed CNS function 
    • confusion, hallucination, convulsion, coma, death
    • infusion or ingstion of large volumes of hypotonic sodium 
    • diuretic use of hypertonic salt solution
  13. hyperkalemia >5
    • severe cardiac arrhythmias, muscle spasms
    • renal failure
    • use of diuretics
    • chronic acidosis 
    • infusion of hypertonic solution
  14. hypokalemia <3.5
    • muscle weakness and paralysis 
    • low K diet
    • diuretics 
    • hypersecretion of aldosterone
    • chronic alkalosis 
    • increase dietary k
  15. electrolyte balance: calcium
    • must abundant mineral in body 
    • absorbed at digestive tract and reabsorbed along DCT
    • stimulated by PTH and calcitriol
    • 1-2 kg in body, mostly in bones
  16. hypercalcemia >5.3.
    • confusion, muscle pain, cardiac arrhythmias, kidney stones, calcification of soft tissue 
    • hyperparathyroidism, cancer, vitamin d toxicity, supplement overdose
    • infuse hypotonic fluid to lower Ca
    • remove gland
    • administe calcitonin
  17. hypocalcemia <4.3
    • muscle spasms, convulsion, intestinal cramps, weak heartbeats, osteoporosis
    • por diet, lack of vitamin d, renla failure, hypoparathyroidism, hypomagnesia 
    • Ca supplements, administer vitamin d
  18. electrolyte balance: phosphate ions
    • required for bone mineralization
    • in ICF, Po4 required for formation of high-energy compounds, activation of enzymes, and synthesis of nucleic acid 
    • reabsorbed from tubular fluid along PCT
  19. electrolyte balance: chloride ions
    • most abundant anions in ECF 
    • are absorbed across digestive tract with Na
    • also reabsorbed by Na carrier proteins along renal tubules

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