Sodium, Chloride, and Dehydrated States

what dehydration type is consistent with a decrease in total body sodium?

hypotonic

what type of dehydration is consistent with total body sodium within reference interval?

isotonic dehydration

hypertonic dehydration

restricted H2O access, h2o loss > Na loss, leads to hypernatremia

isotonic dehydration

h2o loss = Na loss

hypotonic dehydration

h2o loss < Na loss

what other electrolyte does Na closely follow?

Na

If bicarb is low, how does chloride usually follow?

increase

pathogenesis of hypernatremia

1. decrease h2o intake

2. increase h2o loss via kidney

3. water vapor loss

4. increased h20 loss > Na loss

what is the pathogenesis of osmotic diuresis?

glucose from diabetes draws water from the ECF, increased glucose in urine inhibits passive H2O reabsorption and water loss in urine, increased Na Cl in urine

clinical conditions of hypotonic dehydration

1. intestinal loss (diarrhea, vomiting, ect)

2. cutaneous ( sweating in horses)

3. renal (addisons, diuretics, anion loss)

4. 3rd- space loss

pathogenesis of hypotonic dehydration via intestinal loss

1. diarrhea

2. loss of Na Cl and H2O

3. dehydration, hypovolemia

4. stim. thirst and drink h20

5. ADH stimulates reabsorption

6. water dilution of solutes

pathogenesis of hypotonic dehydration via renal loss

1. damage to kidney

2. decreased aldosterone

3. decreased Na Cl

1. decreased cortisol

2. inhibition of ADH release

3. increased ADH

4. H2o retention

5. dilutions

renal Na loss with anions

1. diabetes mellitus > ketosis > anions excreted

2. metabolic acidosis > increased HCO3

3. hypoxia > increased lactate

4. persistent loss of anions obligates loss of Na to maintain electroneutrality - hyponatremia

what diuretic can can hypotonic dehydration and how?

furosemide inhibits of LOH and DT Na/Cl pumps, hypovolemia stimulates ADH and thirst, h2o retention that dilutes

what conditions can cause 3rd space loss of Na?

bladder rupture, Na diffuses into peritoneal cavity

how can hyperglycemia contribute hypotonic dehydration?

glucosuria leads to osmotic diuresis, water follows glucose and increased sodium renal loss if ketoacidosis

pathogenesis of hyponatremic dehydration in an edematous state

involves excess fluid retention leading to dilution of sodium levels, often seen in conditions like heart failure or liver cirrhosis

clinical conditions of isotonic dehydration

1. net retention of isotonic fluids causing edema or transudate (CHF, liver cirrhosis, nephrotic syndrome)

2. net loss of isotonic fluids causing dehydration (alimentary losses, renal losses)

pathogenesis of isotonic dehydration

intestinal losses, cutaneous loss, renal ( defective tubules)

pathogenesis of isotonic dehydration in edematous animal

1. decreased blood volume

2. reabsorption of Na Cl

3. ADH stim

4. retention of water to increase blood volume

5. increased hydraulic venous pressure

6. isotonic fluid moves into ECF and peritoneal cavity

when a sample has increased …… they can displace water in the sample and falsely decrease Na and Cl concentrations

lipids

pathogenesis of hypochloremia due to gastric blockage or sequestration

loss of gastric secretions, leading to decreased chloride levels in the blood, and increased bicarbonate and metabolic acidosis