Fluids, Electrolytes, Acid and Base

Week 2 of Patho Pharm Modules

Intracellular fluid

Fluid inside cells

intravascular fluid

fluid component of blood

Intravascular fluid is also known as what?

Plasma

Transcellular Fluid

Fluid in specialized spaces such as cerebrospinal fluid

Kidneys, lungs, heart, blood vessels, and endocrine hormones

Coordinate to maintain balance

Fluid and electrolytes keep cells properly hydrated and stable

True

Fluid and electrolytes carry electrical charges that allow nerves to signal and muscles to contract

True

Fluid and electrolytes help maintain acid base balance so enzymes and proteins can function correctly

True

Decides where the water goes

Sodium

Concentration of sodium is higher on the outside of the cell so the water flows out of the cell to balance causing the cell to shrink

Hypertonic Sodium Solution

Concentration of sodium is lower outside of the cell causing the water to flow into the cell to balance causing the cell to burst

Hypotonic Sodium Solution

Keeps heart beats and muscle contractions on time

Potassium

Potassium in; insulin, epinephrine, alkalosis

Potassium out; exercise, cell lysis, hyperosmolarity, and acidosis

Internal Potassium Balance

Potassium being ingested and excreted

External potassium balance

Build strong bone and supports contractions

Calcium

Calcium is a positively charged ion

True

Calcium is mostly found in bones

True

Calcium is located in plasma where it is a free ionized form and bounds to proteins like albumin.

True

Calms overactive signals

Magnesium

Fuels every cell

Phosphate

Follows sodium to maintain fluid balance and supports acid base regulation

Chloride

pushed water out of capillaries

hydrostatic pressure

a protein, such as albumin, pulls water back into the capillaries

Oncotic pressure

Moves only water across membranes to equalize concentration

osmosis

Normal pH level

7.35-7.45

A pH that is too acidic is

below 7.35 and is known as acidosis

A pH that is too alkaline is

above 7.45 and is known as alkalosis

acts instantly (bicarbonate→carbonic acid system) in the acid base balance

Buffers

Responds in minutes in the acid base balance by exhaling CO2

Lungs

Responds in hours to days in the acid base balance by excreting H+ and conserving bicarbonate

Kidneys

Fluid retention in tissues; swelling/weight gain

Edema

Fluid loss resulting in thirst, low BP, dizziness and a risk of shock

Dehydration

Low sodium resulting in brain cells swelling causing confusion and seizures

Hyponatremia

High sodium causing brain cells to shrink resulting in restlessness and coma

Hypernatremia

Low potassium resulting in weak muscles, constipation and an irregular heartbeat

Hypokalemia

high potassium causing tingling, weakness, fatal arrhythmias/cardiac arrest

Hyperkalemia

Low calcium causing spasms, tetany, seizures, and airway risks

Hypocalcemia

High calcium causing muscles weakness, constipation, kidney stones and arrhythmias

Hypercalcemia

Low magnesiums causing tremors, seizures, torsades de pointe arrhytmia

Hypomagnesemia

High magnesium causing a loss of reflexes, low BP, slow breathing and cardiac arrest

Hypermagnesemia

Low phosphate causing weak muscles, bone softening, and poor oxygen delivery

Hypophosphatemia

High phosphate causing tetany, cramps and soft tissue calcification

Hyperphosphatemia

Rapid breathing, low BP, and arrhythmias

Metabolic Acidosis

Tingling, cramps, conclusions, and arrhythmias

Metabolic Alkalosis

Hypoventilation, drowsiness, confusion

Respiratory acidosis

Hyperventilation , lightheadedness, tingling and seizures

Respiratory alkalosis

Stays in vessels; there is no shift ( equal); Normal saline 0.9%; used for hypovolemia, shock and transfusions (NS)

Isotonic Solution

Water moves into cell; 0.45% NS, D5W after metabolism; used for hypernatremia, and dehydration inside cells

Hypotonic Solution

Pulls water out of cell; 3% NaCl, D5LR; used for severe hypernatremia and cerebral edema

Hypertonic Solution

Proteins stay in vessels and pull fluids in; Albumin, Dextran, Hetastarch; used for hypovolemia, low albumin, burns

Colloid

Moves across all compartments; oral water, DSW IV; dehydration when Na is normal/high

Free water

Sodium Normal Range

135-145 mEq/L

Potassium Normal Range

3.5-5.0 mEq/L

Chloride Normal Range

96-106 mEq/L

Calcium Normal Range

8.8-10.5 mEq/L

Ionized Calcium Normal Range

1.1-1.3 mmol/L

Magnesium Normal Range

1.8-3.0 mg/dL

Phosphate Normal Range

2.5-5.0 mg/dL

Normal pH range

7.35-7.45

PaCO2 Normal Range

35-45 mmHg

HCO3 Normal Range

21-28 mEq/L

PaO2 Normal Range

80-100 mmHg

SpO2 Normal Range

95-100%