Pathophysiology Exam 2 - Fluids&Electrolytes, Acid&Bases, Shock

the osmolarity of the intracellular fluid is normally _______ as/than the extracellular fluid

the same as

protein responsible for the plasma oncotic pressure

albumin

isotonic fluid excess causes

hypervolemia

renal compensation for an acid-base balance is

slow

pulmonary compensation for an acid-base balance is

fast

fluid moves out of the capillaries by

filtration

fluid moved into or out of the cells by

osmosis

most dangerous effect of hyperkalemia is its action on the ____

heart

proteins that serve as water channels in cell membranes

aquaporins

fluid accumulation in interstitial spaces

edema

who has greater percentage of body weight as water: a lean person or an obese person

lean person

who has greater percentage of body weight as water: an infant or an adolescent

infant

who has greater percentage of body weight as water: woman or man

man

who has greater percentage of body weight as water if both weigh the same: 56 year old person or 78 year old person

56 year old

where potassium ion concentration is greater

intracellular fluid

where sodium ion concentration is greater

extracellular fluid

Aldosterone effect

increases renal sodium and water excretion

atrial natriuretic peptide effect

increases volume in the cardiac atria

antidiuretic hormone effect

increases renal water absorption, vasoconstriction

two most important intracellular buffers

protein and phosphate

when the pH is becoming too high, buffers help keep the pH normal by releasing

hydrogen ions

In which direction does insulin move potassium ions

from ECF into the cell

In which direction does epinephrine move potassium ions

from ECF into the cell

In which direction does alkalosis move potassium ions

from ECF into the cell

In which direction does hypernatremia move water

from the cell to ECF

how do you monitor a patients fluid intake and retainment

by weighing them

osmotic pressure

pulling

hydrostatic pressure

pushing

albumin provides a ____ force

pulling

increased capillary permeability and edema

leaky blood vessels, so fluid leaks out into surrounding tissues

increased hydrostatic pressure and edema

fluid is pushed into interstitial space due to a backup of water in vessels

decreased oncontic pressure and edema

water stays outside the vessel and in the interstitial spaces

Lymphatic obstruction and edema

fluid builds up in lymph areas and leaks out into interstitial spaces

why can we not use water that has leaked into interstitial spaces

because it is not circulating

natriuretic peptide

produced in response to stretching of atria and ventricles; tells us to "pee it off"

ADH

secreted by posterior pituitary gland in response to changes in the concentration of blood; tell us to hang on to water

as osmolarity goes up, concentration goes

up

aldosterone

secreted by adrenal cortex in response to reduced blood flow to the kidneys; tells us to hang on to sodium

where water goes, _____ goes

sodium

RAA system

in response to decreased perfusion, kidneys produce Renin

hypovolemic

decreased water volume, decreased concentration of sodium

hypervolemic

increased water volume, increased concentration of sodium

hyponatremia symptoms

convulsions, seizures, muscle spasms, excess water

hypernatremia symptoms

thirst, weakness, lethargy, lack of water

hypocalcemia symptoms

tingling, spasms, cramping, cardiac arrest

hypercalcemia symptoms

fatigue, constipation, kidney stones

Trousseau's sign

sign of hypocalcemia; involuntary carpal spasm

Chvostek's sign

sign of hypocalcemia; spasm of the facial muscles

hypomagnesemia symptoms

irritability, cramps, convulsions, tachycardia, hyperreflexia

hypermagnesemia symptoms

loss of reflexes, hypotension

hypotension

low blood pressure

hypertension

high blood pressure

kidneys secrete H+ ions in urine causing urine pH to ______ _____

go down

metabolic acidosis symptoms

Kussmaul breathing, lethargy, nausea

metabolic alkalosis symptoms

weakness, cramps, hyperactive reflexes

respiratory acidosis symptoms

headache, blurry vision, dyspnea, warm skin

respiratory alkalosis symptoms

dizziness, confusion, tingling, convulsions

shock

decreased tissue perfusion

oxygen demand ____ oxygen supply

exceeds

clinical indicators of shock

tachycardia, decreased urinary output, metabolic acidosis, elevated lactate, hyperkalemia

general signs of shock

weakness, confusion, dyspnea, fever, anxiety

end result of every shock type

hypotension

cardiogenic shock

shock caused by inadequate pumping of the heart

signs/symptoms of cardiogenic shock

hypotension, pulmonary edema, tachypnea, reduced urine output, weak pulse

treatment of cardiogenic shock

vasopressors to increase BP, restoration of blood flow by stints/bypass

hypovolemic shock

shock resulting from a large loss of volumes in intravascular fluid through hemorrhage or water loss

signs/symptoms of hypovolemic shock

thready pulse, loss of consciousness, poor skin color, thirst

treatment of hypovolemic shock

stop the bleeding, replace blood/plasma and fluids

neurogenic shock

widespread and major vasodilation resulting from trauma to the CNS

signs/symptoms of neurogenic shock

hypotension, bradycardia

anaphylactic shock

severe allergic reaction

sings/symptoms of anaphylactic shock

wheezing, hives, dizziness, edema of tongue/lips

treatment of anaphylactic shock

epinephrine, antihistamines, fluid replacement

septic shock

shock caused by infection (bacterial or viral)

signs/symptoms of septic shock

warm skin or fever, tachycardia, low blood pressure.

treatment of septic shock

fluids, vasopressors, antibiotics

MODS

multiple organ dysfunction syndrome