What are electrolytes?
Electrically charged particles
What are cations?
positively charged ions
What are anions?
negatively charged ions
What determines the balance of electrolytes?
Electroneutrality
What is the main cation for extracellular fluid?
Sodium (Na+)
What is passive transport?
Follow gradients determined by charge/electrical or concentration
What is active transport?
requires energy
What is the main cation for the intracellular fluid?
Potassium (K+)
What is cation exchange?
Transport of one positively charged ion for another in opposite directions across the cell membrane
What is anion exchange?
Transport of negatively charged ions
What is hyponatremia?
Decreased levels of sodium in the blood
Less than 135 mEq/L
What is hypernatremia?
Excessive dietary intake of sodium and loss of body water
Greater than 145 mEq/L
What is hypokalemia?
Loss of potassium resulting from excessive loss due to diuretic use, voimting
Less than 3.5 mEq/L
What is hyperkalemia?
Potassium levels of more than 5 mEq/L in the blood
What anion is major in the extracellular fluid?
Chloride (Cl-)
What is hypochloremia?
Blood chloride levels are less than 98 mEq/L
What is hyperchloremia?
Blood chloride levels are more than 108 mEq/L
What is hypocalcemia?
Calcium blood levels of less than 9.0 mg/dL
What is hypercalcemia?
Calcium blood levels greater than 10.5 mg/dL
What is hypomagnesemia?
Blood levels less than 1.3 mEq/dL
Occurs in association of hypokalemia and hypocalcemia
What is hypermagnesemia?
Magnesium levels greater than 2.1 mEq/dL measured in the blood
What is hypophosphatemia?
Blood phosphate levels less than 2.5 mg/dl
What is hyperphosphatemia?
Blood phosphate levels rise above 4.5 mg/dL
What are the lab values of sodium?
136 to 145 mEq/dL
What are the lab values of potassium?
3.5 to 5 mEq/dL
What are the lab values of calcium totals?
9.0 to 10.5 mg/dL
What are the lab values of magnesium?
1.3 to 2.1 mEq/dL
What are the lab values of phosphorus?
3.0 to 4.5 mg/dL
What are the lab values of chloride?
98 to 106 mEq/dL
Extracellular water makes up what percentage of body weight?
20%
Intracellular water makes up what percentage of body weight?
40%
Interstitial fluid accounts for what percentage of body weight?
14%
Intravascular
in blood vessels
intersitial
in between cells
What is osmosis?
diffusion of water from high to low concentration
What is reabsorption?
Pulling fluid from the interstitial space into the intravascular space
What is filtration?
Force fluid movement from within the vessel to the interstitial space
What is hydrostatic forces?
Pressure is going to be higher on arterial end to push things out
What is osmotic pressure?
The amount of pressure required to stop the osmotic flow of water.
What does thirst do to promote fluid intake?
A desire to drink fluids high in water content, ehich is prompted by uncomfortable sensations in the mouth and pharynx
What does the renin-angiotensin-aldosterone system do to promote fluid intake?
Renal hormone, renin is released from the kidneys and serves as an enzyme. Angiotensin II regulates aldosterone.
What does antidiuretic hormone do to promote fluid intake?
Regulates fluid volume by controlling excretion of total body water
"Don't pee pee hormone
What do diuretics do to promote fluid intake?
Drugs that increase urine production
"Water pill
What is tonicity?
Loss of sodium, loss of water
What is a hypertonic solution?
The solution has a higher solute concentration than the cell so water moves out of the cell and into the solution causing the cell to plasmolyze
What is a hypotonic solution?
the solution has a lower solute concentration than the cell so water moves into the cell causing plant cells to swell and animal cells to swell and burst
What is hypovolemia?
decreased vascular volume
What is hypervolemia?
Excessive increase of fluid in the extracellular compartment
What is hemmorhage?
Excessive bleeding
What is dehydration?
Result of decrease extracellular fluid volume or increased sodium content in relation to water content
What is the patho of Cirrhosis?
Liver disease characterized by interference of local blood flow
Caused by hepatitis and alcohol abuse
Hepatocyte damage
What is the clinical manifestations of Cirrhosis?
Abdominal discomfort
Increased girth
Increased weight
Sodium retention
Hyponatremia
Renal failure
What is the diagnostic criteria for Cirrhosis?
Physical exam
Body weight
Abdominal girth measurement
Lab analysis (Ascitic fluid, Liver and renal function, and cardiac function)
What is the treatment for Cirrhosis?
Paracentesis- Draining fluid
Diuretics
Intravenous albumin
What is the patho for dehydration?
Alteration in fluid and electrolyte balance
Sodium imbalance
Negative fluid imbalance
What causes dehydration?
Decrease fluid intake
Increased fluid output (diarrhea & voimiting)
Fluid shift between compartment
What is the fluid loss in hyponatremic dehydration category?
Hypertonic
What is the fluid shifts in hyponatremic dehydration category?
Intravascular to extravascular
What is the fluid loss in hypernatremic dehydration category?
Hypotonic
What is the fluid shifts in hypernatremic dehydration category?
Extravascular to intravascular
What are the clinical manifestations of dehydration?
Decreased level of consciousness
Prolonged capillary refill time
Dry mucous membranes
Decreased or absent tears
High heart rate and low blood pressure
What is the diagnostic criteria for dehydration?
Hx and physical exam
Fluid intake/output
Characteristics of: urine, stool,emesis,sweat
Nutrition
Lab analyses
Blood concentration: Electrolytes, bicarnonate, blood urea nitrogen, creatinine, specific gravity
What is the treatment for dehydration?
Rehydration: Oral or Intravenous
Correction of electrolyte imbalance
What is the patho for hypoparathyroidism?
Altered calcium balance
Negative feedback regulation by parathyroid glands
Calcium level rise; hormone production stop
Impaired parathyroid function leads to decrease blood calcium levels
What are the clinical manifestations of hypoparathyroidism?
Hair dryness and loss
Nail ridges and breakage
Skin dryness
Bone loss
Tingling in extremities
What are the diagnostic criteria for hypoparathyroidism?
Medical and surgical history
Physical exam
Lab tests: Parathyroid hormone, blood calcium, urinary calcium
What is the treatment for hypoparathyroidism?
Supplements: Calcium,carbonate, citrate
Vitamin D: Calcitriol
What happens when you have low sodium?
Less than 136
Confusion
Tired
Abdominal cramps
Crave salts
Seizures
What happens when you have high sodium?
Higher than 145
Crave water
weak
Low level of consciousness
What happens when you have low potassium?
Less than 3.5
Cramps (legs)
Low bowel sounds
Low GI
Low deep tendon reflex
What happens when you have high potassium?
Higher than 5.0
Cardiac arrest
Weakness
High GI
What happens when you have low calcium?
Lower than 9.0
Weak bones, teeth
Severe cramos
Trousseau Chvaster seizures
High deep tendon reflex
What happens when you have high calcium?
Greater than 10.5
Lethargy
Bone pain
Low deep tendon reflex
Looks like they having a heart attack
What happens when you have low magnesium?
Lower than 1.3
Tremors
High deep tendon reflex
High heart rate
Confusion
What happens when you have high magnesium?
Greater than 2.1
Nausea and vomiting
Vasodilation
Hypotension
Low deep tendon reflex
Cardiac arrest