Chapter 13

A stable mixture of two or more substances in a single phase that cannot be separated using a centrifuge

Solution

A substance dissolved in a solution

Solute

Any liquid in which another substance can be dissolved

Solvent

What are five factors the determine solubility?

1. Nature of solute
2. Nature of solvent
3. Temperature
4. Pressure
5. Concentration

Water is distributed in body via __________

Osmosis

Greater tonicity than 0.9% NaCl

Hypertonic

Less tonicity than 0.9% NaCl

Hypotonic

What are two ways to quantify solute content and activity?

1. Actual weight in g or mg
2. Combining force

greater than 7 has less acid or more base than water = ?

Alkaline

Less than 7 has more acid or less base than water = ?

Acidic

Low intake of H2O, puts out _______________ urine.

concentrated

What are seven major electrolytes?

1. Sodium
2. Chloride
3. Bicarbonate
4. Potassium
5. Calcium
6. Magnesium
7. Phosphorus (Phosphate)

What is the most important extracellular cation?

Sodium

What is reabsorbed or excreted in the kidneys?

Sodium

What is the most common electrolyte imbalance found in hospitalized patients?

Hyponatremia

What are the causes of Hyponatremia?

- GI loss
- Sweating
- Fever
- Diuretics
- Ascites
- Congestive heart failure
- Kidney failure

What are symptoms of hyponatremia?

- Weakness
- Lassitude
- Apathy
- Headache
- Orthostatic
- Hypotension
- Tachycardia

What are causes of hypernatremia?

- Net sodium gain
- Net water loss
- Increased aldosterone
- Steroid Therapy

What are symptoms of hypernatremia?

- Tremulousness
- irritability
- Ataxia
- Confusion
- Seizures
- Coma

What is the normal range for Chloride?

98-106

what is the body's most prominent anion?

Chloride

What are causes of Hypochloremia?

- GI loss
- Diuretics

What are symptoms of Hypochloremia?

- Metabolic alkalosis
- Muscle spasm
- Coma

What are causes of Hyperchloremia?

- Dehydration
- Metabolic acidosis
- Respiratory alkalosis

What are symptoms of Hyperchloremia?

Minimal

What is the normal range for bicarbonate?

22-26

What is the normal range for potassium?

3.5-5.0 mEq/L

What are causes of Hypokalemia?

- Diuretics
- Steroid Therapy
- Renal tubular disease
- Vomiting
- Diarrhea
- Malnutrition
- Trauma

What is most common in renal insufficiency?

Hypokalemia

What are causes of Hyperkalemia?

- Chronic renal disease
- Hemorrhage
- Tissue necrosis
- Nonsteroidal antiinflammatory drugs
- ACE inhibitors
- Cyclosporine

What are symptoms of Hyperkalemia?

- ECG changes
- Ventricular arrythmias
- Cardiac arrest

What is the normal calcium?

8.7-10.4

Calcium is present in the blood in what three forms?

1. Ionized
2. Protein bound
3. Complex

What increases the concentration of calcium?

Acidemia

What decreases the concentration of calcium?

Alkalemia

- Increases levels of calcium
- Most commonly caused by hyperparathyroidism or malignancies

Hypercalcemia

- Low serum levels of calcium
- Causes: hyperparathyroidism, pancreatitis, renal failure, and trauma
- Treatment consist of correcting the underlying cause and replacing Ca either orally or intravenously

Hypocalcemia

What is the normal range for Magnesium?

1.7-2.1 mEq/L

Causes: Inadequate intake/impared absorption of Mg, pancreatitis, alcoholism.
Symptoms: Muscle weakness, irritability, teeny, ECG changes, arrhythmias, delirium, convulsions

Hypomagnesemia

Causes: Dehydration, Renal insufficiency, tissue trauma, lupus erythematosus.
Symptoms: ECG changes, Hyperkalemia, cardiac arrest, respiratory muscle paralysis

Hypermagnesemia

What is the normal range for Phosphorus?

1.2-2.3 mEq/L

Causes: Starvation, malabsorption, hyperparathyroidism, hyperthyroidism, uncontrolled diabetes mellitus.
Symptoms: Diaphragmatic weakness

Hypophosphatemia

Causes: Endocrine disorders, acromegaly, chronic renal insufficiency, acute renal failure, tissue trauma
Symptoms: Minimal

Hyperphosphatemia