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Unit 2 Notes – Fluid, Electrolyte, and Acid-Base ImbalancesKey Terms: define the following using key word phrases. You may write them on paper or directly to flashcards.Anion vs. cationAnorexiaAscitesCapillary permeabilityCarpopedal spasmDiffusion vs. osmosisDiureticDysrhythmiaExtracellular vs. intracellularFiltrationHydrostatic pressure vs. osmotic pressureHypertonic/hyper-osmolar vs. hypotonic/hypo-osmolarHypervolemia vs. hypovolemiaInterstitialIntravascular fluidLaryngospasmmEq (milliequivalent)osmoreceptorparesthesiasskin turgortetanytranscellularNotes: Fluid ImbalanceWater:Water is the medium (substance) in which all _________________________________ take place.Water is also the ______________________ system for the body.Water also facilitates ___________________________________ of body parts.Our bodies are approximately _____% water depending on our age & stage of life. This is medically significant because individuals with less fluid reserve are more likely to be adversely affected by any __________________________________________________.List the ranking of water % from lowest to highest (person & actual #).Fluid compartments: See Ready Reference 1Water constantly circulates within the body and moves between compartments to maintain homeostasis.Intracellular compartment (ICF): Fluid ___________________ the cells that makes up ~ 2/3 of fluid volume.Extracellular compartment (ECF): Fluid __________________ the cells that makes up ~ 1/3 of fluid volume.IVF: _____________________________________________________(1/4)ISF: _____________________________________________________(3/4)Other transcellular fluids make up ~ 1% total. Give some examples:Movement of waterThe amount of water entering the body should ______________ the amount of water leaving the body to maintain a constant level of body fluidsControl of fluid balance: Complete the chartMechanism Description Thirst mechanismAntidiuretic hormoneAldosterone (hormone)Atrial natriuretic peptide (hormone)The ICF and the ECF are separated by the ______________________________ which maintains the appropriate concentrations of substances by active & passive processes.All water movement is ______________________ through the process of _________________.Fluid circulates throughout the body via: Filtration:Osmosis:Water moves between the compartments via: Hydrostatic pressureOsmotic pressureFluid ExcessEdemaDefinition: excess of fluid in __________________________________ compartment.May be ______________________________ or ___________________________________Edema is more severe in which areas & why?Prolonged edema interferes with ___________________________________________, ____________________________________, & ______________________________ in the affected area.Causes of Edema:Increased hydrostatic pressureLoss of plasma proteinsObstruction of lymphatic circulationIncreased capillary permeabilityEffects of EdemaSwelling: ______________________________________________________Pitting edema:Excessive __________Causes pits when _________________________________________Can lead to tissue ________________________Increase in body weightFunctional impairmentRestricts range of ________________________________Intestinal wall edema may interfere with ______________________ & __________________________ of nutrients.Reduced ______________________________: a measure of lung functionImpaired _____________: period of time when the heart muscle relaxesPainPressure on _____________: can cause permanent damage if not resolved quickly_____________ edema causes headache: can lead to death if ICP too highStretching of ________________ capsule: kidney, liverImpaired arterial circulation: ____________ restricts arterial flow - ____________ to cells leads to ______________ which leads to __________ in cell function & cell mitosis.Edematous tissueSusceptible to tissue breakdown from:_________________________________________________________________________________Dehydration: Fluid DeficitInsufficient body fluidInadequate ____________________Excessive loss – more common – affects ___________ firstBoth Fluid loss often measured by change in body ______________________Dehydration more serious in infants and older adultsLack fluid _________________Lack ability to ______________ water quicklyInfants increased metabolic water needsBecome ________________________ quickly – affects heart, brain, kidneysSigns: ____________________________________________________________________Water loss may be accompanied by loss of __________________ and _______________ (e.g., diarrhea).Can lead to changes in osmotic & colloidal pressures – affecting fluid shift even more, leading to:Hypotonic dehydration – loss of more _______________________Hypertonic dehydration – loss of more ______________________TonicityRefers to the effect of a solution (with impermeable solutes) has on cell __________ due to water movement.Isotonic solutions are equivalent to _________ so there will be NO change in cell sizeCauses of DehydrationVomiting and diarrheaLoss of ___________________, _____________________ & waterExcessive sweatingLoss of _______________ and waterDiabetic ketoacidosisLoss of water, electrolytes, and ___________________ in the urineInsufficient water intake in older adults or unconscious personsUse of _________________________ formula in infantsDirect effects of DehydrationDry ______________________ membranes in the mouthDecreased skin ________________ or ________________________________ blood pressure, weak pulse, and fatigue hematocrit - _____ ratio of RBCs to water “thickens” blood – may ______Decreased mental function, confusion, loss of ____________________brain cells functionCompensation for Fluid LossIncreasing thirst (prompted by ______________________________)Increasing heart rate (prompted by __________________________)Constriction of _____________________ blood vesselsForces blood to ____________ organsUrine―______ volume and _______ specific gravityProducing less urine – conserve waterConcentration of urineDue to renal __________________ , increased secretion of _______ & ___________________Third SpacingFirst spacing = Second spacing = Third spacing = Third Space AccumulationBuildup of ECF in ______________________________spaceFluid shifts out of the blood into body cavity or tissue and can no longer reenter ___________________ compartment.No longer available as __________________ fluid (not functional)Results in:Hypovolemia _______Effusions: excess fluid in ___________________ membranesSeverity based on locationBrain, larynx, lung: _______________________________!!Causes:High _________________ pressure of ISF, as in burns or peritonitisIncreased capillary permeability due to ___________________________Acid/Base ImbalancesConcepts & ProcessesSerum pH is ___________________pH of less than 7.35 ___________________________________________________________________pH below _____ or above 7.8 usually results in _________.Why does the body have a tendency toward acidosis?Control of serum pHThree mechanisms compensate for pH_____________________________________________________________________________________________________________________Lungs can only change the amount of ____________Kidneys are slower to adjust but are most effective since they can:______________________________________________________________________________________________________________________Buffer SystemsDefine a buffer:Highlight the 4 major buffer systems (& circle the major ECF buffer) in the diagram-401066777700400190339335910In the bicarbonate-carbonic acid buffer:What ratio is required to maintain serum pH? __________________________How does the respiratory system compensate?When acidosis develops: the RR ______________________ which ____________________ more carbon dioxide (potential carbonic acid) from the body When alkalosis develops: the RR ______________________ which ____________________ more carbon dioxide (potential carbonic acid) from the body39286519852How does the renal system compensate?When acidosis develops: the kidneys can exchange ________ for _______ under the influence of aldosteroneWhen alkalosis develops: the kidneys can remove ________ by combining them with ammonia and other chemicals.312788444500Acid-Base Imbalances: Place the information from Table 2-8 and create a Graphic Organizer for each type of imbalance. Also include any additional information on pages 32-34CompensationCauseThe first change in the bicarbonate ion to carbonic acid (carbon dioxide) 20:1 ratio is determined by the _______________ of the imbalance.Respiratory disorders always have an initial change in the ________________Metabolic disorders always have an initial change in the _______________Compensation does NOT remove the cause of the imbalance – only tries to restore homeostatic levels to retain body function.EffectThe second change in the ratio is due to the ________________________.Compensation requires function by body systems that are _________ involved in the cause.The imbalance is considered to be compensated as long as the bicarbonate to carbonic acid ratio is maintained at ____________ AND serum pH is __________ at 7.35-7.45Compensation is limited.Decompensation occurs if _____________ & ____________ are not functioning adequately, if ______________ changes and ___________pH moves out of normal range. This affects both cell function and ______________________________. Intervention is necessary at this time.Answer the Think About questions #19-25 to the best of your ability using the information in these notes & in your textbook.10560923095290 ................
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