Electrolytes and Fluid Balance

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Questions and Answers

Which of the following is the most abundant extracellular ion?

  • Potassium Ion (K+)
  • Sodium Ion (Na+) (correct)
  • Chloride Ion (Cl-)
  • Calcium Ion (Ca2+)

Chloride ions (Cl-) help balance anion levels in different fluid compartments.

True (A)

What regulates the levels of potassium ions (K+) in the body?

Aldosterone

The ______ is the main regulator of bicarbonate ions (HCO3-) in the body.

<p>kidneys</p> Signup and view all the answers

Match the following electrolyte ions with their primary role:

<p>Sodium (Na+) = Generation of action potentials Calcium (Ca2+) = Bone development and blood clotting Potassium (K+) = Regulation of membrane potential Bicarbonate (HCO3-) = Buffering acid in the blood</p> Signup and view all the answers

Which condition results from low levels of sodium in the body?

<p>Hyponatremia (C)</p> Signup and view all the answers

The buffering system is the slowest mechanism for pH homeostasis in the body.

<p>False (B)</p> Signup and view all the answers

What is the normal pH range of body fluids?

<p>7.35-7.45</p> Signup and view all the answers

Magnesium ions (Mg2+) are essential for ______ metabolism.

<p>carbohydrate and protein</p> Signup and view all the answers

What is the primary role of parathyroid hormone (PTH)?

<p>Stimulate calcium absorption (A)</p> Signup and view all the answers

Which buffer system cannot protect against pH changes due to respiratory problems?

<p>Carbonic Acid-Bicarbonate Buffer System (C)</p> Signup and view all the answers

The phosphate buffer system is primarily responsible for regulating blood pH.

<p>False (B)</p> Signup and view all the answers

What is the primary use of bicarbonates in acid-base therapy?

<p>To increase the HCO3-/H2CO3 ratio.</p> Signup and view all the answers

The main electrolyte used for sodium replacement is __________.

<p>sodium chloride</p> Signup and view all the answers

Match the electrolyte replacement with its category:

<p>Potassium chloride = Electrolyte replenisher Calcium gluconate = Non-irritating calcium source Magnesium sulfate = Anticonvulsant Sodium bicarbonate = Systemic acidosis treatment</p> Signup and view all the answers

Which of the following is used for potassium excretion monitoring?

<p>Electrocardiograms (A)</p> Signup and view all the answers

Hypertonic sodium solutions should be administered quickly in large volumes.

<p>False (B)</p> Signup and view all the answers

What is the role of ammonium chloride in electrolyte therapy?

<p>To act as a systemic acidifier.</p> Signup and view all the answers

In severe hypokalemia, potassium is often administered through __________.

<p>IV injection</p> Signup and view all the answers

Match the following sodium preparations with their categories:

<p>Sodium chloride injection, USP = Fluid and electrolyte replenisher Lactated Ringer’s Injection, USP = Systemic alkalizer Dextrose and sodium chloride injection, USP = Nutrient and electrolyte replenisher Sodium chloride tablets, USP = Electrolyte replenisher</p> Signup and view all the answers

What can cause respiratory paralysis and cardiac depression as an overdose symptom?

<p>Magnesium sulfate (A)</p> Signup and view all the answers

Sodium lactate can lead to more alkalosis than bicarbonates.

<p>False (B)</p> Signup and view all the answers

What should be done if calcium chloride is injected too quickly?

<p>It may cause burning sensation and a drop in blood pressure.</p> Signup and view all the answers

_______________ are often used as anticoagulants in electrolyte therapy.

<p>Citrates</p> Signup and view all the answers

Flashcards

Sodium Ion (Na+)

The most abundant extracellular ion, accounting for half of the osmolarity of the extracellular fluid (ECF). It plays a crucial role in the generation and conduction of action potentials in neurons and muscle fibers.

Chloride Ion (Cl-)

The major extracellular anion, moving relatively easily between extracellular and intracellular compartments due to chloride leakage channels and antiporters. It helps balance anion levels in different fluid compartments.

Potassium Ion (K+)

The major intracellular ion, playing a vital role in establishing membrane potential and regulating the repolarization phase of action potentials in neurons and muscle fibers. It also helps regulate the pH of body fluids.

Bicarbonate Ion (HCO3-)

The second most prevalent extracellular anion, primarily regulated by the kidneys. It's crucial for maintaining acid-base balance and transporting CO2.

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Calcium Ion (Ca2+)

The most abundant mineral in the body, found mainly in bones and teeth. It's a key player in various processes like blood clotting, neurotransmitter release, and muscle contraction.

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Phosphate Ion (PO43-)

The principal intracellular anion, existing in various forms like H2PO4-, HPO42-, and PO43-. It's involved in energy transfer, bone formation, and maintaining acid-base balance.

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Magnesium Ion (Mg2+)

The second most abundant intracellular ion, acting as a cofactor for enzymes involved in carbohydrate and protein metabolism as well as the sodium-potassium pump. It's also crucial for neuromuscular activity and heart function.

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Acid-Base Balance

The body's pH scale, typically ranging from 7.35 to 7.45. Maintaining pH homeostasis is crucial for proper bodily function.

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Buffer Systems

The fastest mechanism for maintaining acid-base balance. These systems temporarily bind excess hydrogen ions (H+), but they do not remove these ions from the body.

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Exhalation of Carbon Dioxide

A mechanism of acid-base balance that involves the removal of CO2 from the body through exhalation. This mechanism directly reduces carbonic acid levels in the blood.

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Protein buffer system

A system that utilizes proteins as buffers. This means amino acid side chains can either gain or lose hydrogen ions, thus helping to regulate pH.

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Carbonic Acid-Bicarbonate Buffer System

The most important buffering system in the blood. It involves carbonic acid (H2CO3) and bicarbonate ions (HCO3-). This system helps to maintain the blood's pH by absorbing or releasing hydrogen ions.

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Renal reabsorption and synthesis of HCO3-

The kidney plays a crucial role in maintaining pH balance by reabsorbing bicarbonate ions and synthesizing new ones. By doing this, it prevents the loss of bicarbonate in urine.

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Phosphate buffer system

This buffer system is mainly important within the cells (cytoplasm). It utilizes dihydrogen phosphate (H2PO4-) and monohydrogen phosphate (HPO42-) ions to buffer pH changes.

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Exhalation of CO2

The process of breathing out carbon dioxide (CO2) is a crucial mechanism for maintaining pH balance. This is because CO2 combines with water to form carbonic acid, which can then be released from the lungs.

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Kidney excretion of H+

The kidneys can directly excrete excess hydrogen ions (H+) in the urine, thus helping to remove acids from the body. This is a critical mechanism for acid-base balance.

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Sodium chloride (NaCl) Isotonic solutions

Isotonic Sodium chloride solution is used as a wet dressing, irrigation solution and as an injection in case of electrolyte depletion.

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Sodium chloride (NaCl) Hypotonic solutions

Administered for maintenance therapy in patients who cannot take fluids and nutrients orally. This helps to prevent dehydration.

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Sodium chloride (NaCl) Hypertonic solutions

Hypertonic solutions are used in scenarios where there is excessive loss of sodium. They should be administered slowly due to their increased concentration.

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Sodium chloride official preparations

A primary choice for electrolyte replenishment. Many official preparations are used for various purposes, such as fluid restoration, injections, and electrolyte replacement.

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Potassium chloride

Potassium chloride is the preferred form for replacing potassium. It is often mixed with fruit or vegetable juice for better taste and absorption.

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Potassium Gluconate

Potassium gluconate is a less irritating form of potassium compared to chloride. It is available as tablets or oral solutions.

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Calcium Chloride

Calcium chloride is a crucial source of calcium for electrolyte replacement. It is available in injections and is used in various commercially available electrolyte solutions.

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Calcium Gluconate

Calcium gluconate offers a gentler approach to calcium replacement compared to calcium chloride. It is available in injections and tablets.

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Study Notes

Electrolytes

  • Electrolytes are essential for various bodily functions, including maintaining proper fluid balance and nerve impulse transmission.
  • They are crucial for the generation and conduction of action potential in neurons and muscle fibers.
  • Extracellular and intracellular fluid composition is key.
  • The balance of electrolytes is regulated by various mechanisms like hormonal control and renal excretion.
  • Imbalances in electrolyte levels can lead to various health issues.

Fluid Compartments and Fluid Balance

  • The body fluids are divided into two main compartments: intracellular fluid (ICF) and extracellular fluid (ECF).
  • ICF comprises about two-thirds of total body water and is found within cells.
  • ECF accounts for about one-third of total body water and is further divided into interstitial fluid and plasma.
  • The distribution of fluids between these compartments is tightly regulated to maintain homeostasis.
  • Water gain and water loss are critical to maintain a steady state.

Extracellular and Intracellular Ions

  • Sodium (Na+) is the most abundant extracellular ion.
  • Chloride (Cl-) is the major extracellular anion.
  • Potassium (K+) is the major intracellular ion.
  • Bicarbonate (HCO3-) is a common extracellular anion.
  • Calcium (Ca²⁺) is a critical ion with various functions.
  • Phosphate plays an important role in bodily functions.
  • Magnesium (Mg²⁺), also a vital intracellular ion, is crucial for enzyme function and other metabolic processes.

Acid-Base Balance

  • The body's pH level is strictly maintained within a narrow range of 7.35-7.45 to ensure optimal bodily functions.
  • Maintaining this pH balance relies on buffer systems, respiratory regulation, and kidney function.
  • Buffer systems temporarily bind H⁺ ions, preventing drastic pH shifts.
  • The respiratory system regulates acid-base balance by controlling the level of carbon dioxide.
  • Kidney function plays a crucial role in excreting excess H⁺ ions or reabsorbing HCO3− ions, thereby adjusting the pH as needed.
  • Several mechanisms help control the acid-base balance.
  • Imbalances in acid-base status can lead to various health conditions.

Electrolyte Replacement Therapy

  • Electrolyte replacement therapy is used to treat imbalances in electrolytes in the body.
  • Sodium chloride, potassium chloride, potassium gluconate, calcium chloride, calcium gluconate, calcium lactate, dibasic calcium phosphate, and tribasic calcium phosphate, and magnesium sulfate are relevant electrolytes used in various therapies.
  • Appropriate electrolyte therapy solutions must be chosen carefully to avoid adverse effects.

Electrolytes Used in Acid-Base Therapy

  • Bicarbonates (NaHCO3 or KHCO3): These are the drug of choice for systemic acidosis.
  • Citrates serve as an anticoagulant.
  • Lactates, acetates, and citrates are converted into other molecules.
  • Sodium biphosphate is a urinary acidifier.
  • Ammonium chloride also helps with acidification.

Electrolyte Combination Therapy

  • Ringer's Injection, Lactated Ringer's Injection, and Oral Rehydration Salts (ORS) solutions are often used for electrolyte replacement therapy.
  • These solutions contain a combination of electrolytes in specific ratios.
  • Oral electrolyte solutions, such as Pedialyte and Gatorade, are also commonly used.

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