Fluid and Electrolyte Balance (Ch 8)

Fluid and Electrolyte Balance (Ch 8)

• Electrolyte Values (Normal): Expected levels of extracellular electrolytes are referenced in Figure 8.1.
• Electrolyte Functions & Imbalances: Electrolytes have vital bodily functions. Imbalances cause various effects (Table 8.1). Sodium loss is from vomiting, diarrhea, or sweating. Potassium loss is from diuretics, severe vomiting, or diarrhea. Renal failure causes hyperkalemia. Hypocalcemia may result from thyroid disorders, severe burns, kidney failure, vitamin D deficiency, and sepsis, alongside other factors.
• Fluid Distribution: Body fluids are located in various compartments. Fluid movement between cells and tissues, as well as in and out of circulation (blood vessels and nephrons) is crucial.
• Fluid Regulation: The body regulates fluid intake and output through intricate mechanisms.
• Tonicity: Isotonic, hypertonic, and hypotonic fluids have different effects on cell volume depending on their concentration of solutes.
• Altered Fluid Balance: Conditions like hypovolemia (low blood volume), hemorrhage, dehydration, water intoxication, hypervolemia (high blood volume), and edema are examples of altered fluid balance.

Acid-Base Balance (Ch 9)

• Physiological pH: The body maintains a specific pH range in the blood.
• Importance of pH: A critical range must be maintained for optimal cellular and tissue function. Deviation from this range can have adverse consequences.
• Buffer Systems: There are 3 buffer systems in the body – bicarbonate, phosphate, and protein – to regulate pH through complex chemical reactions.

Altered Ventilation and Diffusion (Ch 15)

• Ventilation and Diffusion: The process of breathing (inspiration and expiration), gas exchange (partial pressures of O2 and CO2), and transportation of these gases in the blood are essential components of respiratory function.
• Impaired Ventilation and Diffusion: This can lead to hypoxemia (low blood oxygen), hypoxia (reduced tissue oxygen), and hypercapnia (high blood CO2) with accompanying symptoms.
• Ventilation-Perfusion Mismatch: Uneven distribution of air in the lungs and blood flow impacts gas exchange.
• Altered Diffusion: Issues with the exchange of gases across the alveoli and capillaries can compromise oxygenation and CO2 removal.
• Measuring and Treating: Methods to assess and treat impaired ventilation and diffusion (e.g. lab tests and therapies) are addressed in this chapter.
• Clinical Models: Chronic obstructive pulmonary disease (COPD) including emphysema, chronic bronchitis, asthma, and cystic fibrosis are outlined as examples of conditions associated with impaired ventilation and diffusion.

Altered Perfusion (Ch 16)

• Perfusion: Vital for delivering oxygen and nutrients to tissues.
• Circulatory Pathways: Understand the pulmonary and systemic circulatory systems, and the specific path of blood flow, including the heart's function.
• Cardiac Cycle & Electrical Impulses: Explains the mechanical and electrical functioning of the heart.
• Cardiac Output: The heart's pumping capacity.
• Neural Control: The nervous system regulates the heart's rate and blood pressure.
• Altered Perfusion: Conditions leading to problems with blood flow, including ventilation-perfusion mismatch, decreased cardiac output and changes in perfusion needs.
• Diagnosis & Treatment: This discussion involves examining the manifestations of impaired perfusion, using lab tests, and implementing appropriate treatments.
• Clinical Models: This chapter explores the clinical contexts of hypertension (high blood pressure), shock, myocardial infarction, heart failure, and stroke. Other key conditions covered are cirrhosis and dehydration.

Exam 2 Diagnoses (Clinical Models)

• COPD (Emphysema, Chronic Bronchitis)
• Asthma
• Cystic Fibrosis
• Hypertension
• Stroke
• Shock
• Heart Failure
• Myocardial Infarction
• Cirrhosis
• Dehydration
• Metabolic Acidosis