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Questions and Answers
What is the primary electrolyte found in intracellular fluid?
What is the primary electrolyte found in intracellular fluid?
What percentage of total body weight does interstitial fluid account for in an adult?
What percentage of total body weight does interstitial fluid account for in an adult?
Which of the following correctly describes osmosis?
Which of the following correctly describes osmosis?
In which solution do blood cells remain unchanged in terms of osmotic pressure?
In which solution do blood cells remain unchanged in terms of osmotic pressure?
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What process allows water to pass through a semi-permeable membrane?
What process allows water to pass through a semi-permeable membrane?
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What is the total water output from the body in milliliters?
What is the total water output from the body in milliliters?
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Which of the following is a route through which water leaves the body?
Which of the following is a route through which water leaves the body?
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What is the normal sodium level in milliequivalents per liter (mEq/L)?
What is the normal sodium level in milliequivalents per liter (mEq/L)?
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What characterizes primary electrolyte imbalances?
What characterizes primary electrolyte imbalances?
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What condition is defined by a sodium level below 135 mEq/L?
What condition is defined by a sodium level below 135 mEq/L?
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What is one of the primary roles of electrolytes in the body?
What is one of the primary roles of electrolytes in the body?
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Which ion is primarily responsible for osmotic pressure in the intracellular fluid?
Which ion is primarily responsible for osmotic pressure in the intracellular fluid?
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Which hormone promotes retention of sodium and excretion of potassium in the kidneys?
Which hormone promotes retention of sodium and excretion of potassium in the kidneys?
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What can happen if serum albumin is significantly reduced in the body?
What can happen if serum albumin is significantly reduced in the body?
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Which of the following is NOT a mechanism regulating fluid and electrolyte balance?
Which of the following is NOT a mechanism regulating fluid and electrolyte balance?
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What measurement is typically used to express the concentration of electrolytes in body fluids?
What measurement is typically used to express the concentration of electrolytes in body fluids?
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What role do electrolytes play in neuromuscular function?
What role do electrolytes play in neuromuscular function?
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Which of the following compartments relies primarily on sodium (Na+) for osmotic pressure?
Which of the following compartments relies primarily on sodium (Na+) for osmotic pressure?
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What is primarily responsible for the reabsorption of water and solutes in the gastrointestinal tract?
What is primarily responsible for the reabsorption of water and solutes in the gastrointestinal tract?
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Which hormone is produced in the hypothalamus and helps retain water?
Which hormone is produced in the hypothalamus and helps retain water?
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What physiological need is indicated by thirst when there is a decrease in extracellular fluid volume?
What physiological need is indicated by thirst when there is a decrease in extracellular fluid volume?
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What is a condition that can lead to considerable loss of fluids and electrolytes?
What is a condition that can lead to considerable loss of fluids and electrolytes?
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Aldosterone primarily acts on the renal tubules to facilitate which of the following?
Aldosterone primarily acts on the renal tubules to facilitate which of the following?
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What is the main route through which water is lost during respiration?
What is the main route through which water is lost during respiration?
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Which factor can lead to a disturbance in fluid and electrolyte balance?
Which factor can lead to a disturbance in fluid and electrolyte balance?
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What is one of the common ways through which the body loses water?
What is one of the common ways through which the body loses water?
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What is the primary function of body fluids in maintaining blood volume?
What is the primary function of body fluids in maintaining blood volume?
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Which factor is NOT mentioned as affecting fluid and electrolyte balances?
Which factor is NOT mentioned as affecting fluid and electrolyte balances?
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How much water constitutes the total body weight of a young to middle-aged adult?
How much water constitutes the total body weight of a young to middle-aged adult?
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What percentage of total body weight is fluid in infants?
What percentage of total body weight is fluid in infants?
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What is the term used to describe fluid found inside cells?
What is the term used to describe fluid found inside cells?
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What happens to the total body fluid percentage as individuals age?
What happens to the total body fluid percentage as individuals age?
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What is the main role of regulatory mechanisms in fluid balance?
What is the main role of regulatory mechanisms in fluid balance?
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Which compartment does NOT contain intracellular fluid?
Which compartment does NOT contain intracellular fluid?
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What is the maximum amount of fluid lost through diarrhoea in a 24-hour period?
What is the maximum amount of fluid lost through diarrhoea in a 24-hour period?
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What potential issue can prolonged use of laxatives and enemas cause?
What potential issue can prolonged use of laxatives and enemas cause?
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What is a consequence of gastrointestinal obstruction?
What is a consequence of gastrointestinal obstruction?
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What is a symptom of metabolic acidosis?
What is a symptom of metabolic acidosis?
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What can excessive perspiration lead to if hydration is not maintained?
What can excessive perspiration lead to if hydration is not maintained?
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What is the total amount of insensible water loss per day in an average adult?
What is the total amount of insensible water loss per day in an average adult?
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What condition causes retention of excessive carbon dioxide?
What condition causes retention of excessive carbon dioxide?
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What occurs when electrolytes are dissolved in solution?
What occurs when electrolytes are dissolved in solution?
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Study Notes
Fluid and Electrolytes
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Objectives:
- Identify body fluid compartments
- Describe mechanisms regulating fluid and electrolyte balance
- Identify factors affecting fluid and electrolyte balances
- Explain routes by which water and electrolytes enter and leave the body
- Describe types of electrolytes in the body
- Distinguish between electrolyte balance and imbalance
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Introduction:
- Body functions depend on proper fluid and electrolyte distribution between intracellular and extracellular compartments
- Fluid and electrolyte balance is regulated by renal, hormonal, and metabolic mechanisms
- Imbalances can occur due to other disorders or as therapy complications
- The main goal is replacement of fluid and electrolyte losses and prior deficits, along with adequate nutrition.
Fluids
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Importance:
- Crucial for body functions
- Maintains blood volume
- Aids digestion
- Transports materials to and from body cells
- Acts as a medium for cellular metabolism
- Excretes waste
- Regulates body temperature
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Composition:
- Water is the largest component, forming 50-70% of an adult's body weight and 75-80% of an infant's
- By age two, the fluid percentage is similar to an adult (60%)
- Elderly percentages of total body water (TBW) drop to 45-60%
Body Fluid Compartments
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Intracellular fluid (ICF):
- Found within cells
- Accounts for approximately 40-50% of total body weight
- Potassium (K) is the major electrolyte, crucial for cellular chemical functions
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Extracellular fluid (ECF):
- Found outside cells
- Made up of two compartments:
- Interstitial fluid: found in spaces between cells (15% of total body weight in adults)
- Intravascular fluid: found in blood and lymph vessels (about 5% of total body weight in adults)
- Sodium (Na) is the major electrolyte in ECF
Distribution and Concentration of Electrolytes in Body Fluid
- Regulated by:
- Osmosis
- Diffusion
- Active transport
- Filtration
- Pinocytosis (liquid absorption by cells like macrophages)
Osmosis
- Process by which water moves through a semi-permeable membrane from a lower concentration of solution to a higher concentration
- Continues until equilibrium is reached on both sides of the membrane
- Water moves towards areas with more concentrated electrolytes
Common Sources of Fluid and Electrolyte Imbalance
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Vomiting/Gastric suction:
- Reduction in acidic gastric juices leads to loss of vital electrolytes (hydrogen, chloride, potassium, and sodium)
- Results in decreased total body fluid and potential metabolic alkalosis due to increased base bicarbonate
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Diarrhea:
- Significant fluid loss in 24 hours (up to 17,000mL)
- Intestinal suction also leads to substantial daily fluid loss (over 3,000mL).
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Other causes:
- Prolonged laxative or enema use
- Gastrointestinal fistulas or drainage tubes
- Gastrointestinal obstructions
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Wound exudates:
- Fluid loss from wounds leads to protein and sodium losses and possibly affects extracellular fluid volume.
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Excessive perspiration:
- Significant water, sodium, and chloride loss
- Prolonged loss without replenishment causes decreased fluid volume and reduced electrolyte proportions.
- Can cause sodium excess if water intake is insufficient
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Insensible loss:
- Water loss through lungs and skin (about 600-1000mL/day)
- Increases with increased respiratory activity, skin damage, and dry air
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Hyperventilation:
- Excessive carbon dioxide elimination (results in respiratory alkalosis).
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Hypoventilation:
- Retention of carbon dioxide potentially more dangerous (causes respiratory acidosis).
Electrolytes
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Chemicals dissociating into charged ions (cations and anions) when dissolved
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Maintain fluid and acid-base balance
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Crucial for nerve excitability, blood clotting, and cellular metabolism
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Composition and concentration vary in fluid compartments (measured as mEq/L)
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Electrolytes in Body Fluid:
- Regulate cell membrane permeability enabling transfer of materials -Maintain acid-base balance
- Promote nerve and muscle irritability/excitability via electrical energy transmission
- Maintain fluid osmolarity.
Mechanisms regulating fluid and electrolyte balance
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Proteins and electrolytes
- Maintain water in compartments
- Serum albumin (intravascular), sodium (interstitial), and potassium (intracellular) are major forces holding water in compartments
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Kidneys
- Most important regulatory mechanism
- Regulated by antidiuretic hormone (ADH) controlling H2O reabsorption/excretion
- Regulated by aldosterone promoting sodium retention and potassium excretion
- Regulate total ECF, electrolyte concentration, acid-base balance and blood pressure
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Gastrointestinal tract
- Selective absorption of water and solutes generally in the small intestine
- Absorbs about 7 – 9 L of secretions daily
- Some fluid and electrolytes lost in excessive vomiting and diarrhea
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Thirst
- Stimulated by decreased extracellular fluid volume
- Indicating physiological need for water
- Stimulated by increased osmotic pressure, reduced ECF, and dry mouth
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Lungs
- Water lost during inhalation and exhalation (small amount)
- More water loss with increased respiration rate and depth.
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Skin
- Water loss through perspiration
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Hormonal control:
- Three primary hormones regulate fluid and electrolytes balances:
- ADH: Controls water reabsorption, decreasing urine output
- Aldosterone: Promotes sodium reabsorption and potassium excretion
- Parathormone: Regulates calcium and phosphorus balance
- Three primary hormones regulate fluid and electrolytes balances:
Specific Electrolytes
Sodium
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Major cation in ECF
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Regulates fluid volume, ECF osmotic pressure, cellular membrane potential, blood volume and vascular bed size
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Normal level: 135-145 mEq/L
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Hyponatremia: decreased sodium levels in blood (<135mEq/L)
- Causes: inadequate intake, excessive loss of fluids (vomiting/diarrhea), diuretics, hormonal imbalances, excess fluid administration (e.g., 5% D/W; can be linked to water intoxication).
- Classifications: hypovolemic (decreased total body water), euvolemic (normal total body water), and hypervolemic (increased total body water)
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Hypernatremia: increased sodium levels in blood (>145 mEq/L)
- Causes: decreased water intake, excessive water loss, and administration of hypertonic fluids
Potassium
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Major cation in ICF
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Maintains intracellular homeostasis, resting membrane potential, nerve impulse conduction, skeletal muscle function, heart function, protein and CHO metabolism
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Normal level: 3.5-5.0 mEq/L
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Hypokalemia: decreased potassium levels (<3.5 mEq/L)
-Causes: poor dietary intake, use of potassium-wasting diuretics or corticosteroids, excessive loss of GI tract fluids (severe vomiting/diarrhea), prolonged stress or fever, hormonal imbalances
- Clinical observation: smooth muscle issues (decreased bowel movements/constipation), decreased cardiac impulses (hypotension/ irregular pulse), respiratory depression (shallow/ineffective respirations)
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Hyperkalemia: increased potassium levels (>5.0 mEq/L)
-Causes: kidney failure, excessive potassium intake, leakage of potassium from cells (burns/trauma), medication side effects (e.g., ACE inhibitors) -Clinical observation: muscle irritability, pain, and paralysis at increasingly severe levels; cardiac abnormalities (ECG changes)
Calcium
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Most abundant electrolyte in the body (mostly stored in bones/teeth)
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Maintains normal level in ECF (1% of total); necessary for neuromuscular activity/function, blood clotting, decreasing capillary permeability, normal muscle contractility, nerve impulses, bones and tooth development
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Hypocalcemia: decreased blood calcium levels (<9 mg/dL or 2.25 mmol/L)
-Causes: low Vitamin D levels, parathyroid hormone deficit, malabsorption disorders, chronic diarrhea, renal diseases, medications (bisphosphonates), and immobilization -Clinical Observation: Tingling/numbness, muscle cramps, spasms of smooth and skeletal muscles, and seizures
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Hypercalcemia: increased blood calcium levels (>5.3 mEq/L)
-Causes: hyperparathyroidism, over-consumption of calcium supplements, malignancies, immobilization/decalcification -Clinical Observation: Fatigue, decreased neuromuscular excitability, nausea/vomiting, anorexia, deep bone pain, kidney stones, and ECG changes.
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Description
This quiz explores the vital concepts of fluid and electrolyte balance within the human body. It covers body fluid compartments, regulatory mechanisms, and the factors influencing electrolytes, as well as their essential roles in bodily functions. Understanding these principles is crucial for maintaining health and addressing potential imbalances.
