Pathophysiological Concept Chapter 5: Fluids & Electrolytes, Acids & Bases
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Questions and Answers

What is the total body water (TBW) distribution in infants at birth?

  • 85-90% of body weight
  • 50-60% of body weight
  • 75-80% of body weight (correct)
  • 65-70% of body weight

    • Which fluid compartment accounts for approximately two-thirds of total body water (TBW)?

  • Interstitial fluid
  • Intracellular fluid (correct)
  • Intravascular fluid
  • Extracellular fluid

    • What is the primary factor influencing fluid movement from capillaries to the interstitial space?

  • Capillary Oncotic Pressure
  • Hydrostatic Pressure (correct)
  • Interstitial Hydrostatic Pressure
  • Interstitial Oncotic Pressure

    • Which of the following is NOT a component of extracellular fluid (ECF)?

    <p>Intracellular fluid</p> Signup and view all the answers

    Which process is primarily responsible for the return of water from interstitial fluid back into the capillaries?

    <p>Osmotic Pressure</p> Signup and view all the answers

    What factor contributes to the decreased total body water (TBW) percentage in geriatric individuals?

    <p>Decreased free fat mass</p> Signup and view all the answers

    Which condition is a common reason for rapid dehydration in infants?

    <p>High metabolic rate</p> Signup and view all the answers

    What is the main regulatory challenge for geriatric individuals regarding hydration?

    <p>Decreased ability to regulate sodium and water balance</p> Signup and view all the answers

    What is the primary cause of respiratory alkalosis?

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

    Which of the following symptoms is associated with metabolic acidosis?

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

    What compensatory mechanism does the body utilize in response to metabolic acidosis?

    <p>Hyperventilation to decrease CO2</p> Signup and view all the answers

    Which arterial blood gas analysis result indicates respiratory alkalosis?

    <p>pH 7.45, PaCO2 30 mmHg, HCO3 22 mmol/L</p> Signup and view all the answers

    What is a common cause of metabolic acidosis?

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

    What condition results from a significant sodium deficit or water excess, leading to cellular overhydration?

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

    What is a common sign of hypernatremia that is related to the central nervous system?

    <p>Muscle twitching</p> Signup and view all the answers

    Which electrolyte's balance is primarily mediated by aldosterone and plays a significant role in water regulation?

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

    What condition is characterized by excessive fluid retention, weight gain, and distended neck veins?

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

    Which of the following is NOT a typical cause of hypokalemia?

    <p>Excessive sodium intake</p> Signup and view all the answers

    What are the symptoms associated with hypomagnesemia?

    <p>Behavioral changes and muscle cramps</p> Signup and view all the answers

    Which electrolyte imbalance is most likely to occur with renal insufficiency?

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

    What is a common sign of dehydration, indicating a loss of total body water?

    <p>Rapid heart rate</p> Signup and view all the answers

    What is the primary treatment for hypernatremia?

    <p>Oral fluids or isotonic salt-free IV solutions</p> Signup and view all the answers

    Which condition can lead to muscle weakness and loss of muscle tone due to decreased resting membrane potential?

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

    What is the primary cause of edema according to the pathophysiology outlined?

    <p>Increased capillary hydrostatic pressure</p> Signup and view all the answers

    What role does aldosterone play in water balance?

    <p>It mediates sodium retention and regulates water balance</p> Signup and view all the answers

    Which condition may lead to localized edema?

    <p>Sprained finger</p> Signup and view all the answers

    Which type of edema is characterized by a uniform distribution of fluid in interstitial spaces?

    <p>Generalized Edema</p> Signup and view all the answers

    What is the main consequence of increased interstitial oncotic pressure?

    <p>Attraction of water from the capillaries into interstitial space</p> Signup and view all the answers

    What does the term 'pitting edema' indicate?

    <p>Severity graded from +1 to +4 based on indentation response</p> Signup and view all the answers

    Which hormone is responsible for regulating water reabsorption into the plasma?

    <p>Antidiuretic Hormone (ADH)</p> Signup and view all the answers

    What is the effect of impaired lymphatic drainage?

    <p>It causes edema in localized areas</p> Signup and view all the answers

    How does sodium influence extracellular fluid (ECF) balance?

    <p>Regulates osmotic forces and acid-base balance</p> Signup and view all the answers

    What is the primary function of aquaporins in the human body?

    <p>Allowing the passive movement of water across cell membranes</p> Signup and view all the answers

    What is the initial treatment for hypernatremia?

    <p>Isotonic salt-free fluid (5% Dextrose in water)</p> Signup and view all the answers

    Which major organs are involved in maintaining acid-base balance in the body?

    <p>Bones, lungs, and kidneys</p> Signup and view all the answers

    What is the normal range for arterial blood pH?

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

    In respiratory acidosis, what generally occurs?

    <p>Hypoventilation causes high levels of CO2</p> Signup and view all the answers

    Which category of acid-base imbalance results from decreased levels of HCO3-?

    <p>Metabolic acidosis</p> Signup and view all the answers

    What compensatory mechanism occurs in response to respiratory acidosis?

    <p>Elimination of hydrogen ions and retention of bicarbonate</p> Signup and view all the answers

    What condition typically leads to respiratory alkalosis?

    <p>Alveolar hyperventilation</p> Signup and view all the answers

    Which of the following statements about buffers is true?

    <p>Buffers can bind H+ or OH– without significant changes in pH</p> Signup and view all the answers

    What can cause metabolic alkalosis in the body?

    <p>Excessive loss of metabolic acids</p> Signup and view all the answers

    What is the primary result of high levels of H+ in the blood?

    <p>Decreased pH (acidic)</p> Signup and view all the answers

    Study Notes

    Fluid Compartments

    • Total Body Water (TBW) is the sum of fluids in all body compartments.
    • Body fluids are divided into two main compartments:
      • Intracellular Fluid (ICF): ~2/3 of TBW, fluid within cells.
      • Extracellular Fluid (ECF): ~1/3 of TBW, fluid outside cells, including interstitial and intravascular fluids.

    Pediatric and Geriatric Considerations

    • In newborns, TBW constitutes 75-80% of body weight, making them prone to rapid dehydration due to high metabolic rates and larger body surface areas.
    • As people age, TBW percentage decreases due to reduced muscle mass, renal decline, and diminished thirst perception; important to monitor hydration.

    Starling Forces

    • Four forces regulate fluid movement between plasma and interstitial space:
      • Capillary Hydrostatic Pressure: promotes outward movement from capillaries.
      • Capillary Oncotic Pressure: draws water back into capillaries.
      • Interstitial Hydrostatic Pressure: encourages fluid movement into capillaries.
      • Interstitial Oncotic Pressure: attracts water from capillaries to interstitial spaces.

    Edema

    • Edema is the accumulation of fluid in the interstitial space, causing swelling and weight gain.
    • Pathophysiology relates to increased capillary hydrostatic pressure, lymph obstruction, or salt and water retention due to conditions like heart or renal failure.
    • Treatment focuses on addressing underlying causes and may include compression stockings and diuretics.

    Electrolytes and Hormonal Regulation

    • Antidiuretic Hormone (ADH) increases plasma water reabsorption.
    • Sodium (Na+): primary ECF cation; regulates osmotic forces, muscle contraction, and nerve impulse conduction.
    • Chloride (Cl-): primary ECF anion; helps maintain electroneutrality.
    • Aldosterone regulates sodium and potassium balance; renin triggers the renin-angiotensin-aldosterone system.

    Sodium and Chloride Balance Alterations

    • Isotonic changes involve proportional electrolyte fluid balance affecting TBW.
    • Hypertonic changes relate to elevated ECF osmolality (Na+ >145 mmol/L), common in conditions like hypernatremia.
    • Hypotonic conditions involve excessive water or sodium loss leading to cell swelling (Na+ <135 mmol/L).

    Acid-Base Balance

    • Normal blood pH ranges from 7.35 to 7.45; obtained through arterial blood gas sampling.
    • Important organs involved include lungs, kidneys, and bones.
    • Buffers, like bicarbonate (HCO3–), neutralize excess H+ without significant pH changes.

    Acid-Base Imbalances

    • Respiratory acidosis results from hypoventilation (PaCO2 >45 mmHg)
    • Respiratory alkalosis occurs due to hyperventilation (PaCO2 <35 mmHg).
    • Metabolic acidosis involves a decrease in HCO3– levels, often from loss of metabolic acids.
    • Metabolic alkalosis is marked by increased HCO3–, typically reflecting loss of metabolic acids.

    Clinical Symptoms & Treatments

    • Signs of hypernatremia include thirst, muscle twitching, and confusion; treat with isotonic salt-free fluids.
    • Hyponatremia signs include muscle cramps and paralysis; correction involves treating underlying causes.
    • Hypokalemia presents with weakness and abnormal calcium levels; often seen in kidney failure or laxative abuse.
    • Hypermagnesemia symptoms include muscle weakness and respiratory distress, generally linked to renal failure.

    Arterial Blood Gas Analysis

    • Use the ROME method to interpret ABG results.
    • Assess pH, PaCO2, and HCO3– values to determine acid-base status and identify compensatory mechanisms.

    Review Questions

    • Identify components of the Renin-Angiotensin-Aldosterone System.
    • Discuss initial treatment for hypernatremia.
    • Define the fluid compartments within the body.

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    Description

    This quiz covers the fundamental concepts of fluids and electrolytes in the human body, including common imbalances and their clinical manifestations. It addresses the physiological aspects of body fluids, normal values for electrolytes and acid/base balance, as well as the differences between acidosis and alkalosis. Test your understanding of this vital subject in health and disease.

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