Transport Mechanisms and Regulation

Transport Mechanisms

• Diffusion is the movement of solutes from an area of high concentration to an area of low concentration. It requires no energy (passive).
• Osmosis is the movement of water across a selectively permeable membrane from an area of high water concentration to an area of low water concentration. It also requires no energy (passive).
• Filtration is the movement of water and small solutes across a membrane due to hydrostatic pressure. It involves the squeezing of fluid through a membrane.
• Active transport moves solutes against their concentration gradient. This process requires energy (ATP).

Fluid and Electrolyte Regulation

Kidney Role

• Kidneys filter blood, regulating water and electrolyte balance, eliminating wastes.

Lung Role

• Lungs help regulate acid-base balance by removing carbon dioxide.

Endocrine Gland Role

• Endocrine glands (e.g., adrenal glands, parathyroid glands) regulate fluid and electrolyte balance through hormone secretion.

Fluid and Electrolyte Imbalances

Fluid Volume Deficit (FVD)

• Causes: Vomiting, diarrhea, excessive sweating, diuretic use.
• Manifestations: Thirst, decreased urine output, postural hypotension, weight loss.
• Management: Fluid replacement (oral or intravenous).
• Nursing Interventions: Monitor intake and output, vital signs, weight.

Fluid Volume Excess (FVE)

• Causes: Heart failure, kidney failure, excessive IV fluids.
• Manifestations: Edema, increased blood pressure, increased urine output.
• Management: Diuretics, restrict fluid intake.
• Nursing Interventions: Monitor daily weight, intake/output, lung sounds, and vital signs.

Sodium Imbalances

Hyponatremia

• Causes: Excessive water intake, loss of sodium through vomiting or diarrhea.
• Manifestations: Nausea, headache, confusion, seizures.
• Management: Correct underlying cause, administer sodium if needed.
• Nursing Interventions: Monitor neurological status, fluid balance.

Hypernatremia

• Causes: Dehydration, excessive sodium intake.
• Manifestations: Thirst, dry mucous membranes, elevated temperature.
• Management: Fluid replacement, correct underlying cause.
• Nursing Interventions: Monitor fluid status, intake, and output.

Potassium Imbalances

Hypokalemia

• Causes: Diuretic use, vomiting, diarrhea, inadequate potassium intake.
• Manifestations: Muscle weakness, fatigue, cardiac arrhythmias.
• Management: Potassium replacement, monitor cardiac rhythm.
• Nursing Interventions: Assess cardiac rhythm, monitor muscle strength, potassium intake.

Hyperkalemia

• Causes: Kidney failure, excessive potassium intake.
• Manifestations: Muscle weakness, paralysis, cardiac dysrhythmias.
• Management: Diuretics, dialysis.
• Nursing Interventions: Monitor cardiac rhythm, assess for neurological changes.

Other Electrolyte Imbalances

Calcium Imbalances

Hypocalcemia

• Manifestations: Muscle cramps, tetany, seizures.
• Management: Calcium replacement, vitamin D.
• Nursing Interventions: Monitor for muscle and nerve changes.

Hypercalcemia

• Manifestations: Nausea, vomiting, constipation.
• Management: Calcitonin, hydration.
• Nursing Interventions: Monitor for constipation/urinary stones.

Magnesium Imbalances

Hypomagnesemia

• Manifestations: Tremors, muscle spasms, cardiac dysrhythmias.
• Management: Magnesium replacement.
• Nursing Interventions: Monitor cardiovascular and neurological status.

Hypermagnesemia

• Manifestations: Bradycardia, hypotension (reduced heart rate and blood pressure).
• Management: Diuretics, calcium.
• Nursing Interventions: Monitor cardiovascular status, respiratory function.

Phosphorus Imbalances

Hypophosphatemia

• Manifestations: Muscle weakness, anorexia.
• Management: Phosphorus replacement.
• Nursing Interventions: Monitor for neuromuscular changes.

Hyperphosphatemia

• Manifestations: Tetany and muscle spasms.
• Management: Restrict phosphorus intake, phosphate binders.
• Nursing Interventions: Monitor for neuromuscular symptoms

Chloride Imbalances

Hypochloremia

• Manifestations: Weakness, nausea, vomiting.
• Management: Replace chloride.
• Nursing Interventions: Monitor for dehydration.

Hyperchloremia

• Manifestations: Thirst, lethargy, respiratory issues.
• Management: Correct underlying cause (e.g. dehydration).
• Nursing Interventions: Monitor respiratory status.

Acid-Base Balance

Lung, Kidney, and Buffer System Roles

• Lungs: Regulate CO2 levels through respiration.
• Kidneys: Regulate bicarbonate levels.
• Chemical buffers: Rapidly respond to pH changes.

Acid-Base Disorders

Metabolic Acidosis

• Causes: Diabetic ketoacidosis, kidney failure.
• Manifestations: Kussmaul respirations, headache, drowsiness.
• Management: Treat underlying cause, IV fluids.

Respiratory Acidosis

• Causes: Hypoventilation, opioid overdose.
• Manifestations: Headache, confusion, lethargy.
• Management: Improve ventilation, treat underlying cause.

Metabolic Alkalosis

• Causes: Vomiting, excessive use of bicarbonate antacids.
• Manifestations: Muscle weakness, tingling.
• Management: Treat the cause of excess bicarbonate.

Respiratory Alkalosis

• Causes: Hyperventilation.
• Manifestations: Lightheadedness, dizziness, tingling.
• Management: Treat the cause of excessive loss via respiration.

Arterial Blood Gas Interpretation

• Interpretation of arterial blood gas (ABG) values provides information about pH, PaCO2, HCO3, that helps assess acid-base balance and oxygenation status.
• ABG values can assist in identifying various acid-base imbalances including metabolic or respiratory acidosis and alkalosis.

This quiz covers essential transport mechanisms including diffusion, osmosis, filtration, and active transport in relation to fluid and electrolyte regulation. It also explores the roles of kidneys, lungs, and endocrine glands in maintaining balance within the body. Test your knowledge on these critical physiological processes.