fluid and electrolyte 01

8/13/2019 Fluid and Electrolyte 01

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Fluid, Electrolyte and

Acid-Base Dynamics


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Concentration of

Solutions Percent Salt

0.9% NaCl

Milliosmoles 300 milliosmoles/Liter

Milliequivalents

325

milliequivalents/Liter


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Osmosis


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Osmosis


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Hypertonic Solution

0.9%

NaCl

3% NaCl


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Cells Crenate in a

Hypertonic Solution


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Hypotonic Solution

0.9%

NaCl

0.5% NaCl


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Cells in a Hypotonic Solution

Swell and May Lyse


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Isotonic Solution

0.9%

NaCl

0.9% NaCl


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310 mosm

300 mosm

Which Way Will Fluid Move?


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Application Problem 1

Male 18 has recently started

working outdoors in the hot weather

to earn money for his tuition. After afew days he experienced headaches,

low blood pressure and a rapid heart

rate. His blood sodium was down to125 meq/L. The normal is 144

meq/L. How do you explain this?


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Answer to Problem 1

Gentleman has lost sodium byperspiration. The low sodium in his

blood allowed fluid to move into cellsby osmosis. Lack of fluid lowered hisblood pressure to give him a headache.

The increased heart rate was his bodiesway of trying to increase blood

pressure.


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Application Problem 2

FARID has hypertension. His

doctor has advised him to eat a low

salt diet. He consumed a lot of saltthe day before his last checkup. His

blood pressure was up. Why?


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Answer to Problem 2

The extra salt Farid ate made his blood

hypertonic. Hypertonic blood will attract

fluids from body cells by osmosis.


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Electrolyte vrs.

Nonelectrolyte

NaCl Na++ Cl-

Glucose Glucose


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Aldosterone

Hormone secreted

from the adrenal

cortex Stimulates kidneys

Retain sodium

Retain water

Secrete potassium


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Estrogen

Female hormone from the ovaries

Similar to aldosterone

Stimulates the kidneys to retain sodium

Increases fluid retention


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Cortisol

Hormone from the adrenal cortex

Converts lipids and protein to glucose

Depress inflammation

Stimulates the kidneys to retain sodium

Increases fluid retention Elevated levels cause edema


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Antidiuretic Hormone

ADH

ADH

Hypertonic

Interstitial Fluid

Collecting

Duct

H2O

Urine


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Calcitonin

Calcium


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Estrogen

Calcium


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Parathormone

Calcium


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Blood pH = 7.4

(7.35-7.45)Blood pH regulated by

1. Kidneys2. Lungs

3. Buffers in blood


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H+Secreted

HCO3-Rebsorbed

Blood

Kidney

NephronHCO3

-

H

+

Urine


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Kidneys Regulate pH

Excreting excess hydrogen ions, retain

bicarbonate

if pH is too low

Retaining hydrogen ions, excrete

bicarbonate

if pH is too high


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Lungs Regulate pH

Breath faster to get rid of excess carbon

dioxide if pH is too low

Carbon dioxide forms carbonic acid in theblood

Breath slower to retain carbon dioxide if pH

is too high


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Carbon Dioxide and Acid

CO2 + H2O H2CO3 H++ HCO3-

Carbonic Acid


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More Carbon Dioxide = More

Acid = Lower pH Breathing slower will retain CO2, pH will

decrease (more acid)

Breathing faster will eliminate more CO2pH will

increase (less acid)


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Blood pH Drops to 7.3

How does the body compensate? Breath faster to get rid

of carbon dioxide

eliminates acid


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Blood pH Increases to 7.45

How does the body compensate? Breath slower to retain

more carbon dioxide

retains more acid

J h i T ki N i f P i


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John is Taking Narcotics for Pain

The narcotics have depressed his

breathing rate. What will happento his blood pH?

pH will decreasebecause he will retain

excess carbon dioxide

which will increase the

amount of acid in theblood


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Buffers Regulate pH

Chemicals that resist changes in pH

Prevent large pH changes when an acid or

base is added


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Strong Acid

Acid that releases many hydrogen ions

HCl


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Weak Acid

Acid that releases only a few hydrogen ions

Carbonic Acid


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Buffers Change Strong Acids

to Weak Acids

HCl + NaOHStrong

Acid

BaseH2CO3+ NaClWeak Acid Salt


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Bicarbonate: Carbonic Acid

20:1 = pH 7.4

21:1 = pH more than 7.4 19:1 = pH less than 7.4


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Acidosis

pH below 7.35

Depresses the nervous system

coma


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Alkalosis

pH above 7.45

Overexcites the nervous system

convulsions


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Respiratory Acidosis

Any condition that impairs breathing

Carbon dioxide increases in blood

Excess carbon dioxide lowers pH


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Respiratory Alkalosis

Hyperventilation

Carbon dioxide decreases in blood

Low carbon dioxide raises pH


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Metabolic Acidosis

Not caused by breathing or carbon dioxide

imbalance

Excess acid in blood Renal disease, Diabetes or Starvation

Deficiency of bicarbonate in blood

Diarrhea


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Metabolic Alkalosis

Not caused by breathing or carbon dioxide

imbalance

Deficiency of acid in the blood Vomiting, Diuretics

Excess bicarbonate in the blood

Ingesting sodium bicarbonate


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Sodium

Attracts water into the ECF

Nerve impulse

Muscle contractions


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Hypernatremia

Excess sodium in the blood

Hypertension

Muscle twitching

Mental confusion

Coma


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Hyponatremia

Deficiency of sodium in the blood

Hypotension

tachycardia

Muscle weakness


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Potassium

Attracts water into the ICF

Nerve impulse

Muscle contractions


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Hyperkalemia

Excess potassium in the blood

Cardiac arrhythmias and cardiac arrest

Elevated T wave

Muscle weakness


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Hypokalemia

Deficiency of potassium in the blood

Cardiac arrhythmias and cardiac arrest

Flatened T wave

Muscle weakness


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Calcium

Most in bones and teeth

Blood clotting

Nerve impulse

Muscle contraction


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Hypercalcemia

Excess calcium in the blood

Kidney stones

Bone pain

Cardiac arrhythmias


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Hypocalcemia

Deficiency of calcium in the blood

Tetany

Weak heart muscle

Increased clotting time


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Aldosteronism

Excess production of aldosterone

Elevated sodium levels

Depressed potassium levels

Hypertension


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Addisons Disease

Hyposecretion of the Adrenal Cortex

Hyposecretion of Aldosterone

Hyposecretion of Glucocorticoids Hormones that convert protein sugar

Hypotension

Sodium deficiency

Low blood sugar

Not enough glucocorticoids


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Cushings Syndrome

Excess glucocorticoids

Tumor of adrenal gland

Side effect of steroid drugs cortisone

Hyperglycemia

Fat accumulation

Abdomen

Back of neck (buffalo hump)


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Insulin

Glucose

Cell

Blood


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Diabetes Mellites

Hyposecretion or hypoactivity of insulin

Hyperglycemia

Glycosurea Polyurea

Thirst

Body burns more fat

Ketone bodies Metabolic Acidosis

Fat deposits in arteries

Heart Attack, Stroke, Poor Circulation


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Antidiuretic Hormone

ADH

ADH

Hypertonic

Interstitial Fluid

CollectingDuct

H2O

Urine


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Diabetes Insipidus

Hyposecretion of ADH

Increased urine volume


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THE END

fluid and electrolyte 01

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