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Electrolytes

The major electrolytes are ____, _____, ____, and _______

sodium, potassium, chloride, and bicarbonate

Anions move toward _____

anodes

Cations move toward _____

Cathodes

Water is ____% of the bodys total weight

40-75

____ is the bodys primary solvent

Water

______ ____ (fluid inside of the cells) account for 2/3 of the bodys water

Intracellular fluid

______ ____ (fluid outside of the cells) account for 1/3 of the bodys water and is seperated into intravascular ECF (plasma) and interstitial ECF (surrounding cells in tissue)

Extracellular Fluid

Ions in the cells and plasma are maintained by ____ _____ and by ______/_____ _______

active transport and by diffusion/passive transport

______ is the passive movement of ions from a region of high concentration to one of low concentration

Diffusion

______ _______ is the passive movement of ions with the aid of a transport protein

Facilitated Diffusion

Water distribution is maintained by ______ and ____ ______

electrolyte and protein concentration

Biologic membranes are water permeable but __/____ impermeable

ion/protein

______ is the solute to water ratio

Osmolality

If osmolality is high, it triggers ____ release. If it is low it supresses ___ release.

ADH/AVP

Osmolality may be measured in _____ or _____

serum or urine

The most frequent method for determining Osmolality are ______ _____ and ____ _______ changes

freezing point and vapor pressure

Having normal ____ ______ maintains blood pressure and good perfusion

blood volume

______ is the major cation of the ECF (90%)

Sodium

Sodium is responsible for almost ___ of the osmotic strength of plasma

1/2

The body only requires ___ mmol/day of sodium and any excess gets excreted by the kidneys

1-2

Plasma Na concentration greatly depens on ____ _________

water intake/excretion

The proximal tubule reabsorbs _____% of filtered Na

60-75

Having less than 135 mmol/L of Na is ________

Hyponatremia

Hyponatremia is one of the most common ______ ________

electrolyte disorders

Hyponatremia may be caused by __ ___, ___ _____, and _ ____

Na loss, water imbalances, and K deficiency

If you have less that ___ mmol/L of sodium for 2+ days it is considered acute and a medical emergency

120

Greater that ___ mmol/L of sodium is hypernatremia

150

Hypernatremia may be caused by water loss or increased Na intake, as well as ____ _____ or ___ ____ _____

diabtetes insipidus or renal tubular disease

________ most commonly affects the CNS

Hypernatremia

___ mmol/L or more of Na has a 60-75% mortality rate

160

______ is the major intracellular cation

Potassium

Potassium has a concentration __ times greater inside the cells compared to outside the cells

20

Potassium has a major effect on _____ and ____ _____ contraction

skeletal and cardiac muscle

K distribution between the cells and ECF is caused by ___________

Acidosis/Alkalosis, Insulin, catacholamines, and Na-K pump inhibition

_____ _____ leads to gradual K depletion

Diabetes Mellitus

A potassium level less than __ mmol/L is Hypokalemia

3.5

______ can occur with urinary K loss or increased cellular K uptake

Hypokalemia

Symptoms of Hypokalemia are _____, ______, and _________

weakness, fatigue, and constipation

Having a K concentration greater than 5.1 mmol/L is _______

Hyperkalemia

____ ______, _____ _____, and _____ _____ all contribute to Hyperkalemia

Renal insufficiency, diabetes mellitus, and metabolic acidosis

The most common cause of hyperkalemia is ________ _ _______

therapeutic K administration

Symptoms of hyperkalemia are ______________

confusion, weakness, tingling, flaccid paralysis of the extremities, and respiratory weakness

Having >__ mmol/L of K are fatal

10

______ is the major extracellular anion

Chloride

Chlorides function is not well understood, but it maintains ______, ____ _____, and ____ ______

osmolality, blood volume, and electric neutrality

Cl is absorbed by the intestinal tract and excreted by the urine and _____

sweat

Cl maintains electrical neutrality by reabsorbing Na and through the ____ ____

chloride shift

Less than ___ mmol/L of Cl is Hypochloremia

98

_______ may occur with excessive Cl loss through vomiting, diabetic ketoacidosis, aldosterone deficiency, or salt losing renal diseases

Hypochloremia

______ _____ _____ and ______ _____ may lead to hypochloremia

Compensated respiratory acidosis and metabolic alkalosis

Chlorine levels greater than 107 mmol/L is ______

Hyperchloremia

Hyperchloremia may be caused by ___________

excessive HCO3 loss, renal tubular acidosis, or metabolic acidosis

________ is the second most abundant anion in the ECF

Bicarbonate

HCO3 is a major component of the bloods ______ ______

buffering system

__% of bicarbonate is reabsorbed by the proximal tubules and the remaining __% is reabsorbed by the distal tubules

85; 15

_______ _______ are special purpose potentiomatic electrodes that use a semipermeable membrane to develop an electrical potential

Ion-Selective electrodes

Ion-Selective electrodes use a ______ and ______ electrode

reference and measuring

With Ion-Selective electrodes, the difference between the reference and the measuring electrode can be used to calculate ___ ________

Ion concentration

With Ion-Selective electrodes, you can use either a _____ (undiluted) sample or a ______ (diluted) sample

direct; indirect

To measure sodium use of __________ are all acceptable

serum, plasma, whole blood, sweat, and urine

If collecting plasma for sodium analysis, ____ _____, ______ _____, and ______ ______ anticoagulants can be used

lithium heparin, ammonium heparin, and lithium oxalate

Slight hemolysis in a sodium sample is acceptable due to only ___ of the bodys sodium being in RBCs

1/10

When measuring urine samples for electrolytes, the sample should be acquired from the ______ _____ ________ process.

24-hour urine collection

With sodium, __________ _______ are the most common testing method

Ion-Selective electrodes

Potassium may be measured using serum, plasma, whole blood, and urine and _______ is the primary anticoagulant

Heparin

Proper handling and collection of K samples are important because many errors, including ______________________ are possible.

non use of a heparin tube and allowing coagulation, excessive tourniquet use and fist clenching, exercise by patient prior to collection, not centrifuging, keeping the sample cold, and allowing hemolysis.

With K, it is tested with Ion-Selective electrodes using a ________ _______

valinomycin membrane

Chloride could be measured using plasma, serum, whole blood, ____, or urine

sweat

With chloride samples, ______ ______ is the primary anticoagulant

Lithium Heparin

Slight hemolysis in a ______ sample could be accepted due to its RBC concentration being ~ half of its plasma concentration

chloride

Sweat is analyzed for increased Cl concentration to confirm the diagnosis of _____ ______

Cystic Fibrosis

For chloride sample testing ISE, titration, and colorimetry are available. However ISE using a ________ _______ is the most common test

ion-exchange membrane

________ is a drug used to stimulate sweating

Pilocarpine

With bicarbonate, serum or _____ _____ plasma are acceptable

lithium heparin

Bicarbonate specimens should be kept ________

anaerobic

If a bicarbonate specimen is left uncapped CO2 escapes at a rate of _ mmol/L per hour

6

Bicarbonate tests available are the use of an _______ _____________ method or _______ methods

indirect electrode-based; enzymatic

The ______ _____ is the difference between unmeasured anions and unmeasured cations

Anion Gap

The anion gap equation is _________________

(Na + K) - (Cl + HCO3)
(the sum of cations minus the sum of anions)

In normal people, the average AG is __ mmol/L

12

An elevated AG could be from ________________

uremia/renal failure, ketoacidosis, lactic acidosis, hypernatremia, and instrument error

An low AG could be from _______ or _____ ___________

hypoalbuminemia or serious hypernatremia

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