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