Fluid, Electrolyte, and Acid Base

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T OR F: Adipose tissue is one of the most hydrated of all tissues in the human body.

FALSE

T OR F: The most abundant cation in intracellular fluid is sodium.

FALSE

T OR F: Electrolytes determine most of the chemical and physical reactions of the body.

TRUE

T OR F: Solutes, regardless of size, are able to move freely between compartments because water carries them along the osmotic gradients.

FALSE

The fluid link between the external and internal environment is ________.

plasma

Whereas sodium is found mainly in the extracellular fluid, most ________ is found in the intracellular fluid.

potassium

Which of the following describes the distribution of sodium and potassium between cells and body fluids?

K+ mainly in the cells, Na+ in the body fluids

The movement of fluids between cellular compartments ________.

is regulated by osmotic and hydrostatic forces

Extracellular fluid in the human body is composed of all of the following except ________.

lymph and interstitial fluid
cerebrospinal fluid
GLUCOSE
blood plasma

Which of the following statements is true regarding fluid shifts?

Electrolytes have greater osmotic power than nonelectrolytes and therefore have the greatest ability to cause fluid shifts.

Which of the following does not depend on the presence of electrolytes?

maintenance of osmotic relations between cells and ECF
neuromuscular excitability
membrane polarity
AMOUNT OF BODY FAT

The preferred intracellular negative ion is ________.

hydrogen phosphate

The fluid that bathes the cells found in tissues is called:

interstitial fluid

Which of the following is an electrolyte?

potassium

Problems with fluid, electrolyte, and acid-base balance are particularly common in infants because of their ________.

inefficient kidneys

A patient is breathing slowly and blood pH analysis indicates an abnormally high value. What is the likely diagnosis?

metabolic alkalosis

Which of the following is not a chemical buffer system?

protein
phosphate
NUCLEIC ACID
bicarbonate

The regulation of potassium balance ________.

involves aldosterone-induced secretion of potassium

The regulation of sodium ________.

is linked to blood pressure

Which of the following hormones is important in stimulating water conservation in the kidneys?

antidiuretic hormone

Under normal circumstances most water is lost in:

urine

What substance in body fluids determines most of their chemical and physical reactions?

electrolytes

T OR F: The thirst center in the brain is located in the hypothalamus.

TRUE

T OR F: Dehydration can be caused by endocrine disturbances such as diabetes mellitus or diabetes insipidus.

TRUE

T OR F: It is impossible to overhydrate because people need as much water as they can drink to carry out ordinary body functions.

FALSE

T OR F: Water imbalance, in which output exceeds intake, causing an imbalance in body fluids, is termed dehydration.

TRUE

T OR F: To remain properly hydrated, water intake must equal water output.

TRUE

T OR F: Hypoproteinemia reflects a condition of unusually high levels of plasma proteins and causes tissue edema.

FALSE

T OR F: Thirst is always a reliable indicator of body water need.

FALSE

The term hypotonic hydration refers to ________.

a condition that may result from renal insufficiency or drinking extraordinary amounts of water

Hypoproteinemia is a condition of unusually low levels of plasma proteins. This problem is often characterized by ________.

tissue edema

Hypoproteinemia is a condition of unusually low levels of plasma proteins. This problem is often characterized by ________.

antidiuretic hormone

Which of the following is not a disorder of water balance?

edema or tissue swelling, which is usually due to an increased capillary hydrostatic pressure
excess water in interstitial spaces due to a low level of plasma proteins
EXCESSIVE HYDRATION DUE TO EXCESS ADH SECRETION
hypotonic hydration, in which sodium content is normal but water content is high

One of the major physiological factors that triggers thirst is ________.

a rise in plasma osmolality

The most important force causing net water flow across capillary walls is ________.

hydrostatic pressure of capillary blood

The role of ADH is to:

increase water reabsorption

Which of the following would not be expected to lead to edema?

Hypoproteinemia
HYPONATREMIA
Incompetent venous valves
Inflammation

Which of the following does not impact how much sodium is reabsorbed?

Aldosterone
Estrogen
TRANSPORT MAXIMUM OF THE RENAL PROXIMAL TUBULE
Atrial natriuretic peptide

What is the driving force for water intake?

thirst

The body's water volume is closely tied to a powerful water "magnet." What magnet is referred to here?

ionic sodium

A pregnant woman complains to her doctor that her ankles and feet stay swollen all of the time. She is very worried about this. What would you tell her?

She is showing edema, caused by her high blood volume due to her pregnancy. The high blood volume increased the capillary hydrostatic pressure.

A patient is 72 years old and was admitted to the hospital for severe shortness of breath and edema to her lower extremities. She was diagnosed with heart failure. Which side of the heart failed, and how did this cause edema?

The right side of the heart failed, causing edema in her lower extremities. The failure to pump blood around the pulmonary circulation caused pooling of blood in the systemic circulation, leading to edema.

T OR F: Salts are lost from the body in perspiration, feces, and urine.

TRUE

T OR F: Although the sodium content of the body may be altered, its concentration in the ECF remains stable because of immediate adjustments in water volume.

TRUE

T OR F: Sodium is pivotal to fluid and electrolyte balance and to the homeostasis of all body systems.

TRUE

T OR F: When aldosterone release is inhibited, sodium reabsorption cannot occur beyond the collecting tube.

TRUE

T OR F: Aldosterone stimulates the reabsorption of sodium while enhancing potassium secretion.

TRUE

T OR F: Pressure diuresis decreases blood volume and blood pressure.

TRUE

T OR F: Aldosterone is secreted in response to low extracellular potassium.

FALSE

T OR F: The main way the kidney regulates potassium ions is to excrete them.

TRUE

T OR F: Atrial natriuretic peptide reduces blood pressure and blood volume by inhibiting nearly all events that promote vasodilation and potassium and water retention.

FALSE

T OR F: Premenstrual edema may be due to enhanced reabsorption of sodium chloride.

TRUE

T OR F: Heavy consumption of salt substitutes high in potassium can present a serious clinical problem when aldosterone release is not normal.

TRUE

T OR F: Hypercalcemia causes muscle tetany.

FALSE

T OR F: The two hormones responsible for the regulation of calcium are pituitary hormone and calcitonin.

FALSE

T OR F: Calcitonin targets the bones and causes the release of calcium from storage when serum levels are low.

FALSE

The body's water volume is closely tied to the level of which of the following ions?

sodium ions

Which of the following hormones is important in the regulation of sodium ion concentrations in the extracellular fluid?

aldosterone

Atrial natriuretic peptide is a hormone that is made in the atria of the heart. The influence of this hormone is to ________.

reduce blood pressure and blood volume by inhibiting sodium and water retention

Which of the choices below is not an essential role of salts in the body?

secretory activity
membrane permeability
ANABOLISM OF PROTEINS
neuromuscular activity

Which of the choices below exerts primary control over sodium levels in the body?

aldosterone

The single most important factor influencing potassium ion secretion is ________.

potassium ion concentration in blood plasma

What hormone reduces blood pressure and blood volume by inhibiting nearly all events that promote vasoconstriction and sodium ion and water retention?

atrial natriuretic peptide

The regulation of sodium ________.

is linked to blood pressure

Annie has just eaten a large order of heavily salted french fries, some pickled eggs, and some cheese. How will consuming this much salt affect her physiology?

There will be a temporary increase in blood volume.

The regulation of potassium balance ________.

involves aldosterone-induced secretion of potassium

The female hormone ________ seems to decrease sodium reabsorption, thus promoting sodium and water loss by the kidney.

progesterone

The most important hormone that regulates calcium ions in the body is ________.

PTH

________ reduces blood pressure and volume by inhibiting nearly all events that promote vasoconstriction and the retention of sodium ions and water.

Atrial natriuretic peptide

PTH (parathyroid hormone) acts on the _______________ to ___________ Ca2+ reabsorption.

kidneys; increase

Which of the following does not serve as a source of acids in the body?

Fat metabolism
Ingested foods
CO2 in the blood
AEROBIC BREAKDOWN OF GLUCOSE

The primary buffer of the extracellular fluid (ECF) is the:

bicarbonate buffer system

Which of the following is NOT a hormone involved in water and electrolyte balance?

THYROXINE
aldosterone
atrial natriuretic peptide
adh

Which hormone raises blood calcium levels?

PTH

Recently Alex's family noticed that he is craving salt to the point where he uses it excessively on his food. He also has a need to consume strange substances such as clay and burnt match tips. What condition is he suffering from, and what is his unusual appetite called?

Alex is suffering from Addison's disease, and his unusual appetite is called pica.

A 13-year-old girl is admitted to the psychiatric unit for anorexia. Her body weight is 89 lbs. and height is 64 inches. She admits to frequent self-induced vomiting and abuse of laxatives. She was treated on the medical unit with intravenous fluids. Now that she is on the psychiatric unit she is experiencing fluid retention as evidenced by mild puffiness and bloating. Why did she get these symptoms?

The abuse of laxatives and self-induced vomiting caused her to be chronically fluid and electrolyte depleted. She developed a compensatory increased production of aldosterone and ADH.

T OR F: The normal pH of blood is 7.35-7.45.

TRUE

T OR F: Most acidic substances (hydrogen ions) originate as by-products of cellular metabolism.

TRUE

T OR F: Weak acids are able to act as chemical buffering systems for the body because they partially dissociate.

TRUE

T OR F: The phosphate buffer system is relatively unimportant for buffering blood plasma.

TRUE

T OR F: The single most important blood buffer system is the bicarbonate buffer system.

TRUE

T OR F: One of the most powerful and plentiful sources of buffers is the protein buffer system.

TRUE

T OR F: As ventilation increases and more carbon dioxide is removed from the blood, the hydrogen ion concentration of the blood decreases.

TRUE

T OR F: Regulation of the acid-base system is accomplished mainly through respiratory control, and the kidneys also play a small role.

FALSE

T OR F: Severe damage to the respiratory system rarely will result in acid-base imbalances.

FALSE

T OR F: Respiratory acidosis results when lungs are obstructed and gas exchange is inefficient.

TRUE

T OR F: Prolonged hyperventilation can cause alkalosis.

TRUE

T OR F: Blood acidity results in depression of the CNS, whereas blood alkalosis results in overexcitement of the CNS.

TRUE

Respiratory acidosis can occur when ________.

a person's breathing is shallow due to obstructions

Which of the following two organs function as the most important physiological buffer systems?

the lungs and the kidneys

The term alkaline reserve is used to describe the ________ buffer system.

bicarbonate

A falling blood pH and a rising partial pressure of carbon dioxide due to pneumonia or emphysema indicates ________.

respiratory acidosis

Which of the following is not a method for regulating the hydrogen ion concentration in blood?

respiratory changes
DIET
chemical buffer systems
renal mechanism

Which of the following is not a chemical buffer system?

protein
bicarbonate
NUCLEIC ACID
phosphate

The maintenance of the proper pH of the body fluids may be the result of ________.

the control of respiratory ventilation

Select the correct statement about renal mechanisms of acid-base balance.

Kidney tubule cells are able to synthesize bicarbonate ion.

Blood analysis indicates a low pH, and the patient is breathing rapidly. Given your knowledge of acid-base balance, which of the following is most likely?

metabolic acidosis

A patient is breathing slowly and blood pH analysis indicates an abnormally high value. What is the likely diagnosis?

metabolic alkalosis

________ occurs when carbon dioxide is eliminated faster than it is produced.

respiratory alkalosis

The most important ECF buffer of HCl is ________.

sodium bicarbonate

Molecules that can act reversibly as acids or bases depending upon the pH of their environment are called ________.

amphoteric

The breakdown of phosphorus-containing proteins releases ________ acid.

phosphoric

Arterial blood pH below 7.35 is called ________.

acidosis

A decrease in blood CO2 levels leads to:

an increase in blood pH.

The most important renal mechanism for regulating acid-base balance of the blood involves:

maintaining HCO3- balance.

The most common cause of acid-base imbalance is:

respiratory acidosis

Which of the following is not a risk factor for dehydration?

Vomiting
Inefficient kidneys
A high rate of insensible water loss
INCREASED MUSCLE MASS

T OR F: The most abundant cation in intracellular fluid is potassium.

TRUE

Which buffer system is the most abundant in the body?

protein

Which organs are the ultimate acid-base regulatory organs?

kidneys

What is the most common cause of acid-base imbalance?

respiratory acidosis

What is the effect of hyperventilation on pH?

respiratory alkalosis

A patient is admitted to the hospital in complete collapse. His blood pH is 6.8, and his HCO3- is 20 mEq/L. A medical history reveals that this patient is a chronic alcoholic. What diagnosis would you give, and what prognosis?

The pH and bicarbonate levels and the history of alcoholism indicate metabolic acidosis. The patient will go into a coma and death soon follows.

Helen is a 62-year-old smoker. Her physician has diagnosed her as having emphysema that has caused her to hypoventilate. She is tired and sedentary. Besides having difficulty breathing, what other condition is contributing to her tiredness?

Helen is suffering from respiratory acidosis because she is retaining too much carbon dioxide.

After traveling from Los Angeles to Denver, Claire finds she is not feeling well and checks into a clinic for help. What is the diagnosis, and what has caused this problem?

Respiratory alkalosis caused by hyperventilation. Claire is experiencing the effect of the high altitude, breathing faster and deeper to raise her oxygen levels in her blood.

A patient's anxiety caused her to develop respiratory alkalosis. What breathing technique did the nurse recommend, and why?

The nurse instructed the patient to breathe slower and deeper, and to breathe into a paper bag. This will increase the patient's blood level of carbon dioxide by eliminating less carbon dioxide from the lungs, and by breathing in the expired air which has a higher concentration of carbon dioxide. As a result, the blood pH will decrease.

Newborn infants have a relatively higher ________ content in their ECF than do adults.

sodium

Problems with fluid, electrolyte, and acid-base balance are particularly common in infants because of their ________.

inefficient kidneys

T OR F: Potassium balance is controlled mainly by renal mechanisms.

TRUE

Which age group most commonly has fluid, electrolyte, and acid-base balance issues?

infants

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