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47 terms

Electrolytes

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Water loss in sweating & breathing
insensible water loss
Water loss in urine, feces, wounds
sensible water loss
Fluid compartments
intracellular, interstitial, vascular
Fluid distribution in adults
75% interstitial, 25% vascular
Fluids in neonates
80% weight, 90% in premies
RAAS sequence
renin--> angiotensin1--> angiotensin 2--> aldosterone--> vasoconstriction, Na absorption
ANF fx
atrial pressure up--> ANF--> RAAS & ADH release blocked-->vasodilation & Na excretion
Main ICF cation
K
Main ECF cation
Na
Main ICF anion
P (as PO4)
Main ECF anion
Cl
Cation used in coagulation
Ca
Cation used in enzyme rxns
Mg
Serum [Na]
135-145 mEq/L
Hyponatremia causes
SIADH, Addison's, vomiting/diarrhea, heat stroke, renal failure
Hypernatremia causes
dehydration, diabetes insipidus, loop diuretics, hyperaldosteronism
Serum [K]
3.5-5.0 mEq/L
Hypokalemia causes
Diuretics, vomiting/diarrhea, diabetes insipidus, alkalosis, alcoholism & anorexia. hyperaldosteronism.
Hyperkalemia causes
Burns, crushing injuries, renal failure, metabolic acidosis, Hypoaldosteronism (Addison's)
Serum [Ca]
8.9-10.1 mg/dL
Hypocalcemia causes
Hypoparathyroidism, acute pancreatitis, Vit D deficiency, chemo
Hypercalcemia causes
Hyperparathyroidism, pheochromocytoma, Grave's disease, adrenal insufficiency
Serum [PO4]
2.5-4.5 mg/dL
Hypophosphatemia causes
alcoholism, antacids, acidosis, pancreatitis, G- sepsis, steroids
Hyperphosphatemia causes
Hypoparathyroidism, tumor lysis (lymphomas) renal insufficiency
Serum [Mg]
1.5-2.5 mEq/L
Hypomagnesemia causes
Hypercalcemia, malnutrition
Hypermagnesemia causes
Diabetic ketoacidosis, hemolysis, lithium intoxication, renal failure
Hypervolemia
excess ISOTONIC fluid in ECC
Hypervolemia causes
Burns, congestive heart failure, cirrhosis, nephrotic syn, IV
Hypervolemia s/s
edema, low HCT, normal [Na], low BUN
Hypovolemia
low ISOTONIC fluid in ECC
Hypovolemia causes
Fluid loss (hemorrhage, diabetes, diuretics, vomiting) 3rd space shifts (burns, CHF, peritonitis, hypoalbuminemia)
Hypovolemia s/s
Acute weight loss, dizziness, polydipsia, tachy, hypotension
PaCO2
35-45 mm Hg
PaO2
80-100 mm Hg, drops w/ age
Bicarbonate
22-26 mEq/L
Respiratory acidosis
pH < 7.35, PaCO2 >45 mmHg
Respiratory alkalosis
pH >7.45, PaCO2 , 35 mmHg
Metabolic acidosis
pH <7.35, Bicarb <22 mEq/L
Metabolic alkalosis
pH >7.45, Bicarb > 26 mEq/L
Respiratory acidosis w/ compensatory metabolic alkalosis
pH below 7.35, PaCO2 > 45 mm Hg, bicarb > 26 mEq/L
Metabolic acidosis w/ compensatory respiratory alkalosis
pH below 7.35, PaCO2 <35 mm Hg, bicarb < 22 mm Hg
Anion gap calculation
[Na] - ([Cl] + [HCO3])
Anion gap values
10-14 mEq/L
Inflated anion gap causes
Lactic acidosis, ketoacidosis
Depleted anion gap causes
Hypermagnesemia, multiple myeloma