BIO 212 – Exam 2 Study Guide
Ch 39-40 – Fluid, Electrolyte & Acid-Base Disorders
Ch 9 – Stress Adaptations
Ch 26-28 – Blood Disorders
Ch 15 – Immune Disorders
Ch 39-40 – Fluid, Electrolyte & Acid-Base Disorders
ADH, aldosterone, parathyroid hormone—regulated calcium
levels Anything to do with sodium potassium calcium
Intracellular fluid – fluid contains within a cell membrane (ICF)
Extracellular fluid – fluid outside of cell membranes (ECF)
Tissue fluid, interstitial fluid.
2/3rd is Inside cell
1/3rd is outside cell
Where is the water?
Transcellular fluid is fluid that is moving. 1 L
Gradients. Movement of fluid. Very important!
Aquaporins… without them we are Still permeable to fluid
Water is always moving in or out. Consistently moving.
Albumens are made by the liver
o Water magnets!
o Outward push with … , inward pull with osmosis.
Edema – expansion of interstitial fluid volume
Too much fluid …
Always a complication of a disease
process Terminology
o Pitting edema – interstitial fluid exceeds absorptive capacity of the tissue gel
o Nonpitting edema – plasma proteins have accumulated in the tissue
spaces and coagulated
o Effusion – movement of fluid out of blood vessels into the body cavities
o Anasarca – generalized body edema
Ex. Right sided heart failure
o Third space accumulation – ECF trapped in the transcellular spaces
o Ascites (hydroperitoneum) – excessive fluid in the peritoneal
cavity Ex. Liver failure—in abdominal cavity
, Really beginning to fail…
o Transudate – non-inflammatory edema that results from altered
hydrostatic or osmotic pressure of the blood
Contains less protein and cells than exudate
Causes fall into 4 general categories (arteriole = out)
o Increased capillary filtration pressure (increase in hydrostatic pressure)
Increased arterial pressure
Ex: hypertension
Decreased venous pressure
Ex: portal vein distention
Increased blood volume
Ex: heart failure
o Decreased capillary colloidal osmotic pressure
Inadequate plasma protein production
Ex: liver disease causing a lack of function. Not enough
albumens Abnormal loss of plasma proteins or amino acids
Ex:
o Increased capillary permeability
Ex:
o Obstruction of lymph flow
Ex:
Treatment
o Control or correct underlying cause
o Prevent tissue injury
o Diuretics – if ECF is increased
o Elevation of feet/compression stockings if lower extremities are
involved Socks for nurses! :)
o Intravenous albumin
o Light pressure massage
o Compression pumps
o Movement exercises
Disorders of Thirst
Hypodipsia – decreased ability to sense thirst
Hypothalamic lesions
o Lesions in your hypothalamus
o Sense of thirst regulated by
hypothalamus Elderly
True thirst with symptoms
, Inappropriate thirst despite normal serum levels
Compulsive water drinking (psychogenic polydipsia)
Increased (too much) angiotensin levels
Decreased salivary gland
function Anticholinergic drugs
Plasma volume is dropping drink more
water! ECF ~
If everything looks normal …
Activates RAS – trying to increase low blood pressure
Disorders of ADH (Vasopressin)
Diabetes Insipidus (NOTHING TO DO WITH GLUCOSE)
ADH deficiency or decreased responsiveness of
cells Polyuria (3-20L/day)…(2k at most normally!!!)
o No way to increase or decrease levels. Fixed rate.
o Paired with excessive thirst.
o Peeing will happen no matter what so they have to
Excessive thirst
Increased ADH
Can be transient or chronic
o Complication of cancer
Bronchogenic tumors, lung, lymphoid, prostate,
pancreas Causes dilutional hyponatremia
Disorders of Fluid Volume
Na draws water, excessive sweaty, depleting your fluid levels.
Fluid volume depletion (FVD) – results when fluid loss exceeds fluid intake
Sodium and water are lost in equal amounts from the
blood Isotonic dehydration
Hypovolemia
Causes
o Loss of volume – bleeding, severe burns
o Loss of sodium – excessive sweating, diarrhea, burns, excessive
diuretics, kidney failure
o Diuresis – Diabetes Insipidus, Addison’s disease, osmotic diuresis
o Decreased intake – deprivation, Alzheimer’s/dementia, unconscious
Ch 39-40 – Fluid, Electrolyte & Acid-Base Disorders
Ch 9 – Stress Adaptations
Ch 26-28 – Blood Disorders
Ch 15 – Immune Disorders
Ch 39-40 – Fluid, Electrolyte & Acid-Base Disorders
ADH, aldosterone, parathyroid hormone—regulated calcium
levels Anything to do with sodium potassium calcium
Intracellular fluid – fluid contains within a cell membrane (ICF)
Extracellular fluid – fluid outside of cell membranes (ECF)
Tissue fluid, interstitial fluid.
2/3rd is Inside cell
1/3rd is outside cell
Where is the water?
Transcellular fluid is fluid that is moving. 1 L
Gradients. Movement of fluid. Very important!
Aquaporins… without them we are Still permeable to fluid
Water is always moving in or out. Consistently moving.
Albumens are made by the liver
o Water magnets!
o Outward push with … , inward pull with osmosis.
Edema – expansion of interstitial fluid volume
Too much fluid …
Always a complication of a disease
process Terminology
o Pitting edema – interstitial fluid exceeds absorptive capacity of the tissue gel
o Nonpitting edema – plasma proteins have accumulated in the tissue
spaces and coagulated
o Effusion – movement of fluid out of blood vessels into the body cavities
o Anasarca – generalized body edema
Ex. Right sided heart failure
o Third space accumulation – ECF trapped in the transcellular spaces
o Ascites (hydroperitoneum) – excessive fluid in the peritoneal
cavity Ex. Liver failure—in abdominal cavity
, Really beginning to fail…
o Transudate – non-inflammatory edema that results from altered
hydrostatic or osmotic pressure of the blood
Contains less protein and cells than exudate
Causes fall into 4 general categories (arteriole = out)
o Increased capillary filtration pressure (increase in hydrostatic pressure)
Increased arterial pressure
Ex: hypertension
Decreased venous pressure
Ex: portal vein distention
Increased blood volume
Ex: heart failure
o Decreased capillary colloidal osmotic pressure
Inadequate plasma protein production
Ex: liver disease causing a lack of function. Not enough
albumens Abnormal loss of plasma proteins or amino acids
Ex:
o Increased capillary permeability
Ex:
o Obstruction of lymph flow
Ex:
Treatment
o Control or correct underlying cause
o Prevent tissue injury
o Diuretics – if ECF is increased
o Elevation of feet/compression stockings if lower extremities are
involved Socks for nurses! :)
o Intravenous albumin
o Light pressure massage
o Compression pumps
o Movement exercises
Disorders of Thirst
Hypodipsia – decreased ability to sense thirst
Hypothalamic lesions
o Lesions in your hypothalamus
o Sense of thirst regulated by
hypothalamus Elderly
True thirst with symptoms
, Inappropriate thirst despite normal serum levels
Compulsive water drinking (psychogenic polydipsia)
Increased (too much) angiotensin levels
Decreased salivary gland
function Anticholinergic drugs
Plasma volume is dropping drink more
water! ECF ~
If everything looks normal …
Activates RAS – trying to increase low blood pressure
Disorders of ADH (Vasopressin)
Diabetes Insipidus (NOTHING TO DO WITH GLUCOSE)
ADH deficiency or decreased responsiveness of
cells Polyuria (3-20L/day)…(2k at most normally!!!)
o No way to increase or decrease levels. Fixed rate.
o Paired with excessive thirst.
o Peeing will happen no matter what so they have to
Excessive thirst
Increased ADH
Can be transient or chronic
o Complication of cancer
Bronchogenic tumors, lung, lymphoid, prostate,
pancreas Causes dilutional hyponatremia
Disorders of Fluid Volume
Na draws water, excessive sweaty, depleting your fluid levels.
Fluid volume depletion (FVD) – results when fluid loss exceeds fluid intake
Sodium and water are lost in equal amounts from the
blood Isotonic dehydration
Hypovolemia
Causes
o Loss of volume – bleeding, severe burns
o Loss of sodium – excessive sweating, diarrhea, burns, excessive
diuretics, kidney failure
o Diuresis – Diabetes Insipidus, Addison’s disease, osmotic diuresis
o Decreased intake – deprivation, Alzheimer’s/dementia, unconscious
