| How is the anatomy of body fluids? | . |
| How is the ion distribution in different fluid compartments of the body? | . |
| How is water and electrolyte loss in the body normally? | . |
| How are changes in water and electrolytes in different situitations? | Water exchange normally individuals consume 2-2.5 L/Day
Loss (250 ml in stool, 0.8-1.5 L in urine and 600 ml insensible loss as sweat and lung vapor)
Fever increases loss at 250ml/degree/day
Sweat is hypotonic solution, insensible water loss is pure water, GI loss are usually isotonic or slightly hypotonic. |
| What are volume disorders? | . |
| What are sodium disturbances? | Cause CNS devastating consequences, in both hypo or hypernatremia total body Na+ may be increased or decreased, normal natremia is 135-145 mmol/L |
| Table of hypo and hypernatermia? | . |
| What are potassium disturbances? | . |
| Table of hypo and hyperkalemia? | . |
| What are magnesium disturbances? | Binds ATP
Required in: DNA transcription and translation ,nerve conduction , Ion transport and Ca2+ channel activity
Approximately 50%-60% of total body magnesium is found in the bones
Absorbed by the gut
At high concetration Mg2+ acts as a Ca2+ antagonist blocking calcium channels |
| Table of hypo and hyper Mg? | . |
| What are calcium disturbances? | Maintains bone strength
Ca2+ homeostasis is influenced by vitamin D,parathyroid hormone, calcitonin, acid-base balance, and PO4 3− homeostasis
Total serum ca2+: 50% bound to albumin + 50% ionized
Alkalosis promotes the binding of calcium to albumin. |
| Table of hypo and hypercalcemia? | . |
| What are phosphate disturbances? | Like Ca2+ and Mg2+, the majority of PO43− is found in the skeleton.
The large majority of the remainder is found intracellularly, where it functions as a constituent of ATP.
Like Mg2+, it is essential to energy metabolism |
| Table of hypo and hyperphosphatemia? | . |
| What are the phases of post-surgery/trauma/sepsis water and electrolyte disturbances? | Catabolic, early anabolic and late anabolic |
| What is the catabolic phase? | AKA adrenergic-corticoid phase, 1-3 days post surgery/trauma, or immediately after
Sudden increase in metabolic demand and urinary excretion of nitrogen (azote) |
| What is the early anabolic phase? | AKA corticoid withdrawal phase, between day 3-8 after uncomplicated elective surgery or weeks inpatient
Lasts no more than a day or two coincides with diuresis of retained water.
Sharp increase in nitrogen excretion
Nitrogen balance is positive indicating synthesis of protein (gain in weight) |
| What is the late anabolic phase? | Final period of convalescence, lasts weeks-months after injury
Gradual restoration of adipose tissue. |
