Ch. 26 Fluid, Electrolyte, and Acid-Base Balance
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- Body water content is greatest in a. infants, b. young adults, c. elderly adults.
Problem 1
- Potassium, magnesium, and phosphate ions are the predominant electrolytes in a. plasma, b. interstitial fluid, c. intracellular fluid.
Problem 2
- Sodium balance is regulated primarily by control of amount(s) a. ingested, b. excreted in urine, c. lost in perspiration, d. lost in feces.
Problem 3
- Water balance is regulated by control of amount(s) (use choices in question 3). a. ingested, b. excreted in urine, c. lost in perspiration, d. lost in feces.
Problem 4
- Answer questions 5 through 10 by choosing responses from the following: a. ammonium ions b. bicarbonate c. calcium d. chloride e. hydrogen ions f. magnesium g. phosphate h. potassium i. sodium j. water Two main substances regulated by the influence of aldosterone on the kidney tubules.
Problem 5
- Answer questions 5 through 10 by choosing responses from the following: a. ammonium ions b. bicarbonate c. calcium d. chloride e. hydrogen ions f. magnesium g. phosphate h. potassium i. sodium j. water Two substances regulated by parathyroid hormone.
Problem 6
- Answer questions 5 through 10 by choosing responses from the following: a. ammonium ions b. bicarbonate c. calcium d. chloride e. hydrogen ions f. magnesium g. phosphate h. potassium i. sodium j. water Two substances secreted into the proximal convoluted tubules in exchange for sodium ions.
Problem 7
- Answer questions 5 through 10 by choosing responses from the following: a. ammonium ions b. bicarbonate c. calcium d. chloride e. hydrogen ions f. magnesium g. phosphate h. potassium i. sodium j. water Part of an important chemical buffer system in plasma.
Problem 8
- Answer questions 5 through 10 by choosing responses from the following: a. ammonium ions b. bicarbonate c. calcium d. chloride e. hydrogen ions f. magnesium g. phosphate h. potassium i. sodium j. water Two ions produced during catabolism of glutamine.
Problem 9
- Answer questions 5 through 10 by choosing responses from the following: a. ammonium ions b. bicarbonate c. calcium d. chloride e. hydrogen ions f. magnesium g. phosphate h. potassium i. sodium j. water Substance regulated by ADH's effects on the renal tubules.
Problem 10
- Which of the following factors will enhance ADH release? a. increase in ECF volume, b. decrease in ECF volume, c. decrease in ECF osmolality, d. increase in ECF osmolality.
Problem 11
- In an individual with metabolic acidosis, a clue that the respiratory system is compensating is provided by a. high blood bicarbonate levels, b. low blood bicarbonate levels, c. rapid, deep breathing, d. slow, shallow breathing.
Problem 12
- Name the body fluid compartments, noting their locations and the approximate fluid volume in each.
Problem 13
- Describe the thirst mechanism, indicating how it is triggered and terminated.
Problem 14
- Explain why and how ECF osmolality is maintained.
Problem 15
- Explain why and how total body sodium content, ECF volume, and blood pressure are jointly regulated.
Problem 16
- Describe the role of the respiratory system in controlling acid-base balance.
Problem 17
- Explain how the chemical buffer systems resist changes in pH.
Problem 18
- Explain the relationship of the following to renal secretion and excretion of hydrogen ions: a. plasma carbon dioxide levels, b. phosphate, and c. sodium bicarbonate reabsorption.
Problem 19
- Mr. Jessup, a 55-year-old man, is operated on for a cerebral tumor. About a month later, he appears at his physician's office complaining of excessive thirst. He claims to have been drinking about 20 liters of water daily for the past week and says he has been voiding nearly continuously. A urine sample is collected and its specific gravity is reported as 1.001. What is your diagnosis of Mr. Jessup's problem? What connection might exist between his previous surgery and his present problem?
Problem 20
- For each of the following sets of blood values, name the acid-base imbalance (acidosis or alkalosis), determine its cause (metabolic or respiratory), decide whether the condition is being compensated, and cite at least one possible cause of the imbalance. Problem 1: pH 7.63; Pco₂ 19 mm Hg; Hco₃⁻ 19.5 mEq/L Problem 2: pH 7.22; Pco₂ 30 mm Hg; Hco₃⁻ 12.0 mEq/L
Problem 21
- Explain how emphysema and congestive heart failure can lead to acid-base imbalance.
Problem 22
- Mrs. Bush, a 70-year-old woman, is admitted to the hospital. Her history states that she has been suffering from diarrhea for three weeks. On admission, she complains of severe fatigue and muscle weakness. A blood chemistry study yields the following information: Na⁺ 142 mEq/L; K⁺ 1.5 mEq/L; Cl ⁻ 92 mEq/L; Pco₂ 32 mm Hg. Which electrolytes are within normal limits? Which are so abnormal that the patient has a medical emergency? Which of the following represents the greatest danger to Mrs. Bush? a. a fall due to her muscular weakness, b. edema, c. cardiac arrhythmia and cardiac arrest.
Problem 23
- During a routine medical checkup, Shelby, a 26-year-old physiotherapy student, is surprised to hear that her blood pressure is 180/110. She also has a rumbling systolic and diastolic abdominal bruit (murmur) that is loudest at the mid-epigastric area. Her physician suspects renal artery stenosis (narrowing). She orders an abdominal ultrasound and renal artery arteriography, which confirm that Shelby has a small right kidney and the distal part of her right renal artery is narrowed by more than 70%. Her physician prescribes diuretics and calcium channel blockers as temporary measures, and refers Shelby to a cardiovascular surgeon. Explain the connection between Shelby's renal artery stenosis and her hypertension. Why is her right kidney smaller than her left? What would you expect Shelby's blood levels of K⁺, Na⁺, aldosterone, angiotensin II, and renin to be?
Problem 24
