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A. Fluid
a. Accounts for about 60% of adult’s total body weight
b. ICF is 2/3 of this amount while ECF is 1/3 of this amount
c. ECF – intravascular space (fluid within blood vessels), interstitial
space (fluid that surrounds the cell) and transcellular fluid
(digestive juices, water and solutes in the renal tubules and
bladder, pleural fluid
d. 3rd space fluid shift – loss of ECF into a space that does not
contribute to equilibrium between the ICF and ECF
e. Body water distribution according to age:
i. Infant – 80% of body weight
ii. Male – 60% of body weight
iii. Female – 50% of body weight
B. Electrolytes
a. Substance that dissociates and forms ions when mixed with
water
b. ICF – K and PO4 are major electrolytes
c. ECF – Na and Cl are major electrolytes; Na level is the primary
determinant of ECF concentration
d. Normal Values:
i. Na – 135-145 mEq/L
ii. K – 3.5-5.5 mEq/L
iii. Ca – 4.5-5.5 mEq/L
iv. HPO4 – 1.7-2.6 mEq?L
v. Cl – 98-108 mEq/L
vi. Mg – 1.5-2.5 mEq/L
C. Acid-Base Balance
a. Acid – substance that ionizes water and forms H+ ions and
anions; hydrogen donor
b. Base – substance that can bind to hydrogen ions; hydrogen
acceptor
c. pH – hydrogen ion concentration in the blood; the more the
hydrogen, the more acidic is the medium, the lower its pH.
Normal pH: 7.35-7.45
D. Regulatory Mechanisms
a. Osmosis – fluid shifting from an area of low solute concentration
to an area of higher solute concentration
b. Diffusion – fluid movement from an area of high solute
concentration to one of lower solute concentrations
c. Filtration – removal of particles from a solution through the
movement of fluid across a membrane or other partial barrier
d. Active transport – energy-requiring process that transport ions
across the cell membrane against a concentration gradient
↓ Na
F. Homeostatic mechanisms
a. Kidneys
i. Filters 170 L of plasma daily
ii. Reabsorbs HCO3 and secrete H+ and produce NH3
iii. Slower than the lungs; takes days to achieve homeostasis
b. Cardiovascular system
i. Normal ABG values:
1. pH – 7.35-7.45
2. PO2 – 80-100 mmHg
3. PCO2 – 35-45 mmHg
4. HCO2 – 22-26 mEq/L
c. Lungs
i. Controls CO2 and H2CO3 excretion
ii. PCO2 – most powerful respiratory stimulant
d. Buffer systems
i. Chemical systems that maintain body pH by releasing H
ions
ii. HCO3 and H2CO3 – primary buffer system; 20:1 ratio
iii. HCO3 – regulated by kidneys
iv. H2CO3 – regulated by lungs
v. Phosphate and protein buffers – less important
e. Endocrine
i. ADH – secreted by pituitary gland
ii. Aldosterone – adrenal cortex; causes sodium retention and
potassium loss
iii. Parathormone – regulates calcium and phosphate balance
ABNORMALITIES