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Mary, a nursing student, has been caring for burn patients. She notices that they consistently show elevated levels of potassium in their urine and wonders why. What would you tell her?
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Ch. 27 Fluids & Electrolytes
Martini, Nath, Bartholomew12th EditionFundamentals of Anatomy & PhysiologyISBN: 9780137854011
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TOC.tableOfContents
- Ch. 1 An Introduction to Anatomy and Physiology25
- Ch. 2 The Chemical Level of Organization34
- Ch. 3 The Cellular Level of Organization29
- Ch. 4 The Tissue Level of Organization24
- Ch. 5 The Integumentary System17
- Ch. 6 Bones and Bone Structure33
- Ch. 7 The Axial Skeleton11
- Ch. 8 The Appendicular Skeleton17
- Ch. 9 Joints13
- Ch. 10 Muscle Tissue12
- Ch. 11 The Muscular System28
- Ch. 12 Nervous Tissue18
- Ch. 13 The Spinal Cord, Spinal Nerves, and Spinal Reflexes22
- Ch. 14 The Brain and Cranial Nerves20
- Ch. 15 Sensory Pathways and the Somatic Nervous System17
- Ch. 16 The Autonomic Nervous System and Higher-Order Functions30
- Ch. 17 The Special Senses15
- Ch. 18 The Endocrine System21
- Ch. 19 Blood31
- Ch. 20 The Heart31
- Ch. 21 Blood Vessels and Circulation26
- Ch. 22 The Lymphatic System and Immunity25
- Ch. 23 The Respiratory System4
- Ch. 24 The Digestive System18
- Ch. 26 The Urinary System31
- Ch. 27 Fluids & Electrolytes30
- Ch. 28 The Reproductive System12
- Ch. 29 Development and Inheritance17
Martini, Nath, Bartholomew12th EditionFundamentals of Anatomy & PhysiologyISBN: 9780137854011Non è quello che usi tu?Cambia libro di testo
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Martini, Nath, Bartholomew 12th EditionCh. 27 Fluids & ElectrolytesProblema 30
Martini, Nath, Bartholomew 12th EditionCh. 27 Fluids & ElectrolytesProblema 30Capitolo 26, Problema 30
Yuka is dehydrated, so her physician prescribes intravenous fluids. The attending nurse becomes distracted and erroneously gives Yuka a hypertonic glucose solution instead of normal saline. What effect will this mistake have on Yuka’s plasma ADH levels and urine volume?
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Step 1: Understand the difference between isotonic, hypertonic, and hypotonic solutions. A hypertonic glucose solution has a higher solute concentration than normal plasma, which will affect water movement across cell membranes.
Step 2: Recall that plasma ADH (antidiuretic hormone) levels increase when the body senses dehydration or increased plasma osmolality, promoting water reabsorption in the kidneys to conserve water.
Step 3: Consider that administering a hypertonic glucose solution will increase plasma osmolality, causing water to move out of cells into the extracellular fluid, which the body interprets as dehydration.
Step 4: Predict that the increased plasma osmolality will stimulate the hypothalamus to increase ADH secretion, leading to increased water reabsorption in the kidneys and thus a decrease in urine volume.
Step 5: Summarize that the erroneous hypertonic glucose infusion will raise plasma ADH levels and reduce urine volume as the body attempts to conserve water and restore osmotic balance.
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Osmolarity and Tonicity of Intravenous Fluids
Osmolarity refers to the concentration of solutes in a solution, affecting water movement across cell membranes. Normal saline is isotonic, matching plasma osmolarity, while a hypertonic glucose solution has higher osmolarity, drawing water out of cells into the bloodstream. Understanding these differences is crucial to predict fluid shifts and their physiological effects.
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07:59
Osmosis and Osmolarity
Role of Antidiuretic Hormone (ADH) in Fluid Balance
ADH regulates water retention by increasing water reabsorption in the kidneys, thus concentrating urine and reducing urine volume. Its secretion is stimulated by increased plasma osmolarity or decreased blood volume. Changes in plasma osmolarity due to fluid administration directly influence ADH levels to maintain homeostasis.
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Effects of Hypertonic Solutions on Plasma Osmolarity and Urine Output
Administering a hypertonic solution raises plasma osmolarity, causing cells to lose water and plasma volume to increase osmolality. This triggers ADH release to conserve water, leading to decreased urine volume. Recognizing this mechanism explains how the incorrect fluid affects Yuka’s ADH secretion and urine production.
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Domanda del libro di testo
Dan has been lost in the desert for 2 days with very little water. As a result of this exposure, you would expect to observe which of the following?
(a) Increased ADH levels
(b) Decreased blood osmolarity
(c) Normal urine production
(d) Increased blood volume
(e) Cells enlarged with fluid
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Domanda del libro di testo
While visiting a foreign country, Milly inadvertently drinks some water, even though she had been advised not to. She contracts an intestinal disease that causes severe diarrhea. How would you expect her condition to affect her blood pH, urine pH, and pattern of ventilation?
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Domanda del libro di testo
Refer to the diagnostic flowchart in Spotlight Figure 27–18. Use information from the blood test results in the accompanying table to categorize the suspected acid-base disorders of the patients represented in the table.
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