Nursing328

• *Changes in pH can affect K+ balance
• -hydrogen ions move into cell as a result of acidosis and K+ moves out of cell to balance cations across membranes; results in HYPERKALEMIA
• *changes in aldesterone, insulin and epinephrine influence K+ levels
• *kidney also regulator

• *K+ level lower than 3.5
• *K+ balance is described in relation to plasma K+ level
• *causes- low K+ intake, too much K+ going inside cells, increased loss of K+

cardiac dysrhythmias, decreased neuromuscular excitability, skeletal muscle weakness, smooth muscle atony

• *potassium level higher than 5.5
• *rare condition due to good renal function
• *causes: high K+ intake, shift of K+ from ICF to ECF, decreased renal excretion, insulin deficiency, or cell trauma

• *increased neuromuscular irritability
• -restlessness, intestinal cramping, and diarrhea

• *Decreases the resting membrane potential
• -muscle weakness, poor muscle tone, and paralysis

Slow changes tolerated better than aute

• Low K+=t wave that shrinks
• high K+=t wave that gets bigger

• *they go hand in hand but opposite of each other
• *Controlled by: parathyroid hormone (PTH), vitaminD, and calcitocin

• *99% of calcium is located in the bones as hydroxyapatite
• *necessary for structure of bones and teeth, blood clotting, hormone secretion, cell receptor function, plasma membrane stability, transmission of nerve impulses, muscle contractions
• *serum concentration 8.8-10.5

• *Causes:
• -inadequate calcium intake
• -decreased PTH and vitaminD
• -nutritional deficiencies with inadequate eating dairy products or leafy greens
• *Effects:
• -increased neuromuscular excitability
• ---tingling, muscle spasm, intestinal cramping, hyperactive bowel sounds
• -severe cases show convulsions and tetany
• -

• Causes: excess vitaminD, tumor that promotes PTH release, hyperparathyroidism, bone metastases with calcium reabsorption in breast, prostate, renal, and cervical cancers
• effects: boen pain; osteoporosis, fatigue, weakness, lethargy, anorexia,nasea, constipation

• *Like calcium most phosphate is stored in bones
• *provides energy for muscle contraction
• *PTH, VitaminD3, and calcitonin controls levels
• * Normal value 2.5-5

• causes:vitaminD deficiency, long term alcohol abuse
• *malabsorption syndromes, increased renal excretion
• Effects:a lot of bad things,

• *Causes:acute or chronic renal failure, long term use of laxatives, hypoparathyroidism 
• *Effects:Symptoms related to low hypocalcemia, when prolong there is calcification of soft tissues in lungs, kidneys, joints

• *Intracellular cation
• *serum concentration 1.8-3
• *Acts as a cofactor in intracellular enzymatic reactions
• *increases neuromuscular excitability

• Causes: malnutrition, malabsorption syndromes, alcoholism, urinary loses
• Effects: irritability, behavioral changes, convulsions, hypotensions

• causes: renal insufficiency, intake of magnesium antacids, adrenal insufficiency
• Effects: skeletal and smooth muscle contraction, excess nerve function, loss of deep tendon reflex, nausea vomitting, muscle weakness, hypotension,respiratory distress

Carefully regulated to maintain normal pH where enzymes can function and carry out reactions

• *Negative logarithm of the H+ concentration
• *If the H+ is high in number= pH is low which is acidic
• *If H+ is low=pH is high and it is alkaline

• *Acids are formed as end products of protein, carb and fat metabolism
• *to maintain the body's normal pH (7.35-7.45) H+ needs to be excreted or neutralized
• *The bones, lungs, and kidneys are the major organs involved in the regulation of acid-base balance

• *Volatile: H2CO3 (Carboni acid) can be eliminated as CO2 gas
• *Non-volatile:sulfuric, phosphoric and other acids, eliminated by renal tubules with the regulation of HCO3-

• *A buffer is a chemical that can take a change in H+ ions without changing the bodies pH
• * Most important plasma-buffering systems is the carbonic acid-bicarbonate pair
• -h2co3-hco3

• *operate in the lungs and the kidneys
• *the greater the partial pressure of CO2, the more carbonic acid is formed
• -at a pH of 7.4 ratio bicarbonate to carbonic acid is 20:1
• -Bicarbonate and carbonic acid can increase bu the ration must be maintained

• *Respiratory system:by increasing ventilation and letting go of CO2 or by decreasing ventilation and retaining CO2
• *Renal system: by making urine more acidic or more alkaline

• *protein buffering (hemoglobin)
• -pretins are negatively charged which can help as buffers for H+
• *Renal Buffering
• -secretion of H+ in urine and reabsorption of carbonic ions HCO3-

• Normal arterial pH
• -7.35-7.45
• -obtained by arterial blood gas ABG
• Acidosis
• -systemic increase in H+ ions or decrease in bicarbonate acid concentration
• Alkalosis
• -systemic decrease in H+ ions or increase in bicarbonate acid concentration

*Increase in CO2 because of decreased ventilation

• Decrease in CO2 because an increase in ventilation
• *hyperventilating or panic attack

Depression of HCO3- or an increase in any non carbonic ions

Increase in HCO3- ions or decrease or excessive loss of metabolic acids