Montgomery Knolls ES ESOL Program MKES ESOL Night October 22, 2014.
M. GANDUL ATIK YULIANI, MKES., DRH. - s1.fkh.unair.ac.ids1.fkh.unair.ac.id/images/PPT/Body...
Transcript of M. GANDUL ATIK YULIANI, MKES., DRH. - s1.fkh.unair.ac.ids1.fkh.unair.ac.id/images/PPT/Body...
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M. GANDUL ATIK YULIANI, MKES., DRH.
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LIQUID BODY, ELECTROLYTE
AND BASE ACID BALANCE
I. BALANCE OF WATER AND ELECTROLYTE
II. CONDAYS
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THE BALANCE OF WATER AND
ELECTROLYTES
BODY LIQUID PHYSIOLOGY AND EQUIPMENT BALANCE
BODY LIQUID COMPARTMENT
SYSTEM OF BODY LIQUIDS AND ELECTROLYTE
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BODY LIQUID PHYSIOLOGY AND
EQUIPMENT BALANCE
ELECTROLYTE: SUBSTANCE OF POSITIVE OR NEGATIVE IN A LIQUID SOLUTION.
CATION: POSITIVE POWERFUL ELECTRICITY
K+, Na+, Ca++, Mg++
ANION: NEGATIVE POWERFUL ELECTROLYTE
Cl-, HCO3-, PROT, AS. ORG, HPO4-, SO4-
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BODY FLUIDS
TOTAL LIQUID BODY INFLUENCE BY:
• FAT NETS
• GENDER
• AGE
• SPECIES
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USE OF BODY LIQUID
AS MEDIUM REACTION IN THE BODY
EXCHANGE OF CELL AND OUTSIDE
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BODY LIQUID COMPARTMENT
60% BW CONSIST OF WATER
EXAMPLE:
HORSE BB 500 KG 300L
DOG BW 20 KG 20 L
BODY LIQUID IS ENDED:
INTRA CELLULAR (CIS) 40% BB
EXTRA CELLULAR (CES) 20% BB
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EXTRA CELLULAR LIQUIDS
INTERTITIAL LIQUID 15% BB
INTRA VASCULAR LIQUIDS (PLASMA) 5% BB
LIQUID TRANS-CELLULAR LIQUID GASTROINTESTINAL DUCT
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ELECTROLY CONTENT
KATION ANION
CIS K+, Mg++, Na+ HPO4-, PROT-.,
HCO3-, Cl-
CES Na+, Ca++, K+,
Mg++
Cl-, HCO3-,
PROT-, As.Org-,
HPO4-, SO4-
C.INTRAVASK Na+, Ca++, K+,
Mg++
Cl-, HCO3-,
PROT-, As.Org-,
HPO4-, SO4-
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BODY LICENSE BALANCE
IN OUT
Sensible Gain:
Drinks
Food
Insensible Gain:
Metabolism
Sensible Loss:
• Urine
• Feces
Insensible Loss:
• Respiratory
• Sweat
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SYSTEM OF BODY LIQUIDS
AND ELECTROLYTE
1. THERMOREGULATOR
(HIPOTHALAMUS)
AND SECRETION VASOPRESIN.
2. HORMONAL
HORMON ANTIDIURETIK (ADH)
ALDOSTERON
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DISORDERS OF LIGHT
BALANCE
A. INTERRUPTION VOLUME
B. OSMOLARITAS DISORDERS
C. COMPOSITION DISORDERS
D. DISTRIBUTION DISORDERS
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OSMOLALITAS DAN
OSMOLARITAS
OSMOL(OSM) : OSMOTIC UNIT ACTIVITY
OSMOLARITAS IS THE TOTAL NUMBER OF
OSMOL PER LITER SOLUTION
OSMOLALITAS IS THE TOTAL NUMBER OF
OSMOL PER KILOGRAM WATER
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OSMOLALITAS AND
OSMOLARITAS
ISOSMOTIK: its osmolarity is equal to
body fluids.
NaCl 0.9%, Glucose 5%, Urea 1.74%
ISOTONIK: its osmolarity is same with liquid
body and can maintain body cell volume.
NaCl 0.9%, Glucose 5%.
HYPOTHOTICS: osmolaritas lar <body fluids
NaCl 0.45%
HYPERTONIC: lar osmolaritasnya> body fluids
NaCl 1.5%
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INTERRUPTION VOLUME
AND OSMOLARITYEspecially at CES, divided into:
1. Dehydration Volume
* Isotonic: diarrhea, vomiting, blood loss,
Burns.
water deficiency and NaCl.
* Hypotonic: excessive sweating.
Na deficiency
* Hypertonic: Diabetes Mellitus polyuria
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INTERRUPTION VOLUME
AND OSMOLARITY
2. Overhydration / Hyperhydration:
Isotonic: Oedema
Hypotonic: excessive amount of water
giving free electrolyte infusion
Hypertonic: Na extracellular >>; because of
adrenal cortex hyperfunction
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COMPOSITION DISORDERS
Occurs when there is / concentration of
one or several kinds of electrolytes in the
body fluids. Ex:
K - Hipokalemi
K - Hiperkalemi
Na - Hypernatremia
Gluc - Hypoglycemia
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DISTRIBUTION DISORDERS
Stockpiling of Liquids at:
A. Pulmonary membrane Hydrothorax
B. lining Ascites Abdominal
C. Jar. Certain Udema
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BALANCE ACID-BASES
Hydrogen ion concentration (H +) at CES
± 40 nmol / L, pH 7.4 (7.35-7.45)
Enzymatic reactions need optimum pH
Perub. The concentration of H + ions affects
the biological processes and metabolism in
the body
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DEFINITION pH
pH is a negative logarithm of the hydrogen ion concentration.
pH = - log[H+]
When the blood hydrogen concentration increases then the pH goes down acidosis
When the blood hydrogen concentration falls then the pH rises alkalosis
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ACID BASIC SETTINGS
1. BUFFER SYSTEM (BUFFER)
2. RESPECT SYSTEM
3. KIDNEY
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RESERVATION SYSTEM
Fast work serves to capture or release H + so that it can minimize the concentration of hydrogen ions.
Body buffer capacity includes:
* Extracellular buffer: bicarbonate buffer and phosphate
* Intracellular buffering: proteins, organic and inorganic phosphates and in Hb.
* Bone: buffer storage area.
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BIKARBONAT DISTRIBUTOR
SYSTEMSimilar buffers are most effective because of large enough quantities.
CO2+H2O H2CO3 H+ + HCO3
The Henderson-Hasselbalch Equation:
pH= pK +log [A-]
[HA]
For bikarbonat :
pH= 6,1 + log [HCO3-]
[H2CO3]
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RESPIRATORY SYSTEM
• The function regulates the discharge of Co2 gas
through the lungs.
• CO2 breath fast (hyperventilation)
• CO2 slow breath (hypoventilation)
• Respiratory frequency increased due to:
• * pCO2 increases
• * blood pH down
• * pO2 decreases
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RESPIRATORY SYSTEM
The Henderson-Hasselbalch Equation:
pH = 6,1 + log [HCO3- ]
0,03xpCO2
Information :
0.03 = solubility factor of CO2 in plasma
pCO2 = tek. Partial gas CO2 (= 40 mmHg)
HCO3 = 24 mEq / L
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GINJAL
Fungsi : meningkatkan ekskresi H+ dan
mengatur reabsorbsi HCO3 Plasma.
Ada 2 mekanisme :
1. Pertukaran H+ dengan Na+.
2. Pertukaran NH4+ dengan Na+.
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INTERFERENCE BALANCE
BALANCE
Causative factor :
1. Impaired respiratory function.
2. Impaired kidney function.
3. Abnormal acid-base addition.
4. Abnormal acid-base loss.
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PEM. ACID-BASIS
INTERFERENCE LABORATORY
* Sample: ARTERI BLOOD
* Anticoagulants: HEPARIN
* Tool: BLOOD GAS ANALIZER
* Parameters:
-blood pH, normal: 7.4
-pC02, normal: 40 mmHg
-HCO3, normal: 24 mEq / L
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HOW TO INTERPRETATION
The Henderson-Hasselbalch Equation:pH =
6,1 + log [HCO3-]
0,03xpCO2
pCO2 = its value is only changed by
Respiratory Factor (Respiratorik)
[HCO3] = its value is changed not because
of the Respiratory Factor (Metabolic).
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COMPENSATION
* Compensation is due to the increase
the function of controlling organs to try
returns the pH of body fluids to the pH
normal .
* Compensation is done by:
- Respiratory
- Kidney
* Light Compensated
heavy Uncompensated
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ASIDOSIS METABOLIK
* Indicated by a decrease in pH and
bicarbonate (pH <7.4; HCO3)
* Cause:
- Lactic acidosis, ketoacidosis. - Diarrhea
-Pharmaceuticals: salicylate, methanol, - Kidney failure
ethylene glycol, and paraldehyde.
COMPENSATION:
* Response of respiratory compensation with increased ventilation and decreased pCO2
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ASIDOSIS RESPIRATORIK
* Indicated by a decrease in pH and
increased pCO2 (pH <7.4; pCO2)
* Cause: decreased effectiveness of alveolar ventilation due to:
- upper bag breath obstruction, pneumonia, pneumothorax and chronic lung obstruction.
- CNS medications eg for anesthesia and sedatives.
* COMPENSATION:
The compensatory response to renal bicarbonate retention (HCO3)
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ALKALOSIS METABOLIK
* Indicated by increased pH and
bicarbonate (pH> 7.4; HCO3)
* Cause:
-Loss of excessive H + ions due to vomit; use of mineralocorticoids and diuretics.
-Recency of bicarbonate due to renal failure
-Calcalation contraction
COMPENSATION:
* Respiratory response with hypo-ventilation and increased pCO2
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ALKALOSIS RESPIRATORIK
* Indicated by increasing pH and decreasing pCO2 (pH> 7.4; pCO2 )
* Cause: Hyperventilation due to hypoxia due
- pulmonary and cardiac disease (CHF).
disturbance at the center of the breath due to salicylate intoxication and infection with gram-negative bacteria.
psychological-psychological
COMPENSATION:
* Response compensation with decreased bicarbonate through resistance of renal bicarbonate reabsorbtion (HCO3 )
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RANGKUMAN
INTERRU
PTION
pH PRIMARY
DISORDERS
COMPENSION
RESPONSES.
Asidosis
Metabolik
HCO3- pCO2
Alkalosis
Metabolik
HCO3- pCO2
Asidosis
Respiratorik
pCO2 HCO3-
Alkalosis
Respiratorik
pCO2 HCO3-