, 1
D027 – FB Study Guide Reorganized by Unit
**NOTE: You must be logged in to WGU portal for the Mini Lecture links to work. This study
guide is not a substitute for watching them—even the subjects where a screenshot of a topic is
shown. That was done because it helped anchor the memory better than just typing a list.
The page number in parentheses is the starting page number from McCance & Huether’s
Pathophysiology: The biologic basis for disease in adults and children (8th ed.). Elsevier. unless
otherwise noted. Do not depend on this study guide alone. Read the text along with the study
guide and then watch the mini lecture if one is provided.
Some subjects with an “ ** ” could not be located in the text or a Mini Lecture. Since this
is a culmination of many students’ contributions, it is assumed that it is in this guide because it
was mentioned on an exam.
This has been organized by unit so that a person could do the unit in this study guide and
then do the questions in the course material at the end of the unit and chapter quizzes and work
through it sequentially as it appears in the course material.
Unit 2 – Alterations in Homeostasis
Body Regulated or Non-Genetically Linked Disease
1. Aspiration more likely in right lung than left due to bronchus being straighter on that side. Left
bronchus curves more to left. (See Respiratory Mini Lecture)
2. Fluid Alterations (p. 110)
Effects of Alterations in
Extracellular Sodium
Concentration in RBCs, Body
Cells, and Neurons.
A. Hypotonic – Decrease
in ECF Na concentration
(hyponatremia) results in ICF
osmotic attraction of water with
swelling and potential busting of
cells.
B. Isotonic – Normal
concentration of Na in ECF and
no change in shifts of fluid in or
out of cells.
C. Hypertonic – An
increase in ECF Na
concentration (hypernatremia)
results in osmotic attraction of
water out of cells with cell
shrinkage.
, 2
**Hyper = lots of salt so water comes out of cells to compensate.
**Hypo = little salt so water goes into cell to compensate
a. Isotonic
i. Changes in total body weight (TBW) are accompanied by proportional changes
in electrolytes
ii. Osmolality remains in the normal range (280 – 294).
iii. Fluid ordered is usually 0.9 normal saline (0.9 NS).
b. Hypertonic
i. Changes in TBW accompanied by > 0.9 sodium in ECF or free water deficit
ii. Higher than normal osmolality (>294).
iii. Inverse effect on intracellular fluid (ICF). Cells shrink as water leaves ICF to go
to ECF.
iv. Clinical manifestations
1. Hypernatremia
2. Hyperchloremia (because chloride follows salt)
a. Plasma bicarbonate deficits (hyperchloremic metabolic acidosis)
3. Dehydration
4. Thirst, fever, decreased urine output, weakness, lethargy, muscle
twitching, hyperreflexia
5. In extreme cases, confusion, coma and seizures
v. Fluid ordered is usually D5 in water or 0.45 NS depending on serum electrolyte
and glucose values.
, 3
c. Hypotonic
i. Changes in TBW accompanied by < 0.9 sodium in ECF or free water excess
ii. Lower than normal osmolality (<280).
iii. Inverse effect on intracellular fluid (ICF). Cells swell as water enters ICF from
ECF.
iv. Clinical manifestations
1. Hyponatremia
2. Edema, irritability, depression, confusion
3. Weakness, anorexia, nausea, and diarrhea
v. Treat with Fluid restriction, monitor electrolytes and glucose.
vi. If hyponatremic without fluid overload, treat with 3% NS until serum NA is 130
and monitor for peripheral edema and distention of neck veins.
D027 – FB Study Guide Reorganized by Unit
**NOTE: You must be logged in to WGU portal for the Mini Lecture links to work. This study
guide is not a substitute for watching them—even the subjects where a screenshot of a topic is
shown. That was done because it helped anchor the memory better than just typing a list.
The page number in parentheses is the starting page number from McCance & Huether’s
Pathophysiology: The biologic basis for disease in adults and children (8th ed.). Elsevier. unless
otherwise noted. Do not depend on this study guide alone. Read the text along with the study
guide and then watch the mini lecture if one is provided.
Some subjects with an “ ** ” could not be located in the text or a Mini Lecture. Since this
is a culmination of many students’ contributions, it is assumed that it is in this guide because it
was mentioned on an exam.
This has been organized by unit so that a person could do the unit in this study guide and
then do the questions in the course material at the end of the unit and chapter quizzes and work
through it sequentially as it appears in the course material.
Unit 2 – Alterations in Homeostasis
Body Regulated or Non-Genetically Linked Disease
1. Aspiration more likely in right lung than left due to bronchus being straighter on that side. Left
bronchus curves more to left. (See Respiratory Mini Lecture)
2. Fluid Alterations (p. 110)
Effects of Alterations in
Extracellular Sodium
Concentration in RBCs, Body
Cells, and Neurons.
A. Hypotonic – Decrease
in ECF Na concentration
(hyponatremia) results in ICF
osmotic attraction of water with
swelling and potential busting of
cells.
B. Isotonic – Normal
concentration of Na in ECF and
no change in shifts of fluid in or
out of cells.
C. Hypertonic – An
increase in ECF Na
concentration (hypernatremia)
results in osmotic attraction of
water out of cells with cell
shrinkage.
, 2
**Hyper = lots of salt so water comes out of cells to compensate.
**Hypo = little salt so water goes into cell to compensate
a. Isotonic
i. Changes in total body weight (TBW) are accompanied by proportional changes
in electrolytes
ii. Osmolality remains in the normal range (280 – 294).
iii. Fluid ordered is usually 0.9 normal saline (0.9 NS).
b. Hypertonic
i. Changes in TBW accompanied by > 0.9 sodium in ECF or free water deficit
ii. Higher than normal osmolality (>294).
iii. Inverse effect on intracellular fluid (ICF). Cells shrink as water leaves ICF to go
to ECF.
iv. Clinical manifestations
1. Hypernatremia
2. Hyperchloremia (because chloride follows salt)
a. Plasma bicarbonate deficits (hyperchloremic metabolic acidosis)
3. Dehydration
4. Thirst, fever, decreased urine output, weakness, lethargy, muscle
twitching, hyperreflexia
5. In extreme cases, confusion, coma and seizures
v. Fluid ordered is usually D5 in water or 0.45 NS depending on serum electrolyte
and glucose values.
, 3
c. Hypotonic
i. Changes in TBW accompanied by < 0.9 sodium in ECF or free water excess
ii. Lower than normal osmolality (<280).
iii. Inverse effect on intracellular fluid (ICF). Cells swell as water enters ICF from
ECF.
iv. Clinical manifestations
1. Hyponatremia
2. Edema, irritability, depression, confusion
3. Weakness, anorexia, nausea, and diarrhea
v. Treat with Fluid restriction, monitor electrolytes and glucose.
vi. If hyponatremic without fluid overload, treat with 3% NS until serum NA is 130
and monitor for peripheral edema and distention of neck veins.
