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Pharmacology for Nurses

4.3 Maintaining Homeostasis

Pharmacology for Nurses4.3 Maintaining Homeostasis

Learning Outcomes

By the end of this section, you should be able to:

  • 4.3.1 Describe how the body maintains homeostasis.
  • 4.3.2 List factors that affect the body’s homeostasis.
  • 4.3.3 Discuss osmotic equilibrium and transient changes.

Most medical conditions can be attributed to a breakdown in the homeostatic control system, whether it is due to an inability to detect external changes, failure to initiate a feedback loop, inability to respond to or return to the set point, or failure in the set point itself. The primary objective of health care providers is to restore the body’s homeostasis to prevent cellular death and irreversible organ damage.

Maintaining Homeostasis

The human body maintains a state of internal balance, called homeostasis, that is regulated at the cellular level. Even when the external environment fluctuates, the body strives to keep this balance within a narrow range. However, a temporary transient change can occur before the body returns to a steady state. Changes in the extracellular or intracellular fluid compartments can occur due to internal or external factors and are crucial for maintaining a narrow range to prevent cell death, tissue damage, and organ dysfunction (Libretti & Puckett, 2023).

Factors Impacting Homeostasis

Disturbances in physiologic factors can have a significant impact on the body’s ability to maintain homeostasis. Such disturbances include:

  • Disruptions in energy and nutrient balance, such as those that cause fluctuations in glucose levels
  • Dysregulation of immune response modulators, such as pH and cortisol
  • Disturbances in fluid and electrolyte levels, particularly sodium, potassium, and calcium

These components play a critical role in maintaining homeostasis and are governed by a complex homeostatic mechanism called a feedback loop, which is discussed in more depth in a later section of this chapter.

Osmotic Equilibrium

Osmotic equilibrium occurs when the concentration of solutes on either side of a semipermeable membrane is equalized. It is achieved when the osmotic pressure of a solution is equal to the hydrostatic pressure on the solution. The force that causes the reabsorption of fluid from the interstitial fluid into the capillaries is known as osmotic pressure or oncotic pressure. Unlike hydrostatic pressure, which pushes fluid out of the capillaries, osmotic pressure pulls fluid back into them. This balance ensures that the optimal concentrations of electrolytes and nonelectrolytes are maintained in cells, body tissues, and interstitial fluid. Transient changes in the body, such as changes in temperature or pH, can disrupt the osmotic equilibrium, leading to a shift of water and solutes between intracellular and extracellular fluid compartments in an attempt to restore balance.

The Na+K+ATPase pump (also referred to as the sodium-potassium-ATPase pump) is an essential component in maintaining osmotic equilibrium (Pirahanchi et al., 2023). This pump moves sodium ions out of the cell and potassium ions into the cell, against their concentration gradients. This active transport process requires energy from adenosine 5-triphosphate (ATP), an energy molecule (Hoorm et al., 2020). Osmotic equilibrium is essential for maintaining proper functioning of cells and body tissues. Figure 4.5 illustrates the Na+K+ATPase pump and the method by which it allows for osmotic equilibrium.

Many sodium U-shaped potassium pumps are embedded in the cell membrane. Potassium is pumped into the cytoplasm and sodium is pumped out of the cytoplasm.
Figure 4.5 The Na+K+ATPase pump maintains osmotic equilibrium by moving sodium and potassium ions. (credit: modification of work from Anatomy and Physiology 2e. attribution: Copyright Rice University, OpenStax, under CC BY 4.0 license)

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