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what percent of body weight is water in adults? 50-60
what percent of body weight is water in older adults? 45-55
what percent of body weight is water in infants? 70-80
fluid water that contains dissolved or suspended substances such as glucose, mineral salts and proteins
fluid amount volume
fluid concentration osmolality
degree of acidity pH
Intracellular Fluid (ICF) fluids WITHIN cells 2/3 of total body water
Extracellular Fluid (ECF) Fluid OUTSIDE of cells 1/3 of total body water
What are the 3 divisions of Extracellular fluid? Interstitial, Intravascular, Transcellular
Interstitial extracellular fluid between cells and outside of the blood vessels (surrounding cells)
Intravascular extracellular fluid Liquid portion of the blood (plasma)
Transcellular extracellular fluid secreted by epithelial cells (cerebrospinal, pleural, peritoneal and synovial fluids)
Electrolytes (mineral salts) Compounds that seperate into ions (charged particles) when they dissolve in water
Ions (charged particles)- 2 types Cations and Anions
Cations Positively charged- in body fluids: Na+, K+, Ca++,Mg
Anions Negatively charged: Cl-, HCO3
Measurement of electrolytes- international standards mmol/L
Measurement of electrolytes- U.S. mEq
Electrolyte composition: ICF prevalent cation and anion cation: K+, Anion: PO43-
Electrolyte composition: ECF prevalent cation and anion cation: Na+, Anion: Cl-
Active transport Movement of ions against osmotic pressure to an area of higher pressure; requires energy
Diffusion Passive movement of electrolytes or other patricles down the concentration gradient (from highter to lower concentration)
Osmosis Movement of water (or other solute) from an area of lesser to one of greater concentrate
Filtration Movement across a membrane, under pressure from higher to lower pressure
Fluid balance consitst of fluid intake and absorption, fluid distribution, fluid output
Fluid intake drinking and foods, 2300mL, thirst and habit
fluid distribution movement of fluid among its various compartments
fluid output normally via skin, lungs, GI tract, kidneys- abornmally via vomiting, wound drainage, hemorrhage
Fluid output is influenced by ADH, Renin-Angiotensin-Aldosterone System (RAAS), Atrial natriuretic peptides (ANPs)
Normal Sodium level 135-145 mEq/L
Normal Potassium level 3.5-5.0 mEq/L
Normal Chloride level 96-106 mEq/L
Normal Magnesium level 1.5-2.5 mEq/L
Extracellular fluid volume (ECV) deficit Hypovolemia means decreased vascular volume and often is used when discussing ECV deficit
Hypernatremia "water deficit" hypertonic
Hyponatremia "water excess"; hypotonic
Clinical dehydration =ECV deficit and hypernatremia combined
Hypernatremia (Na+ level greater than 145mEq/L)- S/S Extreme thirst, dry and flushed skin, postural hypotension, fever, restlessness, confusion, agitation, seizures if developes rapidly/very severe
Hyponatremia (Na+ level less than 135mEq/L)- S/S Apprehension, nausea and vomiting, headaches, decreased LOC, confusion, lethargy, muscle weakness coma, seizures if develops rapidly/severe
Intake and absorption distribution Plasma concentrations of K+,Ca2+,Mg+ and phosphate (Pi) are very low compared with their concentrations in cells and bone
Why are concentration differences neccessary? For normal muscle and nerve function
Why is Potassium important? Assists in controlling cardiac rate and rhythm, skeletal muscle concentration and function of smooth muscles
Why is Calcium important? Neccessary for muscle contraction
Why is Magnesium unportant? Plays a role in the fundamental enzymatic reactions
Electrolyte imbalances: Potassium (K+) 2 examples and values Hypokalemia (Less than 3.5 mEq/L), Hyperkalemia (Greater than 5.0 mEq/L)
Electrolyte imbalances: Calcium (Ca2+) 2 examples and values Hypocalcemia (Less than 8.4mh.dL), Hypercalcemia (Greater than 10.5mg/dL)
Electrolyte imbalances: Magnesium (Mg2+) 2 examples and values Hypomagnesium (Less than 1.5 mEq/L), Hypermagnesium (Greater than 2.5 mEq/L)
Hyperkalemeia S/S Muscle weakness, Cardiac dysrhythmias, Cardiac Arrest
Hypokalemeia S/S Muscle weakness, life threatening if includes resp muscle, cardiac dysrhythmias, abdominal distention, decreased bowel sounds, constipation
Sources of Potassium Bananas and oranges, potatoes, instant coffee, brazil nuts, salt substitutes, potassium meds, stored blood
Hypercalcemia S/S Anorexia, N/V, constipation, fatigue, lethargy, decreased LOC, confusion, peronality changes, cardiac dysrhythmias, pathological fractures (shifts from bone to ECF)
Hypocalcemia S/S Positive Chvostek's sign,numbness & tingling of the fingers and circumoral region, hyperactive reflexes, muscle twitching and cramping, tetany, seizures, laryngospasm, cardiac dysrhythmias
Sources of Calcium Dairy products, canned fish with bones, broccoli, oranges, requires vitamin D for best absorption, "tums"
Hypermagnesemia S/S Lethargy, Hypoactive deep tendon reflexes, Bradycardia, Hypotension, flushing, sensation of of warmth, severe- flaccid muscle paralysis, decreased rate & depth of resps, cardiac dysrhythmias, cardiac arrest
Hypomagnesemia Positive Chvostek's and Trousseau's signs, hyperactive deep tendon reflexes, insomnia, muscle cramps & twitching, dysphagia, tachycardia, HTN, tetany, seizures, cardiac dysrthyhmias
Sources of Magnesium dark green leafy vegetables, whole grains, Mg2+ containing laxatives and antacids
Risk factors for fluid and electrolyte imbalances Age, Environment, GI output, Chronic disease, Trauma, Therapies, Lifestyle, Dietary intake
I&O Includes Intake includes all liquids eaten, drunk or received through IV; Output includes: urine, diarrhea, vomitus, gastric suction, wound drainage (accurate measurements)
Normal value for Total Calcium 8.6-10.2mg/dL
Created by: aeponton
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