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Fluid and Electrolyt

fluid imblances

ICF 2/3 of water in an adult, provides a medium for chemical functions, and the major cation is K
ECF comprises the other 1/3 of total body water;consists of interstitial and intravascular fluid(plasma), provides a transport system to and from cells and maintains BV, major cation is Na, as well as electrolytes Cl- and HCO3(bicarbonate)
Blood osmolality changes & ADH(antidiurectic hormone) Increase osmolarity(resulting in concentrated >HCT>HGB>BUN) will trigger release of ADH. ADH will reduce urine output by kidneys, increasing permeablily of H2O; osmolality increases
hydrostatic pressure the pressure blood exerts against vessels; water pushing pressure
osmotic pressure pressure exerted by an increased concentration of solutes in a compartment; water pulling pressure
hypertonic solution used to tx. edema & 3rd spacing;solutions are used to replace electrolytes and shift fluids from the ICF to ECF; cell decreases in size because salt sucks; D10,D5NS,D51/2NS,D5RL(55dextros in ringers lactated)
hypotonic solution used to tx burns and dehydration; solutions cause fluid to shift from the ECF into the ICF;more solutes inside cell; cell increases in size;1/2NS;1/3NS;1/4NS
isotonic solution expands vol. of blood; prevents osmolality changes.equal solutes on each side; no cellular changes; Osmolarity btwn 270-300; D5W, D5WNS, LR(lactated Ringers) are only solution that has electrolytes.
thirst an increase in serum osmolality causing osmoreceptors to shrink; 0.5% of body water has been lost
FVD isotonic loss of H2O and Lytes; Refered to as Hypovelmia; Cx by hemorrhage, N/V, diarrhea, Burns, and third spacing. S/S dry lips & mucusa Fluid intake is less than Output; weak/rapid pulse, orthostatic hypotension
FVE Body retains both H2O & Na+; refered to as Hypervolemia; cx. intake of rapid NaCl infusion; exess NA in diet; CHF; Renal failure; S/S JVD, rales, SOB, fully tachycardia, B/P high, Fluid intake >output, moist mocusa.
Dehydration water is lost without lyte changes; Na remains, this increase serum osmolality.
hypotonic excess water volume excess or water intoxication; caused by tap water enemas, wound irrigations, NG tube irrigations, SIADH. S/S mental status changes
edema an increase in capillary fluid pressure, a decrease in capillary colloid osmotic pressure, an increase in the interstitial colloidal osmotic pressure, an increase in capillary permiability, and block in lymphatic vessels
normal level of sodium 135-145 mEq/L
hyponatremia serum osmolality <280;l;CX loop diuretic use, excessive water gain,GI fluid loss S/S headache, lethargy, confusion,seizure, coma, abd.cramps,
hypernatremia ;omolality >300; CX excessive water loss . S/S thirst, decreased U/O, dry mucous membranes, postural hypotension, disorientation
normal level of potassium 3.5-5.0 mEq/L;regulates smooth cardiac muscle conduction, and transmission & conduction of nerve impulses.
hypokalemia in diet, loop diuretics S/sx N/V decreased bowel sounds, muscle weakness, leg cramps, cardiac dysrythmias,
hyperkalemia CX by decreased renal function, . S/Sx , GI hyperactivity; diarrhea, muscle weakness, numbness to extremities and ECG changes
normal levels of calcium 4.5-5.5 mEq/L
hypocalcemia can be caused by decreased absorption from intestine, ETOH abuse, acute pancreatitis. S/Sx Numbness and tingling of mouth, and extremities, , if severe: tetany, seizures, dec. c/o +Trousseaus' & Chvosteks signs.
hypercalcemia , and prolonged immobilization. S/S anorexia, N/V, constipation,weakness, depressed deep-tendon reflex, lethargy, polyuria, flank pain 2* urinary calculi
Mg+ 1.5-2.5 mEq/L FND in ICF; ;regulates cardiac & skeletol muscle excitibility; involved in production & use of ATP.
hypomagnesemia CX loss from GI tract(diarrhea,NG suciton) S/Sx irritability with tremors, hyperreflexia, ,tremors, convulsions+Chvosteck's and Trousseaus's signs.
hypermagnesemia Cx by renal Failure ; S/Sx hypotension, hyporeflexia,, muscle weakness, coma, bradypnia; resp. & cardiac arrest
Respiratory Acidosis Hypoventation Low pH<7.35, High PaCO>45;S/S high H/R, R/R, B/P, confusion; conpensation kidneys increase HCO3 level
Respiratory Alkalosis Hyperventation High pH>7.45, Low PaCO2<35;S/S lightheadedness;numbness & tingling; Compensation Kidneys lower HCO3
Metabolic Acidosis Low pH<7.35, Low HCO3<35, , Low PaCO2<35;S/S headache, confusion, N/V, dec. C/O, Hyperkalemia frequently present. Cx conditions of decrease bicarbonate(diarrhea) excessive infusion of IV NaCl; renal impairment
Metabolic Alkalosis High pH<7.35, High HCO3>26, HIGH PCO2>45;S/S tingling in fingers/toes, Hypokalemia frequently present. CX Excessive loss of acid(NG/GI suction)
pH 7.35-7.45
PaCO2 35 - 45mmHg
HCO3-(Bicarbonat) 22 - 26mEq/L; Fnd in ECF & ICF; primary function is for acid- base balance.
Ca+ 4.5-5.5 mEq/L regulates clotting, nerve impules, cardiac conduction, skeletal and smooth muscle contraction; In bones with aging intestines absorb C+ less and more C+ is excreted via kidney;C+ shifts out of bones to replace these ECF losses, risk for osterporis & fx.
Na+ 135 - 145mEq/L maintains H20 balance;nerve impulses & transmission; regulates acid-base & water balances.
Ka+ 3.5 - 5.0mEq/L Major cation in ICF,important in maintaining ICF water balance. K+ is vital lyte for skeletal, cardia, and smooth muscle activity.
Interstitial Fluid A fluid between cells and outside the blood vessels
Intravascular Fluid Blood Plasma
Hypervolemia Isotonic expansion of he ECF caused by the abnormal retention of water and sodium in approximately the same proportions in which they normally exists in the ECF
Hypovolemia Occurs when loss of ECF volume exceeds the intake of fluid
Cl- 95-105mEq/L FND in ECF; follows Na+; regulates the osmolality and blood vol.;
PO4-(phosphate) 1.8-2.6mEq/L Majority Fnd in ICF some in ECF; similar to Ca+(helps form bones and teeth) Regulates cellular metabolism; forming ATP; help with RBC formation
Anions HCO3-, Cl-, PO4-
30cc 1 oz
1 liter 1000ml
1000ml 2.2 lbs
500ml 1 lb
Created by: rsg175