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Fluid and Electrolyt
fluid imblances
| Term | Description |
|---|---|
| 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
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