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Fluis and electrolytes in body

Primary function of H2O Medium for transport Facilitate metabolism and celular functioning Maintain body temp (thru respirations) Tissue lubricant Body secretions
Solvent Liquid that holds substances in solution
Solute Substance that dissolves in solution for electrolytes
Fluid departments Intracelular (IFC) Extra celular (ECF)
ICF Fluid inside cell K+, Mg+, PO4- other electrolytes
ECF Fluid outside cell Na+, Cl-, HCO3-
ECF (special) Interstitial = Edema, fluid between body cells Intravascular = Main func transport blood (plasma) Transcellular = Cerebrospinal fluid, pleural fluid, peritoneal fluid, Synovial fluid, Digestive Fluid
Careful when administering meds that... affect ICF
40% of body weight is.. ICF
20% of body weight is.. ECF
increase fat will decrease fluids
Women have less..... and more..... fluids, fat
Muscular man have increase fluids due to increase muscle
I & O should be EQUAL
LArgest compartment? ICF
Osmosis Primary mode of movement, H2O moves from less concentrated to higher concentrated area across cell membrane
Isotonic Same make up , same ph. What's inside cell is equal to outside.
Hypertonic Maintains balance w/in compartments. Fluid contains higher concentration than blood. H20 will move from cell to ECF (Cell shrinks)
Hypotonic Fewer soluble concentration. Push fluid into cell from ECF (Cell expands)
Osmolarity Measure of concentration of luid to push/pull from/to cell
Osmotic Potential Ability to pull H2O into fluid compartment EX. Na+ holds to H2O
Diffusion Intermingling of molecules. MOLECULES move from HIGH concentration to LOW concentration until both sides are equal
ATP ENERGY is used to move MOLECULES from LOW concentration to HIGH concentration
Na+ & K+ Pump Na+ concentrations is higher in ECF -> enters cell by diffusion -> Pulls K+ out from ICF
Movement between vascular compartment and Interstitial fluid Filtration
Hydrostatic pressure Pushing force created by fluid w/in closed normal circulatory system
Increased pressure at... than... arterial capillaries, venous system
Osmotic Pressure Solution pulling force to draw H2O
Hydrostatic stronger than osmotic at... Arteries
Osmotic stronger than hydrostatic at... Veins
Normal intake in a day? Normal output in a day? 2,500 ml in 1,500 ml out
Higher fat foods produce more WATER
Protein makes less WATER
Sentible output (measurable) Urine, feces
Insentible Output Skin, Lungs
Mayor regulation of blood in body? KIDNEYS
Thirst Primary regulator supported by hypothalamus
Kidneys Main organ of excretion, output from kidneys is around 1,500 ml. 175 L of plasma daily
Hormones that regulate fluid balance Antidiuretic hormone (ADH) Renin-Angiotensin System Aldosterone Thyroid Hormone Natriuretic Peptid
ADH Causes kidney to retain fluid. Fluid decreases, BP decreases, More ADH is release Fluid increases, BP increases, Less ADH released
Renin-Angiotensin System Fluid decreases -> Rening angiotensin system kicks in and hangs to Na+ and H2O -> Aldosterone is released -> Kidneys stimulate H2O and Na+ into cell and kick out K+
Natriuretic Peptid Atrial (ANP) Brain (BNP) C-Type (CNP)
ANP Right Atrium, Most important indicator of heart failure
Fluid Volume Deficit (FVD) Hypo, Hyper
Hypovolemia Low fluid volume. Occur due to trauma, rupture Proportional loss of fluid/electrolyte from ECF
Dehydration Negative fluid balance. Loss of fluid from ICF and ECF Insufficient intake of fluids Excessive fluid loss EX. bleeding, vomiting, diarrhea Fluids shift (Leaking into body tissues)
Sources of fluid loss Diarrhea/Vomiting, Draining wounds, NG suctioning, Paracentesis/Thoraceentesis, Infection, fever, Diuretics Extensive burns
Fluid Loss Assessment Heart Rate ↑, BP↑, Rapid weak pulses, Skin and mucous membranes ↓, ↓ Skin Turgor, Urine output ↓, Neck veins flat, Muscle Weakness, Temp ↑, HCT lab ↑, SP gravity ↑
At risk for Fluid Loss Older Adults Infants (cant tell you) Toddlers (rather play) Pt's w Diabetes, vomiting, diarrhea
Fluid Volume Excess (FVE) Hypervolemia
Hypervolemia Excess of blood volume Retention of Na+ and H2O Excessive salt intake Disease of liver, kidney, heart <-(Can't bring fluid back from lower body) ↑ Osmotic pressure and ECF (Fluid from cell to ECF)
Dependent Edema Heart not strong enough to pull fluids back from lower body May be up 5-10 lbs weight gain Relieve by elevation
Pitting Edema Pit or depression after finger pressure
Fluid Excess Assessment BP ↑, Pulse strong bounding, Respirations shallow and ↑, Neck veins distended, Skin pale/cool, Urine output ↑/dilute, Weight ↑ (If severe crackles in lungs). BUN ↓, HCT ↓, SP gravity ↓
Acitasis Build up fluid in peritoneum
IONS Atom or molecule carrying an electric charge
ELECTROLYTE Substance capable of braking into electrically charged ions hen dissolved in solution
CATION + charge ion (NA, K, Mg, Ca)
ANION - charge ion (CL, PO4, HCO3)
Functions of electrolytes Regulate water distribution Transmit nerve impulses Clotting blood Regulate Acid Base balances
Na+ Major cation in ECF Normal 135-145
Na+ Function Regulate fluid Volume Helps maintain blood volume Interacts with Ca+ and maintain muscle contraction Stimulates conduction of nerve impulses
Na+ Regulation Moves by ATP Regulated by ADH and aldosterone Reabsorbed and excreted by Kidneys Minimal loss thru feces and perspiration ↓ Na+ = ↑ H2O intake
Na+ Source Salt, Soy sauce, Pork, Cheese, Milk, Canned Products
Hyponatremia ↓ Na+ levels <135 Due to: Diuretics, Adrenal insufficiency, Excessive intake of hypotonic solutions
Hyponatremia Sx Lethargy, Confusion, Muscle cramps, Seizures, Anorexia, Vomiting
Hyponatremia Tx Monitor I & O, Monitor Na+ levels, ↑ Na+intake, seizure precautions if severe.
Hypernatremia ↑ Na+ levels >145 Due to: Excesive Na+ intake, H2O deprivation, ↑ H2O loss, Diabetes
Hypernatremia Sx Thirst, ↑ temp, hallucinations, irritability, lethargy, seizures
Hypernatremia Tx Monitor I&O, VS, ↓ Na+ intake, Watch for hidden Na+, IV solutions that dont contain Na+
K+ Major Cation in ICF Normal 3.5-5
K+ Function Maintain ICF osmolality Regulate conduction of cardiac rhythm Transmit electrical impulses in multiple body systems Assists with acid-base balance
K+ Regulations Regulated by aldosterone Excreted n conserve thru kidneys Loss thru vomiting and diarrhea Loss triggered by many diuretics (↓ Ka+ = ↑ Urine output)
K+ sources Bananas, green lefty veggies, Oranges, Apricots, figs, carrots, potatoes, tomatoes, Dairy products, meats
Hypokalemia Low K+ <3.5 Due to: Steroid administrations, Hyperaldosteronism, anorexia/bulimia
Hypokalemia Sx Fatigue, Muscle weakness, Disrhythmias, ECG changes, sensitive to digitalis
Hypokalemia Tx Monitor I&O, K+ levels, pulse if on Digoxin, K+ supplement pills
Hyperkalemia ↑ K+ levels > 5.0 Due to: inability to excrete K+, Renal failure, K+ sparing siuretics, Hypoaldosteronism, High K+ intake with renal insufficiency, acidosis, major trauma
Hyperkalemia Sx Muscle weakness, dysrhythmias, ECG changes
Hyperkalemia Tx Monitor I&O and K+ levels
Ca+ Most abundant electrolyte in body Normal 8.9-10.1
Ca+ Function Promotes transmision of nerve impulses Major componennt of bone n teeth Regulates muscle contractions (with Na+) Maintain Cardiac automaticity Essential factor in the formation of blood clots Catalyst for many cellular activities
Ca+ Regulations combines with PO4- to form mineral salts of teeth and bones Na+ and PO4- levels inversely proportional PTH stimulates release of Ca+ from bones and reabsorption from kidneys and intestines Absortion stimulated by VIT D
Calcitonin Blocks bone breakdown and lower calcium levels
Ca+ Source Milk, cheeses, Dark green veggies, Salmon, Breads, Cereals
Hypocalcemia ↓ Na+ levels <8.9 due to: Hypoparathyroidism, Pancreatitis, Alakalosis
Hypocalcemia Sx Numbness/tingling of extremities, tetany, Cardia irritability, Trousseau's and Chvostek's
Trousseaus Hand/finger twitching when BP cuff inflated
Chvostek's Twitching of mouth or nose when cheek is tapped
Hypocalcemia Tx Encourage ↑ of Ca+, administer Ca+ supplements, Airway, Seizure and safety precautions
Hypercalcemia Sx Muscle weakness, constipation, Kidney stones, Bizarre behavior, bradycardia
Hypercalcemia ↑ Na+ Levels > 10.5 Due to: Hyperparathyroidism, malignant bone disease, prolonged immobilization, thiazide diuretics, Excessive intake
Hypercalcemia Tx Encourage fluid intake to prevent stone formations. Fiber intake to prevent constipation, Limit Ca+ intake
Mg+ Present in skeleton and ICF Second most abundant in ICF Normal 1.5 -2.5
Mg+ Function Protein and carbohydrate metabolism Necessary for protein and DNA synthesis w/in the cell Maintain normal Intracellular levels of K+ Involved in electrical activity in nerve and muscle. Including heart Influence release n activity of insulin
Mg+ Regulation Ingested in the diet and absorbed thru small intestines Excreted by kidneys Loss due to diuretics, poorly controlled diabetes and excessive alcohol intake
Mg+ Source Green veggies, Cereal, Grains, Nuts
Hypomagnesemia ↓ Mg+, <1.5 Due to: Chronic alcoholism, prolonged gastric suction, diabetes
Hypomagnesemia Sx Neuromuscular irritability, disorientation, disrhythmias,
Hypomagnesemia Tx Avoid alcohol intake, encourage ↑ food with Mg+
Hypermagnesemia Too high Mg+ > 2.5 Due to: Renal failure, adrenal insufficiency, excess replacement
Hypermagnesemia Sx Flushing and warmth of skin, hypotension, lethargy, hypoactive reflexes, depressed respirations, bradycardia
Hypermagnesemia Tx Monitor VS, airway, reflexes, avoid Mg+ supplements and food rich in Mg+
PO4- Major anion in ICF Normal 2.5-4.5
PO4- Function Serves as catalyst for many intracellular activities Promotes muscle and nerve action Assists with Acid bace balance
PO4- Regulation combines with Ca+ to form mineral salts for teeth and bones Ca+ and PO4- levels inversely proportional Regulated by PTH, inverse respond to Ca+ Excreted and reabsorbed by Kidneys
PO4- source Meat, Fish, Poultry, Milk products, Carbonated Beverages, Legumes
Hypophosphatemia ↓ PO4- Levels < 2.5 Due to: refeeding after starvation, alcohol withdrawal, diabetic ketoacidosis, respiratori acidosis
Hypophosphatemia Sx Joint Stiffness, Seizures, impaired tissue oxygenation
Hypophosphatemia Tx Monito PO4- levels, calcium levels
Hyperphosphatemia ↑ levels of PO4- >4.5 Due to: Renal Failure, Hyperthyroidism, Phosphate based laxatives
Hyperphosphatemia Sx Tetany Sx, tingling of extremities and craping, calcification of soft tissue
Hyperphosphatemia Tx Monitor PO4- levels, monitor for tetany, administer milk of magnesia with meals to bind to PO4-
Cl- Major anion in ECF Normal 96-106
Cl- Function Works with Na+ to maintain osmotic pressure between fluid compartments Essential for production for HCL for gastric secretions Functions as buffer in O2-carbon dioxide exchange in RBCs Assist with acid base balance
Cl- Regulation Reabsorbed and excreted through kidneys along w Na+ Regulated by Aldosterone and ADH Deficit will lead to K+ deficit and vise versa
Cl- Source Foods high in Na+ Cheese Processed foods Meats Seafood
HCO3- Major buffer in both ICF and ECF Normal 22-28
HCO3- Function Maintain acid base balance by functioning as the primary buffer in body
HCO3- Regulation Loss thru diarrhea, diuretics, renal insufficiency Excess possible if person ingests quantities of acid neutralizers
HCO3- Sources Acid neutralizers (Sodium bicarbonate)
Acid A substance that donates hydrogen ions Ph 1-6.9
Base A substance that accepts hydrogen ions Ph 7.1 - 14
Created by: 635630362