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