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Four main functions of water
transportation of substances to and from the cell, aid heat regularion by providing sweat, assist maintenance of H+, serve as medium for enzymatic action of digestion
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Adults have what % of water
female-60%, men-50%
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Sodium
135-145, regulates water balance
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Calcium
8.4-10.6, blood coagulation, muscle activity
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Phosphate
2.7-4.5 necessary for formation of ATP
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Chloride
96-106, helps maintain acid base balance, impt for formation of HCl
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Bicarbonate
HCO3, neutralizing buffer
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Hypovolemia
decreased volume of plasma
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Sources of H2O in 24 hours
Oral-1500, food-800, Metabolism 200
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Loss of H2O in 24 hours
Urine-1500, Perspiration-400, Feces-200, expired air-400
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Extracellular fluid
1/3 of total body water; transports stuff to and from cells, high in Na
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Intracellular fluid
2/3 of total body water; fluid contained in the cell walls, high in K
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Intravascular fluid
fluid within blood vessels, plasma and fluid within blood cells, large amounts of protein and electrolytes
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Interstitial fluid
fluid in the spaces surrounding the cells, high in Na
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Transcellular fluid
aqueous humor, saliva, CSF, pleural, GI secretions, urinary system and lymphatics
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Diffusion
Greater to less
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Filtration
water and suspended substances outward through a semipermeable membrane
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3 passive transport
osmosis, diffusion, filtration
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Signs of dehydration
dizziness, dark urine, decreased urine, dry, elevated temp, flat neck veins, increased pulse rate, poor turgor, postural hypotension, thick saliva, thirst, weak, thread pulse, weakness
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Signs of overhydration
Weight gain, crackles, slow bounding pulse, elevated BP, edema
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Causes of edema
kidney failure, heart failure, liver failure, hormonal disorders
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Most common electrolyte imbalance
hyponatremia
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Death ph rates
below 6.8 or above 7.8
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Three control mechanisms for ph
blood buffer system, lungs, urinary system
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Respiratory acidosis
COPD, opiate use, airway obstructions, pneumonia, asthma or chst injuries; slow, shallow respirations; PaCO2>45
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Metabolic acidosis
shock, diabetic ketoacidosis, renal failure, diarrhea, HCO3-<22; hypokalemia as the kidney retains K and excretes H
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Respiratory alkalosis
hyperventilation PaCO2<35; anxiety, high fever, or OD of ASA
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Metabolic alkalosis
vomiting, excessive antacid, hypokalemia HCO3->26; Kussmal�s respirations
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Effects of acidosis
depresses nervous system, headache, lethargy, weakness and confusion
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Effects of alkalosis
inability of the nervous sytem, restlessness, muscle twitching, tingling and numbness, tetany
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Weight gain or loss of 1 kg in 24 hours indicates
gain or loss of 1 L of fluid
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Rapid breathing may cause alkaline by expelling large amounts of CO2 or it may be the body�s way to compensate for acid ph
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Acid base nursing diagnoses
Deficient/excess fluid volume, risk for imbalanced fluid volume, ineffective tissue perfusion, decreased cardiac output, impaired gas exchange, ineffective breathing pattern
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