Fluid and electrolytes

  1. ICF
    • intracellular fluid
    • 2/3 of water in an adult
    • provides a medium for chemical functions
    • major cation is is K
  2. ECF
    • extra cellular fluid
    • comproses 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 Blood volume
    • major cation is Na, as well as Cl- and HCO3 (bicarb)
  3. Blood Osmolality changes & ADH
    Increased osmolarity(resulting in concentrated HCT, HGB and BUN) will trigger the release of ADH. ADH will reduce urine output by kidneys, increasing permeability of H2O; osmolarity increases
  4. osmostic pressure
    Pressure exerted by an increased concentration of solutes in a compartment: water pulling pressure
  5. hydostatic pressure
    the pressure blood exerts against vessels: water pushing pressure
  6. hypertonic solution
    • used to treat edema & 3rd spacing
    • solutions are used to replace electrolytes and shift fluids from the ICF to the ECF
    • cell decreases in size because salt sucks fluid out
    • D10, D5NS, D5 1/2NS, D5RL
  7. hypotonic solution
    • used to treat burns and dehydration
    • solutions cause fluid to shift from the ECF to the ICF
    • more solutes inside the cell
    • cell increases in size
    • 1/2NS, 1/3NS, 1/4NS
  8. isotonic solution
    • expands the colume of blood
    • prevents osmolarity changes
    • equal solutes on each side
    • no cellular changes
    • Osmolarity btwn 270-300
    • D5W, D5WNS, LR (lactated ringers) are only solution that has electrolytes
  9. thirst
    • an increase in serum osmolality causing osmoreceptors to shrink
    • 0.5% of body water has been lost
  10. FVD (Hypovelmia)
    • isotonic loss of H2O and lytes
    • Caused by: hemorrhage, N/V, diarrhea, burns and third spacing.
    • S/S: dry lips & mucosa, fluid intake less than output, weak/rapid pulse, orthostatic hypotension
  11. FVE (Hypervolemia)
    • Body retains both H2O and Na+
    • Causes: intake of rapis NaCl infusion, excess Na+ in diet, CHF, Renal Failure
    • S/S: JVD, rales, SOB, tachycardia, high BP, fluid intake greater than output, moist mucosa
  12. Dehydration
    • water is lost without change in electrolytes
    • Na+ stays the same
    • may increase serum osmolality
  13. hypotonic excess
    • water volume excess or water intoxication
    • Cause: tap water enemas, wound irrigations, NG tube irrigations, SIADH
    • S/S: mental status changes
  14. Normal Sodium Level
    135-145 mEq/L
  15. hyponatremia
    • less than 135 mEq/L
    • Causes: loop diuretic use, excessive water gain, GI fluid loss
    • S/S: headache, lethargy, confusion, seizure, coma, abd. cramps
  16. hypernatremia
    • greater than 145 mEq/L
    • Causes: excessive water loss
    • S/S: thirst, decreased urinary output, dry mucous membranes, postural hypotension, disorientation
  17. normal K+ level and functions of K+
    • 3.5-5.0 mEq/L
    • regulates smooth cardiac muscle conduction and the transmission and conduction of nerve impulses.
  18. hypokalemia
    • less than 3.5 mEq/L
    • Causes: dietary, loop diuretics
    • S/S: Nausea and vomiting, decreased bowel sounds, muscle weakness, leg cramps, cardiac dysrythmias
  19. hyperkalemia
    • greater than 5.5 mEq/L
    • Causes: decreased renal function
    • S/S: GI hyperactivity, diarrhea, muscle weakness, numbness to extremities and EKG changes
  20. Normal Calcium level
    9.0-10.5 gm/dl
  21. hypocalcemia
    • less then 9.0 gm/dl
    • Causes: decreased absorption from intestine, ETOH abuse, acute pancreatitis
    • S/S: Numbness and tingling of the mouth and extremities
    • if severe: tetany, seizures, postive Trousseaus and Chvosteks signs
  22. hypercalcemia
    • greater than 10.5 gm/dl
    • Causes: prolonged immobilization
    • S/S: anorexia, nausea and vomiting, constipation, weakness, depressed DTRs, lethargy, polyuria, flank pain, renal calculi
    • severe hypercal: slow HR and dysrythmias
  23. Magnesium
    1.8-2.7 mg/dl
Card Set
Fluid and electrolytes