Fluid and electrolytes in acute settings Flashcards
Why is adequate circulation essential?
• Maintain oxygen and
nutrient delivery to organs
and tissues
• Remove waste products of
cellular respiration
What are the 4 things which regulate fluid balance in the body?
The Kidney’s
ADH
Renin-Angiotensin-aldosterone system
Atrial Naturetic Peptide hormone
In order for adequate circulation to exist what must be present?
- Good heart function
- Adequate blood volume
- Systemic vascular resistance
- Adequate Haemoglobin
- Oncotic pressure
- Hydrostatic pressure
- Adequate ventilation
How many fluid Compartment are in the body?
3
What are the three major fluid compartment which are functionally connected?
Intracellular fluid compartment
interstitial fluid
plasma
Describe the first type of fluid spacing
Normal distribution within
ECF and ICF
Describe the second type of fluid spacing
Accumulation within the
interstitial compartments.
This causes
oedema but fluid is still available for
exchange between compartments
Describe the third type of fluid spacing
Accumulation in parts of
the body where it is not available for
exchange between different
compartments e.g. Ascites
If there is normal distribution within
ECF and ICF what type of fluid spacing will be presented?
1st spacing
If there is if a patient is presenting oedema and ther is an accumulation within the
interstitial compartments. but fluid is still available for
exchange between compartments, what type of fluid spacing is this?
2nd spacing
if a patient present wth ascites, what type of fluid spacing is being presented?
3rd spacing
What is the volume of each fluid compartment dependent on?
- Total body water amount
- Hydrostatic pressure
- Oncotic pressure
- Solute concentration
What is Hydrostatic Pressure?
The pressure which a fluid exerts on the
wall of its container
The force of blood on the blood vessel
walls
Created by systole and intravascular
volume
How is oncotic pressure created?
the pull of proteins in the plasma
What is main protein responsiblein for creating oncotic into the vebous cavity?pressure
albumin
What is albumin?
a protein produced by the liver which creates oncotic pressure in to the vessels
How does fluid circulate/move between compartments?
osmosis
diffusion
How man molecules of oxygen can haemoglobin hold?
4 oxygen molecules
If a patient has a pulmonary oedema, what can the nurse do immediately to relieve symptoms?
sit them up with their legs dangling of the bed.
What are some of the clinical manifestations of pulmonary oedema?
• Shortness of breath • Use of accessory respiratory muscles • Hypoxia • Anxiety/Restlessness • Coarse crackles on auscultation and percussion • Expectoration of pink frothy fluid
A patient is presenting SOB, and using accessory muscle. They are also expectorating pink frothy fluid. What myight the patient have?
pulmonary oedema.
What are the factors which case pulmonary oedema?
↑capillary permeability – cellulitis, sepsis
↑venous (capillary) pressure – heart
failure, venous insufficiency
↓oncotic capillary pressure - ↓albumin
–liver disease, malnutrition
What is a pulmonary oedema?
Accumuation of fluid in the lungs around he air sacs.
When choosing an IV fluid, what targets should be considered?
Maintenance fluid
Fluid resuscitation (Intravascular space)
Whole body hydration (intracellular compartent
