Fluid, Electrolyte, and Acid-Base Balance Flashcards
Internal to and relatively surrounds all the cells in the body
Fluid
The intentions
Scientific Knowledge Base
Comprises a substantial proportion of body weight
Water
60% total body weight in Water
Men
Less total body weight in Water
Women
Body fluids
Fluid Distribution
Fluid Compartments
Extracellular Fluid / ECF
Intracellular Fluid / ICF
Intravascular Fluid
Major Division
Interstitial Fluid
Minor Division
Technically full of electrolytes
Composition of Body Fluids
Same tonicity / Concentrated solute
Isotonic Solution
More dilute / Low solute
Hypotonic Solution
More concentrated / High solute
Hypertonic Solution
Movement of Water and Electrolytes
Active Transport
Diffusion
Osmosis
Filtration
Force of fluid pressing outward against a surface / Water-pushing effect
Hydrostatic Pressure
Involves blood containing albumin and other proteins
Colloids
Force of fluid pressing inward against a surface / Water-pulling effect
Oncotic Pressure
Water portion of the fluids
Solvent
Particles dissolved in water
Solutes
Measure in osmoles / 1L of water / 275-295 mOsm/L
Osmolarity
Number of osmoles / kg of water / 275-295 mOsm/kg
Osmolality
Orally through drinking and eating too
Fluid Intake
Among various components
Fluid Distribution
Across the skin, lungs, GI tract, and kidneys
Fluid Output
Regulates osmolality of the body fluids
Antidiuretic Hormone
Regulates ECF volume through sodium and water excreted in urine upon blood pressure
Renin-Angiotensin-Aldosterone Hormone
Regulates ECV through sodium and water excreted in urine upon hormones
Atrial Natriuretic Peptide
Regulation of Body Fluids
Thirst Mechanism
Fluid Output
Hormonal Regulation
Lymphatic System
Other factors affecting intake and output
Fluid Intake
Insufficient isotonic fluid in the Extracellular Fluid Compartment
Extracellular Volume Deficit
Too much isotonic fluid in the Extracellular Fluid Compartment
Extracellular Volume Excess
Water deficit
Hypernatremia
Water excess
Hyponatremia
Overall combination of Extracellular Volume Deficit and Hypernatremia
Clinical Dehydration
Best way to monitor fluid status
Daily Weights
Electrolyte Homeostasis
Electrolyte Intake and Absorption
Electrolyte Distribution
Electrolyte Output
Low potassium
Hypokalemia
High potassium
Hyperkalemia
Low calcium
Hypocalcemia
High calcium
Hypercalcemia
Low magnesium
Hypomagnesemia
High magnesium
Hypermagnesemia
For optimal cell function of the body.
Acid Base-Balance
The factors
Nursing Knowledge Base
Monitor and nurture a patient’s acid-base balance
Arterial Blood Gases / ABGs
Acid Production
Carbonic Acid
Metabolic Acid
Maintenance of normal pH body fluids
Acid Buffering
Acid Excretion
Lungs
Kidneys
From alveolar hypoventilation
Respiratory Acidosis
From alveolar hypoventilation
Respiratory Alkalosis
Increased metabolic acid or bicarbonate
Metabolic Acidosis
Decreased HCO3 or metabolic acid
Metabolic Alkalosis
Determination of a patient’s needs, values, and preferences
Through the Patient’s Eyes
Age / Environment / Dietary Intake / Alcohol Intake / Medications
Nursing History
Recent Surgery / Gastrointestinal Output / Acute Illness or Trauma
Medical History
Daily Weights / Fluid Intake and Output Measurement
Physical Assessment
Serum Electrolytes / Urine Osmolality / Urine Specific Gravity / ABG Analysis
Laboratory Values
Cations (+) / Anions (-)
Electrolytes
Serum Value 135-145 mEq/L
Sodium
Serum Value 3.5-5.0 mEq/L
Potassium
Serum Value 4.3-5.3 mEq/L
Calcium
Serum Value 1.5-1.9 mEq/L
Magnesium
Serum Value 1.8-2.6 mEq/L
Phosphorus
Normal Acid-Base Balance
pH 7.35-7.45
PaCO2 35-45 mmHg
PaO2 80-100 mmHg
HCO3 22-26 mEq/L
Enteral Replacement of Fluids / Restriction of Fluids / Parenteral Replacement of Fluids and Electrolytes
Acute Care
Crystalloids
Intravenous Therapy
Blood
Blood Transfusion
Home Intravenous Therapy / Nutrition Support / Medication Safety
Restorative Care