Lecture 5 Fluid And Electrolyte Flashcards
How much %of water makes up the body
60%
What makes up the extracellular compartment
Interstitial (tissue) spaces
Plasma (vascular) compartment
Transcellular compartment
What are the functions of fluid?
Transportation (nutrients, waste and heat)
lubrication and protection
digestion
Intake of fluids is regulated by what
Regulated by thirst mechanism
What does the hypothalamus monitor
Blood osmolality (osmolality inc, thirst stimulates) BP (BP sec thirst increased)
Intake includes what?
Oral and IV
What is output determined by
Flirtation needs
Insensible water loss
Renal regulation
Minimum Amount urine output
400-600 ml/day
Insensible water loss
Respiration, veces, skin, sweating
Diffusion
Movement of particles from area of higher to lower concentration
Concentration gradient
A difference in concentration for one pt to another
Albumin affect on blood
Total albumin in bloodstream= protein nutritional status
Exerts oncotic pressure= pulls fluid back to capillaries
Edema
Excess fluid in ISF And ICF
Hypoalbuminemia= low albumin makes low oncotic pressure
OR elevated hydrostatic pressure by excess water
Causes of fluid volume deficit
Inadequate intake Excessive fluid loss Third spacing (into interstitial space)
S&S of fluid volume defect
Acute weight loss Dec. urinary output Inc. urine specific gravity Hemoconcentrarion Dec. vascular volume= tachycardia, hypotension, depressed fontanelle, sunken eyes, inc. body temp
Causes of fluid volume excess
Excessive sodium and water intake
Inadequate renal loss
S&S of fluid volume excess
Acute weight gain
Pitting and pulmonary edema
Puffy eyelids
Hypertension
Third space fluid accumulation
Fluid (effusion) in cavities caused when ill
Pitting edema
Occurs when pressure is applied to small area and indentation
ADH affect on urine output
Increased levels of ADH decrease urine output because ADH reabsorbes water
Dehydration
State of diminished water volume in the body
Deficit of ICF= cells shrink
Dec amount of water in ECF
Oliguria
Urine production <400 ml/day or <20/30 mL/hr
Assessment of fluid status
Daily weight
24 he intake and output
Assessment of skin turtle, mucous membrane, tears, fontanelles
BP and heart rate checked
Orthostatic hypotension
Occurs in dehydration where BP drastically decreased when changing from laying to standing
Symptoms of dehydration
Thirst Dry mucous membrane Poor skin turgor Hypotension/orthostatic hypotension Dark urine Depressed fontanelle
Sodium
135-145 mEq/mL
Target organ: brain
Regulated in Kidneys, Gi, skin
Main function= water regulation Oop
Hyponatremia
<135
Can occur in low blood volume (hypovolemic hyponatremia) or in high blood volume (dilutional hyponatremia)
Causes of hyponatremia
Diarrhea, vomiting, excess sweating, burns/wounds, inc ADH (stress pain trauma)
Symptoms of Hyponatremia
Headache lethargic apathy confusion nausea vomiting diarrhea muscle cramps/spasms
Causes of hypernatremia
Excess sodium intake
decrease extracellular losses
decrease water intake
Signs of hypernatremia
>145 High specific gravity, Liguria Dry mucous membranes tachycardia hypertension
Hypernatremia relation with water retention
Weight gain
hypertension
Hypernatremia with water loss
Dehydration thirst Irritability tachycardia flush skin dry mucous membranes oliguria
Potassium
3-5 mEq/mL Regulate in kidneys Bananas, orange, lentils, rasins Target organ; heart Main function: smooth electrical conduction of the muscles
Causes of Hypokalemia
Diuretic therapy IV administration poor intake G.I. losses diuretic phase of renal failure
S&S of hypokalemia
Muscle fatigue weakness leg cramps nausea vomiting cardiac arrhythmias postural hypotension Prominent U wave and flattened T wave
Treatment of hypokalemia
Never give rapid potassium a.k.a. bolus IV potassium must always be diluted
Hyperkalemia causes
excess intake
massive crushing injuries
inadequate renal losses
S&S of hyperkalemia
Numbness muscle cramping nausea/diarrhea apathy mental confusion peaked T waves widening QRS complex cardiac arrest
Calcium and phosphorus relationship
Reciprocal relationship when one increases the other decreases and vice versa
Hypocalcemia
<8.5 and main function is bone development, blood clotting, smooth muscle contraction
Causes: Inadequate vitamin D, abnormal ca binding, hypoparathyroidism
S&S: muscle spasms (trousseau and Chvostek) seizures
hypotension
Arrhythmias
Main function of magnesium
Maintains intracellular K and functions in enzyme reactions and proteins and DNA synthesis
Hypomagnesemia
Mg stored in bone
Spasms cardiac arrhythmias similar to hyponkalemja disease
