fluid and electrolyte balance 2011 pam
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8/11/2019 Fluid and Electrolyte Balance 2011 PAM
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Fluid and Electrolyte Balance
Pamela Krupilis MSN, RN, CNS
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Fluid & Electrolyte Balance
A. Composition of Body FluidsFluid – water & other componentsElectrolyte – any compound whendissolved in water, separates intoelectrically charged particles called ions.Cations – (+) charged ions
Anions – (-) charged ionsNon-electrolytes – substance does notionize or carry an electrical charge
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Fluid & Electrolyte Balance
B. Distribution of Body FluidsExtracellular – fluid moving outside the cell1. Interstitial Fluid – between the cells ortissue2. Intravascular Fluid – plasma
Intracellular – fluid within the cellmembrane containing dissolve solutes orsubstances.
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Fluid & Electrolyte Balance
3. Movement of Body FluidsBody fluids are not static.
Shift from compartment to compartment tomaintain homeostasis.
Why do we need fluids?
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Fluid & Electrolyte Balance
Osmotic Pressure – occurs as soluteparticles collide against one another.Osmolality – number of mOsm/kg of water (280-295 mOsm/kg)Osmolarity – mOsm/L of solution.
Solute – substance that is dissolved in aliquid to form a solution.
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Fluid & Electrolyte BalanceTonicity
a. Isotonic Solution – same osmolality asplasma. Ex: 0.9%NSS, LR
b. Hypotonic Solution – lesser osmolalitythan plasma. Fluid will move into thecell. Ex: 0.45%NSS
c. Hypertonic Solution – higher osmolalitythan plasma. Fluid will move out of thecell. Ex: D5/0.45% NSS, D5NSS, D5LR
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Fluid & Electrolyte Balance
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Fluid & Electrolyte Balance
3. Filtration – transfer of water & diffusiblesubstances from high pressure to low pressure.
a. Hydrostatic pressure – exerted by the
pumping action of the heart. Fluids are filteredthrough the arterial end of the capillaries wherethe pressure is greater.
b. Colloid Osmotic Pressure –exerted by
nondiffusible plasma proteins (albumin) in largersolutes. Fluids reenter the venous end of thecapillaries because the pressure is greatestthere.
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Fluid & Electrolyte Balance
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Fluid & Electrolyte Balance
C. Regulation of fluid & electrolytesFluid IntakeLymphatic SystemNeuroendocrine System
Antidiuretic Hormone (ADH)Renin Angiotensin Aldosterone SystemThyroid Hormone (Calcitonin)Parathyroid Hormone
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Fluid & Electrolyte Balance
D. Disturbance in Fluid & ElectrolytesBalance
1. Isotonic Imbalancesa. Fluid Volume Deficitb. Fluid Volume Excess
2. Osmolar Imbalancesa. Hyperosmolar Imbalanceb. Hypoosmolar Imbalance
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Fluid & Electrolyte Balance
Electrolytes
Sodium – 135 to 145 mEq/LPotassium – 3.5 to 5.1 mEq/LCalcium – 8.9 to 10.3 mg/dL
Magnesium – 1.3 to 2.1 mEq/LPhosphate – 2.5 to 4.5 mEq/l
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Fluid & Electrolyte Balance
3. Electrolyte Imbalances
Hyponatremia
Signs & Symptoms
HypernatremiaSigns & Symptoms
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Fluid & Electrolyte Balance
HypokalemiaSigns & Symptoms
HyperkalemiaSigns & Symptoms
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Fluid & Electrolyte Balance
HypomagnesiumSigns & Symptoms
HypermagnesiumSigns & Symptoms
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Fluid & Electrolyte Balance
HypophosphatemiaSigns & Symptoms
HyperphosphatemiaSigns & Symptoms
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Fluid & Electrolyte Balance
E. Variables Affecting Fluid & Electrolyte Balance1. Lifestyle Factors
a. Nutritionb. Exercisec. Stressd. Age
e. Physiological Factorsf. Clinical Factors
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Factors to Consider with I and O
Oral liquidsFoods that are liquid @ room tempIce chipsIV fluidsFormula & H2O administered through GIfeedingFluids used to flush enteral feeding tubesFluids used to flush NG drainage tubes
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Factors to Consider with I and O
UrineVomitus
Liquid stoolDrainage from gastric suction tubesDrainage from chest tube
Drainage from closed drainage tubes
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Questions???