Fluids and Electrolytes

Question 0

Regulation-I/O

Answer 0

• intake–>2400-2800ml
  
  • oral 12-1500
  • foods 1000-1100
  • oxygen 200
• output–>22-2600ml
  
  • urine 14-1500
  • skin 350-400
  • lungs 350-400
  • sweat 100
  • GI 100-200
• oral intake=urine output
• min. output by kidneys/hr =300ml

Why important

• fluid has to go somewhere
• if you know kidneys don’t work, don’t give fluids
• BP, edema

Question 1

Distribution of Body Fluids

Answer 1

Intracellular

• in cells of body
• 2/3 of total body fluids in adults

Extracellular

• outside of cells
• 1/3 of total body fluid
• intravascular, interstitial, transcellular

Question 2

Insensible Water Loss

Answer 2

• continuous loss from the skin and lungs
• not perceived by person, can’t measure
• significantly increases with fever/burns

Question 3

Sensible Water Loss

Answer 3

• loss from skin through perspiration
• can be observed
• directly related to stimulation of sweat glands

Question 4

Monitoring I/O

Answer 4

• post surgery–>lose more blood volume
• unstable condition–>kidney, heart, lungs
• increased temperature–>dehydration
• restricted fluids –>NPO
• IV therapy, catheter
• receiving diuretic–>makes you pee more
• cardiopulmonary illness
  
  • fluid not shifting properly
  • worried about overload
• because body unable to regulate

Question 5

Hormonal Regulation

Answer 5

ADH

• controls amount of fluid excreted by kidneys
• slows fluid excretion because need it elsewhere

Aldosterone

• hormone reabsorbs Na and water from kidney tubules
• opposite

Osmoreceptor Cells

• sense volume and concentration of blood
• stimulate thirst

Hypothalamus
-thirst mechanism

Question 6

Electrolytes-Cations (positive)

Answer 6

Sodium

• most abundant cation in ECF
• regulated by dietary intake and aldosterone secretion
• water balance
• high salt makes you thirsty–>don’t drink, shouldn’t pee

Potassium

• principle cation in ICF
• regulated by diet and renal excretion
• vital for nerve conduction
• too much can kill you from cardiac arrhythmia
• found in bananas

Question 7

Electrolytes-Anions (negative)

Answer 7

Chloride

• major anion in ECF
• regulated in diet and kidneys
• follows sodium

Bicarbonate

• major chemical base buffer in body
• found in ECF and ICF
• regulated by kidneys
• brings acid back to normal

Question 8

Factors in Electrolyte Imbalance

Answer 8

• age–>infants, greater body water proportion
• gender and body size–>men lose weight faster
• environmental temp.–>heat and humidity
• lifestyle
  
  • heavy drinking–>dehydration
  • poverty–>junk is cheaper
  • athletes–>sports drinks high sugar content
  • poor diets high in salt

Question 9

Fluid Deficit

Answer 9

• mild–>2% of body weight loss
• moderate–>5% of body weight loss
• severe–>8% of body weight loss

Question 10

Turgor

Answer 10

• skin’s elasticity

- should return to normal immediately

Question 11

Edema

Answer 11

• swelling resulting from excessive accumulation of fluid
• shiny, skin taut
• weight gain
• wet, leaks fluid

Question 12

Dehydration

Answer 12

• excessive loss of water from tissues
• imbalance of electrolytes

Signs and Symptoms

• poor turgor, dry skin, dry membranes
• coated tongue, sunken eyes
• oliguria, concentrated urine
• irritability, confusion, headache
• thirst, weight loss
• increase TPR, decreased BP, increased Hct