Functions of Body Fluids

1. The fluid movement in the body helps maintain and regulate body temperature and cell shape
o Provides the warmth to maintain the body's homeostasis
2. Fluid helps transport nutrients, gases, and wastes
o The fluid will serve as a medium to distribute the necessary components throughout the
body for proper functioning
3. Most of the body's major organs work together to maintain fluid balance
o In line with the fact that out body is composed mostly of water and serves as the body's
fuel to run the body's delicate machines
 About 60% of the average adult weight is composed of fluids
 Other components includes the marconutrients and micronutrients
 Proteins 18%, Fat, 16%, Minerals, etc 6%
 Coordinate and function as one to maintain the body's homeostasis also
known as equilibrium or balance
o The amount of fluid gained through intake should be equal the amount loss
 Less or more will cause instability and defects
Factors that affect the amount of total body water (ABS)
The average percentage of water in a person's body is around 60% but can vary roughly from 45% to
75%
1. Age
o The proportion of body water decreases with aging
 The amout of water as a percentage decreases with age until puberty
o The risk of suffering fluid imbalance increases with age
 Because skeletal muscle mass declines
 Skeletal muscle cell hold much of water and the proportion of fat tissue
contains less water
o Old age
 Only about 45% of body weight consists of water
o Infants
 Consists of 80% water
 Have the highest proportion of water
 Has greater percentage of body water stored inside the interstitial spaces
 Varies slightly depending on maturity
 Full term infant
 80% water
 37 to 42 weeks gestation
 Preterm infant
 90% water
 Baby born below 36 weeks
o Adult Males
 60% of body weight
o Adult Female
 50% of body weight
2. Body Fat
o Fatty tissues contain less water than muscle, so the percentage of water can vary with
body type
o Obese people
  Have lower percentage of body water
 Because fat tissue is essentially free of water
3. Sex
o The female contains a lower percentage of water than a male
 It's a reality that the lifestyle between male and female is different thus
influencing the amount of water present in the body in terms of their
 Daily routine
 Interests
 Body's profile
 Body's metabolism
o Females
 Higher body fat
 Smaller amount of skeletal muscle
 
How to maintain the amount of fluid in the body?
 People can maintain the balance of water in their bodies by drinking fluids throughout the day.
They may need to drink more water after exercise and in hot weather to compensate with water
requirement.
 
Distribution of Body Fluids
 

o Two basic areas of compartment

 Main purpose is to maintain the proper fluid balance
 The distribution of fluid between the two compartments must maintain
relatively constant
 Intracellular fluid: 40%
 Found within the cells of the body
 Constitutes approximately 2/3 or 40% of the total body fluid in adults
 Equivalent to 28 liters
  Vital for normal cell functioning
 Contains the solutes:
 Oxygen, electrolytes, and glucose
 Provides a medium in which metabolic processes of the cell take place
 Extracellular Fluid: 21%
 Found outside the cell
 Can be broken down
 Accounts for about 1/3 or 21% of the total body fluids
 Equivalent to 14 liters
 Also serves as the transport system that carries the nutrients to the cells and
excretes waste products
 Contains 3 kinds of fluids
 Intravascular Fluid: 4%
 Found within the vascular space
 Includes the plasma
 The liquid portion of the blood
 Carries oxygen from the lungs and glucose from the
gastrointestinal tract to capillaries of the blood system
 Transcellular Fluid: 1%
 Secreted by the epithelial cells
 Includes:
 Cerebrospinal fluid
 Pericardial, pancreatic, pleural, intraocular, biliary
ploutonia, synovial fluid
 Not subject to fluid loss and gain daily
 Interstitial Fluid: 16%
 Found outside the cells
 Surround the cell
 Includes the limb
 Comprises about 3/4 of the total extracellular fluid

Tonicity describes how an extracellular solution can change the volume of a cell by affecting osmosis
1. Hypotonic Solution
o Has a lower concentration of solutes
o A solution outside of a cell is called hypotonic if it has a lower concentration of solutes
o Due to osmotic pressure, water diffuses into the cell, and the cell often appears turgid,
or bloated
 Osmotic pressure is the minimum pressure that is applied to a solution to
prevent the inward flow of its pure solvent across a semipermeable membrane
 The pressure that needs to be applied to prevent osmosis from taking
place
2. Hypertonic solution
o Has a higher concentration of solutes
o A solution outside of a cell is called hypertonic if it has a higher concentration of
solutes
o Contains more dissolved particles (salt and electrolytes) that is found in normal cells
and blood
3. Isotonic Solution
 o The extracellular fluid has the same osmolarity as the cell and there will be no net
movement of water into or out of the cell
 Osmolarity is the number of solute particles per 1L of solvent
o Has the same osmolarity or solute concentration
o The water and other dissolved particles will flow in equal parts out of each solution
and into the other
 The effect is zero water flow
 No net movement
o Some cells must be maintained in such kind of solution to maintain their functioning
 
Types of IV Solutions
1. Hypotonic Solutions
o Less concentrated than extracellular fluid which allows movement from the blood-
stream into cells
 causing the cells to expand
o Osmolality: less than 250 mOsm/kg
 Based on the mass of the solvent
o Example:
 Half-normal saline solution, D2.5% W
 
What are the considerations of Hypotonic solutions in the body?
 Can cause cardiovascular collapse from vascular fluid depletion
o Increasing intracranial pressure (ICP) due to fluid shift into brain cells
 Avoid using in patients who had
o Stroke
o head trauma
o Neurosurgery
o Suffer from abnormal fluid shifts into the interstitial space or body cavities:
 Liver disease
 Burns
 Trauma
2. Hypertonic Solutions
o More concentrated than extracellular fluid which allows movement of fluid from cells
into the blood stream
 Causing the cells to shrink
o Osmolality: greater than 300 mOsm/kg
o Example:
 D10W, D5% in half-normal saline solution, D5% normal saline solution
What are the considerations in administering Hypertonic solutions?
 Not tolerated by those with cardiac or renal disease
o May cause more stress and workload
 May cause fluid overload and pulmonary edema
 Should not be used in patients at risk for cellular dehydration (DKA)
o Such as those with Diabetic Ketoacidosis
3. Isotonic Solutions
o Same concentrations of solute and solvent
 So fluid doesn't shift between extracellular and intracellular spaces
 o Osmolality: 250-300 mOsm/kg
o Example:
 D5W, Normal Saline Solution, Lactated Ringer's Solution

What are the vital organs responsible in body's fluid losses

 The major organs that work together to maintain the proper balance of fluid are:
1. Skin
2. Lungs
3. Kidneys
 
There are two types of fluid losses
1. Insensible losses
o The amount of bodily fluid lost daily
o These are immeasurable losses
o Examples:
 Fluid lost though the
 Skin
 Lungs
 Affected by respiratory rate and depth
 The greater the rate and depth, the greater the loss
 Normally eliminate water vapor at a rate of 300mL per day
2. Sensible losses
o The amount of bodily fluid lost daily
o These are measurable losses
o If the sensible loss constantly exceeds the fluid intake of the person, the possible result
is dehydration
o Examples:
 Urine (through urination)
 Feces (through defacation)
 Wounds
 Discharges
1. Routine Urine Examination/Urinalysis
o Analyzes the urine for:
 Appearance
 Glucose
 Specific gravity
 Ranges from 1.0053-1.030
 Medical Interpretations
As part of the health care team, laboratory information assists the medical
practitioners to make the appropriate evidence-based diagnosis
 Low specific gravity
 Diabetes insipidus
 Glomerulonephritis
 Pyelonephritis
 Other renal abnormalities
 High specific gravity
 Dehydration
  Diarrhea
 Emesis
 Excessive sweating
 Urinary tract/bladder infection
 Glucosuria
 Microscopic microorganisms
2. Blood Urea Nitrogen Test
o Monitoring laboratory data such as Blood Urea Nitrogen (BUN) aid the nurse in
determining the hydration and metabolic functioning
 Urea is the end product of protein metabolism by the liver from both muscle and
dietary intake
o Considering that the main function of your kidneys is to remove waste and extra fluid
from your body
o If there is an abnormality in BUN results, it only signifies that kidney injury or disease is
present, nutrition deficit, and hydration aspects
o Factors that increase the BUN level
 Decreased renal function
 Gastrointestinal bleeding
 Dehydration
 Increased protein intake
 Fever
 Sepsis
o Factors that decrease the BUN level
 End stage liver disease
 Low protein diet
 Starvation
 Any condition that result in expanded fluid volume
1. Example: pregnancy
Because the concern is deficit then we must replace it with fluid
1. Fluid Restoration
o Oral rehydration
 If fluid loss is mild
o Oral glucose replacement
 Glucose will increase the uptake of sodium and thus the water by the intestine
o Avoiding soda, soft drinks
 They do not contain the adequate electrolyte replacement
 The caffeine in the cola may lead to diuresis
 Increase of production of urine
o Give antiemetics
 To control nausea before drinking
o Intravenous rehydration
 When fluid loss is severe or life threatening