FUTURE READY FUTURE SMART PROGRAM

STUDY GUIDE

WEEK 2

Subject Fluids and Electrolytes

Topics
Yr./Section
Date/Week Week 2
Time Allotment
School Year 1st Quarter/SY 2020-2021

I. Objectives

- Discuss the overview of body fluids and its solutes

- Identify sources of body fluids
- Give examples of body Fluids and its solutes
- Distinguish non-electrolytes from electrolytes
- Explain the importance of body fluids and its solutes

II. Discussion

Movements of Body Fluids

1st Phase
Blood Plasma moves around the body within the circulating system and &
nutrients & fluids are picked up from the lungs & GIT

2nd Phase
Interstitial fluid & its component move between the blood & the cells

3rd Phase
Fluids & its component move back from the cells to the interstitial space & then
to the intravascular compartment. The intravascular fluid then flows to the kidney &
where the metabolism by product of the cells are excreted in the form of urine

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 Key Notes:
Fluid shifts or movement are potentially dangerous, mechanism. Plasma to interstitial
fluid shift can result to shock & an interstitial fluid to plasma shift can lead to pulmonary
edema. They are both critical & life threatening complications.

Scenario:
Patient was diagnosed with Renal Failure as patient having problem with the kidney
excretion of the metabolism by product of the cell decrease due to diminished or
decrease in urine output. Once this by product cannot be eliminated it will return back
to intravascular compartment. An excess amount of intravascular fluids will over
hydrate the vascular system resulting to dilution of RBC; the patient then will manifest
sign of anemia & hypotension. Once fluids can no longer accommodate in the
intravascular compartment it will return back to the interstitial compartment occupying
the interstitial space. As fluids overload the interstitial space the fluids will try to find
way to escape from the body; a leak in the interstitial space will result to Edema.
Continuous overflowing of body fluids it will trigger the heart to double its pumping
action to assist the movement of blood in other compartment of the body like the GIT
resulting to Ascites ; Once the GIT become full the fluid then draw back to the lungs
leading to Pulmonary Edema. Continuous pumping of heart more than the normal will
lead to tiredness and patient start to feel weak and tired as the Heart start to congest
leading to Congestive Heart Failure. The end product and excess fluids will not stop but
rather keeps moving finding its way to come out from the body; even to the tiny pores
of the skin will become a route of elimination through perspiration; Larger amount of
end product will blocked the tiny pores resulting to uremic frost, Patient skin become
dry & itchy. Once the skin can no longer be a route the Urea will move up to the brain
triggering the medulla oblongata to dictate the body to increase exhalation (breathing).
It gives ammonia odor or smell of urine to patient. The odor comes out from the breath
and not from urine output. As the lungs collapse patient will suffer from respiratory
failure. The end product will stay in the brain resulting to Azotemia time where in the
patient start to become lethargic, stupor and later on lead to coma. Patient will die of
Multiple End organ Failure.

CONCEPT:
All body fluids are related & mix well with each other plasma become interstitial
fluids as it filters across the capillary wall. Interstitial fluid returned to capillary by
osmosis and entered in the lympathic channels become lymph. Interstitial fluid &
extracellular fluid are in osmotic equilibrium across the cell membrane regulated by the

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 Sodium (Na) ion concentration of interstitial fluid; and the Potassium ion (K)
concentration of intracellular fluid.

Methods of movements of fluids & electrolytes:

1. Diffusion
- Movement of particles into an area which is increase in concentration to
decrease concentration.
2. Osmosis
- Movement of fluids into an area of lower concentration to a higher
concentration.
Key Notes:
Pressure forcing fluids across the membrane called OSMOTIC ONCOTIC
PRESSURE.
3. Filtration
- Movement that separate fluids from suspended particles.

Type of Solution developed during Osmosis:

1. Dilute
- Small amount of solute in a relatively large amount of solvent.
2. Concentrated
- Large amount of solute in a relatively small amount
3. Percentage Solution
- Gram of solute per gram of solution

Solution developed after movement of fluid by osmosis:

1. Hypertonic Solution
- One solution is less osmotic pressure than another it draws fluid from the
other.
2. Hypotonic Solution
- One solution has more osmotic pressure than another it forces fluid into the
other.
Note:
To allow shifting of fluids between 2 compartment; electrolytes does not contain
the same amount.
Example:
Interstitial Intravascular
Decrease Protein Increase Protein
Decrease Concentration Increase Concentration

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 Note:
Role of Protein –is to exert high osmosis effect in fluid movement. Once there is
a shift of plasma to interstitial fluid shift lead to Shock. An interstitial shift to plasma
shift lead to Pulmonary Edema. Which is both a critical and life threatening condition.

Composition of Body Fluids:

 Intracellular Fluid (ICF)
Contains:
H20
Electrolytes
Protein
Nucleic Acid
Lipids
Polysaccharides
 Extracellular Fluid (ECF)
Contains:
H20
Electrolytes
Protein
RBC
WBC
Platelet
 Electrolytes Composition of Body Fluids:
Sodium (Na) – major electrolytes in the ICF
Potassium (K)- major electrolytes in the ECF
Chloride (Cl)
Calcium (Ca)
Magnesium (Mg)
Phosphorus
Bicarbonate

Organs involve in keeping the composition & volume of Body Fluids within normal:

1. Kidney
- Vital to the regulations of fluid & electrolyte balance. It normally filters 170L of
plasma/day in adult.
Major Function:
- Excretion of metabolic works & toxic substances
- Regulation of pH of ECF by retention of hydrogen ions
- Regulation of ECF & osmolality by selective retention & excretion of body fluids

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 -Regulation of electrolytes level in the ECF by retention of needed substance &
excretion of unneeded substance.

2. Heart
- Pumping action of the heart circulates blood through the kidney under
sufficient pressure for urine to form
Note:
Failure to pump – interfere with renal perfusion

3. Blood Vessel
- Capillary pressure causing vasodilation & vasoconstriction that influence
balance of fluids & electrolytes.

4. Lungs
-has a major role in maintaining acid-base balance.
Note:
Through exhalation lungs remove approximately 300ml of H20 daily in the
normal adult.
Factors that increases loss of fluids in the lungs:
- Abnormal deep breathing
- Continuous coughing
- Excessive talking
- Excessive laughing

Note:
Hypoventilation & hyperventilation influence loss of carbon dioxide & H20 which
Causing effect to fluid & electrolytes balanced.

5. GIT
- Stomach & intestines help balance the body fluid & electrolytes by absorbing
those that are needed & eliminating those that are unneeded
Note:
NaCl ions are reabsorbed
Bicarbonate was secreted by the nerveosa of the large intestine;
- It helps neutralized the acidic end product of bacterial action in the colon

6. Hypothalamus
- Primary regulator if water intake
It manufacture hormone which is responsible in the retention of H20 in the body
& its excretion.

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 7. Pituitary Gland
- Stores (ADH) Anti-Diuretic Hormone which is water conserving hormone
causing retention of H20 in the body.

8. Adrenal Glands
- Adrenal cortex secreted hormones known as Aldosterone a mineralocorticoid
which has profound effect on fluid balance.
Note:
Increase secretion result to Na retention, K loss, H20 retention.
Decrease secretions result to K retention, Na loss, H20 loss

9. Parathyroid Glands
- Embedded in the corners of the thyroid gland, regulate Ca & Phosphate
balance by means of Parathyroid Hormones.
Note:
- InfLuence bone resorption
Ca absorption - intestine
Ca reabsorption - renal tubules

Hormones that maintain Fluids & Electrolytes balance:

1. Anti-diuretic hormone (ADH)

- Also known as vasopressin. Hormone released from the posterior lobe of the
Pituitary Gland. Contains water re absorption by the kidney & regulates body fluid
osmolality resulting to increase H20 absorption.

2. Aldosterone
- A hormone secreted by zona glomerulosa of the adrenal cortex. It increase
renal reabsorption & H20 thus regulating ECF
Note:
Increase secretion result to Na retention, K loss & H20 retention
Decrease secretion result to K retention, Na loss & H20 loss

3. Parathyroid Hormone
Hormone secreted by the parathyroid glands that maintain serum calcium level

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 4. Thyroid Hormone
Kinds:
 Thyrocalcitonin
- Help maintain Ca balance
 T3 – Triiodothyronine
 T4 – Thyroxine
- Maintain sufficient cardiac output to adequately perfuse the kidney nephron to promote
glomerular filtration to maintain urine output.

Factors Stimulating ADH Secretions:

- Emotional & Physiologic Stress
- Presence of pain
- Reduced circulating blood volume
- Administration of Morphine SO4, Barbiturate & Anesthetic agent
- Hyperosmolality
= decrease in H20 relative to solute concentration or increase in solute relative
to H20.

Factors Stimulating Release of Aldosterone:

- Decreasing circulating blood volume
- Hyperkalemia
- High ACTH (Adrenocorticotropic Hormone)
- Stress

Function of Parathyroid Hormones:

1. Increase the release of Ca from bones
2. Stimulating Vitamin D production to increase Ca re absorption from the GIT
3. Stimulating Ca re absorption from urine.

Four Routes of Fluid Output:

1. Kidney
- Major avenue of fluid output in the formed of urine.
Normal Urine output:
30-150 ml/Hour
500ml- minimum amount/void
800-1,500ml/day - average

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 2. Skin
- In the formed of perspiration.
Note:
Stratum Corneum,the outer layer of the epidermis that controlled fluid loss
through the skin. And the movement of fluid is by diffusion.
Content of Sweat:
- NaCl (sodiumchloride)
- Urea
- Lactic Acid
- K (potassium)

3. Lungs
- fluid comes out as water vapour in the expired air.
Approximately 300-500ml/day

4. GIT
- fluid loss through the intestine in the form of CHYME that passes from the
intestine into the large intestine, it contain H20 & electrolytes.
Approximately 1,500ml/day – volume of chime that passes through ileocecal valve into
the cecum.

References:
Medical-Surgical Nursing 12th Edition
Brunner & Suddarth’s
Principles of Anatomy & Physiology 12th Edition
Jerald J. Tortora

III. Learning Rubric

Instruction: Please read carefully and check the

corresponding box for your answer. (Basahin ng
mabutiangbawattanong at i-tsekangkahon ng iyongsagot).

Note: Your honest answers will help us gather accurate data in order for the Teachers
to understand and provide appropriate interventions for the topic discussed.

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 (Angmatapatnapagsagot ay makapagbibigay ng tumpaknadatosupang mas higitnamaunawaan at
makapagbigay ng nararapatinterbensiyonpatungkolsapaksangito.)

YES MAYBE NO
Content
(3) (2) (1)
1. I have background knowledge about the topic.
(Mayroonnaakongkontingkaalamantungkolsapaksa.)
2. I can analyze the content to deepen my understanding.
(Kaya kongsuriingmabutiangpaksaupangmapalawak pa
angakingkaalaman.)
3. I can give my own examples.
(Kaya kongmagbigay ng sarilikonghalimbawa.)
4. I can summarize the content and information that I have
learned.
(Kaya konglaguminangpaksa at angkaalamangakingnatutunan.)
5. I clearly understood the topic.
(Luboskongnaunawaanangpaksa ng aralin.)
6. I understand the direction of each activity and answered it
correctly.
(Nauunawankoangpanuto ng bawatgawain at nasagutanito ng tama.)
7. I can enumerate the necessary steps and procedures related
to the lesson.
(Kaya konghanayinangmgahakbang at prosesona may
kaugnayansapaksangtinalakay.)
8. I can independently perform the skill, strategy or process.
(Kaya kongi-apply angakingnatutunanupangmagsagawa ng
isangkasanayan, pamamaraan, o proseso.)
9. I can relate the topic in real-life situations.
(Kaya kongiugnayangpaksasatotoongbuhay.)
10. I accomplished the task on time.
(Nataposkoangmgagawainsaitinakdangoras.)

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photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the Good Samaritan Colleges.