FUTURE READY FUTURE SMART PROGRAM

STUDY GUIDE

WEEK 3

Subject NCM 105- Fluids & Electrolytes

Topics Factors Affecting Fluids & Electrolytes
Yr./Section BSN 3
Date/Week Week 3
Time Allotment 3:30-6:30PM
School Year SY 2021-2022

I. Objectives

- Identify factors affecting Fluids & Electrolytes loss

- Enumerates sources of fluid intake
- To be able to assess an individual with Fluid & Electrolytes
Imbalance (Head to Toe Assessment)
- Learn normal values of different laboratory test requested to identify alterations
in fluids & electrolytes

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 II. Discussion

Factors affecting Fluids & Electrolytes loss:

1. Climate
2. Diet
- inadequate nutritional intake
3. Stress
4. Illness
5. Trauma
6. Medical Treatment
7. Medication
8. Surgical Procedures

Abnormal Sources of Fluid Intake:

1. Intravenous Solution
- Solution containing fluids & electrolyte which is used to replace volume &
correct abnormalities
2. Total Parenteral Nutrition (TPN)
- it is also referred as hyper alimentation;
- an IV fluids providing concentrated glucose, fat emulsion, protein & additives
such as vitamins, minerals, electrolytes, trace elements & lipids
3. Blood Volume Replacement
4. Colloids
- Fluids that contains solutes of a higher molecular weight; they are
hypotonic substances; they pull H2o from the interstitial space.

Head-to- Toe Assessment of Fluid & Electrolytes imbalance

What to Observe:
1. Behavior & appearance
2. Skin
3. Mucous membrane
4. Eyes
5. Vital Sign
6. Neurological sign
7. Neurovascular sign
8. Weight
9. Urine
10Laboratory Test
Laboratory Test used to Assess F & E:

1. Osmolality
- Laboratory test defining solute concentration per liter of solvent. It measures
solute concentration per kg in blood & urine
Measurement:
Milliosmole/kg of H20 (mOsm/kg)
Normal Value:
Serum: 280-300mOsm/kg
Urine: 50-1400mOsm/kg
Factors causing increase Osmolality:
Urine:
FVD (Fluid Volume Deficit)
Serum:
Diabetes Mellitus
Hyperglycemia
Na Overload
Uremia
Factors causing decrease Osmolality:
Urine:
FVE (Fluid Volume Excess)
Serum:
Renal Failure
Diuretics
Adrenal Insufficiency
2. Osmolarity
- Measurement of the number of solute particles per liter of solution.
Measurement:
Milliosmoles per liter (mOsm/L)
Normal values:
270-300mOsm/L
3. Urine Specific Gravity
-Measures the kidney ability to excrete & conserve H20.
Normal Range: 1.001-1.040
Random: 1.000-1.020
Physiologic Range: 1.025-1.035
- less reliable indicator of concentration because it varies with urine volume.
4. BUN (Blood Urea Nitrogen)
- made of urea which is an end product of protein metabolism
Normal range:
10-20 mg/dl (3.5mmol/L

5. Creatinine
- End product of muscle metabolism
Normal Range:
0.6-1.5 mg/dl (5.3mmol/L)
- Best indicator of renal function than BUN
6. Hematocrit
- Measures the volume percentage of RBC in whole
blood Normal Range:
Female: 37-47%
Male: 40-54 %

7. Urine Na values
-Affected by Na intake & status of fluid volume.
Normal Range:
50-130mEq/L (50-130mmol/L)

Client at Risk for Fluid % Electrolytes Imbalances:

 Client dependent on others to meet their food & fluid needs
 Clients who have gained or loosed more than 5lb. in a week
 Client who are permitted Nothing Per Orem
 Client with retention catheter & urinary drainage system
 Client intravenous infusion
 Client with special drainage or suctions
 Client receiving diuretic
 Client experiencing excessive fluid losses requiring increase intake
 Client who retain fluid
 Client with fluid restriction
 Client with severe trauma or burns
 Client with chronic disease
 Confused client or those who/or with altered LOC (Level of Consciousness) who may
not be able to communicate their needs or respond to thirst.

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.
(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.)