WEEK 8: BODY FLUIDS

BODY FLUIDS
The primary body fluid is water, it is said to be the most important nutrient of life. Although life can be sustained
for many days without food, humans can only survive a few days without water. Water in the body functions primarily to
transport nutrients to cells, also wastes from this cells. It also functions to transport hormones, enzymes, blood
platelets, red blood cells and white blood cells. Water is also involved in cellular metabolism and proper chemical
functioning of different bodily structures. Helps normal body temperature and facilitate digestion and promotes the
elimination of toxic substances
Intracellular Fluid (ICF)
Fluid within cells constituting about 70% of the total body water or 40% of an adult’s body weight.
Extracellular Fluid (ECF)
Fluid outside of the cells, it accounts for about 30% of the total body water or 20% of an adult’s body weight. It
includes 2 major areas: Intravascular and Interstitial Compartments. Third, usually minor compartment is the Trans
cellular Fluid
 Intravascular Fluid
Plasma- liquid component of the blood.
 Interstitial Fluid
Fluid that surrounds tissue cells and it includes your lymph.
 Trans cellular Fluid
Includes cerebrospinal fluid, pericardial, synovial, intraocular, plural fluids as well as sweat and digestive
secretions
FLUID INTAKE AND OUTPUT. In the hospital when we record a pts fluid input and output, the values are close,
more or less they are equal.
Water is added to the body by 2 major sources.
First, it is ingested in the form of liquids or watering food,
which together normally add about 2100 mL per day to
the body fluids Second, it is synthesized in the body by
oxidation of carbohydrates. So via the oxidation of
carbohydrates, you have the addition of about 200 mL per
day. So this mechanisms provide a total water intake of
about 2300 mL per day.
** General rule: in the healthy adults, the output of urine
normally approximates the ingestion of liquids. And the
water from food and oxidation is balanced by the water
loss through the feces, the skin, and the respiratory
process. SO the intake output balance may not always
occur in a single 24 hour period but should normally be
achieved within 2-3 days, any deviation from these
normal ranges should alert the nurse to potential
imbalances.

MAJOR ELECTROLYTES

Electrolytes – substances that are capable of breaking into particle called ion.
Ion – an atom or molecule that carries an electrical charge. Some ions develop a positive charge and it is called cations.
Major cations in body fluids are: Sodium, Potassium, Calcium, Hydrogen and Magnesium Ions. Other develop a
negative charge and are called Anions.
Electrolyte Normal Value Functions and Sources
Sodium (Na+) chief 135 – 145 mEq/L Role in the muscle contraction and transmission of nerve
electrolyte of ECF impulses.
Normally enters the body through the gastrointestinal tract from
dietary sources, such as salt added to processed foods, sodium
preservatives added to processed foods

**In the hospital when caring with a pt with hypertension, low

salt diet, for the heart muscle won’t be stressed. Other role of
sodium is it increases both the amount of fluid surrounding the
cells and the volume blood in the blood stream. So increased
blood volume would mean more work for the heart and more
pressure on the blood vessels. So overtime, the extra work and
pressure can stiffen blood vessels leading to high blood pressure
or heart attack and stroke.

Potassium (K+) major cation
of ICF
3.5 – 5.0 mEq/L Role in the transmission of electrical impulses in nerve, heart,
skeletal, intestinal, and lung tissue
Leading food sources: fruits and vegetables, dried peas and
beans, whole grains, milk, meats. Lost via kidneys, stool, sweat,
emesis (vomiting). Gastrointestinal (GI) secretions contain
potassium in large quantities, so can be lost through vomitus.

**Trivia: Potassium – diets that emphasize greater potassium

intake can help keep the blood pressure in a healthy range
 compared with potassium poor diet

Calcium (Ca2+): most
abundant electrolyte in the
body; 99% of the body
calcium is stored in bone;
1% inside cells
4.5 – 5.1 mg/dL Role in blood coagulation and in transmission of nerve impulses
Absorbed from foods in the presence of normal gastric acidity
and vitamin D
Lost via feces and urine

** Getting enough vit D maybe the most important variable in

preventing osteoporosis. It’s because vit D’s function in the
body is to aid or help in calcium absorption.

Magnesium (Mg2+): second
most abundant ICF cation
after potassium
13 – 2.3 mEq/L Acts on cardiovascular system, producing vasodilation (blood
vessels dilating)
Magnesium found in green, leafy vegetables; nuts; sea food,
whole grains, dried peas and beans, cocoa

Lost via urine with use of loop diuretics (drugs help induce
urination)

**Mg is naturally present in a variety of foods available as a

supplement and an ingredient in antacids and laxatives. This
mineral plays an important role in assisting more than 300
enzymes to carryout chemical reaction in the body.

Chloride (CI-): major ECF 97-107 mEq/L Major component of intestinal and lymph fluid; gastric and
anion pancreatic juices, sweat, bile and saliva

Bicarbonate (HCO3): an 25 – 29 mEq/L Regulates acid-base balance

anion that is the major
chemical base buffer within
the body; found in both ECF
and ICF
Phosphate (PO4)
Losses possible via diarrhea, diuretics
Excess possible via over ingestion of acid neutralizers, such as
sodium bicarbonate
2.5-4.5 mg/dL Promotes energy storage, carbohydrate, protein and fat
metabolism

FLUID HOMEOSTASIS (how fluids are balanced in the body)

Osmosis – cells are said to be semi permeable, cell membrane is permeable to water or
fluids. Through the proses of osmosis, water passes from an area of lesser solute
concentration and more water to an area of greater solute concentration and less
water until equilibrium is established. As a result, the volume of more concentrated
solution increases and the volume of the weaker solution decreases. The process of
osmosis stops when the concentration of solutes has been equalized on both sides of
the cell membrane.

Diffusion (coasting downhill) – tendency of solutes to move freely throughout

solvents so the solutes move from an area of higher concentration to an area of lower
concentration (downhill) until equilibrium is established. Gasses also move by diffusion. Oxygen and CO2 exchange in
the lungs alveoli and capillaries to … by diffusion

Active Transport (pumping uphill)– it uses energy. It is a process that requires

energy for the movement of substances through a cell membrane against the
concentration gradient from an area of lesser solute concentration to higher solute
concentration. So ATP which is stored in cells supplies energy for solute
movement in and out of the cell. This process explains the so called pump
mechanism. It is somewhat similar with diffusion just that in AT, there is energy
used. Substances believe to use active transport which include the amino acid,
glucose and ions of sodium potassium, hydrogen and calcium
Filtration- it is the passage of fluid through a permeable membrane. Fluids move
from an area of high pressure to one of lower pressure. Capillary filtration results
from the force of blood pushing against the walls of the capillaries.
The pushing force is called the hydrostatic pressure. Reabsorption
is the process that acts to prevent too much fluid from leaving the
capillaries no matter how high the hydrostatic pressure is. So you have
the involvement now of plasma proteins particularly albumins
concentrated in the intravascular space or plasma facilitate this
reabsorption process by pulling the fluid back in the capillaries. This
pulling force is called colloid osmotic pressure or oncotic pressure.
Filtration is also involved in the proper functioning of the glomeruli of
the kidneys.
BLOOD
“Blood is a connective tissue that consists of blood plasma (liquid) plus formed
elements (ed blood cells, white blood cells, and platelets”
*Centrifuge – used to separate fluids, gas or liquid based on density .
 These blood cells all start up as PHSC. So the blood cells begin their lives in the bone marrow from a single type
of cell called pluripotential hematopoietic stem cells, from which all the cells of the circulating blood are eventually
derived. All these cells produce small portion of them remain exactly like the original pluripotential cells and is retained
in the bone marrow to maintain a supply of these.
**PHSC ang pinagmumulan ng blood cells natin, so they mature in the erythrocytes, macrocytes, T-lymphocytes and B-
Lymphocytes, pero hindi lahat ng pluripotential stem cells nag mamature into these things.yung iba they remain as PHSC
in the bone marrow.

Reaction of RBC to different solutions like Isotonic, Hypertonic

and Hypotonic solution.
Isotonic Solution - no changes happen to RBC
Hypertonic Solution – cells would shrink
Hypotonic Solution – cells would swell or burst

**When RBC are in a hypertonic, water flows out of the cell

faster than it comes in. This results in crenation or shriveling of
the blood cell
When RBC is in hypotonic, will result in more water flowing
into the cell than out. Meaning, in swelling of the cell and
potential hemolysis (bursting of the cell)
In isotonic, the flow of water in and out of the cell is happening
at the same rate, there is no changes.

SEMEN
A mixture of sperm and seminal fluid, a liquid that consists of the secretions of the seminiferous tubules,
seminal vesicles, prostate, and bulbourethral glands.
The volume of semen in a typical ejaculation is 2.5 – 5 millimeters (mL), with 50-150 million sperm per mL.
Sperm Cells are stored and mature in the epididymis. When the number falls below 20 million per mL, the male is likely
considered to be infertile. So a very large number of sperm is required for a successful fertilization because only a tiny
fraction ever reaches the secondary oocyte or eggcell
Fluids contributed by the seminal vesicles are approximately 60 percent of the total semen volume; these fluids
contain fructose, amino acids, citric acid, phosphorus, potassium and hormones known as prostaglandins. The prostate
gland contributes about 30 percent of the seminal fluid; the constituents of its secretions are mainly citric acid, acid
phosphate, calcium, sodium, zinc, potassium, protein- splitting enzymes, and fibrolysin (an enzyme that reduces blood and
tissue fibres). A small amount of fluid is secreted by the bulbourethral and urethral glands; this is a thick, clear,
lubricating protein commonly known as mucus.
Despite the slight acidity of prostatic fluid, semen has a slightly alkaline pH of 7.2 – 7.7 due to the higher pH
and larger volume of fluid from the seminal vesicles.
The prostatic secretion gives semen a milky appearance, and fluids from the seminal vesicles and bulbourethral glands
give it a sticky consistency. ** Seminal Fluid provides the sperm with a transportation medium, nutrients and protection
from the hostile acidic environment.
Coagulates within 5 minutes once ejaculated due to the presence of clotting proteins from the seminal vesicles.
After about 10 to 20 minutes, semen reliquefies because prostate specific antigens and other protolithic enzymes produce
by the prostate breakdown the clot.

LYMPH
About 30 liters of fluid pass from the blood capillaries into the interstitial spaces each day, whereas only 27 L
pass from the i interstitial spaces back into the blood capillaries. If the extra 3 L of interstitial fluid remained in the
interstitial spaces, edema would result, causing tissue damage and eventually death. Instead, the 3L of fluid enters
the lymphatic capillaries, where it is called lymph, and it passes through the lymphatic vessels to return to the blood.

COMPOSITION OF LYMPH
Lymph contains solutes derived from two sources:
a. Substances in plasma, such as ions, nutrients, gases, and some proteins, pass from blood capillaries into the interstitial
spaces and become part of the lymph
b. Substances such as hormones, enzymes, and waste products, derived from cells within the tissue, are also part of the
lymph.

CEREBROSPINAL FLUID
Cerebrospinal fluid (CSF) bathes the brain and spinal cord, providing a protective cushion around the CNS. It is
produced by the choroid plexuses, specialized structures made of ependymal cells, which are located in the ventricles.
CSF fills the brain ventricles, the central canal of the spinal cord, and the subarachnoid space.
** The normal color of the CSF has to be clear and colorless. When there is blockage of the openings in the fourth
ventricle, or the cerebral aqueduct, you can have CSF that accumulates in the ventricle or what we call the Hydrocephalus.
** Subarachnoid Hemorrhage or bleeding occurs when blood leaks into the space between the two membranes
surrounding the brain. So the subarachnoid space must not contain blood. A swollen blood vessel or aneurism usually
raptures and causes the condition. Hemorrhage of this type can lead to a stroke or severe consequences.

FORMATION OF URINE
 * There must be no protein
and glucose in the urine. Normal volume of the urine is usually is 1 to2 litters in 24 hours.
*ASCITES – associated with pts with liver disease. Lumalkaki si tiyan. Because of the fluid accumulation

CHAIN OF INFECTION
At any point, it can be broken.
 If WBC is elevated as well as the neutrophils, lympho…etc possible that there is an infection na linalabanan nung
pt