Fluids and Electrolytes

Prepared by: Mr. Nestlee S. Cabaccan RN, MSN, USRN

Mr. Nestlee S. Cabaccan RN, MSN, USRN

Fluid and Electrolyte Balance

 

To maintain good health, a balance of fluids and electrolytes, acids and bases must be normally regulated for metabolic processes to be in working state. A cell, together with its environment in any part of the body, is primarily composed of FLUID. Thus fluid and electrolyte balance must be maintained to promote normal function. Potential and actual problems of fluid and electrolytes happen in all health care settings, in every disorder and with a variety of changes that affect homeostasis.

Mr. Nestlee S. Cabaccan RN, MSN, USRN

Definition of terms
Fluids  a solution of solvent and solute Solvent  a liquid substance where particles can be dissolved Solute  a substance, either dissolved or suspended in a solution Solution  a homogeneous mixture of 2 or more substances of dissimilar molecular structure  usually applied to solids in liquids but applies equally to gasses in liquids
Mr. Nestlee S. Cabaccan RN, MSN, USRN

Osmole  the weight in grams of a substance producing an osmotic pressure of 22.4 atm. when dissolved in 1.0 litre of solution  (gram molecular weight) / (no. of freely moving particles per molecule) Osmolality  the number of osmoles of solute per kilogram of solvent Osmolarity  the number of osmoles of solute per litre of solution Mole  that number of molecules contained in 0.012 kg of C12, or,  the molecular weight of a substance in grams = Avogadro's number  = 6.023 x 1023 Molality  the number of moles of solute per kilogram of solvent Molarity  is the number of moles of solute per litre of solution
Mr. Nestlee S. Cabaccan RN, MSN, USRN

THE BODY FLUIDS
A

solution of solvent and solutes  Our body is made up of fluids and solids  About 50-60% of the body weight is WATER  In a 70 Kg adult male: 60% X 70= 40-42 Liters  Note that 1 kg body weight= 1 liter of water  The body has two major compartments: 1 Intracellular 2. Extracellular

Mr. Nestlee S. Cabaccan RN, MSN, USRN

The Proportion of Body Fluids
Interstitia l 15%
Intravascu lar 5%
Transcellula r 1-2%

Intracellular fluid 40%

Mr. Nestlee S. Cabaccan RN, MSN, USRN

TOTAL BODY WATER (AS PERCENTAGE OF BODY WEIGHT) IN RELATION TO AGE AND SEX

AGE UNDER 18 18-40 40-60 OVER 60
Mr. Nestlee S. Cabaccan RN, MSN, USRN

MALE 65% 60% 50-60% 50%

FEMALE 55% 50% 40-50% 40%

Electrolytes
 Active

chemicals that carry positive (cations) and negative (anions) electrical charges  Major cations: • Major anions:
    

Sodium Potassium Calcium Magnesium Hydrogen ions

– Chloride – Bicarbonate – Phosphate – Sulfate

 Electrolyte

– in the fluid compartments concentrations differ Proteinate ions

Mr. Nestlee S. Cabaccan RN, MSN, USRN

Electrolytes (cont.)
 Major

cation in ECF cation in ICF

Sodium Potassium

 Major

Mr. Nestlee S. Cabaccan RN, MSN, USRN

Body Fluids

Mr. Nestlee S. Cabaccan RN, MSN, USRN

Function

   

Transporter of nutrients , wastes, hormones, proteins and etc Medium or milieu for metabolic processes Body temperature regulation Lubricant of musculoskeletal joints Insulator and shock absorber

Mr. Nestlee S. Cabaccan RN, MSN, USRN

THE Normal DYNAMICS OF BODY FLUIDS

The methods by which electrolytes and other solutes move across biologic membranes are Osmosis, Diffusion, Filtration and Active Transport. Osmosis, diffusion and filtration are passive processes, while Active transport is an active process.

Mr. Nestlee S. Cabaccan RN, MSN, USRN

Regulation of Fluid
 Movement

of fluid through capillary walls depends

on:

Hydrostatic pressure

Pressure exerted on the walls of blood vessels Pressure exerted by the protein in the plasma

Osmotic pressure

 The

direction of fluid movement depends on the differences of hydrostatic and osmotic pressure

Mr. Nestlee S. Cabaccan RN, MSN, USRN

Regulation of Fluid (cont.)
 Osmosis  Diffusion  Filtration  Active

transport

Mr. Nestlee S. Cabaccan RN, MSN, USRN

Osmosis
 Movement

of fluid from and area of lower solute concentration to an area of higher solute concentration

Mr. Nestlee S. Cabaccan RN, MSN, USRN

Diffusion
 Movement

of molecules and ions from an area of higher concentration to an area of lower concentration

Mr. Nestlee S. Cabaccan RN, MSN, USRN

Filtration
 Movement

of water and solutes from an area of higher hydrostatic pressure to an area of lower hydrostatic pressure.  Process where substances/solutes move from an area of lower concentration to an area of higher concentration with utilization of ENERGY  It is called an “uphill movement”  Usually, a carrier is required. An enzyme is utilized also
Mr. Nestlee S. Cabaccan RN, MSN, USRN

Active Transport
 Physiologic

pump that moves fluid from an area of lower concentration to one of higher concentration against the concentration gradient

 Movement

 Sodium-potassium

pump maintains the higher concentration of extracellular sodium and intracellular potassium adenosine (ATP) for energy

 Requires

Mr. Nestlee S. Cabaccan RN, MSN, USRN

Types of Active Transport:

Primarily Active Transport
 

Energy is obtained directly from the breakdown of ATP One example is the Sodium-Potassium pump Energy is derived secondarily from stored energy in the form of ionic concentration difference between two sides of the membrane. One example is the Glucose-Sodium co-transport; also the Sodium-Calcium counter-transport

Secondary Active Transport

Mr. Nestlee S. Cabaccan RN, MSN, USRN

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