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Fluid Electrolyte Basics
Fluid Electrolyte Basics
Basics
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2013
www.pocketprofnursing.com
Homeostasis
Body fluids are in
constant motion
transporting nutrients,
electrolytes, and oxygen
to cells while carrying
away waste products
Many disease and
treatments affect this
balance
Water
More important to life than any other nutrient
Intake
Measurable
Output
Measurable
Oral fluid,
tube
feedings
Urine
Parenteral
fluid
Emesis
Enemas
Feces
Retained
irrigation
fluid
Drainage
from
body cavities
Not
Measurable
Not
Measurable
Solid foods
Sweating
Metabolism
Vaporization
through
Electrolytes
Chemicals dissolved in the body fluid,
distribution affects fluid balance
Regulated by intake, output, acid-base
balance, hormones, and cell integrity
Sodium
Major extracellular electrolyte
Controls and regulate water balance
Potassium
Major intracellular electrolyte
Helps maintain intracellular water balance
Transmit nerve impulses to muscles and
contract skeletal and smooth muscles
F&E Labs
Sodium (Na) 135-145
Determines whether water is retained, excreted, or
moved
Imbalances cause neuro problems
Potassium (K) 3.5-5.0
Increased with poor kidney function
Decreased with excessive urination, diarrhea, vomiting
Imbalances cause cardiac problems
Chloride (Cl) 96-106
Works with sodium to maintain osmotic pressure
Increased with poor kidney function
Decreased with excessive vomiting or diarrhea
F&E Labs
Calcium (Ca) 9.0-10.5
Transmission of nerve impulses, heart and muscle
contractions, blood clotting, formation of teeth and
bone
Requires Vit D for absorption
Phosphate (PO4) 3.0-4.5
Balance is intertwined with calcium
Other tests
BUN 6-20
Creatinine 0.6-1.3
Hematocrit 42-52% (males), 37-47% (females)
Total protein, albumin
Range
Magic 4
Potassium
3.5 5.5
Chloride
98 106
104
Sodium
135 - 145
140
pH
7.35 7.45
7.4
pCO2
35 45
40
HCO3
22 26
24
Filtratio
n
Osmosi
s
Fluid Spacing
First spacing
Normal
Second spacing
Edema
Third spacing
Ascites
Burn edema
IV Fluids
Isotonic
NS
D5W
LR
Hypertonic
3% NS
D51/2NS
D10W
Hypotonic
1/2NS
Plasma Expanders
Gerontologic considerations
Percent of body weight of water is decreased
Structural changes in the kidney and decreased
renal blood flow
Decreased GFR
Decreased creatinine clearance
Loss of ability to concentrate urine and thus
conserve water
Decrease in renin and aldosterone
Increase in ADH and ANP
Assessment Considerations
History nutrition, I/Os, insensible losses,
use of diuretics/laxatives, weight changes,
kidney or endocrine disorders, LOC, mental
status, depression, eating disorders, alcohol
intake
Physical hydration status, skin turgor,
mucous membranes, I/Os
Dx tests electrolyte levels, BUN, glucose,
creatinine, pH, bicarb, osmolality, Hgb, Hct,
urine dipstick, urine pH, urine specific gravity
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