• transport of nutrients, electrolytes, and oxygen to cells 
• acid base balance 

water loss you can not count

ex: perspiration

• Increases the oncotic pressure
• oncotic pressure keeps fluid intravascular

albumin (a protein) pulls fluid into the veins 

assessment of body fluids: Skin

appearance and turgor

(elasticity or tonus)

assessing body fluid: Urine

what do we test

Specific gravity and Urine volume

(concentration of urine)

ways to assess body fluids

name 4

1. Skin - apperance and turgor
2. Urine volume and specific gravity (urine concentration)
3. Fluid balance - difference of intake and output
4. Daily weights - best indicator of fluid status

Diagnostics for fluid status:

name 5

1. BUN     6-20
2. Crt     0.5-1.2
3. CBC
4. UA     1.005-1.030
5. Total protein

BUN

(blood urea nitrogen)

BUN 6-20

elevated BUN generally reflects intravascular depletion

Crt

(Creatinine)

Crt 0.5 - 1.2

• provides an indication of renal perfusion that is not affected by hydration status
• kidney function

CBC

(complete blood count)

• May provide some indication of dehydratioin
• Hematocrit and hemoglobin will be elevated in dehyration and hypovolemia

Urinalysis

the specific gravity of the urine is related to the client's hydration state - what are normal values?

1.005 1.030

numbers go up in dehydration

urine ions can be specifically requested and are helpful in determining whether sodium is being retained or not

3 - 5 g/dL

excess of accumulation of fluid in the

interstitial (tissue)spaces

assessing edema 

1 ,    2mm, immediate rebound

2 ,    4mm, a few seconds to rebound

3 ,    6mm, 10-12 seconds to rebound

4 ,     8mm, >20 seconds to rebound

these symptoms are a sign of what condition

• rapid breathing
• dyspnea
• crackles in lungs
• hypertension ↑ b/p
• JVD
• moist skin
• acute weight gain
• edema 

the following treatments are for what condition

• identify cause
• fluid and sodium restriction
• TED hose to mobilize fluids
• assess amount of edema
• administer plasma proteins and albumin if ordered
• monitor VS and daily weight

these symptoms are signs of what condition

• orthostatic hypotension
• tachycardia
• thirst
• flattened jugular veins
• sunken eyeballs
• dry mucous membranes
• rapid weight loss
• decreased urine output
• prolonged capillary refill 

the following treatment is appropriate for what condition:

administration of IV fluids

monitor for fluid overload

• SOB
• JVD
• CRACKLES
• ↑ B/P 

passive transport

name 3 processes

1. diffusion
2. osmosis
3. filtration  

movement of particles

• solutes move from area of higher concentration to lower concentration resulting in equal distribution

movement of water from an area of lower solute concentration to higher solute concentration

(higher water concentration to lower water concentration)

through a semipermeable membrane to equalize the concentration of ions or molecules

• same electrolyte concentration and same osmotic pressure as extracellular fluid
• risk of fluid overload

Lactated Ringers is an example of what type of solution

(LR), NS (normal saline, or 0.9% saline in water)

• water is pulled from vasucular compartment in the the interstitial fluid compartment

D5NS .45 (5% dextros in 1/2 normal saline) is an example of what type of solution

• pulls fluids and electrolytes from the intracellular and interstitial compartments into the intravascular compartment

2.0% NS, blood products and albumin are examples of what type of solution

what is the substance that is sometimes called minerals, salts, or ions that develop electrical charges

• sodium (Na)
• chloride (cl)
• calcium  (Ca)
• Bicarbonate (HCO3)

are found where? (cellular)

• Potassium (K )
• Phoshorus
• Magnesium (Mg ) 
• Proteins

are found where? (cellular)

Na - Sodium

135-145 mEq/dL

 (Na) Sodium

normal values

• influences distribution of water
• maintains nerve function
• acid - base balance

are functions of what electrolyte?

sodium - Na

normal values 135-145 mEq

Na

Soduim

135-145 mEq

confusion is a sign of what electrolyte deficiency

why

name

sodium (Na)

sodium maintains nerve function

hyponatremia

high Sodium levels

hypernatremia

potassium (k)

normal values

potassium (K)

3.5 -5 mEq/L

increase cardiac muscle excitability leading to

arrhythmias

Low Potassium (k)

below 3.5

• encourage foods high in potassium (k)
• oral potassium chloride liquid supplement (kcl) - mix with water or juice
•  NEVER GIVE IV PUSH - cardiac arrest

• avocados
• broccoli
• dairy
• dried fruit
• cantaloupe
• bananas 

high potassium

above 5 mEq/L

s/s of hyperkalemia

name 5

1. nausea
2. vomiting
3. increase motility
4. diarrhea
5. hyperactive bowel sounds 

meds for hyperkalemia

name and type

name 2

1. Lasix - urine
2. Kayexalate - stool 

maintains acid base balance

• prolonged vomiting
• diarrhea

Calcium (Ca)

normal values

s/s of hypocalcemia

name 2

1. Facial twitching (Chvostek's Sign)
2. Carpopedial spasms (Trousseau's Sign) 

• oral or IV calcium
• vitamin D to increase absorption
• seizure precautions
• encourage foods high in calcium - dairy, dark green vegetables 

s/s of hypercalcemia

name 4

1. lethargy
2. irritability
3. loss of energy
4. confusion 

calcitonin

(decreases serum calcium by putting it into the bones)

hypomagnesemia s/s

name 2

1. diminished reflexes
2. muscle weakness 

Bicarbonate HC03

normal values

• maintains the normal levels of acidity (pH) in blood and other body fluids  - neutralizes acids in the body
• one of the 4 major buffers or buffer systems in the body

HCO3

22-26 mEq/L

PaC02

35-45 mm Hg

risk factors for respiratory alkalosis

name 5

1. hypermetabolic states
2. fever
3. sepsis
4. anxiety
5. hepatic failure (increased ammonia(renal and kidney) → acidosis)

risk factors for metabolic acidosis

name 4

1. diarrhea
2. intestinal malabsorption
3. loss of HC03 (bicarb) by the intestine 
4. salicylate intoxication, excess acids

risk factors for metabolic alkalosis

name 5

1. chronic vomiting
2. nasogastic drainage or lavage without electrolyte replacement
3. alkaline antacids
4. low serum chloride
5. low serum potassium

Lab finding with metabolic alkalosis

name 4

1. decrease chloride
2. increase pH
3. increase Hct
4. decrease K (potassium) 

ABG

(arterial blood gas)

pH        7.35 -7.45

PaCO2      35 - 45

HCO3       22 - 26

• renal failure
• diabetic ketoacidosis
• diarrhea

are possible causes of what

• vomiting or
• GI suctioning

are possible causes for what....

1. what is the pH
2. what is the C02 - does it match the pH
3. what is the HC03
4. is pH normal

if CO2 does not match the pH it is metabloic

math formula

gtt/min

amount to be infused

math formula

mL/hr

volume