Fluid & Electroylte balance

Fluid balance occurs when the amount taken in equals the amount that is lost

imbalance occurs when there is too much, or an overload of fluid, when there is a deficient in the amount provided to replace loses

Describe normal intake & output

too much is not good, too little not good in water.

water---> is the greatest part of the body

approximately 80% of body weight is water

average adult is 60% water weight

(intake) 1500 ml fluid po------->1500 mil urine (output)

(intake) 700ml food----->400ml lungs(output)

(intake)350ml oxidative------>500ml skin(output)

(intake) none for stool------>200 ml stool

Normal intake & output chart

(cont'd)

Average intake and output is approxiamtely 2500ml per day.

MAy take 2-3 days to acheive balance. Look at the I & O for the past 48-72 hours

Assess for (1)balance

(2) deficit

(3) overload

List ways that fluid & electrolyte can leave the body

The body loses soe of its water as a result of various body functions called "obligatory loss".

You need 500cc urinary output in 24 hours

Intracellular Fluids

(ICF)

Fluid found inside the cells.

Interstital fluid accounts for about 75% of the extra cellular fluid

Extracellular fluid

(ECF)

contains

All the fluid outside the cells

1/ intravascular fluid {plasma}

2/ interstital fluid {fluid that surrounds tissue cells, includes the lymphs}

Hyponatremia

(etiology)

* diuretics

*repeated tap water

*long term diarrhea

*long term vomiting

*Drinking too much water

Hyponatremia

(effects)

* sodium effects movemnet of fluid between compartments. Decrease of sodium in blood stream can cause movement of water from intravascular compartment to cells.

Brain cells swell

Osmolarity

* concentration of particles of a solution

measured vascularity. also by urine

isotonic

* has the same solute concentration as another solution

example: normal saline solution is considered isotonic because the concentration of sodium in the solution nearly equals the cocnetration of sodium in the blood.

hypertonic

hypotonic

fluids have a lower concentration of solutes
than is found inside the cells, which causes fl uid to flow into cells and out of
the extracellular spaces. This causes cells to swell and possibly burst

example: one solution contains only a little sodium and another solution contains more

filtration

* the movemnt of fluids through capillaries.

selective allowance or blockage of substances across a
membrane, wherein movement is influenced by a pressure gradient

osmosis

*the passive movement of fluid across a membrane from an area of lower solute concentration and comparativley more fluid into an area of higher solute concentration and compartiviey less fluid.

* major method of transporting body fluids

Fluid remains in body, but in the wrong compartment.

* 3rd spacing foten seen after abdominal surgery,burns,ascities,peritonitis, and allergic reactions.

*s/s-->decrease output, edema, increase weight, decrease b/p,increase p,

Hydrostatic pressure & plasma proteins

Cations electrolytes

(positive charge)

* sodium

*potassium

*calcium

*magnesium

anions electrolytes

(negative charge)

* chloride

*bicarbonate

*phosphate

*sulfate

Hyponatremia

signs

anxiety, apprehension, coma, confusion, convulsion, fatigue, muscle, weakness, muscle twitching, and abdominal cramps

symptoms

seizures

Hypernatremia

signs & symptoms

thirst, elevated temp, dry mouth and sticky mucous membranes.

symptoms

accidental intestinal overload, (formulas) undiluted gastric feedings. sodium & plasma becomes concetrated & pulls toward it.  Too much water can be pulled from brain cells & shrink them

hypokalemia

signs& symptoms

fatigue, anorexia, nausea, and vomiting, muscle weakness, decreased Gi motility, dysrhythmia,paresthesia,flat t wave on ECG, increased sensitivity to digitalis

symptoms

may be manifesed in chges of nerve & muscle activity, adv, distention & anorexia. cardiac functioning heart cannot work properly

hyperkalemia

signs & symptoms

potassium excess

overhydration

no p; no k

rapid weight gain, periphereal edema, distended neck veins, full bounding pulse, polyuria

symptoms

moist rales in lungs

raised BP; pt. =pounding pulse

dehydration

signs and symptoms

thirst(subjective), furrows in tongue, dry mucous membrane, warm to touch, skin dry, axillary & groin dry. Decrease skin turgor, scanty concentrated urine(objective)

symptoms

*increases fluids to differential age groups

*increase pulse respirations

infant

plan for encouraging fluids

needs 1 qt of fluid in 24 hour

feeding should not exceed 30 mins

* burp frequently to allow the escape from stomach

toddler

encouraging fluids for a patient

companionship during meals is an effective way to encourage intake

allow to choose from 2 types of fluid

use straw

discuss bottle feasiblity

kids regression

count # of cups of fluid intake

assist child to draw a drinking chart & to color in cups of fluid taken

set up short intervals within which the child must drink a given amount of fluid

encouraging fluids for a adolescent & adult

offer them something to drink

often small amounts