1. Fluid, Electrolyte, and Acid-Base Imbalances
Chapter 17 Overview
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Water Content of Body
Body Fluid Compartments
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Water Content of Body
Fig Relative volumes of three body fluids. Values represent fluid distribution in a young male adult.
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Electrolytes
Fig Electrolyte content of fluid compartments.
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5. Mechanisms Controlling Fluid and Electrolyte Movement
Diffusion
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6. Mechanisms Controlling Fluid and Electrolyte Movement
Fig Diffusion is the movement of molecules from an area of high concentration to an area of low
concentration. Eventually the sugar molecules are evenly distributed.
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7. Mechanisms Controlling Fluid and Electrolyte Movement
Facilitated Diffusion
Active Transport
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8. Mechanisms Controlling Fluid and Electrolyte Movement
Fig Sodium-potassium pump. As sodium (Na+) diffuses into the cell and potassium (K+) diffuses out of the
cell, an active transport system supplied with energy delivers Na+ back to the extracellular compartment and K+ to
the intracellular compartment. ATP, Adenosine triphosphate.
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9. Mechanisms Controlling Fluid and Electrolyte Movement
Osmosis
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10. Mechanisms Controlling Fluid and Electrolyte Movement
Fig Osmosis is the process of water movement through a semipermeable membrane from an area of low
solute concentration to an area of high solute concentration.
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11. Mechanisms Controlling Fluid and Electrolyte Movement
Osmosis, continued
Measurement of osmolality
Osmotic movement of fluids
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12. Mechanisms Controlling Fluid and Electrolyte Movement
Fig Effects of water status on red blood cells. A, Hypotonic solution (H2O excess) results in cellular
swelling. B, Isotonic solution (normal H2O balance) results in no change. C, Hypertonic solution (H2O deficit)
results in cellular shrinking.
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13. Mechanisms Controlling Fluid and Electrolyte Movement
Hydrostatic Pressure
Oncotic Pressure
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14. Fluid Movement in Capillaries
Fig Dynamics of fluid exchange between a capillary and tissue. An equilibrium exists between forces filtering
fluid out of the capillary and forces absorbing fluid back into the capillary. Note that the hydrostatic pressure is
greater at the arterial end of the capillary than at the venous end. The net effect of pressures at the arterial end of
the capillary causes a movement of fluid into the tissue. At the venous end of the capillary, there is net movement
of fluid back into the capillary.
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15. Fluid Movement in Capillaries
Fluid Shifts
Shifts of plasma to interstitial fluid
Elevation of venous hydrostatic pressure
Decrease in plasma oncotic pressure
Elevation of interstitial oncotic pressure
Shifts of interstitial fluid to plasma
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16. Regulation of Water Balance
Hypothalamic Regulation
Pituitary Regulation
Adrenal Cortical Regulation
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17. Regulation of Water Balance
Fig Factors affecting aldosterone secretion. ACTH, Adrenocorticotropic hormone.
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18. Regulation of Water Balance
Fig Effects of stress on fluid and electrolyte balance. ACTH, Adrenocorticotropic hormone; ADH,
antidiuretic hormone; CRH, corticotropin-releasing hormone.
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19. Regulation of Water Balance
Renal Regulation
Cardiac Regulation
Gastrointestinal Regulation
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20. Regulation of Water Balance
Insensible Water Loss
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21. Gerontologic Considerations
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22. Fluid and Electrolyte Imbalances
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Calcium Imbalances
Hypercalcemia
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Calcium Imbalances
Hypocalcemia
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Magnesium Imbalances
Fig Effects of stress on fluid and electrolyte balance. ACTH, Adrenocorticotropic hormone; ADH,
antidiuretic hormone; CRH, corticotropin-releasing hormone.
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Acid-Base Imbalances
pH and Hydrogen Ion Concentration
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Acid-Base Imbalances
Table Terminology Related to Acid-Base Physiology.
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Acid-Base Imbalances
Fig Osmosis is the process of water movement through a semipermeable membrane from an area of low
solute concentration to an area of high solute concentration.
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Acid-Base Imbalances
Acid-Base Regulation
Buffer system
Respiratory system
Renal system
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Acid-Base Imbalances
Alterations in Acid-Base Balance
Respiratory acidosis
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Acid-Base Imbalances
Fig Kinds of acid-base imbalances. A, Respiratory imbalances caused by carbonic acid (CA) excess and
carbonic acid deficit. B, Metabolic imbalances caused by base bicarbonate (BB) deficit and base bicarbonate
excess.
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Acid-Base Imbalances
Alterations in Acid-Base Balance, continued
Respiratory alkalosis
Metabolic acidosis
Metabolic alkalosis
Mixed acid-base disorders
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Acid-Base Imbalances
Clinical Manifestations
Blood gas values
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Acid-Base Imbalances
Table Normal Arterial Blood Gas Values *
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Acid-Base Imbalances
Table Arterial Blood Gas (ABG) Analysis.
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36. Assessment of Fluid, Electrolyte, and Acid-Base Imbalances
Subjective Data
Important health information
Past health history
Medications
Surgery or other treatments
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37. Assessment of Fluid, Electrolyte, and Acid-Base Imbalances
Subjective Data, continued
Functional health patterns
Health perception–health management pattern
Nutritional-metabolic pattern
Elimination pattern
Activity-exercise pattern
Cognitive-perceptual pattern
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38. Assessment of Fluid, Electrolyte, and Acid-Base Imbalances
Objective Data
Physical examination
Laboratory values
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39. Oral Fluid and Electrolyte Replacement
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40. Intravenous Fluid and Electrolyte Replacement
Solutions
Hypotonic
Isotonic
Hypertonic
Intravenous additives
Plasma expanders
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