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Fluid, Electrolyte, and Acid- Base Imbalances Chapter 17 Overview Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

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Presentation on theme: "Fluid, Electrolyte, and Acid- Base Imbalances Chapter 17 Overview Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc."— Presentation transcript:

1 Fluid, Electrolyte, and Acid- Base Imbalances Chapter 17 Overview Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

2 2 Water Content of Body Body Fluid Compartments Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

3 3 Water Content of Body Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Fig Relative volumes of three body fluids. Values represent fluid distribution in a young male adult.

4 4 Electrolytes Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Fig Electrolyte content of fluid compartments.

5 5 Mechanisms Controlling Fluid and Electrolyte Movement Diffusion Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

6 6 Mechanisms Controlling Fluid and Electrolyte Movement Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 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.

7 7 Mechanisms Controlling Fluid and Electrolyte Movement Facilitated Diffusion Active Transport Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

8 8 Mechanisms Controlling Fluid and Electrolyte Movement Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 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.

9 9 Mechanisms Controlling Fluid and Electrolyte Movement Osmosis Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

10 10 Mechanisms Controlling Fluid and Electrolyte Movement Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 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.

11 11 Mechanisms Controlling Fluid and Electrolyte Movement Osmosis, continued   Measurement of osmolality   Osmotic movement of fluids Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

12 12 Mechanisms Controlling Fluid and Electrolyte Movement Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Fig Effects of water status on red blood cells. A, Hypotonic solution (H 2 O excess) results in cellular swelling. B, Isotonic solution (normal H 2 O balance) results in no change. C, Hypertonic solution (H 2 O deficit) results in cellular shrinking.

13 13 Mechanisms Controlling Fluid and Electrolyte Movement Hydrostatic Pressure Oncotic Pressure Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

14 14 Fluid Movement in Capillaries Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 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.

15 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 Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

16 16 Regulation of Water Balance Hypothalamic Regulation Pituitary Regulation Adrenal Cortical Regulation Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

17 17 Regulation of Water Balance Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Fig Factors affecting aldosterone secretion. ACTH, Adrenocorticotropic hormone.

18 18 Regulation of Water Balance Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Fig Effects of stress on fluid and electrolyte balance. ACTH, Adrenocorticotropic hormone; ADH, antidiuretic hormone; CRH, corticotropin-releasing hormone.

19 19 Regulation of Water Balance Renal Regulation Cardiac Regulation Gastrointestinal Regulation Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

20 20 Regulation of Water Balance Insensible Water Loss Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

21 21 Gerontologic Considerations Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

22 22 Fluid and Electrolyte Imbalances Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

23 23 Calcium Imbalances Hypercalcemia Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

24 24 Calcium Imbalances Hypocalcemia Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

25 25 Magnesium Imbalances Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Fig Effects of stress on fluid and electrolyte balance. ACTH, Adrenocorticotropic hormone; ADH, antidiuretic hormone; CRH, corticotropin-releasing hormone.

26 26 Acid-Base Imbalances pH and Hydrogen Ion Concentration Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

27 27 Acid-Base Imbalances Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Table Terminology Related to Acid-Base Physiology.

28 28 Acid-Base Imbalances Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 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.

29 29 Acid-Base Imbalances Acid-Base Regulation   Buffer system   Respiratory system   Renal system Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

30 30 Acid-Base Imbalances Alterations in Acid-Base Balance   Respiratory acidosis Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

31 31 Acid-Base Imbalances Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 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.

32 32 Acid-Base Imbalances Alterations in Acid-Base Balance, continued   Respiratory alkalosis   Metabolic acidosis   Metabolic alkalosis   Mixed acid-base disorders Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

33 33 Acid-Base Imbalances Clinical Manifestations   Blood gas values Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

34 34 Acid-Base Imbalances Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Table Normal Arterial Blood Gas Values *

35 35 Acid-Base Imbalances Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Table Arterial Blood Gas (ABG) Analysis.

36 36 Assessment of Fluid, Electrolyte, and Acid-Base Imbalances Subjective Data   Important health information Past health history Medications Surgery or other treatments Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

37 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 Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

38 38 Assessment of Fluid, Electrolyte, and Acid-Base Imbalances Objective Data   Physical examination   Laboratory values Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

39 39 Oral Fluid and Electrolyte Replacement Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

40 40 Intravenous Fluid and Electrolyte Replacement Solutions   Hypotonic   Isotonic   Hypertonic   Intravenous additives   Plasma expanders Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.


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