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FLUID, ELECTROLYTE, AND ACID-BASE BALANCE NUR 102 - Chapter 14.

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Presentation on theme: "FLUID, ELECTROLYTE, AND ACID-BASE BALANCE NUR 102 - Chapter 14."— Presentation transcript:

1 FLUID, ELECTROLYTE, AND ACID-BASE BALANCE NUR 102 - Chapter 14

2 Body fluids Extracellular fluids (ECF) Interstitial fluid - fills the spaces between most cells of the body Intravascular fluid - plasma (WBC, RBC and platelets in this fluid)

3 Body fluids Intracellular fluids (ICF) Liquids within cell membranes 40% of body weight

4 Components in body fluids Electrolyte an element that when dissolved can carry an electrical current Cations - (+) ; Anions - (-) neuromuscular function acid-base balance

5 Components of body fluids Minerals ingested compounds serve as catalysts in nerve response, muscle contraction, and metabolism of nutrients in foods, regulate electrolyte balance

6 Movement of body fluids Diffusion Area of higher concentration to an area of lower concentration till even distribution Osmosis Movement of a pure solvent, e.g. water through a semipermeable membrane from a solution that has a lower solute concentration to one that has a higher solute concentration

7 Osmotic pressure Drawing power of water (dependent on the number or molecules in solution) Isotonic Hypotonic Hypertonic

8 Movement of body fluids Filtration Water and diffusible substances move together in response to fluid pressure Active transport Requires energy Able to move larger molecules and go from less to greater concentration

9 Fluid Intake Hypothalamus - thirst control center Oral fluid intake requires an alert state Osmoreceptors - monitor osmolality

10 Fluid Output Loss through the kidneys and GI tract Insensible Sensible

11 Cations Sodium (Na+) Most abundant in the extracellular fluid Maintains water balance, transmits nerve impulses, contracts muscles Values - 135-145 mEq/L

12 Cation Potassium (K+) Major intracellular cation Regulates neuromuscular excitability, muscular contraction, and acid-base Value - 3.5 -5.3 mEq/L

13 Cation Calcium (Ca2+) Cardiac conduction, blood coagulation, bone growth and formation, & muscular relaxation Value - 4 - 5 mEq/L

14 Cation Magnesium (Mg2+) Second most important of intracellular fluids Enzyme activities, muscular excitability Value - 1.5 - 2.5 mEq/L

15 Electrolyte Imbalances Hyponatremia GI losses, sweating, & diuretics S/S: N/V/D, abd cramps, personality change Hypernatremia Ingestion of large amounts S/S: Dry tongue and mucous membranes, restlessness, convulsions, thirst, dry skin

16 Electrolyte imbalances Hypokalemia Causes: K+ wasting diuretics N/V/D polyuria S/S: weak, irregular pulse hypotension weakness

17 Electrolyte imbalances Hyperkalemia Causes: Renal failure S/S: irregular slow pulse, weakness, irritability

18 Electrolyte Imbalances Hypocalcemia Causes: Vitamin D deficiency S/S: Numb and tingling fingers and circumoral region, muscle cramps Hypercalcemia Causes: osteoporosis, prolonged immobilization S/S: decreased muscle tone, weakness, lethargy, kidney stones

19 Electrolyte imbalances Hypomagnesemia Causes: malnutrition and alcoholism polyuria S/S: muscular tremors, hyperactive deep tendon reflexes Hypermagnesemia Causes: Renal failure S/S: hypoactive deep tendon reflexes, shallow and slow respirations

20 Acid - Base Balance Blood pH - 7.35 - 7.45 paCO2 - 35 - 45 Bicarbonate (HCO3) - 22-26 mEq/L

21 Respiratory Acidosis pH < 7.35 paCO2 > 45 mm Hg Causes: Respiratory failure Hypoventilation Resp muscles paralysis Airway obstruction

22 Respiratory Alkalosis pH > 7.45 paCO2 < 35 mm Hg Causes: excessive exhalation of CO2 (hyperventilation)

23 Metabolic Acidosis pH < 7.35 bicarbonate - < 22 mEq/L Causes: Starvation, DKA, Diarrhea, drug use

24 Metabolic Alkalosis pH > 7.45 bicarbonate > 26 mEq/L Causes: excessive vomiting, prolonged gastric suctioning

25 Fluid & Electrolyte Imbalances Burns - body fluid loss Renal D/O - abnormal retention of Na, Cl, K GI Disturbances - Loss of fluid, potassium, and chloride Exercise

26 S/S electrolyte imbalance Head: irritability Fontanels: depressed, bulging Eyes: sunken periorbital edema Mouth: mucous membranes CV: neck veins, edema, blood pressure Resp: Crackles

27 Imbalances GI: abdomen, V/D Renal: Oliguria or anuria (FVD, FE) Diuresis (FVE) Increased urine spec. gravity (FVD) Skin (Temp) increased - met acidosis, hypernatremia decreased - FVD

28 Replacement of fluids and electrolytes Types of IV fluids Isotonic Hypertonic Hypotonic

29 IV complications Infiltration IVF enter SQ space Phlebitis vein inflammation S/S: pain, redness, warmth Fluid overload Fluids given too rapidly Bleeding

30 Discontinuing an IV Stop infusion Remove tape 1 - 2 minute pressure

31 Blood transfusions Large bore catheter (18 ga or larger) Give with normal saline Baseline vital signs Double check with two RNs Begin transfusion slowly Observe closely for first 15 min

32 Transfusion Reactions Caused by: blood incompatibility allergic sensitivity S/S: fever, chills, rash, hypotension, shock Treatment: stop transfusion, give NS, save tubing, prepare for emergency drugs


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