1. Fluid and Electrolyte Balance
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Maintaining homeostasis
Water/fluid balance
Electrolyte balane

3. Interstitial = tissue
Water balancing issue between all these parts of the body
Food sources; aboout 700 cc fluid
200 cc fluid by product
2300 total ccs
Maintaining water balance 1400 ccs taking in liquid
700 ccs from foods
200 ccs byproduct of metablosim
Total 2300 ccs

4. 1,000 ccs = 1L
INFANTS:
30 ccs per ounce
40-60 for adolescents because they are more active than adults
Adults: manage based on their activity level

5. Body Solutes Types of solutes Electrolytes Other molecules
Sodium, potassium, calcium, magnesium, chloride, bicarbonate, phosphate, sulphate
Ions dissociate to form charged particles
Other molecules
Glucose, protein, urea, lactate, organic acids
Remain stable
Extracellular: Na, Ca, bicarb, Cl, S
Intracellular: K, Mg, Phosphate
Glucose pulls out fluids,
Protein is susceptible to hydration status

6. Body Solutes Distribution of solutes
Sum of cations must be equal to sum of anions within a given compartment
Movement of solutes influenced by: maintaing fluid balance and removing waste between blood as well as tissue
Molecular size
Electrical charge of the molecule
Hydrostatic pressure
Method of solute transport
Cations positive charge
Anion negative charge
Measured by molecular charge

7. plasma5 % water
Interstitial fluid 15% water
Intracellular water 40% water

9. ***Commit to memory***

10. Regulation of Fluid and Electrolytes
Osmotic and hydrostatic pressure:
Thirst:
Renal:
Hormonal influence – RAAS:
Electrolyte regulation:

11. Regulation of Fluid and Electrolytes
Thirst: triggered by hypothalamus, don’t want to get to point where you feel thirst
Renal function:
Renin-Angiotension-Aldosterone System: influencing kidneys to retain sodium, pull fluid back into the blood

13. GFR of kidneys
Low sodium load and what your body will do to adjust it

14. Increased blood calcium body tries to inhibit D uptake; eg
Increased blood calcium body tries to inhibit D uptake; eg. Osteoporosis, renal-prescribe phosphate binders,
Decreased blood calcium body needs to increase D intake; eg. Premature infants,

15. Disorders of Fluid Balance
Alterations in volume
Hypovolemia: fluid volume
Hypervolemia: fluid volume
Alterations in osmolality: electolyte imbalance
Sodium imbalances composition of fluid chem 7 panal; acid base balance
Hyponatremia
Hypernatremia
Potassium imbalances
Hypokalemia look at albumen levels; eg. Bone abnormalities, blood clotting
Hyperkalemia: renal status

16. Disorders of Fluid Balance
Calcium imbalance: bone
Hypocalcemia
Hypercalcemia
Phosphorus imbalance: acid base balance
Hypophosphatemia
Hyperphosphatemia
Magnesium imbalance: kidneys regulating, bone,
Hypomagnesemia
Hypermagnesemia

17. Disorders of Fluid Balance
What are the…
Causes ?
Clinical manifestations ?
Laboratory findings ?
Treatment ?
Identify underlying cause
#1 reason for acid/base imbalance: kidneys
Pitting
Adema
Fluid overload: low sodium
Treatment: underlying cause; might have to change Na, K, fluid,

18. Rapid changes in weight, look at hair, lips, eyes
Acid/base changes, osmolality
Urin panal: fluid status, look at color, volume, waste of Na, K, Cl
© 2007 Thomson - Wadsworth

20. Rehydration;
300 mOsm is normal for blood

21. Fluid and Electrolyte Balance
Assess for factors that affect fluid and electrolyte balance:
Disease or injury: burn patient, diabetic in DKA,
Medication or treatment: lacics (heart meds), fluid removing drugs
Fluid loss: severe trauma; gun shot wound
Nutrient restriction: cardiovascular disease, renal disease,
Oral intake: not adequate
Intake vs. output: