Fluid and Electrolyte Balance Quiz

Fluid and Electrolyte Balance

• Fluid and electrolytes are crucial for optimal body function
• Homeostasis is the body's mechanism to maintain normal conditions. This includes body temperature, blood electrolytes (sodium, potassium, calcium), blood pH, and blood volume.
• Total body water (TBW) is 50% to 60% of body weight in a healthy adult.
• Infants have significantly more TBW and extracellular fluid (ECF) than adults. Age, sex, and fat content influence TBW.
• Women and obese individuals generally have less body water than men.

Body Fluid Distribution

• Body fluids are categorized into two main compartments:
  • Extracellular fluid (ECF): Found outside the cells, comprises approximately one-third of the total body fluid. It further divides into intravascular (within blood vessels) and interstitial (surrounding cells) fluids.
  • Intracellular fluid (ICF): Located within the cells, and makes up about two-thirds of the total body fluid.

Body Fluids Summary

• ECF (15 Liters): Comprises interstitial and intracellular fluids
• ICF (25 Liters): Fluid within cells.

Composition of Body Fluids

• Body fluids contain electrolytes:
  • Anions (negative charge): Chloride (Cl−), bicarbonate (HCO3−)
  • Cations (positive charge): Sodium (Na+), potassium (K+), calcium (Ca2+), Magnesium (Mg2+)
• Electrolytes are measured in milliequivalents per liter (mEq/L).

Functions of Water

• Water is the primary solvent in the body.
• Essential for regulating temperature.
• Transporta nutrients, electrolytes, and oxygen to the cells.
• Facilitates waste excretion.
• Lubricates joints and membranes.
• Essential for digestion.
• Forms a major component of blood plasma.
• Vital for metabolism.

Functions of Electrolytes

• Crucial for neuromuscular function.
• Maintain fluid volume and osmotic pressure.
• Enable the distribution of water between different fluid compartments.
• Regulate acid-base balance.

Movement of Body Fluids and Electrolytes

• Osmosis: Movement of water across a semi-permeable membrane from an area of lower solute concentration to an area of higher solute concentration to equalize concentration.

• Osmotic pressure: Water`s drawing power.

• Osmolarity: Concentration of a solution.

• Diffusion: Movement of ions and molecules (solute) from an area of higher concentration to an area of lower concentration to achieve equilibrium.

• Filtration: Movement of fluid and solute together across a membrane from an area of higher pressure to an area of lower pressure.

• Active Transport: Process that moves substances against a concentration gradient using energy, important in maintaining sodium and potassium concentration gradients between ECF and ICF.

Regulation of Body Fluids

• Homeostasis is maintained through:
  • Fluid intake regulation
  • Hormonal regulation
  • Fluid output regulation

Acid-Base Balance

• Acids: Release hydrogen ions (H+) in solutions.
• Bases: Accept hydrogen ions (H+) in solutions.
• pH: Reflects hydrogen ion (H+) concentration in a solution. A lower pH indicates a higher H+ concentration and acidity. Body fluids are slightly alkaline (normal pH range is 7.35-7.45).

Important Ions

• PaCO2: Partial pressure of carbon dioxide, measured to assess acid-base status. Normal range is about 35-45 mm Hg.
• HCO3−: Bicarbonate, a key component of the body's buffer system and measured to assess acid-base status, normal range is 22-26 mEq/L.

Acid-Base Regulation

• Three body systems regulate acid-base balance:
  • Buffers
  • Respiratory System
  • Renal System.

Buffers

• Prevent drastic pH changes by absorbing or releasing hydrogen ions.

Respiratory Regulation

• Lungs regulate pH by controlling carbon dioxide (CO2) levels in blood. Higher breathing rate reduces CO2, making the resultant blood more alkaline.

Renal Regulation

• Kidneys regulate pH over hours by controlling bicarbonate (HCO3−) levels.

Types of Acid-Base Imbalances

• Respiratory acidosis
• Respiratory alkalosis
• Metabolic acidosis
• Metabolic alkalosis
• Mixed pattern

Home IV therapy

• Nutritional support
• Medication safety
• Patient education

Fluid Intake and Output

• Intake: oral fluids, water in food, metabolism
• Output: urine, feces, insensible losses (lungs, skin, sweat)

Electrolyte Imbalances

• Hypokalemia: Low potassium
• Hyperkalemia: High potassium
• Hyponatremia: Low sodium
• Hypernatremia: High sodium
• Hypocalcemia: Low calcium
• Hypercalcemia: High calcium
• Hypomagnesemia: Low magnesium

Assessment of Fluid Deficits/Overload

• Fluid deficit: Hypotension, weak rapid pulse, decreased temperature if hypovolemic, increased in dehydration, weight loss, poor skin turgor, concentrated urine and blood. Signs in infants include sunken fontanelle, sunken eyes, and poor skin turgor.
• Fluid overload: Weight gain, bounding pulse, dyspnea, cough, crackles, jugular vein distention, edema, increased blood pressure

Causes of Dehydration

• Hemorrhage
• Vomiting
• Diarrhea
• Profuse salivation
• Fistulas
• Abscesses
• Burns
• Severe wounds
• Diuretic therapy
• GIT suctioning

Causes of Fluid Overload

• Excess intake of fluids
• Excess intake of sodium
• Congestive heart failure
• Cirrhosis
• Renal failure
• Normal postoperative response

Nursing Management of Fluid Overload

• Daily weights
• Strict I&O monitoring
• Reduced fluid intake
• Reduced sodium intake
• Diuretics administration
• Electrolyte monitoring
• Elevating the legs

Assessment Cont.

• Nursing history: Age, prior medical history, acute illness, surgery, chronic illness (cancer, CVD, renal disorders, GI disturbances), burns, respiratory disorders, head injury
• Environmental factors: Diet, lifestyle, medications

Laboratory Studies

• Osmolality: Concentration of blood and urine per kilogram.
• Blood osmolarity: 280-300 mOsm/kg
• Urine osmolarity: 50-1400 mOsm/kg
• BUN: 10-20 mg/dL (blood urea nitrogen), produced by the liver
• Creatinine: 0.7-1.5 mg/dL (muscle metabolism by-product)
• Serum electrolytes: Sodium (Na+), potassium (K+)

Nursing Diagnoses

• Decreased cardiac output
• Acute Confusion
• Deficient fluid volume
• Excess fluid volume
• Impaired gas exchange
• Deficient knowledge
• Impaired skin integrity
• Ineffective tissue perfusion

Planning

• Determine goals and outcomes
• Set priorities
• Collaborative care (Medical doctor, dietician, pharmacy)

Implementation

• Health promotion (education)
• Acute care (enteral/parenteral fluid/electrolyte replacement, total parenteral nutrition (TPN), IV fluids, blood products, transfusion reactions).
• Acute Care (enteral/parenteral fluid/electrolyte replacement, total parenteral nutrition (TPN), IV fluids, blood products, transfusion reactions), blood groups, autologous transfusions
• Restoration (Home IV therapy, nutritional support, medication safety, patient education).

Evaluation

• Determine if goals have been met.
• Assess for changes in the patient's assessment (symptoms)
• Evaluate to decide whether the plan should be continued or revised according to patient progress.

Test your knowledge on fluid and electrolyte balance in the human body. Explore concepts like homeostasis, body fluid distribution, and factors affecting total body water. This quiz will help reinforce your understanding of essential physiological processes.