Fluid and Electrolyte Imbalance Study Notes

Fluid and Electrolyte Imbalance Study Notes

• Fluid Balance:
  • Intracellular fluid (ICF): Fluid inside body cells
  • Extracellular fluid (ECF): Fluid outside body cells
    • Interstitial fluid: Surrounds cells, includes lymph
    • Intravascular fluid: Blood plasma in arteries, veins, capillaries
    • Transcellular fluid: Specialized compartments (cerebrospinal, digestive, synovial)
• Movement of Fluids & Electrolytes:
  • Active transport: Requires energy (ATP)
  • Passive transport: No energy required
    • Diffusion: Movement from high to low concentration
    • Filtration: Movement from high to low pressure across a semipermeable membrane
    • Osmosis: Movement of water across a semipermeable membrane from low to high solute concentration
• Tonicity/Osmolarity:
  • Isotonic: Same osmolarity as blood (e.g., normal saline 0.9%)
  • Hypertonic: Higher osmolarity than blood (water leaves cells)
  • Hypotonic: Lower osmolarity than blood (water enters cells)
• Fluid Imbalances:
  • Dehydration/Hypovolemia: Loss of fluid, decreased blood volume
    • Causes: Hemorrhage, vomiting, diarrhea, excessive sweating, NPO status
    • Diagnostic tests: Elevated BUN, hematocrit, decreased skin turgor, cap refill
    • Interventions: Fluid replacement, address underlying cause
  • Fluid Overload/Fluid Excess/Hypervolemia: Too much fluid in the body
    • Causes: Poorly controlled IV therapy, excessive fluid intake, adrenal gland dysfunction, corticosteroid use
    • Diagnostic tests: Decreased BUN
    • Interventions: Replace fluids & resolve dehydration cause, encouraging fluid intake, daily weight monitoring, monitoring I&O.

Electrolyte Imbalances

• Electrolytes: substances carrying electrical charge in body fluids (dividied into cations and anions)
  • Sodium (Na+): Normal range = 135-145 mEq/L
    • Hyponatremia: Sodium level < 135 mEq/L causes cellular swelling
    • Hypernatremia: Sodium level > 145 mEq/L causes cellular dehydration
  • Potassium (K+): Important for cardiac muscles, normal range is 3.5-5.0 mEq/L
    • Hypokalemia: Potassium level < 3.5 mEq/L (muscle weakness, cardiac arrhythmias)
    • Hyperkalemia: Potassium level > 5.0 mEq/L (cardiac arrest)
  • Calcium (Ca2+): Normal range 9-11 mg/dL
    • Hypocalcemia: Calcium level <9 mg/dL (muscle cramps, tetany, seizures)
    • Hypercalcemia: Calcium level > 11 mg/dL (weakness, constipation, cardiac arrhythmias)
  • Magnesium(Mg2+): Normal range =1.5 to 2.5 mg/dl
    • Hypomagnesemia: Muscle weakness, tremors, lethargy
    • Hypermagnesemia: Decreased reflexes, bradycardia, lethargy.

Acid-Base Balance

• Acids and Bases: Acids release hydrogen ions; bases bind hydrogen ions
  • Maintaining blood pH: essential for body functions via buffers, lungs, and kidneys
• Respiratory Acidosis: Decreased blood pH and increased CO2 levels (Hypoventilation)
• Respiratory Alkalosis: Increased blood pH and decreased CO2 levels (Hyperventilation)
• Metabolic Acidosis: Decreased blood pH and bicarbonate levels
• Metabolic Alkalosis: Increased blood pH and bicarbonate levels

Other Fluid and Electrolyte Related Topics

• Pneumonia (Bacterial/Viral/Aspiration/Ventilator-associated): Infection of the lungs
• Tuberculosis (TB): Infectious bacterial disease
• Bronchiectasis: Dilation of the airways
• Pulmonary Fibrosis: Scarring and thickening of lung tissues
• Pleural Effusion/Empyema: Fluid buildup in the pleural cavity
• Pulmonary Embolism: Blood clot traveling to the lungs
• Pneumothorax: Air in the pleural space
• Acute Respiratory Distress Syndrome (ARDS): Lung injury leading to fluid buildup in alveoli, most commonly caused by widespread sepsis

General Notes

• Lab values: Know normal ranges and implications of abnormal values.
• Signs and symptoms: Understand clinical manifestations of imbalances.
• Interventions: Recognize proper treatment strategies.
• Patient education: Understand the importance of patient self-management.
• Diagnostic tests: Recognize their role in assessing and treating imbalances.