Fluid and Electrolytes Overview
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Questions and Answers

What is the primary electrolyte found in intracellular fluid?

  • Chloride (Cl)
  • Potassium (K) (correct)
  • Sodium (Na)
  • Calcium (Ca)
  • What percentage of total body weight does interstitial fluid account for in an adult?

  • 10%
  • 15% (correct)
  • 5%
  • 20%
  • Which of the following correctly describes osmosis?

  • Water moves across a membrane until concentrations are equal on both sides. (correct)
  • Water remains in one location regardless of concentration differences.
  • Water is actively transported against a concentration gradient.
  • Water moves from a more concentrated solution to a more dilute solution.
  • In which solution do blood cells remain unchanged in terms of osmotic pressure?

    <p>Isotonic solution (A)</p> Signup and view all the answers

    What process allows water to pass through a semi-permeable membrane?

    <p>Osmosis (D)</p> Signup and view all the answers

    What is the total water output from the body in milliliters?

    <p>2,400ml (D)</p> Signup and view all the answers

    Which of the following is a route through which water leaves the body?

    <p>Sweating (A), Skin diffusion (C), Defecation (D)</p> Signup and view all the answers

    What is the normal sodium level in milliequivalents per liter (mEq/L)?

    <p>135-145 mEq/L (A)</p> Signup and view all the answers

    What characterizes primary electrolyte imbalances?

    <p>They occur independently. (B)</p> Signup and view all the answers

    What condition is defined by a sodium level below 135 mEq/L?

    <p>Hyponatremia (A)</p> Signup and view all the answers

    What is one of the primary roles of electrolytes in the body?

    <p>Maintaining fluid and acid-base balance (B)</p> Signup and view all the answers

    Which ion is primarily responsible for osmotic pressure in the intracellular fluid?

    <p>Potassium (K+) (D)</p> Signup and view all the answers

    Which hormone promotes retention of sodium and excretion of potassium in the kidneys?

    <p>Aldosterone (B)</p> Signup and view all the answers

    What can happen if serum albumin is significantly reduced in the body?

    <p>Oedema formation (D)</p> Signup and view all the answers

    Which of the following is NOT a mechanism regulating fluid and electrolyte balance?

    <p>Liver function (C)</p> Signup and view all the answers

    What measurement is typically used to express the concentration of electrolytes in body fluids?

    <p>Mill-equivalents per liter (mEq/L) (B)</p> Signup and view all the answers

    What role do electrolytes play in neuromuscular function?

    <p>Facilitating electrical energy transmission (D)</p> Signup and view all the answers

    Which of the following compartments relies primarily on sodium (Na+) for osmotic pressure?

    <p>Interstitial fluid (B)</p> Signup and view all the answers

    What is primarily responsible for the reabsorption of water and solutes in the gastrointestinal tract?

    <p>Small intestine (C)</p> Signup and view all the answers

    Which hormone is produced in the hypothalamus and helps retain water?

    <p>Antidiuretic hormone (ADH) (C)</p> Signup and view all the answers

    What physiological need is indicated by thirst when there is a decrease in extracellular fluid volume?

    <p>Need for water (C)</p> Signup and view all the answers

    What is a condition that can lead to considerable loss of fluids and electrolytes?

    <p>Vomiting (A)</p> Signup and view all the answers

    Aldosterone primarily acts on the renal tubules to facilitate which of the following?

    <p>Retention of sodium and excretion of potassium (D)</p> Signup and view all the answers

    What is the main route through which water is lost during respiration?

    <p>Expiration (D)</p> Signup and view all the answers

    Which factor can lead to a disturbance in fluid and electrolyte balance?

    <p>Insufficient intake of fluid (C)</p> Signup and view all the answers

    What is one of the common ways through which the body loses water?

    <p>Through perspiration (B)</p> Signup and view all the answers

    What is the primary function of body fluids in maintaining blood volume?

    <p>Transporting materials (D)</p> Signup and view all the answers

    Which factor is NOT mentioned as affecting fluid and electrolyte balances?

    <p>Age of the individual (A)</p> Signup and view all the answers

    How much water constitutes the total body weight of a young to middle-aged adult?

    <p>60-70% (A)</p> Signup and view all the answers

    What percentage of total body weight is fluid in infants?

    <p>70-80% (B)</p> Signup and view all the answers

    What is the term used to describe fluid found inside cells?

    <p>Intracellular fluid (C)</p> Signup and view all the answers

    What happens to the total body fluid percentage as individuals age?

    <p>Decreases due to body tissue changes (A)</p> Signup and view all the answers

    What is the main role of regulatory mechanisms in fluid balance?

    <p>Maintain homeostasis (B)</p> Signup and view all the answers

    Which compartment does NOT contain intracellular fluid?

    <p>Blood plasma (A)</p> Signup and view all the answers

    What is the maximum amount of fluid lost through diarrhoea in a 24-hour period?

    <p>17,000 ml (D)</p> Signup and view all the answers

    What potential issue can prolonged use of laxatives and enemas cause?

    <p>Electrolyte and water disturbances (D)</p> Signup and view all the answers

    What is a consequence of gastrointestinal obstruction?

    <p>Fluid accumulation within the intestine (B)</p> Signup and view all the answers

    What is a symptom of metabolic acidosis?

    <p>Shortness of breath (C)</p> Signup and view all the answers

    What can excessive perspiration lead to if hydration is not maintained?

    <p>Sodium excess (A)</p> Signup and view all the answers

    What is the total amount of insensible water loss per day in an average adult?

    <p>600 to 1,000 ml (A)</p> Signup and view all the answers

    What condition causes retention of excessive carbon dioxide?

    <p>Hypoventilation (D)</p> Signup and view all the answers

    What occurs when electrolytes are dissolved in solution?

    <p>Total cations equal total anions (D)</p> Signup and view all the answers

    Flashcards

    Extracellular fluid (ECF)

    Fluid found outside the cells, composed of interstitial fluid and intravascular fluid.

    Interstitial Fluid

    Fluid in the spaces between cells, about 15% of total body weight.

    Intravascular Fluid

    Fluid within blood and lymph vessels, about 5% of total body weight.

    Osmosis

    Water movement across a semi-permeable membrane from lower to higher solute concentration until equilibrium.

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    Electrolytes

    Charged particles in body fluids, like potassium (K+) and sodium (Na+).

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    Body Fluid Compartments

    Body fluids are found in two main compartments: Intracellular fluid (inside cells) and Extracellular fluid (outside cells).

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    Intracellular Fluid

    Fluid inside the body's cells.

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    Extracellular Fluid

    Fluid outside the body's cells.

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    Fluid Percentage (Adults)

    About 60% of an adult's body weight is water.

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    Fluid Percentage (Infants)

    Infants have a higher percentage of fluid in their body weight (75-80%).

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    Fluid Percentage (Elderly)

    Elderly people have a lower percentage of fluid in their body weight compared to young adults (45-60%).

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    Body Fluid Functions

    Body fluids maintain blood volume, aid digestion, transport materials, support metabolism, excrete waste, and regulate temperature.

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    Fluid and Electrolyte Balance

    The body needs to maintain the correct amount of water and salts (electrolytes) in the right places for proper bodily functions.

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    Diarrhea fluid loss

    Diarrhea can lead to significant fluid loss, potentially up to 17,000 ml per day.

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    Intestinal suction fluid loss

    Intestinal suction, a medical procedure, can result in a daily fluid loss of 3,000 ml.

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    Fluid loss from fistulas

    Abnormal connections (fistulas) between body parts, often involving the intestines, can cause fluid loss.

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    Gastrointestinal obstruction fluid loss

    Blockage in the intestines prevents fluid movement, leading to fluid buildup and loss of absorption.

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    Metabolic acidosis

    Gastrointestinal disturbances can lead to metabolic acidosis, a condition where the blood is too acidic.

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    Wound exudates fluid loss

    Oozing fluids from wounds can cause loss of protein, sodium, and extracellular fluid.

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    Excessive perspiration fluid loss

    Heavy sweating can result in loss of water, sodium, and chloride, leading to dehydration.

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    Insensible water loss

    The body loses water through breathing and skin, amounting to 600-1000 ml daily.

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    What are electrolytes?

    Charged particles (like sodium and potassium) found in body fluids that play vital roles in fluid balance, nerve function, muscle contraction, and many other processes.

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    What are the compartments of body fluids?

    Body fluids are divided into two main compartments: intracellular fluid (ICF) inside cells and extracellular fluid (ECF) outside cells.

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    How do electrolytes help maintain fluid balance?

    Electrolytes create osmotic pressure, attracting water to specific compartments. This helps keep the right amount of fluid in each area of your body.

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    What is the role of serum albumin in fluid balance?

    Serum albumin is a protein found in blood plasma. It helps to keep water within the blood vessels, preventing fluid from leaking out into surrounding tissues.

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    How do the kidneys regulate fluid and electrolyte balance?

    The kidneys act as filters, controlling what substances are retained or excreted from the body. They help regulate overall fluid volume, electrolyte concentrations, pH balance, and blood pressure.

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    What are the two hormones involved in kidney function?

    Antidiuretic hormone (ADH) controls water reabsorption, while aldosterone promotes sodium retention and potassium excretion.

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    What are other mechanisms that regulate fluid and electrolyte balance?

    Besides the kidneys, other mechanisms include the gastrointestinal tract (absorbing fluids and electrolytes), thirst (motivating fluid intake), lungs (losing water vapor), skin (sweating), and hormonal control.

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    What happens when a patient loses a lot of serum albumin?

    Losing serum albumin can lead to edema (swelling) as fluid leaks from the blood vessels into surrounding tissues. This is because the protein that normally holds water within the blood vessels is now reduced.

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    Fluid Balance

    The body's ability to maintain a stable amount of water and electrolytes. Intake must equal output.

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    Electrolyte Imbalance

    Disruption in the normal balance of electrolytes in the body. Can be primary (occurring independently) or secondary (resulting from another condition).

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    Sodium's Role

    The main cation in the extracellular fluid (ECF) that controls fluid volume, osmotic pressure of ECF, helps with nerve impulses, and regulates blood volume.

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    Hyponatremia

    Low sodium levels in the blood (< 135 mEq/L).

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    Normal Sodium Level

    The typical range of sodium levels in the blood is 135-145 mEq/L.

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    Gastrointestinal Tract Fluid Absorption

    The gastrointestinal tract absorbs approximately 7-9 liters of glandular and gastrointestinal secretions daily, primarily in the small intestine through water and solute reabsorption.

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    Fluid Loss Through Bowel

    The bowel typically excretes about 100 ml of water daily, with the majority being reabsorbed.

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    Fluid Loss in Vomiting and Diarrhea

    Conditions like vomiting and diarrhea can lead to significant fluid and electrolyte losses.

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    Thirst Mechanism

    Thirst is triggered by a decrease in extracellular fluid volume, indicating the body's need for water. It can be stimulated by increased osmotic pressure, decreased extracellular fluid, and dry mucous membranes in the mouth.

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    Fluid Loss Through Lungs

    Water is lost during breathing, but the amount is typically small. Increased respiration rate and depth, like during exercise or fever, increase water loss through the lungs.

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    Fluid Loss Through Skin

    Water is lost through perspiration, also known as sweating.

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    Antidiuretic Hormone (ADH)

    ADH is produced in the hypothalamus and released from the posterior pituitary gland. It acts on the renal tubules to retain water and decrease urinary output.

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    Aldosterone Function

    Aldosterone, secreted by the adrenal cortex, works on the renal tubules to reabsorb sodium and excrete potassium, increasing blood volume by reabsorbing water along with sodium.

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    Study Notes

    Fluid and Electrolytes

    • Objectives:

      • Identify body fluid compartments
      • Describe mechanisms regulating fluid and electrolyte balance
      • Identify factors affecting fluid and electrolyte balances
      • Explain routes by which water and electrolytes enter and leave the body
      • Describe types of electrolytes in the body
      • Distinguish between electrolyte balance and imbalance
    • Introduction:

      • Body functions depend on proper fluid and electrolyte distribution between intracellular and extracellular compartments
      • Fluid and electrolyte balance is regulated by renal, hormonal, and metabolic mechanisms
      • Imbalances can occur due to other disorders or as therapy complications
      • The main goal is replacement of fluid and electrolyte losses and prior deficits, along with adequate nutrition.

    Fluids

    • Importance:

      • Crucial for body functions
      • Maintains blood volume
      • Aids digestion
      • Transports materials to and from body cells
      • Acts as a medium for cellular metabolism
      • Excretes waste
      • Regulates body temperature
    • Composition:

      • Water is the largest component, forming 50-70% of an adult's body weight and 75-80% of an infant's
      • By age two, the fluid percentage is similar to an adult (60%)
      • Elderly percentages of total body water (TBW) drop to 45-60%

    Body Fluid Compartments

    • Intracellular fluid (ICF):

      • Found within cells
      • Accounts for approximately 40-50% of total body weight
      • Potassium (K) is the major electrolyte, crucial for cellular chemical functions
    • Extracellular fluid (ECF):

      • Found outside cells
      • Made up of two compartments:
        • Interstitial fluid: found in spaces between cells (15% of total body weight in adults)
        • Intravascular fluid: found in blood and lymph vessels (about 5% of total body weight in adults)
        • Sodium (Na) is the major electrolyte in ECF

    Distribution and Concentration of Electrolytes in Body Fluid

    • Regulated by:
      • Osmosis
      • Diffusion
      • Active transport
      • Filtration
      • Pinocytosis (liquid absorption by cells like macrophages)

    Osmosis

    • Process by which water moves through a semi-permeable membrane from a lower concentration of solution to a higher concentration
    • Continues until equilibrium is reached on both sides of the membrane
    • Water moves towards areas with more concentrated electrolytes

    Common Sources of Fluid and Electrolyte Imbalance

    • Vomiting/Gastric suction:

      • Reduction in acidic gastric juices leads to loss of vital electrolytes (hydrogen, chloride, potassium, and sodium)
      • Results in decreased total body fluid and potential metabolic alkalosis due to increased base bicarbonate
    • Diarrhea:

      • Significant fluid loss in 24 hours (up to 17,000mL)
      • Intestinal suction also leads to substantial daily fluid loss (over 3,000mL).
    • Other causes:

      • Prolonged laxative or enema use
      • Gastrointestinal fistulas or drainage tubes
      • Gastrointestinal obstructions
    • Wound exudates:

      • Fluid loss from wounds leads to protein and sodium losses and possibly affects extracellular fluid volume.
    • Excessive perspiration:

      • Significant water, sodium, and chloride loss
      • Prolonged loss without replenishment causes decreased fluid volume and reduced electrolyte proportions.
      • Can cause sodium excess if water intake is insufficient
    • Insensible loss:

      • Water loss through lungs and skin (about 600-1000mL/day)
      • Increases with increased respiratory activity, skin damage, and dry air
    • Hyperventilation:

      • Excessive carbon dioxide elimination (results in respiratory alkalosis).
    • Hypoventilation:

      • Retention of carbon dioxide potentially more dangerous (causes respiratory acidosis).

    Electrolytes

    • Chemicals dissociating into charged ions (cations and anions) when dissolved

    • Maintain fluid and acid-base balance

    • Crucial for nerve excitability, blood clotting, and cellular metabolism

    • Composition and concentration vary in fluid compartments (measured as mEq/L)

    • Electrolytes in Body Fluid:

      • Regulate cell membrane permeability enabling transfer of materials -Maintain acid-base balance
      • Promote nerve and muscle irritability/excitability via electrical energy transmission
      • Maintain fluid osmolarity.

    Mechanisms regulating fluid and electrolyte balance

    • Proteins and electrolytes

      • Maintain water in compartments
      • Serum albumin (intravascular), sodium (interstitial), and potassium (intracellular) are major forces holding water in compartments
    • Kidneys

      • Most important regulatory mechanism
      • Regulated by antidiuretic hormone (ADH) controlling H2O reabsorption/excretion
      • Regulated by aldosterone promoting sodium retention and potassium excretion
      • Regulate total ECF, electrolyte concentration, acid-base balance and blood pressure
    • Gastrointestinal tract

      • Selective absorption of water and solutes generally in the small intestine
      • Absorbs about 7 – 9 L of secretions daily
      • Some fluid and electrolytes lost in excessive vomiting and diarrhea
    • Thirst

      • Stimulated by decreased extracellular fluid volume
      • Indicating physiological need for water
      • Stimulated by increased osmotic pressure, reduced ECF, and dry mouth
    • Lungs

      • Water lost during inhalation and exhalation (small amount)
      • More water loss with increased respiration rate and depth.
    • Skin

      • Water loss through perspiration
    • Hormonal control:

      • Three primary hormones regulate fluid and electrolytes balances:
        • ADH: Controls water reabsorption, decreasing urine output
        • Aldosterone: Promotes sodium reabsorption and potassium excretion
        • Parathormone: Regulates calcium and phosphorus balance

    Specific Electrolytes

    Sodium

    • Major cation in ECF

    • Regulates fluid volume, ECF osmotic pressure, cellular membrane potential, blood volume and vascular bed size

    • Normal level: 135-145 mEq/L

    • Hyponatremia: decreased sodium levels in blood (<135mEq/L)

      • Causes: inadequate intake, excessive loss of fluids (vomiting/diarrhea), diuretics, hormonal imbalances, excess fluid administration (e.g., 5% D/W; can be linked to water intoxication).
      • Classifications: hypovolemic (decreased total body water), euvolemic (normal total body water), and hypervolemic (increased total body water)
    • Hypernatremia: increased sodium levels in blood (>145 mEq/L)

      • Causes: decreased water intake, excessive water loss, and administration of hypertonic fluids

    Potassium

    • Major cation in ICF

    • Maintains intracellular homeostasis, resting membrane potential, nerve impulse conduction, skeletal muscle function, heart function, protein and CHO metabolism

    • Normal level: 3.5-5.0 mEq/L

    • Hypokalemia: decreased potassium levels (<3.5 mEq/L)

      -Causes: poor dietary intake, use of potassium-wasting diuretics or corticosteroids, excessive loss of GI tract fluids (severe vomiting/diarrhea), prolonged stress or fever, hormonal imbalances

      • Clinical observation: smooth muscle issues (decreased bowel movements/constipation), decreased cardiac impulses (hypotension/ irregular pulse), respiratory depression (shallow/ineffective respirations)
    • Hyperkalemia: increased potassium levels (>5.0 mEq/L)

      -Causes: kidney failure, excessive potassium intake, leakage of potassium from cells (burns/trauma), medication side effects (e.g., ACE inhibitors) -Clinical observation: muscle irritability, pain, and paralysis at increasingly severe levels; cardiac abnormalities (ECG changes)

    Calcium

    • Most abundant electrolyte in the body (mostly stored in bones/teeth)

    • Maintains normal level in ECF (1% of total); necessary for neuromuscular activity/function, blood clotting, decreasing capillary permeability, normal muscle contractility, nerve impulses, bones and tooth development

    • Hypocalcemia: decreased blood calcium levels (<9 mg/dL or 2.25 mmol/L)

      -Causes: low Vitamin D levels, parathyroid hormone deficit, malabsorption disorders, chronic diarrhea, renal diseases, medications (bisphosphonates), and immobilization -Clinical Observation: Tingling/numbness, muscle cramps, spasms of smooth and skeletal muscles, and seizures

    • Hypercalcemia: increased blood calcium levels (>5.3 mEq/L)

      -Causes: hyperparathyroidism, over-consumption of calcium supplements, malignancies, immobilization/decalcification -Clinical Observation: Fatigue, decreased neuromuscular excitability, nausea/vomiting, anorexia, deep bone pain, kidney stones, and ECG changes.

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    Description

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