Wk 1 PDF - Fluid and Electrolyte Balance

Wk. 1 Monday, January 13, 2025 7:21 PM SC: Fluid and Electrolyte Balance Homeostatic mechanisms: Water is the main component of body -- around 60% body weight is water weight for...

Wk. 1 Monday, January 13, 2025 7:21 PM SC: Fluid and Electrolyte Balance Homeostatic mechanisms: Water is the main component of body -- around 60% body weight is water weight for - Renal regulation: renal tubules are the site of action of ADH and aldosterone adults, for younger children, it gets to be around 70-80% - Hypothalamic/pituitary regulation: release ADH if necessary-- sense increase in osmolarity - Adrenal cortical (RAAS) regulation: activated by decreased perfusion to kidneys --- -intracellular: fluid within cells; greatest component - ADH enzyme helps the body hold onto water, adosterone is sodium and water -extracellular: fluid outside of cells Interstitial: surrounding the cells; largest component of extracellular insterstitium Kidney is primary organ for regulating fluid and electrolyte balance by adjusting urine volume through Intravascular: within blood vessels (plasma and blood) selective reabsorption of water and electrolytes --- regulating volume status Transcellular: very small amount of fluid in specialized cavities--- CSF, synovial (joint) fluid, pericardial fluid (heart and pericardium) Pituitary/hypothalamic: releases ADH (antidiuretic hormone- don’t pee hormone) Function of water in body: - Stimulates kidney to retain water, resulting in dilution of blood with water (raise blood levels) - Lubrication of joints - AKA vasopressin - Transport mechanism - Osmoreceptors that sense concentration of blood and adapts to whatever adjustment needed to - Medium for cellular metabolism -- energy take - Regulation of body temp - Stimulates thirst center and ADH released from pituitary, results in increased free water and - Component in all body cavities decreased plasma osmolarity Maintaining equilibrium: homeostasis: involves positive and negative mechanisms up to a Kidneys: ADH signaling them certain point (illness stage) - Kidneys compensate by raising blood pressure to increase perfusion Body is always trying to get back into natural state - Renin angiotensin aldosterone system (RAAS) pg. 232 Sick in bed, nothing to keep down or in, low blood volume Solvent: solution, something being dissolved in Kidneys kick in, renin secreted from kidneys and circulates in bloodstream Solute/molecule: particle, electrolyte, etc Liver recognizes renin and produces angiotensin- transports to turn into angiotensin 1 in blood stream, which angiotensin converting enzyme ACE and converts it from 1 to angiotensin 2 Movement of solutes: diffusion, facilitated diffusion, active transport, filtration Angiotensin 2 does two things: causes vasoconstriction (raising blood pressure in vessels, Water movement: osmosis narrowing of walls) and aldosterone release (stimulates adrenal gland In order to release. (coffee straw vs boba straw, a lot more pressure on coffee)(vasoconstriction does this with kidneys) Angiotensin 2, gets to adrenal gland-- releases aldosterone (na and H20 holder) which causes the Osmosis: semipermeable membrane between two compartments, only water could body to reabsorb water (do not pee) and hold onto sodium and pushes potassium away pass through-- membrane is not permeable to solutes Increasing blood volume with a tighter area to get through will increase blood pressure - Water moves from area of low concentration of solute to area of high concentration [ of solute--- they need more room to move so the water needs to get to it Sarah or brittanyRN - Passive movement, no energy Diffusion: movement of solutes - Passive transport, seen the most in nursing Fluid balance: - Same level of fluid, diff levels of solutes, permeable membrane for solutes LABS- affected by volume status - Molecules move from high concentration of solutes to low concentration Osmolarity: concentration of solutes v solvents (blood to serum) - Deep breathe, o2 in lungs and alveoli, diffuses into low concentrated bloodstream, Specific gravity: density of urine compared to water co2 needs to get out through lungs and on expiration BUN and creatinine: kidney function tests, creatinine more specific (end product of muscle Facilitated diffusion: metabolism) BUN (end product of protein metabolism) a rise indicates poor function or damage of - Passive transport from high to low concentration, but needs a helper kidney - Size of molecule is larger. Carrier proteins Hematocrit: hemoglobin, percentage of RBC within blood - Glucose molecules are big, potassium are big and like to stay in the cell and does not easily move--- as body senses levels, the body tries to get rid of it by pulling it into As you age: cell through the use of helper protein - Loss of thirst mechanism - Blood sugars---- worry about potassium level, do not want it to get too low - Hormonal changes Active transport: movement of solutes against gradient - Kidney function worsens with age - Low to high concentration - Body has certain reasons to raise concentration Intake and output: important monitoring fluid status - ATP is utilized --- energy Positive and negative balance - Na/K pump-- pushes and pulls sodium against gradient -- requires energy Filtration: passive transport Weight: 1kg-1L--daily weight is best indicator of fluid status bc of no user error - Water and dissolved solutes movement based on pressure. Vital signs - Move from area of high to low hydrostatic pressure Hydrostatic pressure in blood vessels is generated by each beat of heart Hypovolemia: low blood volume in intravascular space (extracellular fluid compartment) fluid volume Filtration occurs in glomerulus of kidney and in capillaries deficit Dissolved into fluid, body gets rid Exceeds intake of fluid Electrolyte concentration remains same Hydrostatic v osmotic pressure Causes are: inadequate intake fluid, excess loss fluid Hydrostatic: filtration, force within compartment such as blood vessels that pushes (ex. Differs from dehydration; do not lose electrolytes Water) - Elevated hgb & hct, BUN & creatinine, serum osmolarity, urine specific gravity Osmotic: oncotic pressure exerted by solutes that pull - Restore fluid volume, rehydration orally is best route, IV fluids, skin care due to dry skin, stop diuretics Third spacing: fluid does not stay in appropriate compartment- unavailable to use, Hypervolemia: high blood volume, extra fluid circulating in blood stream, expansion of extracellular need to get it back to where it belongs fluid- serum sodium remains unchanged - Swelling, abdominal fluid Related to increase in total body sodium (causes increase in total body water content) - Low hydrostatic pressure Causes: simple fluid overload or excessive sodium intake, altered homeostatic mechanisms - Sitting in interstitial area (kidneys are not working) - Decreased hgb, serum osmolarity and urine specific gravity - Elevated hct, BUN and creatinine - Enforce sodium and fluid restrictions as ordered, skin care for moist or weeping skin (third spacing), diuretic or osmotic pull due to third spacing Potassium lives in gut 3111 Page 1