Fluids Lecture PDF

Renal Part Fluids Lecture  Learning Outcomes ga - 1 Fluid Compartments Describe human body fluid compartments and importance of fluid balance. 2 Fluid Types Differentiate between types of fluids and their uses. 3 Application Apply flui...

Renal Part Fluids Lecture  Learning Outcomes ga - 1 Fluid Compartments Describe human body fluid compartments and importance of fluid balance. 2 Fluid Types Differentiate between types of fluids and their uses. 3 Application Apply fluid balance concepts to manage fluid imbalances. · Is) Homeostasis Fluid Balance Electrolyte Balance Maintaining normal fluid volume in the body. Regulating concentrations of ions like sodium and potassium. Osmotic Balance Acid-Base Balance Balancing solute concentrations across cell membranes. Maintaining proper pH levels in body fluids. General Principles 1 Diffusion Movement of particles from high to low concentration areas. 2 Osmosis Movement of water towards higher electrolyte concentration. 3 Osmotic Pressure Pressure needed to prevent solvent migration.  Body Fluids and Compartments Total Body Water 60% body weight Intracellular Fluid (ICF) &40% body weight Extracellular Fluid (ECF) O 20% body weight : 19a Interstitial ( between) 80 % of ECF Sesemm Intravascular (inside) & 20 % of ECF · Practical Example 1 What is the water content in each fluid compartments in an adult 70-kg male, knowing that (1 L = 1 kg)? Time 5 mins 60 % A. Total Body Water = 46 70x60 B. Intracellular = zu 20% C. Extracellular = Practical Example 1 What is the water content in each fluid compartments in an adult 70-kg male, knowing that (1 L = 1 kg)? Time 5 mins Total Body Water = 42 L (60% of BW) Intracellular = 28 L (40% of BW) 22, Extracellular = 14 L (20% of BW) Who has the highest water content in the body? Time=1 mins O A. Infants B. Adults C. Older Adults D. All are the same Age-Related Fluid Changes Changes 1 Infant 80% body water content 2 Adult 60% body water content 3 Older Adult 40% body water content Fluid Balance Mechanisms 1 Hydrostatic Pressure Fluid movement due to pressure differentials. 2 Osmotic Pressure Fluid movement due to solute concentration differences. 3 Homeostasis Body regulates volumes, solute charge, and osmotic load. Solute Homeostasis Electrolytes Non-electrolytes Charged particles: cations (Na+, K+) and anions (Cl-, Uncharged particles: proteins, urea, glucose, O2, HCO3-). CO2. Regulatory Mechanisms 1 Baroreceptor Reflex - Responds to changes in blood pressure. 2 Volume Receptors Detect fluid excess in atria and great vessels. 3 Renin-Angiotensin-Aldosterone Regulates blood pressure and fluid balance. 4 Antidiuretic Hormone Controls water reabsorption in kidneys. Baroreceptor Reflex Location Function Effect Atrial walls, vena cava, aortic Responds to falls in arterial Constricts afferent arterioles, arch, carotid sinus. blood pressure. retaining fluid. Volume Receptors 1 Location 2 Function 3 Effect Atria and great vessels. - & Respond to fluid excess. Stimulate renal response, increasing urine output. Renin-Angiotensin- Aldosterone System 1 Renin 00 Enzyme secreted by kidneys when pressure or volume drops. 2 Angiotensin Converted in lungs, causes vasoconstriction. = 3 Aldosterone Controls Na+ and K+ levels, increases fluid volume. Antidiuretic Hormone (ADH) Function Restores intravascular fluid volume. Trigger Osmoreceptors in hypothalamus thirst center. Effect Fluid volume excess decreases ADH, deficit increases ADH. Basic Fluid Requirements Requirements 1 Method A 35 mL of fluids per kg body weight per 24 hours. 2 Method B 35-ke2 Varies based on weight: 100 mL/kg/d for first 10kg, 50 mL/kg/d for second 10kg, 20 mL/kg/d above 20kg. Practical Example 2 100X 20 Calculate your basic fluids requirements? Please use both methods and compare the results? Time=5mins Share your results Fluid Types Fluids Types Crystalloids Balanced salt/electrolyte solution; forms a true solution and is capable of passing through a semipermeable membranes. May be: minora ✓Isotonic i ✓Hypertonic ✓Hypotonic Isotonic Solution Free movement - No fluid shift because solutions are equally concentrated Normal Saline (0.9%), Dextrose (5%) Lactated Ringer, Plasma Lyte O s % · North sil Fluid , A LR S Hypotonic Solution * Lower solute concentration Fluid shifts from hypotonic solution into the more concentrated solution to create a balance (cells swell) Normal Saline (0.33%, 0.45%) 20. 9 Hypertonic Solution Higher solute concentration incerebral exema Fluid is drawn into the hypertonic solution to create a balance (cells shrink) Hypertonic saline (3%, 5%, & 7.5%), Dextrose (10%, 70%) 09. CoVCS Fluids Types Colloids: High molecular -weight solutions, draw fluid into intravascular compartment via oncotic pressure (pressure exerted by plasma proteins not capable of passing through membranes on capillary walls). Examples: Albumin, Hetastarch, Pentastarch, Plasma and Dextran Fluid Types: Colloids 1 Definition 2 Examples High molecular-weight solutions that draw fluid Albumin, Hetastarch, Pentastarch, Plasma, into intravascular compartment. Dextran Disturbances of Fluid Homeostasis Fluid Balance intake= output Dehydration (hypovolemia), Overhydration (hypervolemia) - - - - Osmolarity Isonatremic, Hyponatremic, Hypernatremic Dehydration 1 Definition Loss of body fluids, increased solute concentration in blood. 2 Effect Fluid shifts out of cells, cells shrink and malfunction. Hyperonic Dehydration: Symptoms and Treatment Symptoms Treatment Irritability, confusion, dizziness, thirst, decreased Fluid replacement, monitor symptoms, maintain I&O, E urine output, dry skin, tachycardia daily weights In take out put. ,  Hypovolemia 1 Definition Isotonic fluid loss from extracellular space. # bl geting. tear- 20% ex in 2 Causes liver failure Excessive fluid loss, decreased intake, third space fluid shifting. c Blood 15, & Pressure volume extrasiturat - introvascular Hypovolemia: Symptoms and Treatment For intravascular why ? Symptoms Treatment e Mental status changes, thirst, tachycardia, delayed & Fluid replacement, albumin replacement, blood capillary refill, orthostatic hypotension transfusions, vasopressors whe hypotensive Cost & Vasodia lat of Tomantine The Balance Hypovolemic Shock Clinical Presentation Treatment Severe hypovolemia leading to inadequate tissue & Rapid fluid resuscitation, blood products, and liver perfusion and organ dysfunction. injur addressing underlying cause. Acute Kidney Aluminarener Hypervolemia 1 Definition Excess fluid in extracellular compartment due to retention or excessive intake. 2 Consequences Can lead to CHF and pulmonary edema. Hypervolemia: Symptoms and Treatment Symptoms CHF Treatment Seri Tachypnea, dyspnea, crackles, JVD, edema, Fluid and Na+ restriction, diuretics, monitor vital signs hypertension and labs ↳ loop Overhydration 1 Cause 2 Effects Excessive fluid intake with failure to eliminate. Decreased sodium concentration and osmolality, reduced hematocrit. - Case Scenario: Patient Presentation Patient 64-year-old female with recent heart failure diagnosis. Medications Enalapril, metoprolol, furosemide (recently stopped). Symptoms Confusion, tachycardia, tachypnea, edema, crackles, JVD. gervolemin Case Scenario: Diagnosis 1 Fluid Imbalance O Hypervolemia 2 Cause Stopping diuretic medication (furosemide) Case Scenario: Treatment Treatment Best Option Restart Lasix and implement water restriction Rationale Addresses fluid overload and prevents further accumulation Key Messages 1 Fluid Compartments Understand body fluid compartments and importance of balance. 2 Fluid Types Differentiate between fluid types and their uses. 3 Application Apply fluid balance concepts to manage imbalances effectively.