Fluid and Electrolyte

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Fluid and Electrolyte
2012-02-01 20:06:05

Fluids and Electrolytes Ch 24
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  1. Homeostasis
    • State of balance
    • causes of alteration environment, personal behaviors, infection, disease
    • ongoing process
    • essential to life
    • when the body loses the ability to maintain homeostasis and the internal enviornment changes, the physiologic processes can be interupted or changed, leading to disease, disorder, or death
  2. Elements
    • made of tiny units called atoms
    • four elements (oxygen, carbon, hydrogen, nitrogen) constitute more than 95% of the total body weight of the elements
  3. Atoms
    • smallest unit of chemical structure
    • no chemical change can ulter it
    • protons+, neutrons, electrons-
    • the number of protons and neutrons in the nucleus is approximately equal to the atomic weight
  4. Isotopes
    • atoms of the same element that have a different atomic weight
    • some are radioactive isotopes- have an unstable nucleus
    • alpha- least harmful
    • gamma- most harmful
  5. Molecules
    • atoms of the same element join together
    • H + H -> H2
  6. Compounds
    • atoms of 2 or more different elements join together
    • Na + Cl -> NaCl
    • inorganic- without carbon
    • organic- with carbon
    • 2H + O -> H2O
  7. Ions
    • compounds placed in water decompose
    • an atom bearing an electrical charge
    • cation+, anion-
  8. Processes
    • Synthesis
    • decomposition
    • solute
    • solvent
    • electrolyte solution
  9. Water
    • constitutes 60% of total body weight in adult
    • 70-80% infants, 45-55% older adult
    • Functions- solvent, transporter, regulate body temp, lubricate, componant of all cells, hydrolysis
    • balance regulated by hypothalmus
    • involved in many of the physical and physiological processes
    • major component of blood
  10. Gases
    • 2 important in body oxygen and carbon dioxide
    • oxygen needed by the cells to carry out functions
    • when its used leaves body as carbon dioxide
    • breathing is stimulated by high CO2 levels
  11. Acids
    • anyhting that gives up hydrogen
    • yeild hydrogen ions with a positive charge
    • important hydrochloric acid and carbonic acid
    • all other body fluids contained in the cells
  12. Bases
    • accepts H+ to form a bond
    • contains no hydrogen bond
    • Sodium bicarbonate
  13. Salts
    • acid and base react with each other
    • many of the compounds that dissociate into ions in living cells are salts
  14. pH
    • 7 neutral
    • greater then 7- base or alkaline
    • less then 7- acid
    • pH is of great biological importance
    • human body ranges from 7.35 to 7.45
    • below 7.35 acidosis (death usually occurs first)
    • above 7.45 alkalosis (S/S hightened state of nervous system activity, resulting in spasmodic muscle contractions, convulsions, and even death)
  15. Buffers
    • substances that try to maintain the pH
    • bicarbonate buffer system, phosphate buffer system, protein buffer system
  16. Bicarbonate Buffer System
    • found in both the intracellular and extracellular fluids
    • body's primary buffer system
    • attemps to maintain bodys pH
    • 2 components carbonic acid and sodium bicarbonate
  17. Phosphate Buffer System
    regulate the pH of intracellular fluid and the fluid of the kidney tubules.
  18. Protein Buffer System
    • found inside the cells
    • maintain pH inside the cell mostly RBC
  19. Substance Movement
    • Passive- diffusion(particles from are of greater concentration to an area of less concentration), osmosis(movement of water until equal always attracted to higher concentration), filtration(movement of substances against cell membrane)
    • Active- carrier molecule moves substances into cells
  20. Isotonic Solutions
    0.9% NS, Lactated Ringers
  21. Hypotonic Solutions
    • 0.45% NS (1/2 NS)
    • 0.33% NS
  22. Hypertonic Solutions
    • 5% Dextrose & 0.45% NS (D51/2 NS)
    • 5% Dextrose & LR (D5LR)
    • 3-5% NaCl
  23. Body Fluid Compsrtments of Adults
    • 65% intracellular
    • 35% extracellular (9% intervascular, 26% interstitial)
  24. Fluid & Electrolyte Balance
    • human life is suspended in a saline solution having a salt concentration of 0.9%
    • for life to continue and cells to properly function, fluids must remain fairly conctant
    • electrolytes make up 90-95% of bodies solution molecules
  25. Fluid Balance/Imbalance (Dehydration)
    • Water moves out of the cells
    • causes- water deprivation, sweating, excess urination, hemorrhage, diuretics, diarrhea, laxatives abuse, vomiting burns
    • Hormones- ADH, Aldosterone, Renin
    • Regulators of Fluid Balance- hydrostatic and Osmotic pressure
  26. Edema
    • occurs in interstitial space
    • causes- kidney disease, liver disease, heart disorder
    • weight gain is a sign
  27. Sodium
    • Location- Extracellular
    • Function- regulates fluid balance through osmotic pressure that results from water following sodium, stimulates conduction of nerve impulses, help maintain neuromuscular activity
    • Source- dietary
    • Excreted- kidney
    • Normal values- 135-145mEq/L
  28. Hyponatremia
    • decreased Na
    • Causes- decreased Na intake, prolonged vomiting, diarrhea, gastric or intestinal suctioning
    • Complications- edema, hypotension, rapid thready pulse, weakness, seizures, abd cramping
    • Data Collection-
    • Interventions- limit fluids, IV, I&O, daily weight, safety
  29. Hypernatremia
    • increased Na
    • causes- DI, cushings, decreased water intake, corticosteroid use,
    • data collection- neuro changes, low grade fever, flushed dry skin, dry mucus membranes
    • Interventions- low Na 2g/day, increase fruits and vegi, no salt subs, vitals, I&O, increase water
  30. Sodium foods
    table salt, soy sauce, cottage cheese, america cheese, mustard, ketchup, chicken, beef lean
  31. Potassium
    • Location- intracellular
    • Functions- nerve impulses and muscle function- heart
    • Source- dietary
    • Excreted- kidney
    • normal values- 3.5-5mEq/L
  32. Hypokalemia
    • 2.5 critical
    • causes- decreased intake,
    • Data collection- muscle weakness, leg cramps, hypotension, cardiac arrhythmias
    • Interventions- vitals, I&O, neuro strength , safety, oriented frequently, bed low, alarm, check every 30 mins, peak P flat T
  33. Hyperkalemia
    • 6.5 fatal
    • causes- meds, metabolic acidosis, celluar destruction, adrenal insuf, intake, kidney failure, excretion
    • Data Collection- muscle weakness, oliguria, anuria, respiratory distress, decreased cardiac contractility, EKG changes, reflexes
    • Interventions- may need insulin, diuretics, kayexalate, decrease K intake
  34. Kayexalate (Sodium polystyrene sulfonate)
    • Potassium removing resin
    • releases Na in exchange for K
    • PO, Enema
    • SE- constipation, anorexia, low levels of K, Ca, Mg
    • Interventions- monitor bowel function, electrolyte levels
  35. Calcium
    • Location- 99% bones and teeth, 1% blood
    • Function- bone and teeth integrity, blood clotting, smooth & skeletal muscle, nerve impulse
    • Value- 9-10.5mq/dL (8.6-10 nclex)