Fluid and Electrolytes

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SSTEMT
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169873
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Fluid and Electrolytes
Updated:
2012-09-09 17:45:04
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EMT Paramedic 111
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Flash cards for the lecture from 9-7-12
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  1. Intracellular Fluid
    Fluid inside the cell
  2. Extracellular Fluid
    Fluid outside the cell
  3. Intravascular Fluid
    Fluid inside the vasculature
  4. Interstitial Fluid
    Fluid outside of the cell membrane but not within the circulatory system
  5. Dehydration
    Abnormal decrease in total body water
  6. Overhydration
    Retention of abnormally high amount of body fluid
  7. Electrolytes
    • Substances that seperate into electrically charged particles
    • Cations have a positive charge (+)
    • Anions have a negative charge (-)
  8. Types of Cations
    • Sodium (Na+)
    • Potassium (K+)
    • Calcium (Ca++)
    • Magnesium (Mg++)
  9. Sodium (Na+)
    • Most prevalent cation in extracellular fluid
    • "Water follows sodium"
    • Important in transmission of nervous impulses
    • Hypernatremia is an abnormal increase in sodium
    • Hyponatremia is an abnormal decrease in sodium
  10. Potassium (K+)
    • Most prevalent cation in the intracellular fluid
    • Important in transmission of electrical impulses
    • Hyperkalemia is an abnormally high potassium level
    • Hypokalemia is an abnormally low potassium level
  11. Calcium (Ca++)
    • Plays a major role in muscle contraction as well as nervous impulse transmission
    • Hypercalcemia is an abnormally increased calcium level
    • Hypocalcemia is an abnormally decreased calcium level
  12. Magnesium (Mg++)
    • Necessary for several biochemical processes
    • Closely associated with phosphate
    • Hypermagnesemia is an abnormally increased level of magnesium
    • Hypomagnesemia is an abnormally decreases level of magnesium
  13. Types of Anions
    • Chloride (Cl-)
    • Bicarbonate (HCO3-)
    • Phosphate (HPO4-)
  14. Chloride (Cl-)
    • Negative charge balances the positive charge of cations
    • Major role in fluid balance and renal function
    • Associated with sodium
  15. Bicarbonate (HCO3-)
    • Principle buffer of the body
    • Neutralizes the hydrogen ion and other organic acids
  16. Phosphate (HPO4-)
    • Important in body energy stores
    • Closely associated with magnesium in renal function
    • Acts as a buffer, primarily in the intracellular space
  17. Diffusion
    The movement of a substance from an area of greater concentration to an area of lower concentration
  18. Types of Solutions
    • Isotonic
    • Hypertonic
    • Hypotonic
  19. Isotonic
    Solutions on opposite sides of a membrane are equal concentration
  20. Hypertonic
    The concentration of a given solute is greater on one side of a membrane than the other
  21. Hypotonic
    The concentration of a given solute is less on one side of a membrane than the other
  22. Osmosis vs. Solutes
    • Osmosis is the movement of water from an area of higher WATER concentration to an area of lesser WATER concentration
    • Because water is a solvent, it moves from an area of lower SOLUTE concentration to an area of higher SOLUTE concentration
  23. Active Transport
    • The movement of a substance across the cell membrane against the osmosis gradient (towards the side that already has more substance)
    • Faster than diffusion
    • Requires energy
  24. Facilitated Diffusion
    • Certian molecules can move across the cell membrane with the assistance of "helper proteins"
    • Glucose is one example
    • Depending on the substance, this movement may or may not require energy
  25. Osmotic Pressure
    Pressure exerted my the concentration of solutes on one side of a semipermeable membrane
  26. Oncotic Force (Colloid Osmotic Pressure)
    Osmotic pressure exerted by large protein particles
  27. Starling's Hypothesis
    Net filtration=Forces favoring filtration-Forces opposing filtration
  28. Edema
    Accumulation of water in the interstitial space due to disruption in the forces and mechanisms that normaly keep net filtration at zero
  29. Fluid Imbalances
    The body maintains a constant balance between intake and excretion of waterAmount gained every day approximately equals the amount lost
  30. Classifications of Dehydration
    • Isotonic
    • Hypernatremic
    • Hyponatremic
  31. Isotonic Dehydration
    Loss of sodium and water in equal amounts
  32. Hypernatremic Dehydration
    Loss of water in excess of sodium
  33. Hyponatremic Dehydration
    Loss of water in excess of water
  34. Isotonic Dehydration
    • Causes
    • Severe or long term diarrhea or vomiting
    • Systemic infection
    • Intestinal obstruction
    • Signs and Symptoms
    • Dry skin or mucous membranes
    • Poor turgor
    • Oliguria (less urinary output)
    • Anuria (no urinary output)
    • Acute weight loss
    • Depressed or sunken fontanelles in infants
    • Management
    • IV infusion of isotonic fluid
  35. Hypernatremic Dehydration
    • Causes
    • Excessive or misuse of diuretics
    • Continued administration of sodium in absence of water intake
    • Excessive loss of water without loss of sodium
    • Profuse, watery diarrhea
    • Inhalation or ingestion of salt water
    • Signs and Symptoms
    • Dry, sticky mucous membranes
    • Flushed skin
    • Intense thirst
    • Oliguria or Anuria
    • Increased body temperature
    • AMS
    • Management
    • Volume replacement with isotonic solution or hypotonic based on serum sodium levels
  36. Hyponatremic Dehydration
    • Causes
    • Use of diuretics
    • Excessive perspiration
    • Salt loosing renal disorders
    • Increased water intake
    • Inhalation or ingestion of fresh water
    • Signs and Symptoms
    • Abdonimal or muscle cramps
    • Seizures
    • Rapid thready pulse
    • Diaphoresis
    • Cyanosis
    • Management
    • IV replacement with normal saline or lactated ringers
    • Occasionally, hypertonic saline
  37. Overhydration
    • An increase in body water with a decrease in solute concentration
    • May result from..... Parenteral administration of too much water,Impaired cardiac function, Impaired renal function, Some endocrine dysfunctions
    • Signs and Symptoms
    • SOB
    • Puffy eyes
    • Edema
    • Polyuria
    • Moist crackles in the lungs
    • Acute weight gain
    • Management
    • Cause dependent
  38. Electrolyte Imbalance: Potassium
    • A very narrow range of serum level must be maintained for normal function 3.5 to 5.0 mEq
    • Loses areusually minimal and are replenished through dietary intake
    • Excessive potassium is usually excreted through the kidneys
    • Imbalances interfer with neuromuscular functions
    • May cause sudden death
  39. Hypokalemia
    • Possible Causes
    • Reduced dietary intake
    • Poor potassium absorption by the body
    • Medications
    • Diuretics
    • Steroids
    • Theophyline
    • Signs and Symptoms
    • Malaise
    • Skeletal muscle weakness
    • Decreased reflexes
    • Weak pulses
    • Faint or distant heart sound
    • Shallow respirations
    • Low blood pressure
    • GI problems
    • Anorexia
    • Vomiting
    • Gaseous distention
    • Excessive thirst
    • Management
    • Based on exact serum level
  40. Hyperkalemia
    • Causes
    • Acute or chronic renal failure
    • Burns
    • Crush injuries
    • Severe infections in which large amonts of potassium is released
    • Excessive use of potassium salts
    • Signs and Symptoms
    • Irriability
    • Abdominal distension
    • Nausea
    • Diarrhea
    • Oliguria
    • Weakness to Paralysis
  41. Electrolyte Imbalance: Calcium
    • Essential for body function
    • Neuromuscular transmission
    • Cell membrane permeability
    • Hormone secretion
    • Growth and ossification of body
    • Muscle contraction
    • Calcium intake in a normal balanced diet is sufficient for needs
    • Calcium is excreted through :Urine, Feces, Perspiration
  42. Hypocalcemia
    • A decrease in serum calcium
    • Possible causes
    • Endocrine dysfunction
    • Renal insufficiency
    • Decrease in intake or malabsorption
    • Deficiency, malabsoption or inability to activate Vitamin D
    • Signs and Symptoms
    • Paresthesia
    • Tetany
    • Abdominal cramps
    • Neural excitability
    • Personality changes
    • Abnormal behavior
    • Convulsions
  43. Hypercalcemia
    • Possible causes
    • Various neoplasms (tumors)
    • Parathyroid dysfunction
    • Diuretic therapy
    • Excessive administration of Vitamin D
    • Calcium can be deposited into various body tissue, including organ systems: GI System, CNS, Neuromuscular System, Cardiovascular System
    • Signs and Symptoms
    • Decreased muscle tone or tension
    • Renal stones
    • AMS
    • Deep bone pain
  44. Electrolyte Imbalance: Magnesium
    • Activates many enzymes
    • Approximately 50% of the body's magnesium is in insoluble state in the bones
    • 45% as an intracellular cation
    • 5% as an extracellular solution
    • Excreted by the kidneys
    • Has physiological effects on the nervous system silimalr to those seen with calcium
  45. Hypomagnesemia
    • Possible Causes
    • Alcoholism
    • Malabsorption
    • Starvation
    • Diarrhea
    • Diuresis
    • Certain disease states
    • Characterized by irritability of the nervous system
    • Signs and Symptoms
    • Tremors
    • Nausea and Vomiting
    • Diarrhea
    • Hyperactive reflexes
    • Confusion
    • Muscle spasms or seizures
    • Cardiac dysrhythmias
    • Management
    • IV magnesium sulfate
  46. Hypermagnesemia
    • Possible Causes
    • Chronic renal insufficienct
    • Ingestionof large amounts of magnesium compunds such as anacids
    • Magnesium Citrate
    • Magnesium Sulfate
    • Magnesium Hydroxide
    • May cause
    • CNS depression
    • Profund muscle weakness
    • Areflecia (absence of reflexes)
    • Cardiac rhythm disturbances
    • Signs and Symptoms
    • Sedation
    • Confusion
    • Muscle weakness
    • Respiratory paralysis
    • Management
    • Hemodialysis
    • Calcium salts
    • IV glucose and insulin

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