fluid and electrolyte & acid-base homeostasis and imbalances
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intracellular fluid? extracellular fluid? types?
- Intra: inside the cell
- Extra: intravascular and interstitial.
- Intravascular (plasma): its what in the vesicles.
- Interstitial: fluid that is around the cell.
What is fluid volume deficit? etiology? CM?
- Caused by removal of sodium-containing fluid from the body (decrease in salt and water- bc H2O goes where sodium goes)
- There is a decrease vascular volume, and interstitial volume. However, the is normal osmolality (concentration) .
- Etiologies: vomiting, diarrhea or gastric suction, polyuria, scessive sweating, decrease intake, ascites (third space).
- CM: sudden weight loss, and many other in adults. In infants: Fontanels may be sunken, neck veins are not reliably assessed in infants.
What is fluid Volume Excess? Etiologies? CM?
- amt of extracellular fluid is abnormally increased. Increased in the vascular and interstitial volume.
- Etiology: Renal dailure, CHF, Cirrhosis, dietary sodium.
- CM: gain weight, decreased BUN, HCT, in infants= bulging fontanel, neck vein sticks out.
Hyponatremia? etiologies? CM?
- A serum sodium concentration below the lower limit of normal (sodium is more in the extracellular fluid)
- It is the most common electrolyte abnormally.
- The cell swells-up.
- Etiology: 2 primary reasons.
- A gain of relative more water than salt (due to the use of diuretics)
- a loss of relatively more salt tahn water (loos of GI fluids -- vomiting, diarrhea, etc -- or GI suctioning)
- CM: mild CNS dysfuctions (malaise, nausea, vomiting, headache, etc) or severe CNS dysfunctions (confusion, lethargy, seizures when drop is fast, etc)
hypernatremia? Etiology? CM?
- Serum sodium concentration above upper limit of normal. there is more sodium than water in the extracellular space causing the cell to shrink.
- etiologies: dehydration, watery diarrhea (colitis), heat stroke, diabetes insipidus (a prob w ADH)
- CM: Mild (thirst, oliguria (decrease in urine output), confusion, lethargy, dry sticky membranes.
- Severe (disorientation, seizures, coma, death)
What is clinical dehydration? Etiologies? CM?
- It is the combination of 2 fluid disorders: usually extracellular volume deficit, and hypernatremia.
- Etiologies: Vomiting, diarrhea, gain of more salt than water (ppl w renal disease), Loss of more water than salt).
- CM: Common symptoms of dehydration, plus hypovolemis shick (dehydration trauma, could cause death-- associated w hemorrhaging.
What is edema?
- It is the excess fluid in interstitial compartments.
- Could also be caused by blockage of the lymphatic drainage.
- Decreased capillary osmotic pressure: plasma proteins decreased; extensive edema.
- increased in fluid osmotic pressure: inflammation causes proteins to leak out from vascular permeability/
What is potassium's functions?
- It is the major intracellular electrolyte, cation.
- It is essential for transmission and conduction of nerve impulses, normal cardiac rhythms, and skeletal and smooth muscle contraction.
- Pts w potassium issues are usually hospitalized bc of 2 reasons: K is usually intake by mouth, and they need to be monitor for dysrhythmias.
Hypokalemia? etiologies? CM?
- Decreased k ion concentration in extracellular fluid.
- Etiology: Decreased intake, GI loss (vomiting/diarrhea)
- Renal losses, Diuretics.
- CM: Paralytic ileus (decrease paralisis), dysrhythmias, bilateral muscle weakness (pts who are falling all of the sudden).
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