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fluid within (inside) each cell and has equal amounts. ICF contains potassium, magnesium, phosphate ions & protein
are found outside of the body cells and are the body’s transportation system. ECF contains sodium, chloride, calcium, hydrogen, & bicarbonates, plus oxygen, glucose, fatty acids & amino acids. ECF also contain blood plasma and interstitial fluids
the space within the blood vessels whose main function is to carry blood, blood plasma, RBC, WBC, & platelets.
Fluid that is everywhere in the body between the cells and vascular compartments; the function is to carry nutrients & waste products between the cells and blood vessels.
found in the spaces in the cerebrospinal canals in the brain, lymph, tissue, synovial joints, and eyes
What is an Electrolyte?
Exert a major influence on the movement of water between compartments on enzyme reaction, on the neurmuscular activity, and on acid base regulation. This movement is also known as homeostasis.
Normal pH of blood is....
7.35 - 7.45
What is pH?
A measurment of effective hydrogen ion concentration
What level of pH is incompatible with life?
<6.8 or >7.8
What pH level does acidosis occurs?
What pH level does Alkalosis occur?
What is the normal values of PaCO2?
What is the normal values of HCO3?
What is acidosis?
Systemic increase in hydrogen ion concentration; occurs when lung can't eliminate CO2, or if diarrhea causes loss of bi-carbs anions, or if kidneys fail to reabsorb bi-carb or secrete hydrogen ions
What is Alkalosis?
body-wide decrease in hydrogen ion concentration caused by hyperventilation and loss of non vital acids during vomiting or from excessive ingestion of base
what are some developmental factors for infant and children that affects fluids?
Highest grow nad metabolic activity; immature renal system; a decrease ability to concentrate urine which leads to increase fluid loss
what are some developmental factors for Adolescents that affects fluids?
Increase hormonal activity and excercise; pregnant teenagers have an increase demand on the fetus during a time when their own body's needs have increased
what are some developmental factors for Older Adults that affects fluids?
At the highest risk for fluid imbalances because of chronic diseases; decrease thirst mechanism; decrease renal function r/t aging and they take more meds with side effects of vomiting and diarrhea
What is Fluid volume deficit (FVD) ?
A decreased intravascular, interstitial and/or intercellular fluid below normal range (dehydration, waterloss, and lost in electrolytes without a change in sodium)
What is sodium "Na+"?
major ECF that regulates renin-angiotensin-aldosterone system (retains absorbed Na+ and H2O) excess sodium in the ECF may cause edema or conditions in which H2O loss exceeds Na loss
What are some risk factors for hypernatremia?
- Presence renal disease
- Cv problems
What are some risk factors for Hyponatremia?
- Decrease of sodium in the ECF
- Can result in an acidic enviroment
- May be due to severe vomiting & diarrhea
- May cause muscle weakness
- decrease skin turgor
- Low salt diet
What is Potassium "K+"
(3.5 – 5 mEq/L) – major ICF that regulates renin-angiotensin-aldosterone system (kidneys excrete K+ in exchange for Na+); extracellular lost from metabolic or respiratory acidosis
What are the risk factors for hyperkalemia?
- excess potassium in the blood; due to dehydration, diet, or renal failure
- Can result in muscle weakness
- or cardiac failure
What is hypokalemia?
- Potassium deficiency diarrhea, vomiting, diabetic acidosis, severe malnutrition, diet low in K+. GI suctioning, excessive use of laxatives or diuretics
- Can result in Cardiac abnormalties (tachycardia)
What is calcium?
4.5 - 5.5 mEq/L; decrease calcium is r/t to hypoparathyroidism; increase calcium is r/t increase bone loss because of immobility, cancer, and multiple fractures
What is magnesium?
- 1.5 - 2.4 mEq/L;
- decrease in magnesium r/t alcoholism & malnutrition
- Increase magnesium r/t renal disease
What is phosphate?
- 1.2 - 3.0 mEq/L
- Decrease in phosphate is r/t hyperparathryroidsm and malnutrition
- Increase in phosphate is r/t massive trauma, strokes, and renal failure
What are some other NANDA statements?
(North American Nursing Diagnosis Association)
- Impaired gas exchange
- Impaired oral mucous membrane
- Fluid volume Excess (Hypervolemia)
- Fluid Volume Deficit (Hypovolemia)
What will you notice in a client that might have FVD?
- weight - loss greater than 2lbs in 24hrs
- B/P - Low
- Temp. - Elevated or normal
- Pulse - Weak, Rapid, Shallow
- RR - Rapid, Shallow
- Urine - Scant, Dark yellow
- Stool - Dry, Smallvolume
- Skin - Warm flushed, Dry poor skin turgor
- Eyes - Sunken
What will you notice in a client that might have FVE?
- Weight - weight gain more than 2lbs in 24hrs (edema)
- Temp. - normal
- Pulse - full, Bounding
- Urine - Light, polyuria (if kidneys are working normally)
- Stool - bulky
- Skin - Cool, pale, moist, pitting edema
- Eyes - Swollen
- Lung/Breathing - Crackels, gargles, dyspnea, increase RR, labored breathing, orthopnea
- Neck vein distention
- Lab findings - decreased hematocrit level <38% and decrease BUN level <10mg/100mL (hemodilution)
Clear breath sounds are consistent with.....?
What are some nursing interventions and comfort measures?
How many mL of water the body requires per day?
1,200 - 1,500 mL of water
What percentage of our body weight is water?
What is the Crystalloid Solutions?
Its a type of IV solution that is water and other crystals (ex. Salts and sugars) - NS, Dextrose & water, Lactated Ringers.
What is a Colloid Solution?
An IV solution that is water, molecules of a suspended substances (ex. Blood cells & Blood products; Albumin and plasma)