Fluids and Electrolytes Made IE - Balancing Fluids
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- The most obvious and life-threatening problems are seen when?
- dehydration decreases the plasma volume
- Dehydration results in?
- fluid volume deficit
- Define isotonic dehydration?
- water and dissolved electrolytes are lost in equal proportions
- Define hypertonic dehydration?
- water loss is greater than electrolyte loss
- Define hypotonic dehydration?
- electrolyte loss is greater than water loss
- What happens to circulating blood volume in isotonic dehydration?
-
*circulating blood volume decreases (hypovolemia) and leads to inadequate tissue perfusion
*loss of plasma volume causes problems - In hypotonic dehydration, what is the relationship between plasma, interstitial fluid, and cells?
- fluid moves out of plasma and interstitial space and into cells, causing cells to swell
- In hypertonic dehydration, what is the relationship between plasma, interstial fluid, and cells?
- fluid moves out of cells and into interstitial spaces and plasma, causing cells to shrink
- Common causes of hypertonic dehydration include?
-
excessive sweating
hyperventilation
ketoacidosis
prolonged fevers
watery diarrhea
early-stage renal failure
diabetes insipidus
excessive sodium bicarbonate
administration
tube feedings
dysphagia
impaired thirst
unconsciousness
impaired motor function
systemic infection - Common causes of hypotonic dehydration include?
-
chronic illness
chronic renal failure
malnutrition
excessive fluid replacement - Common causes of isotonic dehydration?
-
hemorrhage
vomiting
diarrhea
profuse salivation
fistulas
abscesses
ileostomy
cecostomy
frequent enemas
profuse diaphoresis
burns
severe wounds
long-term NPO
diuretic therapy
GI suction - Cardiovascular effects of dehydration?
-
increased pulse rate
thready pulse quality
decreased blood pressure
postural (orthostatic)
hypotension
flat neck and hand veins in
dependent positions
diminished peripheral pulses
weight loss - Respiratory effects of dehydration?
-
increased repiratory rate
increased depth of
respirations - Neuromuscular effects of dehydration?
-
decreased cns activity
(lethargy to coma)
fever - Renal effects of dehydration?
-
decreased urine output
increased urine specific
gravity - Integumentary effects of dehydration?
-
skin dry and scaly
turgor poor, tenting present
mouth dry and fissured,
pastelike coating present - Gastrointestinal effects of dehydration?
-
constipation
decreased motility
diminished bowel sounds - Hypotonic dehydration can result in?
- skeletal muscle weakness
- Hypertonic dehydration can result in?
-
hyperactive deep tendon
reflexes
increased sensation of thirst
pitting edema - ___________ __________ area of an infant is greater than that of an adult relative to their respective _________ so infants ________ more _______from their skin than adults do and are at higher risk for ____________.
-
Body surface
weights
water
dehydration - Normal daily output and intake is about?
- 2600 ml
-
What is the daily output for
skin? - 600 ml
- What is the daily output for lungs?
-
400 ml
(200 for each side) - What is the daily output for kidneys (urine)?
- 1500 ml
- What is the daily output for intestines (feces)?
- 100 ml
- Daily total intake of liquids is?
- 1500 ml
- Daily total intake of solid foods is?
- 800 ml
- Daily total intake of water of oxidation?
- 300 ml
- Examples of sensible losses are? They are so deemed because they are measurable.
-
urination
defecation
wounds - Examples of insensible losses because they can't be measured are?
-
skin
lungs - Define extracellular?
- interstitial and intravascular spaces
- Which structures separate intracellular fluids from extracellular fluids?
- capillary walls and cell membranes
- In an adult, the total amount of intracellular fluid averages ____ of the person's body weight or about _____ Liters
-
40%
28 - The total amount of extracellar fluid averages ____ of the person's body weight or about _____ Liters.
-
20%
14 - In adults, interstitial fluid (surrounds cells accounts for about ____ of extracellular fluid.
- 75%
- In adults, intravascular (or plasma) accounts for about ____ of extracellular fluid.
- 25%
-
Transcellular fluids are other fluids besides extra and intracellular fluids and are located in which places?
(5) -
cerebrospinal column
pleural cavity
lymph system
joint
eyes - About ______ of the body weight of a full-term neonate is water.
- 80%
- About _____ of the body weight of a premature infant is water.
- 90%
- In a typical 154 lb lean adult male, about _____ of body weight is water.
- 60%
- _________ cells hold much of the body's water while _____ cells contain very little water.
-
Skeletal
fat - The body's fluids are found in these 3 types of solutions?
-
isotonic
hypertonic
hypotonic -
_________ _________ is considered isotonic because the concentration of ________
in the solution nearly equals the concentration of ________ in the blood. -
Normal saline
sodium
sodium - Fluid imbalances occur in the elderly population because?
-
their skeletal muscle mass declines.
(Skeletal muscle cells hold lots of water. The elderly are more prone to get fat cells which does not hold water.) - After age 60, water content drops to about ______
- 45%
- About _____ of body's total fluid volume is made up of plasma and remains stable through life.
- 5%
- Define hypotonic solution?
-
The first solution has a lower SOLUTE concentration than the second solution, so the fluid is going to flow to the second solution.
(So the first solution is hypotonic to the second solution.) - Half-normal saline is considered ________ because the concentration of sodium is lower than the concentration in patient's blood.
- hypotonic
- Define hypertonic solution?
- The first solution has a higher SOLUTE concentration than the second solution, so the fluid is going to flow to the first solution. So the first solution if hypertonic to the second solution.)
- A solution of dextrose 5% in NS is considered ______ to patient's blood?
-
hypertonic
(because the concentration of solutes in the NS is greater than the solutes in patient's blood. - If a hypotonic fluid is given to a patient, it may cause too much fluid to move from the _________ into the ___________, and the __________will swell.
-
veins
cells
cells - If a hypertonic solution is given to a patient, it may cause too much fluid to be pulled from ______ into the ___________, and the cells may __________.
-
cells
bloodstream
shrink - Define diffusion?
- SOLUTES move from an area of higher concentration to an area of lower concentration by passive transport, because no energy is used.