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Fluid & Electrolyte Balance (Unit 3) (Intravenous Therapy…
Fluid & Electrolyte Balance
(Unit 3)
Distribution of Body Fluids
Intracellular
2/3 of all body fluids and cells
3 solutes
Electrolytes
O2
Glucose
Extracellular
1/3 body fluids and outside cells
Tansport system in the body
Intavascular: Plasma, blood
Interstitial: In between and surrounding cells
Regulating Body Fluids
Most water is stored in the muscles
Assists to regulate body temp
I & O are balanced
2400 mL/daily intake
Sensible: can be measured
Urine
Liquid stool
Vomit
Insensible: cannot be measured
Breathing
Sweat
Factors Affecting Body Fluids
Age
Older= less water r/t less muscle mass
Sex and Body Size
Women: decreased water r/t less muscle mass
Males: Increase water r/t increased muscle mass
Temperature
Replace water in hotter weather
Life Style
Active
Sedentary
Fluid Imbalances
Fluid Volume Deficit
AKA: Hypovolemia
Dehydration
Dry skin/mucous membranes
Tenting skin
Confusion
Sudden weight loss
Thirsty
Weak
High Hematocrit levels: >47/52%
High Specific Gravity Levels: >1.025
Fluid Volume Excess
AKA: Hypervolemia
Edema
0+ No pitting edema
1+ Mild pitting edema; 2mm depression that disappears rapidly
2+ Moderate pitting edema; 4mm depression that disappears in 10-15 seconds
3+ Moderately severe pitting edema; 6mm depression lasts > 1 min.
4+Severe pitting edema; 8mm depression that lasts >2 min.
SOB/Dyspnea
Increase weight
Decreased Hemoglobin: <14/12 g/dL
Decrease Hematocrit: <42/37%
BP changes
Orthopnea
Anxiety
Excess fluid goes to lungs first! Edema comes later
JVD (Jugular Vein Distention)
Adventitious BBS (Wet sounding)
Intravenous Therapy
Hydration
Medications administration
Blood transfusions
Feeding (TPN/PPN)
Iron
Routes
Peripheral
Arms, legs; Usually changed every 3 days
Implanted parts
IVADs (Upper chest)
Long term
Central Lines (CVADs)- Chest/Neck
Long term
PICC lines
Month or longer
Complications
Phlebitis: Inflammation of the vein
Infiltration: Leakage of fluid, swelling, cool to touch
Extravasation: chemo. or something that burns the tissue
Overall fluid overload
Fluid and electrolyte imbalances
Electrolyte Imbalances
Potassium K+: 3.5-5.0 mEq/L
R/t Cardiac function!
Watch for fluid excess and deficit
Sodium Na+: 136-145 mEq/L
Water balance
Where goes the water, there goes the salt
Major cation
Confusion r/t to low Na+
Chloride Cl-:98-106 mEq/L
Follows Na+
Calcium Ca+: 9.0-10.5 mg/dL or 4.5-5.6 mg/dL
R/t Nutrition and Bone health
Magnesium Mg+: 1.3-2.1 mEq/L
R/t Cardiac and Musculo-skeletal function
ATP productioni
DNA synthesis
Metabolic function
Phosphorus PO4-: 3.0-4.5 mg/dL
R/t bone and musculo-skeletal function
Found in bones, nerves, and muscle
Parathyroid abnormalties
Watch in malnourished pts. (alcoholics)
Specific Gravity: 1.010-1.025
Relates to the concentration of particles (wastes and electrolytes) in the urine