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Ch. 24 - Fluid & Electrolytes - Coggle Diagram
Ch. 24 - Fluid & Electrolytes
Body Fluids
Intracellular = inside the cell
Extracellular = outside the cell
Interstitial = between the cells but in ECF
Intracellular
inside cells, 2/3 of the fluid
Extracellular
between the cells = interstitial compartment
in the blood vessels = vascular compartment
in dense connective tissue and bone
in transcellular fluids = synovial, cerebrospinal, and gastrointestinal fluids
Components of Fluid Homeostasis
Fluid intake = entry into the body via any route
Fluid absorption = GI tract depends on osmotic forces by absorption of electrolytes & other particles
Fluid Distribution = filtration (between vascular & interstitial compartments across permeable capillaries)
or
Osmosis = water movement between interstitial & intracellular compartments
Fluid Excretion
Urinary tract = highest volume of fluid excreted in urine
Skin = visible sweat (may or may not happen) & insensible perspiration (always happens)
Lungs = person exhales
Bowels = fluid in feces w/normal bowel function; increase w/diarrhea)
Abnormal Fluid Loss
Fluid lost through abnormal routes can disturb fluid homeostatsis
Examples
Emesis
Tubes in GI tract or other body cavities (drain fluids)
Hemorrhage
Drainage from fistulas, wounds or open are a in skin
Paracentesis = removal of fluid from a body cavity via a needle
Imbalances
Extracellular fluid volume AKA ECV (saline imbalances = isotonic salt water, too much/little of it)
Body fluid concentration (water imbalances = concentration of ECF, reflects osmolality of the blood)
Fluid Volume
Excess
Examples
IV drip
Heart failure
Hyperaldosteronism = too much salt
Cirrhosis = affects liver
Acute glomerylonephritis = affects kidneys
End-stage renal disease
Cushings Disease = pituitary tumor releasing ACTH
Corticosteoid therappy = prednisone
Causes
increase BP
increase HR
increase jugular vein distention
Edema
GI stuff: nausea, not hungry
Confusion
Headaches
Seziures
Loss
Example
Emesis = vomiting
Hemorrhage = excessive blood loss
Burns
Fistulas = abnormal connection between two organs
Diarrhea
NG suctioning/decompression
Diuretics = losses urines
Bed rest
Diaphoresis = excessive sweating
Paracentesis = needle to remove abdomen fluid
Tachypnea = respirations, H20 leaving the body, breathing faster
Causes
Increase HR
Thready
Dry skin, mucous membrane
Thirst
Vomit/Diarrhea
Tenting skin (pinch & it stays)
Weak pulse
Confusion
Electrolytes
Absorption
Excretion
Distribution
Magnesium
Normal range: 1.5-2.5 mEq/L
Hypomagnesemia
decrease in magnesium
decrease magnesium intake or absorption
decrease concentration of the ECF
Signs/symptoms
Dysrhthmias
Insomnia, seizures
Twitching, cramping, grimacing, tremors
Increased excitability, Trousseau sign, Chvostek sign, hyperactive reflexes, tetany
Dysphagia
Nystagmus, ataxia
Hypermagnesemia
increase of magnesium
increase magnesium intake
decrease magnesium excretion
Older adults are at high risk from these magnesium-containing medications
Signs/symptoms
Bradycardia, dysrhythmias, cardiac arrest
Hypotension, flushing
Drowsiness, lethargy
Respiratory depression
Flaccid paralysis
Depressed reflexes
Diaphoresis = sweating
Phosphate
Normal range: 2.5-4.5 mEq/L
Hypophosphatemia
decrease of phosphate
decrease phophate intake
shift phosphate from ECF to cells
increase pohosphate excretion
loss of phosphate through abnormal routes
Signs/symptoms
Impaired cardiac function, decreased cardiac output
Confusion, stupor = near unconsciousness, coma, seizures
Respiratory failure
Aching, weakness
Paresthesia, depressed reflexes
Anorexia
Malaise = difficult to identify, hemolysis
Hyperphosphatemia
increase of phosphate
Hyperphosphatemia causes hypocalcemia
Chronic kidney disease causes deposition of calcium phosphate salts into the soft tissues of the body
Signs/symptoms
May cause decrease in calcium = hypocalcemia
If calcium remains high, damage from deposition of crystals
If calcium remains high, pruritus = the urge to scratch, conjunctivitis = pink eye, arthritis
Sodium
Normal Range: 135-145 mEq/L
Hyponatremia
decrease in sodium
excess in water compared to salt ions
Excessive ADH
Signs/symptoms
Confusion, lethargy, coma, seziure
Anorexia, nausea, emesis
Malaise = difficulty to identify, headache
Euvolemic
Equal H20, less Na
Hypervolenic
Increase H20, equal Na
Hypovolemic
Decrease H20, decrease Na
Hypernatremia
increase in sodium
too little water compared to salt ions; too concentrated
Signs/symptoms
Confusion, lethargy, coma, seziures
Oliguria = small amounts of urine
Thirst
Potassium
Normal range: 3.5-5 mEq/L
Hypokalemia
decrease in potassium
decrease potassium intake
shift potassium from ECF to cells
increase potassium excretion through normal routes
Cause potassium loss from the body by some abnormal route
Signs/symptoms
Dysrhythmias
Postural hypotension
Ascending weakness, flaccid, paralysis
Abdominal distention, bloating, decreased bowel sounds, constipation, paralytic ileus = obstruction
Polyuria = large amounts of urine
Hyperkalemia
increase of potassium
increase of potassium intake
shift potassium from cells into the ECF
decrease potassium excretion
Signs/symptoms
Dysrhythmias, cardiac arrest
Ascending weakness, flaccid paralysis
Transient mild cramping, diarrhea
Calcium
Normal range: 9-11 mg/dL or 4.5-5.5 mEq/L
Hypocalcemia
decrease in calcium
decrease calcium intake or absorption
decrease physiologic availability of calcium
increase calcium excretion
Signs/symptoms
Dysrhythmias, impaired myocardial contractility
Seizures
Twitching, cramping, carpal spasm, pedal spasm
Increased excitability, Trousseau sign, Chvostek sign, paresthesias, hyperactive reflexes, tetany
Laryngospasm
Hypercalcemia
increase in calcium
elevation of calcium concentration of ECF
Signs/symptoms
Dysrhythmias
Confusion, lethargy, personality change
Weakness
Decreased excitability, depressed reflexes
Polyuria = large amounts of urine
Fatigue, headache
Hormones
Antidiuretic Hormone/Vasopressin
Increase when the body:
increase osmolatity of ECF concentration
decrease blood volume
Pain/nausea/stress
Reabsorb H20 = decrease urine volume
Decrease when the body:
decrease osmolatity of ECF, dilute
ETOH consumption
Aldosterone
Cortex of adrenal glands in response to anginotenssin II
decrease blood volume
Potassium in plasma reabsorbs