1 / 80

Fluids and Electrolytes

Fluids and Electrolytes. Staying Balanced Spring 2008. Water – H 2 O. “Universal solvent” 60% of body’s weight Cells “haf to have it.” –Arnold Schwarzenegger. How much is that?. 154# person x .60 (60%) = 92# Water is approx 8# per gallon 11 ½ gallons water (Obese people/ less)

renee-wood
Download Presentation

Fluids and Electrolytes

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Fluids and Electrolytes Staying Balanced Spring 2008

  2. Water – H2O • “Universal solvent” • 60% of body’s weight • Cells “haf to have it.” • –Arnold Schwarzenegger

  3. How much is that? • 154# person x .60 (60%) = • 92# • Water is approx 8# per gallon • 11 ½ gallons water • (Obese people/ less) • (Thin people/ more) • Infants • Elders

  4. Basic Cellular Review • The fundamental unit • Requires: • Cell membrane • Enzymes • Internal membranes • Genetic material

  5. Basic tissue types • Epithelial • Connective • Muscle • Nervous

  6. The cellular environment • All metabolic reactions occur • The precise regulation of volume and composition of body fluid is essential to health.

  7. Body fluid compartments • Intracellular Fluid - ICF • Extracellular Fluid – ECF • Intravascular Fluid- Plasma • Interstitial Fluid

  8. Intracellular - ICF • Fluid in all body cells • 75% of the water (60%) • 31.50 L (70 kg adult) • 40% of total body weight

  9. Extracellular - ECF • 20% of water (60%) • 10.50 L (70 kg adult)) • Includes intravascular and interstitial compartments

  10. ECF • Intravascular • 4% of (60%) • 7.5 L

  11. ECF • Interstitial • 16% of (60%) • 17.5 L • Fluid between cells and outside the vascular bed • Connective tissue, cartilage, bone, CSF, intraocular fluid

  12. Hydration • Water – Universal Solvent • Intake & Output (I&O)

  13. Hydration • Homeostasis • The body’s need for balance

  14. Aging and distribution of fluids • Newborns – TBW ~ 80% • Children – TBW ~ 60-65% • Elders – TBW < ~ 60%

  15. Intake vs Output • Food - 1200 ml • Drink - 1000 ml • Metabolic sources - 300 ml = 2,500 ml • Lungs - 400 ml • Kidneys - 1500 ml • Skin - 400 ml • Intestine (Feces) - 200 ml = 2,500 ml

  16. Hydration • Osmoreceptors - anterior hypothalamus • Baroreceptors - carotid sinus, aortic arch, kidneys • High and low blood pressure

  17. Hydration • Anti-diuretic hormone (ADH) • If tide goes out • Pituitary Gland Excretes • Tide comes in!!! • Re-absorb from kidneys • Decrease urine • Thirst also regulates

  18. Dehydration • Abnormal decrease in TBW • Thus the weigh-in at fires • Rarely involves only water loss • Electrolyte loss

  19. Dehydration Causes • Signs and symptoms? • Treatment?

  20. Causes of dehydration • GI losses • N/V/D • Insensible losses • Normal losses + with fever • Hyperventilation • High Environmental Temps • Increased sweating

  21. Causes Of Dehydration • Internal losses • “Third” spacing • Peritonitis • Pancreatitis • Malnourished • No protein to retain water

  22. Causes of Dehydration • Plasma Losses • Burns • Surgical Drains • Open Wounds

  23. Signs And Symptoms • Signs of shock • Skin changes (turgor) • Orthostatic hypotension • Thirst • Increased pulse rate • Furrowed tongue

  24. S/S, cont. • Decreased BP • Dry mucosa • Infants: Anterior fontanelle sunken • Dry diapers • Absent tears • Cap refill > 2 seconds • Dry mucosa

  25. Treatment • O2 • ABCs • Fluids • Flavor? • Consider PASG • ECG

  26. Overhydration – “No thanks I’m full.” • Edema • Peripheral vs. central (more later…) • Aggressive treatment if Pulmonary Edema

  27. Overhydration • ABCs • O2 • Consider ETT • Meds: • NTG. • Lasix • M.S.

  28. Fluid & Electrolyte Disturbances • Medical causes • Diabetes • Heat Emergencies • Blood Loss • Traumatic causes • Blood loss

  29. Electrolytes • In H2O dissociate into ions • Cations = positive • Anions = negative

  30. Principle CationsSodium-Potassium Pump • Sodium (Na+) • Prevalent in ECF • “Water follows it” • Nerve impulses • Hyper/ • Hyponatremia • Potassium (K+) • Prevalent in ICF • Nerve impulses • Hypo/ • Hyperkalemia

  31. Other Cations • Calcium (Ca++) • Prevalent in ICF • Muscle contraction • Nerve impulse • Hypo/hypercalcemia

  32. Other Cations • Magnesium (Mg++) • Present in ICF • Necessary for many processes • Found in some: • Antacids • Laxatives • Most associated with phosphate • Renal Functions

  33. Principal Anions • Chloride (Cl-) • Present in ECF • Balances cations • Fluid balance • Renal function • Usually found hanging around sodium

  34. Principal Anions • Bicarbonate (HCO3-) • Found in ECF • The Buffer • Neutralizes Acidic (H+) • Tx for acidosis

  35. Anions • Phosphate (HPO4--) • Found in ICF - buffer • Energy stores • Mg++ in renal function

  36. Electrolytes - mEq/L • Non-Electrolytes - • Glucose • Urea • Proteins

  37. How does it get there? • Osmosis • Diffusion • Active Transport • Facilitated Diffusion

  38. Isotonic • Hypertonic • Hypotonic • Osomotic gradient - difference in concentration

  39. Osmosis • Movement of water (solvent) • Semi-permeable membrane • Towards highersoluteconcentration

  40. Diffusion • Movement of solutes • Across membrane • Towards lesser solute concentration

  41. Active transport • Movement of solutes • Across membrane • Against osmotic gradient • Requires energy (ATP) • Sodium-potassium pump

  42. Active transport

  43. Facilitated diffusion • Helper proteins • Insulin • Open gate • Glucose

  44. Facilitated diffusion

  45. Osmotic Pressure • Governs movement of water and solutes across cell membrane • Pressure exerted by concentration of solutes • Pulls from other side of membrane

  46. LysisCrenation

  47. Blood Plasma • Colloid osmotic pressure • Plasma • Hydrostatic pressure • Blood pressure • Filtration

  48. Edema • Localized • Site of injury • Organ systems - brain, lungs, heart, abdomen • Generalized • Dependent edema • Pitting edema

  49. RELATIVE HYDRATION • Body water in interstitial spaces not available for metabolism • Relative dehydration

  50. Edema • Decrease in production of plasma proteins • Liver disorder • Burns • Open wounds

More Related