Upload
alexis-franklin
View
239
Download
0
Tags:
Embed Size (px)
Citation preview
Body SolutesTypes of solutes
Electrolytes Sodium, potassium, calcium, magnesium, chloride,
bicarbonate, phosphate, sulphate Ions dissociate to form charged particles
Other molecules Glucose, protein, urea, lactate, organic acids—keep these
in a stable range! Hyperglycemic patient: excess sugar in the blood,
where it is pulling fluids out, and fluid status would therefore not be balanced
Remain stable
Body SolutesDistribution of solutes
Sum of cations (positive charge) must be equal to sum of anions (negative charge) within a given compartment
Movement of solutes influenced/measured by:Molecular sizeElectrical charge of the moleculeHydrostatic pressure (pressure exerted by fluid due to
the force of gravity)Method of solute transport (what’s going on with the
proteins?)
Regulation of Fluid and Electrolytes
Osmotic and hydrostatic pressure—keep in balance
Thirst—triggered by hypothalamus and increased with fluid intake (preventative hydration)
Renal—increases amount of fluids running through the kidney
Hormonal influence – RAAS (influencing kidneys to retain sodium and pull fluid back into the blood)
Electrolyte regulation—want to keep all of these in balance
Regulation of Fluid and Electrolytes
Thirst
Renal function
Renin-Angiotension-Aldosterone SystemRAAS
Disorders of Fluid BalanceAlterations in volume
Hypovolemia Hypervolemia
Alterations in osmolality From electrolytes imbalances
Sodium imbalances Hyponatremia Hypernatremia
Potassium imbalances (looking at acid/base balance as well) Hypokalemia (look at albumin levels first)
Concerns: bone abnormalities/blood clotting Hyperkalemia (look at renal status)
Disorders of Fluid Balance
Calcium imbalanceHypocalcemiaHypercalcemia
Phosphorus imbalance (looking at a status of energy deficiency and acid/base balance)HypophosphatemiaHyperphosphatemia
Magnesium imbalance (looking at kidneys regulating this and bone)Hypomagnesemia (muscle weakness and tremors)Hypermagnesemia (muscle weakness)
Disorders of Fluid Balance
What are the…Causes ?
Kidney disfunction
Clinical manifestations ? Edema/fluid overload Pitting edema: hyponatremia (sodium levels)
Laboratory findings ?Treatment ?
Identify underlying cause Might need to change the administration of:
Na, K, Pro, Fluid
Fluid and Electrolyte Balance
Assess for factors that affect fluid and electrolyte balance:Disease or injury: burn patients, individuals who
have sores in mouth or brain injury making it so they don’t physically consume enough, DKA
Medication or treatment: medications (Lasics) that pull out Na or K
Fluid loss: gun shot woundNutrient restriction: cardiovascular disease, renal
diseaseOral intake: inadequate amount Intake vs. output: concern with geriatric population