Fluid, Electrolit and Acid-base Balance - Copy_2

7/30/2019 Fluid, Electrolit and Acid-base Balance - Copy_2

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FLUID, ELECTROLYTE, ANDACID-BASE BALANCE

Rini Rachmawarni BachtiarPhysiology Departement

Hasanuddin University


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BODY FLUIDS


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Body fluids

Extracellular fluids (ECF)

Interstitial fluid - fills the spaces between most

cells of the body

Intravascular fluid - plasma (WBC, RBC andplatelets in this fluid)


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Body fluids

Intracellular fluids (ICF)

Liquids within cell membranes

40% of body weight


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COMPONENT

S IN

BODY FLUIDS


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Components in body fluids

Electrolyte

an element that when dissolved can carry an

electrical current

Conduct electricity and control fluid levels.Pass electricity from the brain through our nerves

and into our muscles and organs

Cations - (+) ; Anions - (-)

neuromuscular function

acid-base balance


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Components of body fluids

Minerals

ingested compounds

serve as catalysts in nerve response, muscle

contraction, and metabolism of nutrients in foods,regulate electrolyte balance


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Movement of body fluids

Diffusion

Area of higher concentration to an area of lower

concentration till even distribution

OsmosisMovement of a pure solvent, e.g. water through a

semipermeable membrane from a solution that

has a lower solute concentration to one that has a

higher solute concentration


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Osmosis


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Osmotic pressure on blood cells


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Movement of body fluids

Filtration

Water and diffusible substances move together in

response to fluid pressure

Active transportRequires energy

Able to move larger molecules and go from less

to greater concentration


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FLUIDINTAKE &

OUTPUT


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Fluid Intake

Hypothalamus - thirst control center

Oral fluid intake requires an alert state

Osmoreceptors - monitor osmolality


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The hypothalamuslinks the nervous system to the endocrine

system by stimulating the secretion of

hormones from the pituitary gland. It

controls our emotions, body temperature,

hunger, thirst, fatigue, and circadian cycles.


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Fluid Output

Loss through the kidneys and GI tract

Insensible

Sensible


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CATION

S


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Cations

Sodium (Na+)

Most abundant in the extracellular fluid

Maintains water balance, transmits nerve

impulses, contracts musclesValues - 135-145 mEq/L


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Cation

Potassium (K+)

Major intracellular cation

Regulates neuromuscular excitability, muscular

contraction, and acid-baseValue - 3.5 -5.3 mEq/L


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Cation

Calcium (Ca2+)

Cardiac conduction, blood coagulation, bone

growth and formation, & muscular relaxation

Value - 4 - 5 mEq/L


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Cation

Magnesium (Mg2+)

Second most important of intracellular fluids

Enzyme activities, muscular excitability

Value - 1.5 - 2.5 mEq/L


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ELECTROLYTE

IMBALANCES


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Electrolyte Imbalances

Hyponatremia

GI losses, sweating, & diuretics

S/S: N/V/D, abd cramps, personality change

Hypernatremia Ingestion of large amounts

S/S: Dry tongue and mucous membranes,

restlessness, convulsions, thirst, dry skin


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Electrolyte imbalances

Hypokalemia

Causes: K+ wasting diuretics

N/V/D

polyuria

S/S: weak, irregular pulse

hypotension

weakness


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Hyperkalemia

Causes: Renal failure

S/S: irregular slow pulse, weakness, irritability


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Electrolyte Imbalances

Hypocalcemia

Causes: Vitamin D deficiency

S/S: Numb and tingling fingers and circumoral

region, muscle cramps Hypercalcemia

Causes: osteoporosis, prolonged immobilization

S/S: decreased muscle tone, weakness, lethargy,kidney stones


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Hypomagnesemia

Causes: malnutrition and alcoholism polyuria

S/S: muscular tremors, hyperactive deep tendon

reflexes Hypermagnesemia

Causes: Renal failure

S/S: hypoactive deep tendon reflexes, shallowand slow respirations


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ACID - BASE

BALANCE


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Acid - Base Balance

Blood pH - 7.35 - 7.45

paCO2 - 35 - 45

Bicarbonate (HCO3) - 22-26 mEq/L


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Respiratory Acidosis

pH < 7.35

paCO2 > 45 mm Hg

Causes: Respiratory failure

Hypoventilation

Resp muscles paralysis

Airway obstruction


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Respiratory Alkalosis

pH > 7.45

paCO2 < 35 mm Hg

Causes: excessive exhalation of CO2

(hyperventilation)


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Metabolic Acidosis

pH < 7.35

bicarbonate - < 22 mEq/L

Causes: Starvation, DKA, Diarrhea, drug use


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Metabolic Alkalosis

pH > 7.45

bicarbonate > 26 mEq/L

Causes: excessive vomiting, prolonged gastric

suctioning


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FLUID & ELECTROLYTE

IMBALANCES


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Fluid & Electrolyte Imbalances

Burns - body fluid loss

Renal D/O - abnormal retention of Na, Cl, K

GI Disturbances - Loss of fluid, potassium, and

chloride

Exercise


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S/S electrolyte imbalance

Head: irritability

Fontanels: depressed, bulging

Eyes: sunken

periorbital edema

Mouth: mucous membranes

CV: neck veins, edema, blood pressure

Resp: Crackles


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REPLACEMENT

OF

FLUIDS ANDELECTROLYTES

Replacement of fluids and


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Replacement of fluids and

electrolytes

Types of IV fluids

Isotonic

Hypertonic

Hypotonic


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IV complications

Infiltration

Phlebitis

vein inflammation

S/S: pain, redness, warmth

Fluid overload

Fluids given too rapidly

Bleeding


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Discontinuing an IV

Stop infusion

Remove tape

1 - 2 minute pressure


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Transfusion Reactions

Caused by:

blood incompatibility

allergic sensitivity

S/S: fever, chills, rash, hypotension, shock

Treatment: stop transfusion, save tubing,

prepare for emergency drugs


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Fluid, Electrolit and Acid-base Balance - Copy_2