Fluids & Elec - New

8/8/2019 Fluids & Elec - New

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FLUIDSFLUIDS

ANDAND

ELECTROLYTESELECTROLYTES



Fluid and electrolyte balance is aFluid and electrolyte balance is a

dynamic process that is crucialdynamic process that is crucialfor life.for life.



Amount and composition of Amount and composition of

Body FluidsBody FluidsYoung adult/typical adult weight:Young adult/typical adult weight:

consists approximately 60% of consists approximately 60% of

waterwaterElderly people:Elderly people: Less than 50%Less than 50%

Infants:Infants: within 70 % to 80 %within 70 % to 80 %

Note:Note:*Women have less body fluid than*Women have less body fluid thanmen.men.

* Fat cells contain little water.* Fat cells contain little water.



Most water in theMost water in the

body is found inside body is found inside

the cells and is knownthe cells and is known

as intraas intra-- cellular fluidcellular fluid

The extraThe extra--cellular cellular

fluid includes water fluid includes water found in both vascular found in both vascular

tissue and betweentissue and between

cells (interstitial fluid)cells (interstitial fluid)



Body fluids also containBody fluids also containsolid substances thatsolid substances that

dissolvedissolvecalled:called: SolutesSolutes

Solutes are electrolytesSolutes are electrolytesand non electrolytes.and non electrolytes.



Two Body Fluid CompartmentsTwo Body Fluid Compartments

Intracellular Fluid (ICF)Intracellular Fluid (ICF) --approximately 2/3 of the body fluidsapproximately 2/3 of the body fluids

Extracellular fluid (ECF)Extracellular fluid (ECF)

IntravascularIntravascular ±± contains plasmacontains plasma(approximately 3L)(approximately 3L)

InterstitialInterstitial ±± contains fluid thatcontains fluid thatsurrounds the cell and totalssurrounds the cell and totalsabout 11 to 12 Labout 11 to 12 L

TranscellularTranscellular ±± the smallestthe smallestdivision of the ECF and isdivision of the ECF and is

approximately 1Lapproximately 1L



FLUID COMPARTMENTSFLUID COMPARTMENTS

describes the distribution of water indescribes the distribution of water in

the body fluid compartments which arethe body fluid compartments which are

separated byseparated by semi permeablesemi permeablemembranesmembranes

capillary wall separates the plasmacapillary wall separates the plasma

and theand the interstitial fluid cell membraneinterstitial fluid cell membrane

separates the cytoplasm andseparates the cytoplasm andinterstitial fluidinterstitial fluid



FLUID COMPARTMENTSFLUID COMPARTMENTS





Normal CellNormal CellEnvironment:Environment:

Extracellular andExtracellular and

intracellular fluidintracellular fluidhave the samehave the sameionion

concentration,concentration,thus cellsthus cellsmaintain theirmaintain their

biconcavebiconcave



Functions of Body FluidsFunctions of Body Fluids

1.1. Facilitate the transport of Facilitate the transport of nutrients, hormones,nutrients, hormones,

proteins, and otherproteins, and othermolecules into cellsmolecules into cells

2.2. Aid in the removal of cellularAid in the removal of cellular

metabolic waste productsmetabolic waste products3.3. Provide the medium in whichProvide the medium in which

cellular metabolism takescellular metabolism takes

placeplace



4.4. R egulates body temperatureR egulates body temperature

5.5. Provide lubrication of Provide lubrication of

musculoskeletal jointsmusculoskeletal joints6.6. Act as a component in all bodyAct as a component in all body

cavitiescavities( eg. Pericardial fluid, pleural,( eg. Pericardial fluid, pleural,spinal & peritoneal fluid )spinal & peritoneal fluid )



Role of Fluids and ElectrolytesRole of Fluids and Electrolytes

1.It is necessary to maintain1.It is necessary to maintainphysiologic homeostasis.physiologic homeostasis.

2. Maintained by intake and2. Maintained by intake andoutput of water andoutput of water and

electrolytes.electrolytes.3. Regulated by renal and3. Regulated by renal and

pulmonary system.pulmonary system.




Are active chemicals which carries :

Positive charges ±

Cations

Negative charges ±

AnionsIs expressed in terms of mEq/L

(a measure of chemical activity)




AnAnelectrolyte iselectrolyte is

a solutiona solutionthat conductsthat conductselectricity.electricity.



MajorMajorelectrolytes inelectrolytes inthe ECF :the ECF :

Sodium ionsSodium ions

MajorMajorelectrolytes inelectrolytes in

the ICF

:the ICF

: PotassiumPotassium

PhosphatesPhosphates



What Are Electrolytes Needed For?What Are Electrolytes Needed For?

1.To help regulate nerve and1.To help regulate nerve andmusclemuscle function.function.

2.To help maintain acid2.To help maintain acid--basebasebalance necessary for normalbalance necessary for normalcellcell functions.functions.

3.To maintain normal fluid levels in3.To maintain normal fluid levels incompartmentscompartments(cells,tissues,organs)(cells,tissues,organs) and to moveand to movefluids around from cellfluids around from cell to cell, tissueto cell, tissueto tissue, and organ toto tissue, and organ to organ asorgan asneeded.needed.



Regulation of Body FluidRegulation of Body Fluid

CompartmentsCompartments

Fluids and electrolytes moveFluids and electrolytes move

in the body by active andin the body by active and

passive transportpassive transport



Active transportActive transport ±± energy must beenergy must beexpended for the movement to occurexpended for the movement to occuragainst a concentration gradient.against a concentration gradient.

ex. Sodiumex. Sodium ±± Potassium PumpPotassium Pump

Passive transportPassive transport ±± no energy isno energy isexpended specifically to move theexpended specifically to move thesubstances.substances.

ex. Diffusion, filtration, and osmosisex. Diffusion, filtration, and osmosis



SodiumSodium ± ± Potassium PumpPotassium Pump

Na concentration is greater inNa concentration is greater inthe ECF thus, it has the tendencythe ECF thus, it has the tendencyto enter the cell by diffusion.to enter the cell by diffusion.This is offset by the NaThis is offset by the Na-- K pumpK pumpwhich is located in the cellwhich is located in the cellmembrane.membrane.

Conversely, the high ICF K+Conversely, the high ICF K+concentration is maintained byconcentration is maintained bypumping potassium into the cell.pumping potassium into the cell.





FiltrationFiltration Is the movement of bothIs the movement of both

water and smallerwater and smallermolecules through a semimolecules through a semipermeable membrane.permeable membrane.

The membrane keeps theThe membrane keeps the

larger substances on onelarger substances on oneside and permits only theside and permits only thesmaller molecules to filtersmaller molecules to filterto the other side of theto the other side of themembrane.membrane.

Promoted by hydrostaticPromoted by hydrostaticpressure (the force thatpressure (the force thatwater exerts) differenceswater exerts) differencesbetween areas.between areas.



OsmosisOsmosis

Is the movement of Is the movement of

water from an area of water from an area of low solutelow soluteconcentration to anconcentration to anarea of high solutearea of high solute

concentration.concentration.OSMOLARITYOSMOLARITY-- termterm

that describes thethat describes theconcentration of concentration of

solutions or thesolutions or theconcentration of concentration of substances in bodysubstances in bodyfluids.fluids.

Normal serum osmolarityNormal serum osmolarity ±±

280 to 300mOsm/kg280 to 300mOsm/kg



Routes of Gains & LossesRoutes of Gains & Losses

Gains:Gains:

DrinkingDrinking

EatingEating IntravenouslyIntravenously

Enteral feedingEnteral feeding

Losses:Losses:

KidneysKidneys ±± urineurinevolume of 1 to 2 Lvolume of 1 to 2 L

SkinSkin ±± 0 to 1000ml0 to 1000ml /hr /hr

LungsLungs ±± 400400

ml/dayml/day

GI tractGI tract ±± 100 to100 to200 ml daily200 ml daily



Organs involved in HomeostaticOrgans involved in Homeostatic

MechanismsMechanismsKidneysKidneys

HeartHeart

Blood VesselsBlood Vessels

LungsLungs

G

ITG

IT

Adrenal glandsAdrenal glands

ParathyroidParathyroid

glandsglandsPituitaryPituitary

glandsglands



KIDNEYSKIDNEYS

Vital to theVital to theregulation of regulation of fluid & fluid & electrolyteelectrolytebalance. Itbalance. Itnormally filternormally filter

170L of plasma170L of plasmaper day in theper day in theadult.adult.



Major Functions of the Kidney:Major Functions of the Kidney:

Excretion of metabolic wastes & toxicExcretion of metabolic wastes & toxicsubstances.substances.

Regulation of pH of ECF by retentionRegulation of pH of ECF by retention

of hydrogen ionsof hydrogen ionsRegulation of ECF & osmolality byRegulation of ECF & osmolality by

selective retention & excretion of selective retention & excretion of body fluids.body fluids.

Regulations of electrolytes levels inRegulations of electrolytes levels inthe extracellular fluid by retention of the extracellular fluid by retention of needed substance & excretion of needed substance & excretion of

unneeded substance.unneeded substance.



HEARTHEART

Pumping actionPumping actionof the heartof the heartcirculates bloodcirculates bloodthrough thethrough thekidneys underkidneys undersufficientsufficient

pressure forpressure forurine to form.urine to form.



BLOOD VESSELSBLOOD VESSELS

CapillaryCapillarypressure causingpressure causingvasodilation & vasodilation & vasoconstrictionvasoconstrictionthat influencethat influencebalance of fluidsbalance of fluids

& electrolytes.& electrolytes.



LUNGSLUNGS

HypoventilationHypoventilationandandhyperventilationhyperventilationinfluences loss of influences loss of carbon dioxide & carbon dioxide & H2O whichH2O which

effects fluids & effects fluids & electrolytes.electrolytes.





PITUIT ARY GLANDPITUIT ARY GLAND

Stores ADHStores ADHwhich is waterwhich is waterconservingconservinghormones thathormones thatcauses retentioncauses retentionof H2O in theof H2O in the

bodybody





PAR ATHYROID GLANDPAR ATHYROID GLAND

Embedded in theEmbedded in thecorners of thecorners of thethyroid gland,thyroid gland,regulate calciumregulate calcium& phosphate& phosphatebalance bybalance by

means of means of Par athyroid Par athyroid Hormones.Hormones.



An Overview of Primary An Overview of Primary

Regulatory HormonesR

egulatory Hormones1. Antidiuretic1. Antidiuretic

HormoneHormone

2. Aldosterone2. Aldosterone

3.3. AtrialAtrialNatriureticNatriuretic

Peptide (ANP)Peptide (ANP)



antidiuretic hormoneantidiuretic hormone

causes widespread constrictioncauses widespread constrictionof arterioles, which leads toof arterioles, which leads to

increased arterial pressure.increased arterial pressure.Secretion of antidiureticSecretion of antidiuretic

hormone is also simulated byhormone is also simulated by

decreases in blood pressuredecreases in blood pressureand volumeand volume



Aldosterone Aldosterone

acts on the kidney by promotingacts on the kidney by promotingthe reabsorption of sodium ionsthe reabsorption of sodium ions

(Na+) into the blood.(Na+) into the blood.Water follows the salt and thisWater follows the salt and this

helps maintain normal bloodhelps maintain normal blood

pressure.pressure.



atri al natriuretic peptideatri al natriuretic peptide

Actions:

Actions:

reduction of ADHreduction of ADH--induced waterinduced waterreabsorption in the collectingreabsorption in the collectingductsducts

relaxation of renal arteriolesrelaxation of renal arterioles

modulatory effects of the GFRmodulatory effects of the GFR

inhibition of aldosteroneinhibition of aldosteronemediated sodium reabsorption inmediated sodium reabsorption inthe distal tubule (natriureticthe distal tubule (natriureticeffect)effect)



Factors affecting Fluids &Factors affecting Fluids &

Electrolytes loss:Electrolytes loss:ClimateClimate

DietDiet

StressStress IllnessIllness

TraumaTrauma

MedicationMedicationSurgicalSurgical

proceduresprocedures



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Fluids & Elec - New