Is a mixture of water, chemicals called electrolyte and nonelectrolytes and blood cells.
Water – can live only a short time without water. There is no known substituted for it among living organisms. Water makes up to 45% to 75% of mans body weight. It is necessary for every major physiological function.
It is the medium of all body fluids including gastrointestinal secretions, lymph , blood, urine and perspiration.
It provides the solvent for products of digestion and metabolism.
It cushions the cells of the body.
It is essential for the action of the second component of body fluid,electrolyte substances.
Body fluid is located two general compartments:
Intracellular fluid ( Fluid inside cell)
Extracellular fluid (fluid outside cell)
Interstitial fluid – fluid in the tissue space between and around the cells.
Intravascular fluid – watery plasma or serum, portion of blood)
Percentages of Body Fluid to Age and Gender
Fluid infants adult adult elderly
Compartments men women
Intravascular 4% 4% 5% 5%
Interstitial 25% 11% 10% 15%
Intracellular 48% 45% 35% 25%
Total 77% 60% 50% 45%
Are chemical substances that develop electrical charges when they are placed in water.
Are positively charges are called cations.
The electrolytes with positive charges are sodium, potassium, calcium and magnesium.
The electrolytes with negative charges are chloride, bicarbonate, carbonic acid,phosphate, protein, lactate and citrate.
Are measures in the serum of blood specimens and the amount is reported in milliequivalents(mEq).
Major serum electrolytes
Electrolyte Chemical Cation Normal Predominant
symbol anion level compartment
Sodium Na + 135-148 ECF
Potasium K + 3.5-5.0 ICF
Chloride CL - 90-110 ECF
Phosphate PO4 - 1.7-2.6 ICF
Calcium Ca + 2.1 -2.6 ICF
Magnessium Mg + 1.3 -2.1 ICF
Bicarbonate Hcos - 22-26 ICF
Are chemical compounds that remain bound together when dissolved in a solution and do not conduct electricity.
The chemical end –products of carbohydrate ,protein and fat metabolism namely: glucose, amino acids and fatty acids – provide continuous supply of nonelectrolytes.
Consists of 3 liters of plasma or fluid. 2 liters of blood cells for a total of 5 liters circulating blood volume.
Blood cells includes erythrocytes or red blood cells ( RBC) and Platelets known as thrombocytes.
For every 500 red blood cells there are approximately 30 platelets and 1 white blood cells.
Any disorder that allert the volume of body fluid whether it is fluid retention or loss affects the plasma volume of blood.
Physiologic transport mechanism
Osmosis – helps to regulate the distribution of water by controlling the movement of fluid from one location to another.
Under the influence of osmosis ,water moves through a semipermeable membrane like those surrounding body cells .capillary walls and the body organs and cavities from an area where the fluid is more dilute to another are where the fluid is more concentrated.
The presence and quantity of colloids on either side of the semipermeable membrane osmosis.
Colloids are undissolved proteins substances such as albumin and blood cells within the body fluids that do not readily pass through the membranes.
Their presence produces a colloidal pressure (Force for attracting water) that influences fluid volume in any given fluid location.
Movement of water and substances from a compartment where the pressure s higher to one where the pressure is lower.
It is another mechanism that influences fluid distribution
The force of filtration is referred to as hydrostatic pressure( pressure exerted against a membrane)
Is the physiologic process in which dissolved substances such as electrolytes and gases move from an area of higher concentration to an area of lower concentration through a semipermeable membrane.
It occurs without an expenditure of energy , hence it was passive.
Facilitates electrochemical neutrality( identical balance of cations awith anions)
Is the process in which certain dissolved substances require assistance of a carrier molecule to pass from one side of a semipermeable membrane to another.
It regulates chemical balance
Glucose is an example of a substance distributed by facilitated diffusion
Insulin is the carrier substance for glucose.
A process of chemical distribution that requires an energy source invloves a substance called adenosine triphoshate(ATP).
Provides energy to drive dissolved chemical against the concentrations gradient.
It allows chemical distribution from an area low concentrations to one that is higher-opposite of passive diffusion.
Fluid Volume Assessment
Intake and Output is one tool to asess fluid status by keeping a record of a clients fluid intake and fluid loss over a 24 hour period.
The movement of intravascular fluid to nonvascular fluid compartment, where it becomes trapped and useless.
It is manifested by tissue swelling or fluid that accumulates in a body such as the peritoneum
Third spacing is associated commonly with disorder in which albumin levels are low.
HYPOALBUMINEMIA - deficit in albumin in the blood – caused by liver disease, chronic disease and disorders in which the capillary and cellular permeability is altered such as burns and severe allergic reactions.
The priority is to restore the circulatory volume by providing iv fluids ,sometimes in large volumes at rapid rates (FULL BLASTS)
Blood transfusions or the administration of albumin by Iv infusions also, is used to restore colloidal osmotic pressure and full trapped fluid back into the intravascular space .
When this conditions occurs, client who were previously hypovolemic can suddenly become hypervolemic.
The nurse closely monitors client’s who receives albumin replacement for signs of circulatory overload.
Fluid Deficit Fluid Excess
Starvation kidney failure
Impaired swallowing heart failure
Vomiting rapid administration
Gastric suction administration of albumin
Laxative abuse corticosteroid drug therapy
Potent diuretics excessive intake of sodium
Fever and sweating
Exercise and sweating
Environment heat and humidity
Intravenous fluid administration
Policies and practices concerning how much responsibility the practical/vocational nurse assume with iv fluid therapy.
Intravenous (IV ) fluids are solutions infused into a client’s vein to :
Maintain and restore fluid balanc when oral replacement is inadequate or impossible.
Maintain and replace electrolytes.
Administer water-soluble vitamins.
Provide a source of calories
Route for administration of drugs
Replace bloods and blood products.
TYPES OF SOLUTIONS
Crystalloid Solutions- are made of water and other uniformly dissolved crystals such as salt and sugar. They are classified as:
2. Colloid Solutions – are made of water and molecules of suspended substances such as:
b. blood products ( albumin )
They are both administered intravenously.
Contain the same concentration of dissolved substances as normally found in plasma.
It is administered to maintain balance in clients who may not be able to eat or drink for a short period of time.
Because of equal concentration, an isotonic solution does not cause any appreciable redistribution of body fluid.