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Fluid And Electrolyte Balance Chapter 026
 

Fluid And Electrolyte Balance Chapter 026

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    Fluid And Electrolyte Balance Chapter 026 Fluid And Electrolyte Balance Chapter 026 Presentation Transcript

    • Maintaining Fluid and Electrolyte Balance Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc.
    • Concepts of Fluid Balance
      • Functions of body fluids
      • Fluid compartments
      • Electrolytes
      • Movement of fluids and electrolytes
      • Regulation of fluid balance
      • Problems of fluid balance
      Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc.
    • Functions of Body Fluids
      • Body needs:
        • 1500 mL daily
        • 700 mL from food we eat
        • 300 mL from oxidation of food
      • Functions
        • Makes half the body weight
        • Transports nutrients and wastes to and from cells
        • Acts as solvent for electrolytes and nonelectrolytes
        • Facilitates digestion and elimination
        • Maintains acid-base balance
        • Lubricates joints and other body tissues
      Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc.
    • Fluid Compartments
      • Intracellular fluid compartment
        • Contain 70% of body fluids
        • Fluid loss at cellular level affects entire body
      • Extracellular fluid compartment
        • Contain 30% of body fluids
        • Intravascular fluids
        • Interstitial fluids
        • Transcellular fluids
      Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc.
    • Electrolytes Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Electrolyte Normal Plasma Value Sodium 135 to 145 mEq/L Potassium 3.5 to 5.0 mEq/L Calcium 4.5 to 5.5 mg/dL Magnesium 1.5 to 2.5 mg/dL Chloride 98 to 106 mEq/L Phosphorus 1.2 to 3.0 mg/dL
    • Movement of Fluids and Electrolytes
      • Osmosis
        • Hypotonic
        • Hypertonic
      • Diffusion
      • Active transport
      • Filtration
        • Colloid osmotic pressure
        • Hydrostatic pressure
      Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc.
    • Regulation of Fluid Balance
      • Thirst
        • Intake of fluids
      • Lymphatic system
        • “ Sponging up”
      • Neuroendocrine system
        • Hormones
      • Gastrointestinal system
        • Absorbs — secretes — reabsorbs
      • Renal system
        • Works with neuroendocrine system to regulate volume
      Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc.
    • Problems of Fluid Balance
      • Deficient fluid volume
        • Hypovolemia
        • Dehydration
      • Excess fluid volume
        • Hypervolemia
        • Water intoxication
      • Electrolyte imbalance
        • Deficit or excess of one or more electrolytes
      • Acid-base imbalance
        • Respiratory acidosis and respiratory alkalosis
        • Metabolic acidosis and metabolic alkalosis
      Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc.
    • Factors Affecting Fluid Balance
      • Lifestyle factors
        • Nutrition
        • Exercise
        • Stress
      • Physiological factors
        • Cardiovascular
        • Respiratory
        • Gastrointestinal
        • Renal
        • Integumentary
        • Trauma
      • Developmental factors
        • Infants and children
        • Adolescents and middle-aged adults
        • Older adults
      • Clinical factors
        • Surgery
        • Chemotherapy
        • Medications
        • Gastrointestinal intubation
        • Intravenous therapy
      Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc.
    • Assessment of Fluid Balance
      • General
      • Focused assessment for deficient fluid volume
      • Focused assessment for excess fluid volume
      • Focused assessment for associated problems
      Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc.
    • General Assessment
      • Health history
        • Chief complaint
        • Past history of illnesses
      • Physical examination
        • Standard clinical measurements
        • Weighing the client
        • Input and output
        • Assessing edema
      • Diagnostic tests
        • Plasma sodium
        • Plasma osmolality
        • Urine osmolality
        • Hematocrit
        • Blood urea nitrogen (BUN)
      Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc.
    • Focused Assessment for Deficient fluid volume
      • Defining characteristics
        • Extracellular
        • Intracellular
      • Related factors
        • The acuteness of the loss
        • The severity of the loss
        • The client’s age and state of health
        • The degree to which the client combats the deficit
      Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc.
    • Focused Assessment for Excess fluid volume
      • Defining characteristics
        • Extracellular
        • Intracellular
      • Related factors
        • Any increase in fluid intake
        • Any increase in sodium intake
        • Increase in capillary permeability
        • Protein loss
        • The client’s response to fluid excess
      Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc.
    • Focused Assessment for Associated Problems
      • Electrolyte imbalances
        • Fluid imbalances rarely exists without electrolyte imbalance
        • Anticipate the risk for imbalance
      • Metabolic acidosis
        • End-stage renal disease
        • Severe diarrhea
        • Hypoxia
        • Hyperglycemia
      • Metabolic alkalosis
        • Consumption of excessive bicarbonate products
        • Loss of excessive potassium and hydrochloric acid
      Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc.
    • Diagnosis
      • Deficient fluid volume or Risk for deficient fluid volume
      • Excess fluid volume or Risk for excess fluid volume
      • Related nursing diagnoses
        • Fatigue
        • Anxiety
        • Ineffective health maintenance
        • Imbalanced nutrition
        • Impaired skin integrity
        • Impaired tissue perfusion
        • Impaired gas exchange
        • Constipation
        • Impaired oral mucous membranes
        • Disturbed sleep pattern
      Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc.
    • Planning (Expected Outcomes)
      • Deficient fluid volume
        • Increase in fluid intake
        • Moist mucous membranes
        • Absence of tongue furrows
      • Excess fluid volume
        • Decrease in peripheral edema
        • Weight loss
        • Decrease in fatigue and weakness
      • Associated problems
      Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc.
    • Interventions
      • To reduce the risk of deficient fluid volume
        • Teaching client about fluid needs
        • Preventing excessive fluid deficits
        • Restoring lost fluids
      • To increase fluid volume
        • Restoring fluid balance
        • Preventing further loss
        • Instituting rehabilitative care
        • Administering intravenous therapy
      • To decrease fluid volume
        • Restoring fluid balance
        • Preventing complications
        • Instituting rehabilitative care
      Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc.
    • Interventions
      • To balance electrolyte levels
        • General interventions
          • Nutrition is the key
        • Sodium imbalance: hyponatremia or hypernatremia
        • Potassium imbalance: hypokalemia or hyperkalemia
        • Calcium imbalance: hypocalcemia or hypercalcemia
        • Magnesium imbalance
        • Phosphate imbalance
      Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc.
    • Intravenous Therapy
      • Types of intravenous (IV) solutions
      • Categorized by osmolality: how solution affects other fluids
        • Isotonic
        • Hypotonic
        • Hypertonic
      • Sites for IV therapy
      • Potential complications
        • Infiltration
        • Phlebitis
        • Infection
        • Air embolism
        • Allergic reaction
        • Circulatory overload
      • Care of IV site
        • Peripheral
        • Central
      Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc.
    • Evaluation
      • The time frame for
      • evaluating fluid or electrolyte imbalance varies with the urgency of the imbalance.
      Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc.