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2. Abhishek A. Joshi
Nursing Tutor
GCON,Bhavnagar

3. Thought of the Day

4.  Introduction
 Terminology
 Fluid and Electrolytes
 Homeostasis and Fluid balance
 Factors affecting Fluid & Electrolyte imbalance
 Importance of Electrolytes in Human body
 Nursing Care and Management
 Quiz

5.  Fluid and electrolyte balance is essential for health.
 Many factors, such as illness, injury, medication, surgery and
treatments, can disrupt the patient's fluid and electrolyte
balance.
 Even a patient with a minor illness is at risk for fluid and
electrolyte imbalance.
 The nurse continuously serves and evaluates patient's
progress. Hence, she is most logically accountable for
assessing and reporting real or potential fluid and electrolyte
disturbances.

6.  Very minor changes in patient's behaviour such as slight
restlessness, twitching or a change in breathing patterns may
be an early sign of imbalance.
 A knowledgeable nurse can recognize these minor changes,
report them accurately and manage the situation effectively.
 Adults requires at least 40 ml/Kg fluid per day.
 Example - A man with weight of 60 kg, requires at least 2400
ml fluid per day.

8.  Diffusion: the process by which solutes move from an
area of higher concentration to one of lower
concentration; does not require expenditure of energy
 Osmosis: the process by which fluid moves across a
semipermeable membrane from an area of low solute
concentration to an area of high solute concentration;
the process continues until the solute concentrations
are equal on both sides of the membrane.
 Active transport: physiologic pump that moves fluid
from an area of lower concentration to one of higher
concentration; active transport requires adenosine
triphosphate (ATP) for energy.

9.  Osmolarity: the number of osmoles, the standard
unit of osmotic pressure per liter of solution. It is
expressed as milliosmoles per liter (mOsm/L);
describes the concentration of solutes or dissolved
particles.
 Osmolality: the number of osmoles (the standard unit
of osmotic pressure) per kilogram of solution.
Expressed as mOsm/kg. Used more often in clinical
practice than the term osmolarity to evaluate serum
and urine.
 In addition to urea and glucose, sodium contributes
the largest number of particles to osmolality.
Cont..

10.  Hypertonic solution: a solution with an osmolality
higher than that of serum.
 Hypotonic solution: a solution with an osmolality lower
than that of serum.
 Isotonic solution: a solution with the same osmolality as
serum and other body fluids.
 pH Value: A concentration of Hydrogen ion in Blood
Steam, it shows the potentials of Hydrogen.
 it's regulated by Buffers.

11.  Homeostasis: “ it is the process through which bodily
equilibrium is maintained”
 The body is designed to maintain a constant
maintenance of internal environment like body fluid
compositions, temperature, blood pressure, blood
glucose level; etc.
 Fluid Balance: The amount of water coming into the
body each day must equal the amount of water
eliminated from the body over the same period of time.
 If not, the body will have either a net water gain or net
water loss.

12.  1) Water Sources:
 Drinking water
 Water contained in food
 Metabolism to CO2 & H2O
 2) Water Loses:
 Urinary loss
 Fecal loss
 Sweat loss
 Pathological Loss

13.  Age
 Stress
 Diaphoresis
 Renal Disease
 Dehydration
 Hormones
 Lifestyle

14.  Body fluids contain certain substances which dissociate
and carry electrical changes and are known as
electrolytes.
 Natural minerals in food become electrolytes or ions in
the body through digestion and metabolism.
 Electrolytes are usually measured in milli equivalents
per litter (mEq/L) or on milligrams per decilitre (mg/dl).
 There is many electrolytes plays an important roles in
human body are as belows.

15.  There is a mainly Two types of ions…
 (i) Cations
 Sodium (Na+)
 Potassium (K+)
 Calcium (Ca2+)
 Magnesium (Mg2+)
 (ii) Anions:
 Chloride (Cl-)
 Bicarbonate (HCO3-)
 Phosphate (PO)

16.  is the most abundant cation (90%) in ECF.
 Na ions are the major contributors in
maintaining water balance.
 Nerve impulses transmission & Muscles
contraction.
 Regulation of acid base balance.
 Participation in cellular chemical reaction.
 Regulator of ECF volume influences ICF
volume.
 Essential electrolyte in Sodium – Potassium
pump.
 Normal Value : 135 to 145 mEq/L

17.  Most of the sodium comes from the dietary
intake.
 Sodium particularly in Mustard, Cheese,
Bread, Cereal, Table salt.
 Daily allowance for sodium is 500 mg.

18.  Potassium is the primary intracellular cation.
 Potassium is very important in the human body along
with Sodium. It's regulates the water balance and the
acid base balance in blood and tissues.
 Potassium plays a vital role in “Sodium - potassium
pump.”
 Potassium is also very important in cellular biochemical
reactions and energy metabolism.
 The normal potassium serum level is 3.5 to 5.0 mEq/L.

19.  Normally Potassium is supplied in food.
 Potassium rich diet includes Bananas,
Potatoes, Orange, Lentils, Tomatoes etc.
 Daily requirement : 3400 mg/day.

20.  Calcium is stored in bone, plasma and body cells.
 99% of Calcium is located in Bone and only 1% Calcium is in
ECF.
 Approx. 50% calcium in the plasma is bound to protein and
other is free ionized calcium.
 Responsible for construction, formation and maintenance of
bone and teeth.
 It is vital component in blood clotting system and also helps
in wound healing.
 it’s essential for muscle contraction.
 Normal level of Ca in adult is 8.5 to 10.0 mg/dl.

21.  The main source of calcium is dairy products.
 Other sources of calcium includes green leafy
vegetables, pease, lentils etc.
 Daily requirement: 2500 mg/day.

22.  About 50 to 60% of body Mg is contained within ECF
compartment and only 1% Mg contained in ICF.
 Mg is vital to many intracellular processes including
enzyme reactions and synthesis of proteins/Nucleic
acid.
 It’s essential ion for neuromuscular transmission and
cardiovascular function.
 The normal serum Magnesium level is 1.6-2.6 mg/dl.

23.  Magnesium is obtained through the diet.
 Green vegetables, grains, nuts, meat and
seafood.
 Daily requirement: 400-420 mg/day.

24.  Chloride is major anion found in the fluid outside of
cells and in the blood.
 Acts with sodium and maintain the osmotic pressure of
the blood.
 Vital role in the body acid base balance.
 Essential for the production of HCL (Hydrochloric acid).
 The normal serum range is 98-108 mEq/L.

25.  Most phosphate 95% is found in bones and about 14% is
in ICF and only 1% is in ECF.
 PO is essential to intracellular processes such as the
production of ATP (Adenosine Phosphate).
 Is vital for RBC function and O2 delivery to tissues.
 Promotes Neuromuscular action and participates in
carbohydrate metabolism.
 Normal Value 2.5-4.5 mg/dl.

26.  Phosphate is ingested in the diet, absorbed in
the jejunum and excreted by the kidneys.
 A relationship exist b/w Po and Ca+, when
one increase the other decrease.
 Daily requirement 700 mg/day.

27.  Bicarbonate found in ECF and ICF.
 Bicarbonate working as a buffer and maintain a pH level
in body as well as maintain acid base balance.
 Normal pH level of Blood is 7.35-7.45.
 If pH level bellows 7.35, its called Acidosis.
 If pH level of blood above 7.45, it’s called Alkalosis.
 Bicarbonate ion Normal level is 22-26 mEq/L.

28.  Assessment:
 Health History
 Physical Assessment
 Diagnostic Test
 Management:
 Fluid Management
 Dietary Management
 Nursing Management

32. Q.3 Mr. Ali’s pH value
is 8.2, that condition
called?

33. 1. PEE VEE ; ‘‘ FUNDAMENTALS OF NURSING’’
SECOND EDITION;PUBLISHED BY JAYPEE BROTHERS
MEDICAL PUBLISHERS (P) LIMITED;NEW DELHI;
2. LOTUS PUBLISHERS; ‘‘A TEXT BOOK OF NURSING
FOUNDATIONS’’EDITION;EDITED
BY CELESTINA FRANCIS & KRITIKA MISRA
;P.NO. 340 TO 352.
3. WEBPAGE; WWW.WIKIPEDIA.COM: THE TOPIC OF “NURSING
CARE WITH THE PATIENT OF FLUID & ELECTROLYTE
IMBALANCE” BY DR KIRAN SADHU.