it explain about definition of fluid and electrolyte disturbance, causes and different types of fluid disturbance. diagnostic evaluation and their emergent management along with supportive management.

1. FLUID AND ELECTROLYTE
IMBALANCE
MS. BHARTI SHARMA
NURSING TUTOR
BECON, JAMMU.

2. GENERAL OBJECTIVE:
At the end of the presentation the group
will be able to know about the topic Fluid
and Electrolyte Imbalance and can utilize
that knowledge in clinical settings.

3. ELECTROLYTE
Electrolytes are minerals in blood and other body fluids that
carry an electric charge. Electrolytes affect the amount of water
in body, the acidity of blood (pH) muscle function, and other
important processes.
Common electrolytes include:
 Chloride
 Magnesium
 Phosphorous
 Potassium
 Sodium
 Electrolytes can be acids, bases, and salts.

4. MINERALS:
“A mineral is an element or chemical compound
that is normally crystalline and that has been
formed as a result of geological processes” (Nickel,
E. H., 1995).
“Minerals are naturally-occurring inorganic
substances with a definite and predictable chemical
composition and physical properties.” (O'
Donoghue, 1990).

5. Fluid Balance
Fluid balance is the concept of human homeostasis .
Body fluids are mainly located in two compartments of body
i.e. intracellular and extracellular spaces.
1 Intracellular spaces- ( Fluid within cells)
2 Extracellular spaces- ( fluid outside cells) It is further divided
into three-
 Intravascular spaces- (fluid within blood vessels)
 Interstitial spaces- (Fluid present in interstitial spaces that
surrounds the cell).
 Transcellular spaces- It contains approximately 1L of fluid.eg.
CSF

6. SOURCES OF BODY WATER GAIN AND
LOSS
METABOLIC
WATER(200 ML)
Ingested
foods
(700 ml)
Ingested
liquids
(1600 ml)
GASTROINTESTINAL
TRACT(100 ML)
Lungs
(300 ml)
Skin
(600ml)
Kidneys
(1500 ml)

7. REGULATION OF WATER AND
SOLUTE LOSS
Osmosis Diffusion Filtration

8. FLUID VOLUME DEFICIT (HYPOVOLEMIA)
The state in which an individual experiences
vascular, cellular, or intracellular dehydration-
According to NANDA.
Fluid volume deficit or hypovolemia, occurs
from a loss of body fluid or the shift of fluids
into the third space or from a reduced fluid
intake.

9. FLUID VOLUME EXCESS
(HYPERVOLEMIA)
The state in which an individual experiences
increased fluid retention and edema -
According to NANDA
Fluid volume excess or hypervolemia, occurs
from an increase in total body sodium content
and an increase in total body fluid volume.

10. Fluid Volume Disturbances
1.Fluid Volume Deficit (Hypovolemia)- Fluid volume deficit(FVD)
occurs when loss of extracellular fluid volume exceeds the
intake of fluid.
Etiology-
 decreased fluid intake.
 vomiting, diarrhea
 may occur after blood donation
 Trauma
Risk factors include diabetes insipidus, adrenal insufficiency,
osmotic diuresis, hemorrhage and coma.

11. Clinical Manifestations
Acute weight loss
Concentrated
urine
Decreased skin
turgor
Postural
hypotension
Weak , rapid heart
rate
Cold and clammy
skin
Oliguria
Flattened neck
veins

12. Moderate deficit Severe deficit
Skin Flushed, dry Cold, Clammy
Mouth Dry mucus membrane Dry, cracked tongue
Eyes Soft, sunken eyeballs
Cardiovascular Tachycardia, Hypotension
CNS Apprehension, restlessness Lethargy, coma
Blood Increased hematocrit, BUN
and electrolytes
Urine High specific gravity, Oliguria, concentrated
Scanty amount urine
Other Thirst, weight loss Thirst, weight loss and
fever

13. Assessment and Diagnostic Finding
 History and physical examination
 Laboratory tests include assessment of BUN and serum
creatinine concentration
 Hematocrit levels
 Serum electrolyte changes also occur-
Hypokalemia occurs with GI and renal losses.
Hyperkalemia occurs with adrenal insufficiency
Hyponatremia occurs with increased thirst and ADH release.
Hypernatremia results from increased insensible losses and
diabetes insipidus.

14. Complications
Hypovolemic shock
Stroke
Heart attack
Liver failure
Kidney failure
Gangrene of an extremity

15. Medical Management
Oral fluids that include moderate sugars
and electrolytes are needed to replenish depleted
sodium ions.
Emergency oxygen should be immediately
employed to increase the efficiency of the patient's
remaining blood supply
Isotonic electrolyte solutions eg. Lactated Ringer’s
or 0.9 % sodium chloride) are frequently used to
treat the hypotensive patient
Blood transfusions

16. Nursing Management
Record intake and output
Monitor body weight
Monitor vital signs
Monitor skin turgor
Assess the mental functions
Assess the cardiovascular functions
Preventing FVD
Correcting FVD

17. Fluid Volume Excess ( Hypervolemia)
It refers to an isotonic expansion of the ECF caused by
the abnormal retention of water and sodium in
approximately the same proportion in which they
normally exist in the ECF.
Etiology-
-heart failure, renal failure and cirrhosis of liver.
-excessive amount of table salt may lead to increase
in total body water
-Excessive intake of fluids
-Excessive administration of I.V. fluids.
-Long term use of corticosteroids.

18. Clinical manifestations
Tachycardia
Confusion
Increased blood
pressure
Crackles
Distended
neck veins
Increased urine
output
Shortness of
breath
Headache
Edema

19. Assessment and Diagnostic Findings
History and physical examination
Laboratory test include assessment of BUN and
hematocrit levels. Both of these values may be
decreased because of plasma dilution.
Chest X-rays can be done to reveal pulmonary
congestion

20. Complications
Congestive heart
failure Hypervolemic
hyponatremia
Polyuria
Non pitting
edema
Dysarhythmias

21. Medical Management
excessive administration of sodium containing fluids,
discontinue the infusion.
Pharmacologic therapy- Diuretics are prescribed
when dietary restriction of sodium alone is
insufficient to reduce edema
When pharmacological agents cannot act efficiently
in case of renal impairement, Hemodialysis or
peritoneal dialysis may be used to remove
nitrogenous wastes.
In diet, sodium restriction should be done.

22. Nursing Management
Record intake and output
Monitor body weight
Assess the breath sounds
Monitor the skin condition
Preventing FVE
Patient education

23. ELECTROLYTES IN BODY FLUIDS
ELECTROLYTE: A substance that is dissolved in solution and
some of its molecules spilt or dissociate into electrically
charged atoms or ions. The ions formed when electrolytes
dissolve and dissociate serve four general functions in the
body.
 control the osmosis of water between fluid compartments
 maintain the acid base balance
 production of action potentials and graded potentials
 serve as cofactors needed for optimal activity of enzymes

24. 1.SODIUM
Sodium is the abundant electrolyte in the ECF,
accounting for 90% of the extracellular catoins. Its
normal blood Na+ concentration is 136 to 148 mEq/L.
Sodium has a major role in controlling water
distribution throughout the body
The most common sodium imbalances are
sodium deficit and sodium excess.

25. HYPONATERMIA
Hyponatremia is a sodium deficit or serum sodium level of less
than 135 mEq/L.
1. Increased sodium excretion
 Excessive diaphoresis
 Diuretics
 Renal disease
2. Inadequate sodium intake
 Nothing by mouth
 Low – salt diet
3. Dilution of serum sodium
 Renal failure
 Hyperglycemia

26. CLINICAL MANIFESTATION
• Hypovolemic
• Hypervolemic
• Normovolemic
Cardiovascular
• shallow, ineffective respirations
Respiratory
• Generalized skeletal muscles weakness
Neuromuscular

27. • Headache
• Personality changes
Cerebral
function
• Hyperactive bowel sounds
• Nausea
• Abdominal cramping and diarrhoea
Gastrointestinal
• Increased urinary output
• Decrease specific gravity
Renal

28. MEDICAL MANGEMENT
IV saline for patient who have hyponatremia without
fluid overload. Isotonic (0.9 percent), hypertonic (3
percent).
For fluid overload , diuretics restrictions to a total of
800ml in 24 hrs
Such as lithium and declomycin these are
antagonize anti diuretic hormone may be
administered

29. NURSING MANAGEMENT
Monitor cardiovascular, respiratory, neuromuscular,
cerebral, renal and gastrointestinal status
Instruct the client to increase oral sodium intake
If the client is taking lithium monitor lithium level
maintain intake and output chart
assesses for signs of circulatory overload e.g. cough,
dyspnea, puffy eyelids, weight gain in 24hrs.
 lungs should be auscultated for crackles

30. HYPERNATREMIA
Hypernatremia is excess sodium in ECF or
serum sodium of greater than 145 mEq/L.
because the osmotic pressure of extra cellular
fluid is increased.

31. CAUSES
Decreased sodium excretion
• Renal failure
• Corticosteroids
Increased sodium intake
• excessive oral sodium ingestion
• excessive administration of sodium containing IV fluids
Increased water loss
• excessive diaphoresis
• watery diarrhoea

32. Clinical manifestation
Respiratory
Neuromuscular
Renal
• pulmonary edema
• irregular muscle contractions
• deep tendon reflexes
diminished
• Increased specific gravity
• Decreased urinary output

33. COMPLICATIONS-
Skeletal muscles weakness
Respiratory arrest
LABORATORY FINDING-
Serum sodium above 145 mEq/ L
Serum osmolality above 300 mEq/L
BUN
Urine specific gravity

34. MEDICAL MANAGEMENT
Infusion of a hypotonic electrolyte solution
e.g. 0.3% sodium chloride or dextrose 5% in
water in indicated when water needs to be
replaced without sodium
Diuretic- Lasix
If kidneys are not functioning then dialysis
should be performed

35. NURSING MANAGEMENT
Dietary history of
the patient
Physical
examination
Restrict sodium
intake
Daily weight should
be monitored
intake and out put
chart of the patient
monitor the
changes in behavior

36. 2.POTASSIUM
It is the major intracellular electrolyte, 98% of
the body’s potassium is inside the cell. The
remaining 2% in the ECF and is important in
neuromuscular functions. The normal serum
potassium concentration ranges from 3.5 to 5.0
mEq/L.

37. HYPOKALEMIA
HYPOKALEMIA is a potassium deficit or a serum
potassium level of less than 3.5mEq/L.
CAUSES
Actual total body potassium loss
Inadequate potassium intake
Dilution of serum potassium
Water intoxication
Intravenous therapy with potassium poor solution

38. CLINICAL MANIFETSTION
• Thready , weak, irregular pulse
• Orthostatic hypotension
Cardiovascular
• Diminished breath sound
• Shallow, ineffective respiration
Respiratory
• Anxiety, confusion, coma
• Skeletal muscle weakness, flaccid paralysis
Neuromuscular
• Nausea, vomiting, constipation, abdominal
distention
• Paralytic ileuS
Gastrointestinal

39. COMPLICATIONS-
Dysarrhythmias
Respiratory failure
coma
LABORATORY FINDINGS-
Serum potassium below 3.5mEq/L
Arterial blood gases may show alkalosis
T wave flattering and ST segment depression
on ECG
PH of blood will increase 7.4

40. MEDICAL MANAGEMENT
provide the food high in potassium
the adult recommended allowance for potassium is
1875 to 5625mg/day
oral potassium therapy for mild hypokalemia( 3.3 to
3.5mEq/l)
Severe hypokalemia require IV intervention. A
clients level with 3 and 3.4 mEq/l needs 100 to
200mEq of IV potassium for to increase 1mEq/l. if it
is less than 3 then client need 200 to 400 mEq/l

41. NURSING MANAGEMENT
history focus on dietary
intake, conditions for
potassium loss, use of
diuretics
Review the laboratory reports
physical examination
Check vital signs closely
check redial pulse
The nurse should assess renal
function before administering
potassium
Take the precautions with
intravenously administered
potassium

42. HYPERKALEMIA
Hyperkalemia is a serum potassium level that exceeds
5.1mEq/L. It can lead to cardiac arrest.
CAUSES
Excessive
potassium
intake
Decreased
sodium
excretions
Tissue
damage
Acidosis

43. CLINICAL MANIFESTATION
Cardiovascular
• Slow, weak, irregular heart rate
• Decreased blood pressure
Respiratory system
• respiratory failure

44. Neuromuscular
• EARLY- muscles twitches, parenthesis
• LATE- Profound weakness, flaccid paralysis in
the arms and legs
Gastrointestinal
• Increased motility, hyperactive bowel sounds
• Diarrhoea

45. MEDICAL MANAGEMENT
 If plasma potassium level is less than 5.5 mEq/l restrict the diet
that is rich in potassium
 If level is higher the provide the potassium wasting diuretics to
improve urine output.
 If hyperkalemia is severe then infusion of IV calcium gluconate
to decrease the effect of potassium excess on the myocardium.
 As hyperkalemia increase then sodium polystyrene sulfonate
may be given orally.
 In marked renal failure peritoneal dialysis or hemodialysis may
be needed.

46. NURSING MANAGEMENT
 Take the dietary history of the patient.
 Check the vital signs bowel functions, urine output, lung
sounds (crackles) and peripheral edema every 4 to 8 hours,
in severe hyperkalcemia performs hourly checks of vital signs
including apical pulse.
 Nurse should monitor the cardiovascular, respiratory,
neuromuscular, renal and gastrointestinal status, place on a
cardiac monitor.
 ECG changes should be monitored continuously.
 Prepare for the IV administration of glucose with regular
insulin to move excess potassium into the cells.
 Instruct the client to avoid the use of use salt substitutes or
other potassium containing substance.

47. 3.CALCIUM
99% of the calcium is found in the bones. Its normal
value 8.6 to 10.0mg/dl. The most important
regulator of calcium concentration in blood plasma
is parathyroid hormone (PTH). A low level of
calcium in blood plasma promotes release of more
PTH, which stimulates osteoclasts in bone tissue to
release calcium from bone extracellular matrix.

48. HYPOCALCEMIA
Inhibition of calcium absorption
from the gastrointestinal tract
Increased calcium excretion
Conditions that decrease the
ionized fraction of calcium

49. CLINICAL MANIFESTATION
CARDIO-VASCULAR
• decreased
heart rate
• Hypotension
RESPIRATORY
• respiratory
failure or
arrest
NEUROMUSCULAR
• seizures
• Painful
muscle
spasm

50. LABORATORY FINDINGS
Serum calcium less
than 8.5 mg/dl
Lengthened QT
interval
Prolonged ST
segments

51. MEDICAL MANAGEMENT
 Provide the calcium gluconate, calcium lactate or calcium
chloride.
 Calcium supplement should be given with a glass of milk
with meals. Vitamin D in the milk promotes calcium
absorption.
 Mild hypocalcemia can be treated to give the diet high in
calcium like dairy products- cheese, ice cream, milk
 IV calcium chloride or calcium gluconate must be given
slowly to avoid hypotension and bradycardia.
 Use D5 solutions when dilution is necessary; avoid saline
solutions because they promote calcium loss.

52. NURSING MANAGEMENT
 Take the history of the client current and chronic illness, diet intake and
medications, identify the risks for calcium deficit
 Monitor cardiovascular, respiratory, neuromuscular and gastrointestinal
status; place the client on cardiac table.
 when administering calcium intravenously , warm injection to body
temperature before administering , administer slowly, monitor for
electrocardiogram changes, observe for infiltration monitor for
hypocalcemia
 Move the client carefully and monitor for signs of a fracture.
 Keep 10% calcium gluconate available for treatment of acute calcium
deficit.
 Instruct the client to consume foods high in calcium like cheese, milk and
Soya milk, spinach, low fat etc

53. HYPERCALCEMIA
Hypercalcemia is a total serum calcium level
greater than 10.5 mg/dl, it most often occurs
when calcium is mobilized from the bony
skeleton. It may occur in any age group. It is a
common disorder that can have serious
physical complications.

54. CAUSES
Increased calcium absorption
Decreased calcium excretion
Increased bone reabsorption of calcium
Dehydration

55. CLINICAL MANIFESTATION
Cardiovascular
• bradycardia
• increased blood
pressure
Respiratory
• ineffective
respiratory
movements
Neuromuscular
• muscle
weakness
• Disorientation

56. Renal
• increased urinary output
• formation of renal calculi
Gastrointestinal
• Decreased motility and
hypoactive bowel sounds
• Anorexia
• Nausea
• constipation

57. MEDICAL MANAGEMENT
Administer the IV normal saline, rapidly with
furosemide to prevent fluid over load
Administer medications as prescribed that
inhibit calcium reabsorption from the bone
like aspirin, nonsteroidal anti-inflammatory
drugs.
 Corticosteroids drugs decrease calcium level

58. NURSING MANAGEMENT
 Take the history of the patient and identify the high risk patient.
 Assess the vital signs, apical pulses, and ECG every 1 to 8 hours.
 Check the bowel sounds, renal function and hydration status should be
assessed every 8 hours.
 If flank pain arises, strain all urine to capture renal calculi for analysis.
 Report urine output of less than 0.5ml/kg/hr for 2 hours.
 Advise the patient to take sodium unless it is contraindicated to promote
calcium loss through the kidneys
 Advise the patient to report the clinical manifestation of renal calculi such
as flank pain, hematuria or cardiacdysfunctions
 Instruct the client to avoid foods high in calcium like cheese, milk and soy
milk Spinach, low fat.

59. 4.MAGNESIUM
It’s normal value 1.6 to 2.6mg/dl. In adults, about
54% of the total body magnesium is part of
bone matrix as magnesium salts. Magnesium is
a cofactor for certain enzymes needed for the
metabolism of carbohydrates and proteins and
for the sodium-potassium pump.

60. HYPOMAGNESEMIA
Hypomagnesemia Is a serum magnesium level less
than 1.6 mg/dl
CAUSES
Insufficient magnesium intake
Increased magnesium excretion
Intracellular movement of
magnesium

61. CLINICAL MANIFESTATION
• Tachycardia
• Hypertension
Cardiovascular
• Anorexia, nausea, abdominal distention
• decreased bowel sounds
Gastrointestinal
• shallow respiration
Respiratory
• Seizures
• Tetanus
• Irritability,Confusion
Neuromuscular

62. MANAGEMENT
 Monitor the cardiovascular, gastrointestinal, respiratory, neuromuscular
and central nervous system, place the patient on cardiac monitor
 Restore the calcium level because hypocalcemia frequently accompanies
hypomagnesemia
 Administer magnesium sulfate by the IV route in severe cases(
intramuscular injections pain and tissue damage) monitor serum
magnesium levels frequently.
 Oral preparations of magnesium may cause diarrhea and increase
magnesium loss
 Instruct the client to increase the intake of foods that contain magnesium
like cauliflower, green leafy vegetable such as spinach, milk, potatoes

63. HYPERMAGNESEMIA
Hypermagnesemia is a serum magnesium level that
exceeds 2.6 mg/ dl.
CAUSES-
Increased magnesium intake
 magnesium – containing antacids and laxatives
 excessive administration of magnesium
intravenously
 Decreased renal excretion of magnesium as a result
of renal insufficiency

64. CLINICAL MANIFESTATION
Cardiovascular
• Hypotension
• Bradycardia
Respiratory
• respiratory
insufficiency
Neuromuscular
• Skeletal
muscle
weakness
• Drowsiness
• Lethargy
• Progress to
coma

65. MANAGEMENT
 Monitor cardiovascular , respiratory, neuromuscular and
central nervous system status, place client on cardiac
monitor
 Administer diuretic that are prescribed by physician to
increase renal excretion of magnesium
 Intravenously administered calcium chloride or calcium
gluconate may be prescribed to reverse the effects of
magnesium on cardiac muscles
 Instruct the client to restrict dietary intake of magnesium
containing foods like cauliflower, green leafy vegetables such
as spinash
 Instruct the client to avoid the use of laxatives and antacids
containing magnesium.

66. 5.PHOSPHATE
About 85% of the phosphate in adults is present as
calcium phosphate salts, which are structural
components of bone and teeth. The normal blood
plasma concentration of ionized phosphate is only
1.7mEq/liter .Although some are free, most phosphate
ions are covalently bound to organic molecules such
as lipids, proteins, carbohydrates, nucleic acids, and
adenosine triphosphate(ATP).

67. HYPOPHOSPHATEMIA
The normal value of phosphorus is 2.7 to 4.5mg/dl, when
their amount is less than 2.7mg/dl is called
hypophosphatemia.
CAUSES
Insufficient
phosphorus
intake
Increased
phosphorus
excretion
Intracellular
shifts

68. CLINICAL MANIFESTATION
• Decreased contractibility and cardiac output
• Shallow respiration
Cardiovascular
• Weakness
Neuromuscular
• Irritability, confusion, seizure
Central nervous
system
• Decreased platelet aggregation and
increased bleeding
Hematological

69. MANAGEMENT
 Monitor cardiovascular, respiratory, neuromuscular, central
nervous and hematological status.
 Administer phosphorus orally along with a vitamin D
supplement
 Administer phosphorus intravenously only when serum
phosphorus level fall below 1 mg/dl and when the client
experience critical clinical manifestation.
 Administer phosphorus intravenously slowly because of the
risks associated with hyerphosphatemia
 Assess renal system before administering phosphorus
 Instruct client to increase intake of phosphorus containing
foods while decreasing the intake of calcium containing
foods like fish, nuts, whole grain breads and cereals.

70. HYPERPHOSPHATEMIA
Hyperphosphatemia is a serum phosphorus level that
exceeds 4.5mg/dl, most body systems tolerating
elevated serum phosphorus level well. An increase in
the serum phosphorus level is accompanied by a
decrease in the serum calcium level.
CAUSES-
 Decreased renal excretion resulting from renal insufficiency
 Tumor lysis syndrome
 Increased intake of phosphorus including dietary intake or
overuse of phosphate containing laxatives or enemas.

71. CLINICAL MANIFESTSTION
Cardiovascular
• Hypotension
• Decreased
heart rate
• Diminished
peripheral
pulse
Respiratory
• decreased
respiratory
movement
Neurovascular
• Painful
muscle
spasm in the
calf
• Numbness
that may
affect lips,
nose, and
ears

72. MANAGEMENT
Administer phosphate binding medications that
increase fecal excretion of phosphorus from food in
the gastrointestinal tract.
Instruct client to avoid the laxatives and enemas
Advise the patient to decrease the intake of food
that are rich in phosphorus like fish, beef chicken
etc.
Instruct client in how to take phosphate binding
medications, emphasizing that they should be taken
with meals or immediately after meal.

73. RISK FACTORS FOR FLUID , ELECTROLYTE
ANDACID BASE IMBALANCE
Pathophysiology of lungs and chest wall
Renal Pathophysiology
Diabetes mellitus
Other endocrine pathophysiology
Prolonged vomiting or gastric suction
Newborn
Older people

74. ASSESSMENT AND DIAGNOSTIC FINDING FOR
FLUID AND ELECTROLYTE IMBALANCE
History
• Intake of fluid and
electrolyte
• Excretion of fluid and
electrolyte
• Abnormal loss of fluid
and electrolyte
Physical
examination
• Level of consciousness
• Cardiac rate and
rhythm
• Respiratory rate,
depth and lung sound
Laboratory tests
• BUN and serum
creatinine
concentration.
• Arterial blood gas
measurment
• Hematocrit levels

75. INTRAVENOUS FLUID THERAPY
PURPOSES
Provide water, electrolytes and nutrients
when people cannot ingest enough orally
Provide vascular access for infusion of
medication or blood component
Allow vascular access for monitoring devices.

76. INTRAVENOUS SOLUTIONS
 Isotonic Solution
 0.9 % NaCl
Na+ = 154 mEq/L, Cl- = 154 mEq/ L
 Lactated Ringer’s Solution- (Hartmann’s solution)
Na+ = 130 mEq/L
K+ = 4 mEq/L
Ca2+ = 3 mEq/L
Cl- = 109 mEq/L
Lactate= 28 mEq/L
 5% dextrose in water ( D5W)-
No electrolytes.
50 g of dextrose

77. INTRAVENOUS SOLUTIONS
Hypotonic Solution- 0.45%NaCl
Composition Na+ = 77 mEq/L
Cl- = 77 mEq/L
Hypertonic Solutions- 3% NaCl, 5% Nacl
Composition-
Na+ = 513 mEq/L
Cl- = 513 mEq/L

78. BLOOD TRANSFUSION
A blood transfusion is a process that involves
taking blood from one person (the donor) and
giving it to someone else
INDICATIONS-
To replace blood lost
To treat anaemia
To treat the certain disorders

79. Home based and community based
care
Record intake
and output
Monitor body
weight
Monitor vital
signs
Monitor skin
turgor
Assess the
cardiovascular
functions
Assess the
mental
functions

80. RESEARCH STUDY
AN EXPERIMENTAL STUDY ON FLUID AND ELECTROLYTE
IMBALANCE AND ITS CORRECTIVE MEASURES AMONG CHILDREN
ABSTRACT OF RESEARCH FINDINGS
Fluid and electrolyte imbalance is most commonly associated with
diarrhea among children (3-5 yr). Among all the disease conditions
encountered in children, diarrhea is the most common causing the
highest morbidity and mortality. Dehydration and acidosis are the
most common cause of death in diarrheic children. The present
study was carried out on 24 children including six clinically healthy
and 18 diarrheic children. Physiological, Hematological, blood
biochemical and electrocardiographic changes were monitored in
control as well as diarrheic children. Efficacy of fluid therapy regimen
i.e. ORS was evaluated in treating fluid and electrolyte imbalance in
diarrheic children during the period of study.

81. CONTI…
RESULTS:
Following the administration of fluid therapy regimen i.e.
ORS, the physiological, (HR, RR) hematological (Hb, PCV
and TEC), plasma biochemical (total protein, glucose,
sodium, potassium, chloride and phosphorus) and
electrocardiographic parameters exhibited a trend towards
restoration to normal by the 3rd to 5th day of treatment.
ORS was found to be more efficacious and rapid in
correcting fluid and electrolyte imbalance in the diarrheic
children.

82. CONCLUSION
The ORS used in the present study, may be recommended for
clinical and field trials for correcting fluid and electrolyte
imbalance in mildly to moderately dehydrated diarrheic
children. A further study needs to be undertaken, on the
combined use of oral and parenteral hypertonic solutions for
treating severe dehydration in children.

83. SUMMARIZATION
 ELECTROLYTES
 MINERALS
 FLUID BALANCE
 FLUID VOLUME DISTURBANCES:
 HYPERVOLEMIA
 HYPOVOLEMIA
 ELECTROLYTE IMBALANCE:
 SODIUM IMBALANCE
 POTASSIUM IMBALANCE
 CALCIUM IMBALANCE
 MAGNESIUM IMBALANCE
 PHOSPHATE IMBALANCE
 INTRAVENOUS FLUID THERAPY