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Mr. M.K. Irshad ali
Associate Professor,
RJSCON, Khopergao.
Of course not,………
 because water is essential to sustain life.
 Likewise, body fluids are vital to maintain
normal body functioning.
 Total body fluid (TBW), accounts for
approximately 60% of total body weight (this
can be 70% or higher in a newborn down to
50–55% in a mature woman).
 Total Body Fluid can be divided into
Intracellular and Extracellular
•Found inside the plasma membrane of the
body's cells.
•In humans (average 70 KG), the intracellular
compartment contains on average about 28
liters of fluid .
•2/3 of the total body water is found as intra
cellular.
•Includes
•Interstitial,
•Intravascular and
•3rd space
•Accounts for 1/3 of the Total body water
1- Interstitial compartment
•It the small, narrow spaces between tissues or parts of an
organ and the fluid is called Interstitial fluid.
•In the average male (70 kg) human body, the interstitial
space has approximately 10.5 liters of fluid.
2-Intravascular compartment
•The main intravascular fluid in humans is blood; the
average volume of blood in humans is approximately 70-
75 ml/kg
3- Third space
•The third space is space in the body where fluid does not
normally collect in larger amounts.
•Eg;peritoneal cavity and pleural cavity
Composition of Body Fluids
•Water is a universal solvent and dissolves various ionic and
covalent bonded compounds that are classified as either an
electrolyte or nonelectrolyte
•Nonelectrolytes contain covalent bonds that prevent them
form dissociating in solution and therefore have no electrical
charge (eg. glucose, lipids, and urea)
•Electrolytes dissociate into ions (ionize) in water; ions are
charged particles and conduct an electrical current
•Electrolyte examples --> Mg+, Na+, Cl-, K+
•Dissolved solutes increase osmotic activity of a
fluid; electrolytes have higher osmotic power
than nonelectrolytes because each electrolyte
molecule dissociates into at least two ions
NaCl ---------> Na+ + Cl-
MgCl2 ---------> Mg2+ + Cl- + Cl-
glucose ---------> glucose
•Therefore electrolytes have a greater ability to
cause fluid shift
Daily Water Balance (liters)
INPUT OUTPUT
FLUID INTAKE 1.5
IN FOOD 0.8
METABOLIC 0.3
Total 2,6
INSENSIBLE 0.8
SWEAT 0.1
FECES 0.2
URINE 1.5
Total 2.6
Water Balance
•Water intake = Water output
•Intake = 2500 ml/day, water ingested as fluids (60%), foods
(30%), and produced from cell metabolism or also called
metabolic water (10%)
•Water output - vapor in lungs/diffusion from the skin (28%),
perspiration (8%), and feces (4%); rest is excreted by kidneys
as urine (60%)
•Rise in plasma osmolarity (solute concentration) triggers:
Thirst, provoking water intake
ADH release, causing the kidneys to excrete concentrated
urine
Regulation of Water….. Intake
•Thirst Mechanism
Decrease in plasma volume and increase in plasma
osmolarity causes dry mouth, in stimulating the
hypothalamic thirst centers
Dry mouth results from a decrease in water filtered from
the bloodstream (therefore increased osmolarity) and
therefore salivary gland receives less water, in turn
producing less saliva
Hypothalamic stimulation occurs when water moves (due
to hypertonic ECF) out of thirst center osmoreceptors by
osmosis, causing osmoreceptors to become irritable and depolarize
(therefore sensation of thirst)
Regulation of Water …………..Output
•Obligatory water losses - insensible water loss from
lungs and through skin, undigested food, feces, and
urine
•Kidneys can concentrate urine, but only a minimum
of 500 ml of water is lost in urine/day and therefore
concentration and volume of urine excreted depends
on fluid intake
Disorders of Water Balance
•Dehydration - water loss exceeds
water intake
•Hypotonic hydration - ECF is
diluted; sodium concentration is
normal but there is an increase in
water, causing ECF sodium levels to
lower (hyponatremia), increase in
osmosis occurs and tissue cells
swell (edema)
•Fluid Therapy is the administration of fluids to
a patient as a treatment or preventative
measure. It can be administered via an
intravenous, intraperitoneal, intraosseous,
subcutaneous and oral routes.
•Hypotension
•Hypovolemia
•Electrolyte, metabolic and acid base
disorders
•Decreased oxygen delivery
•Geriatric patients at risk of organ failure
•The fluids used in clinical practice are
usefully classified into
•colloids,
•crystalloids and
•blood products
Electrolytes are important, because
they are what cells use to maintain
voltages across their cell membranes
and to carry electrical impulses cross
themselves and to other cells.
Kidney work to keep the electrolyte
concentrations in blood constant
despite changes in the body
•The levels of electrolytes in your body can
become too low or too high. This can happen
when the amount of water in your body
changes. The amount of water that you take
in should equal the amount you lose. If
something upsets this balance, you may have
dehydration or over hydration.
•Some medicines, vomiting, diarrhea,
sweating, and liver or kidney problems can
all upset your water balance.
What Are Electrolytes?
An electrolyte is a compound
which produces ions when
dissolved in a solution such
as water.
•Sodium was first isolated by Humphry Davy in 1807 by
the electrolysis of sodium hydroxide.
•Sodium is Most abundant ion in the extracellular fluid
• Sodium is regulated by
•Salt intake
•Aldosterone
•Urinary output
Regulation of Sodium By Aldosterone
Regulation of Sodium By Baroreceptors
•Functions
•Maintain balance of extracellular fluid, thereby it
controls the movements of the water between fluid
compartments
•Transmission of nerve impulses
•Neuro muscular and myocardial impulse
transmission
•Normal concentration : 135 to 145 mEq/L
•HYPERNATREMIA (Vomiting, Diarrhea, Sweating, Diuretics)
•HYPONATREMIA (Excessive salt intake, Diabetes insipidus,
heatstroke)
•Pottassium metal was first isolated in 1807 in England
by Sir Humphry Davy
•Potassium is a mineral that is found in the foods you eat
such as fruits vegetables meats etc
•It is Main intracellular electrolyte.
•It Helps in maintaining fluid balance of the intracellular fluid
•Potassium is regulated by kidney
•FUNCTIONS :
•Regulates neuromuscular excitability and muscle
contraction
•Needed for glycogen formation and protein synthesis
•Correction of acid base imbalances.
•Potassium ion can be exchanged with hydrogen ion (H+)
•NORMAL CONCENTRATION : 3.5 to 5.3 mEq/L
•HYPERKALEMIA (High potassium intake, Renal insufficiency)
•HYPOKALEMIA: Loss of K+ in the form of vomiting ,GI suction poor
K intake diuretics steroid administration
Calcium was first isolated in 1808 in England by Sir
Humphry Davy
Calcium is the most abundant element in the body
Calcium is found in extracellular fluid
Regulated
by the action of
Thyroid gland
(calcitonin) &
parathyroid gland
(Parathyroid
hormone)
FUNCTIONS :
Maintenance of cell membrane, its integrity and
structure
Conduction of nerve impulses in the skeletal
muscle
Stimulation and depolarization and contraction of
cardiac muscles
Aids in blood coagulation, Growth and formation of
bones & Muscle relaxation
Normal concentration :4 to 5 mEq/L
•HYPERCALCEMIA (Hyperparathyroidism - Prolonged
immobilization - Thiazide diuretics - Large doses of Vitamin A
and D)
•HYPOCALCEMIA: (Vitamin D/Calcium deficiency
Primary/surgical hyperparathyroidism - Pancreatitis - Renal
failure)
•Eventually it was recognized to be magnesium
sulphate, MgSO4. Joseph Black recognized
magnesium as an element in 1755.
•It was isolated by Sir Humphry Davy (1778-1829) in
1808 almost 200 years after its discovery
•.Magnesium is the second most important ion in the
intracellular fluid
•It has an inhibitory effect on skeletal muscles.
•FUNCTIONS :
•Precipitation of metabolic activities of cells
•Enzyme activity
•Neuro chemical activity
•Muscular excitability
•NORMAL CONCENTRATION : 1.5 to 2.4 mEq/L
•HYPERMAGNESEMIA (Renal failure, Untreated diabetic
ketoacidosis)
•HYPOMAGNESEMIA: (Chronic Alcoholism,Diarrhea
•Phosphate is a buffer anion in extracellular and intracellular fluid
Phosphate absorption is through gastrointestinal tract
•Calcium and phosphate are inversely proportional. When one rises
the other falls
•Serum phosphate is regulated by kidneys & Parathyroid hormone
•FUNCTIONS:
•Development and maintenance of bones and teeth
•Participates in carbohydrate metabolism
•Assist in acid base regulation
•Maintains levels of ATP
•NORMAL CONCENTRATION : 2.5 to 4.5 mEq/L
•HYPO PHOSPHOTEMIA (Severe protein-calorie malnutrition)
•HYPER PHOSPHOTEMIA (Renal failure,Chemotherapy)
•Chlorides are found in extracellular and intracellular
fluids
•Chloride is regulated through kidneys
•The dietary intake of chloride and the amount
excreted in urine are closely related.
FUNCTIONS :
•The chloride ion balances the ions within the
extracellular fluid
•The ion exchange helps to maintain the electrical
neutrality
NORMAL CONCENTRATION : 100 to 106 mEq/L
•Bicarbonate is found in extracellular and intracellular
fluids
•It is a major chemical buffer in the body
•Regulation is through kidneys
FUNCTIONS :
•It is an essential component of the carbonic acid-
bicarbonate buffering system essential to acid base
balance
NORMAL ARTERIAL BICARBONATE : 22 to 26 mEq/L
NORMAL VENOUS BICARBONATE : 24 TO 30 MEQ/L
Fluid and electrolyte

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Fluid and electrolyte

  • 1.
  • 2. Mr. M.K. Irshad ali Associate Professor, RJSCON, Khopergao.
  • 3.
  • 4. Of course not,………  because water is essential to sustain life.  Likewise, body fluids are vital to maintain normal body functioning.  Total body fluid (TBW), accounts for approximately 60% of total body weight (this can be 70% or higher in a newborn down to 50–55% in a mature woman).  Total Body Fluid can be divided into Intracellular and Extracellular
  • 5. •Found inside the plasma membrane of the body's cells. •In humans (average 70 KG), the intracellular compartment contains on average about 28 liters of fluid . •2/3 of the total body water is found as intra cellular.
  • 7. 1- Interstitial compartment •It the small, narrow spaces between tissues or parts of an organ and the fluid is called Interstitial fluid. •In the average male (70 kg) human body, the interstitial space has approximately 10.5 liters of fluid. 2-Intravascular compartment •The main intravascular fluid in humans is blood; the average volume of blood in humans is approximately 70- 75 ml/kg 3- Third space •The third space is space in the body where fluid does not normally collect in larger amounts. •Eg;peritoneal cavity and pleural cavity
  • 8. Composition of Body Fluids •Water is a universal solvent and dissolves various ionic and covalent bonded compounds that are classified as either an electrolyte or nonelectrolyte •Nonelectrolytes contain covalent bonds that prevent them form dissociating in solution and therefore have no electrical charge (eg. glucose, lipids, and urea) •Electrolytes dissociate into ions (ionize) in water; ions are charged particles and conduct an electrical current •Electrolyte examples --> Mg+, Na+, Cl-, K+
  • 9. •Dissolved solutes increase osmotic activity of a fluid; electrolytes have higher osmotic power than nonelectrolytes because each electrolyte molecule dissociates into at least two ions NaCl ---------> Na+ + Cl- MgCl2 ---------> Mg2+ + Cl- + Cl- glucose ---------> glucose •Therefore electrolytes have a greater ability to cause fluid shift
  • 10. Daily Water Balance (liters) INPUT OUTPUT FLUID INTAKE 1.5 IN FOOD 0.8 METABOLIC 0.3 Total 2,6 INSENSIBLE 0.8 SWEAT 0.1 FECES 0.2 URINE 1.5 Total 2.6
  • 11. Water Balance •Water intake = Water output •Intake = 2500 ml/day, water ingested as fluids (60%), foods (30%), and produced from cell metabolism or also called metabolic water (10%) •Water output - vapor in lungs/diffusion from the skin (28%), perspiration (8%), and feces (4%); rest is excreted by kidneys as urine (60%) •Rise in plasma osmolarity (solute concentration) triggers: Thirst, provoking water intake ADH release, causing the kidneys to excrete concentrated urine
  • 12. Regulation of Water….. Intake •Thirst Mechanism Decrease in plasma volume and increase in plasma osmolarity causes dry mouth, in stimulating the hypothalamic thirst centers Dry mouth results from a decrease in water filtered from the bloodstream (therefore increased osmolarity) and therefore salivary gland receives less water, in turn producing less saliva Hypothalamic stimulation occurs when water moves (due to hypertonic ECF) out of thirst center osmoreceptors by osmosis, causing osmoreceptors to become irritable and depolarize (therefore sensation of thirst)
  • 13.
  • 14. Regulation of Water …………..Output •Obligatory water losses - insensible water loss from lungs and through skin, undigested food, feces, and urine •Kidneys can concentrate urine, but only a minimum of 500 ml of water is lost in urine/day and therefore concentration and volume of urine excreted depends on fluid intake
  • 15.
  • 16. Disorders of Water Balance •Dehydration - water loss exceeds water intake •Hypotonic hydration - ECF is diluted; sodium concentration is normal but there is an increase in water, causing ECF sodium levels to lower (hyponatremia), increase in osmosis occurs and tissue cells swell (edema)
  • 17. •Fluid Therapy is the administration of fluids to a patient as a treatment or preventative measure. It can be administered via an intravenous, intraperitoneal, intraosseous, subcutaneous and oral routes.
  • 18. •Hypotension •Hypovolemia •Electrolyte, metabolic and acid base disorders •Decreased oxygen delivery •Geriatric patients at risk of organ failure
  • 19. •The fluids used in clinical practice are usefully classified into •colloids, •crystalloids and •blood products
  • 20. Electrolytes are important, because they are what cells use to maintain voltages across their cell membranes and to carry electrical impulses cross themselves and to other cells. Kidney work to keep the electrolyte concentrations in blood constant despite changes in the body
  • 21. •The levels of electrolytes in your body can become too low or too high. This can happen when the amount of water in your body changes. The amount of water that you take in should equal the amount you lose. If something upsets this balance, you may have dehydration or over hydration. •Some medicines, vomiting, diarrhea, sweating, and liver or kidney problems can all upset your water balance.
  • 22. What Are Electrolytes? An electrolyte is a compound which produces ions when dissolved in a solution such as water.
  • 23.
  • 24. •Sodium was first isolated by Humphry Davy in 1807 by the electrolysis of sodium hydroxide. •Sodium is Most abundant ion in the extracellular fluid • Sodium is regulated by •Salt intake •Aldosterone •Urinary output
  • 25. Regulation of Sodium By Aldosterone
  • 26. Regulation of Sodium By Baroreceptors
  • 27. •Functions •Maintain balance of extracellular fluid, thereby it controls the movements of the water between fluid compartments •Transmission of nerve impulses •Neuro muscular and myocardial impulse transmission •Normal concentration : 135 to 145 mEq/L •HYPERNATREMIA (Vomiting, Diarrhea, Sweating, Diuretics) •HYPONATREMIA (Excessive salt intake, Diabetes insipidus, heatstroke)
  • 28. •Pottassium metal was first isolated in 1807 in England by Sir Humphry Davy •Potassium is a mineral that is found in the foods you eat such as fruits vegetables meats etc •It is Main intracellular electrolyte. •It Helps in maintaining fluid balance of the intracellular fluid •Potassium is regulated by kidney
  • 29. •FUNCTIONS : •Regulates neuromuscular excitability and muscle contraction •Needed for glycogen formation and protein synthesis •Correction of acid base imbalances. •Potassium ion can be exchanged with hydrogen ion (H+) •NORMAL CONCENTRATION : 3.5 to 5.3 mEq/L •HYPERKALEMIA (High potassium intake, Renal insufficiency) •HYPOKALEMIA: Loss of K+ in the form of vomiting ,GI suction poor K intake diuretics steroid administration
  • 30. Calcium was first isolated in 1808 in England by Sir Humphry Davy Calcium is the most abundant element in the body Calcium is found in extracellular fluid Regulated by the action of Thyroid gland (calcitonin) & parathyroid gland (Parathyroid hormone)
  • 31. FUNCTIONS : Maintenance of cell membrane, its integrity and structure Conduction of nerve impulses in the skeletal muscle Stimulation and depolarization and contraction of cardiac muscles Aids in blood coagulation, Growth and formation of bones & Muscle relaxation Normal concentration :4 to 5 mEq/L •HYPERCALCEMIA (Hyperparathyroidism - Prolonged immobilization - Thiazide diuretics - Large doses of Vitamin A and D) •HYPOCALCEMIA: (Vitamin D/Calcium deficiency Primary/surgical hyperparathyroidism - Pancreatitis - Renal failure)
  • 32. •Eventually it was recognized to be magnesium sulphate, MgSO4. Joseph Black recognized magnesium as an element in 1755. •It was isolated by Sir Humphry Davy (1778-1829) in 1808 almost 200 years after its discovery •.Magnesium is the second most important ion in the intracellular fluid •It has an inhibitory effect on skeletal muscles.
  • 33. •FUNCTIONS : •Precipitation of metabolic activities of cells •Enzyme activity •Neuro chemical activity •Muscular excitability •NORMAL CONCENTRATION : 1.5 to 2.4 mEq/L •HYPERMAGNESEMIA (Renal failure, Untreated diabetic ketoacidosis) •HYPOMAGNESEMIA: (Chronic Alcoholism,Diarrhea
  • 34. •Phosphate is a buffer anion in extracellular and intracellular fluid Phosphate absorption is through gastrointestinal tract •Calcium and phosphate are inversely proportional. When one rises the other falls •Serum phosphate is regulated by kidneys & Parathyroid hormone
  • 35. •FUNCTIONS: •Development and maintenance of bones and teeth •Participates in carbohydrate metabolism •Assist in acid base regulation •Maintains levels of ATP •NORMAL CONCENTRATION : 2.5 to 4.5 mEq/L •HYPO PHOSPHOTEMIA (Severe protein-calorie malnutrition) •HYPER PHOSPHOTEMIA (Renal failure,Chemotherapy)
  • 36. •Chlorides are found in extracellular and intracellular fluids •Chloride is regulated through kidneys •The dietary intake of chloride and the amount excreted in urine are closely related. FUNCTIONS : •The chloride ion balances the ions within the extracellular fluid •The ion exchange helps to maintain the electrical neutrality NORMAL CONCENTRATION : 100 to 106 mEq/L
  • 37. •Bicarbonate is found in extracellular and intracellular fluids •It is a major chemical buffer in the body •Regulation is through kidneys FUNCTIONS : •It is an essential component of the carbonic acid- bicarbonate buffering system essential to acid base balance NORMAL ARTERIAL BICARBONATE : 22 to 26 mEq/L NORMAL VENOUS BICARBONATE : 24 TO 30 MEQ/L