Here are the key points about hyperkalemia:
- Causes include excessive potassium intake, medications like potassium supplements or potassium-sparing diuretics, decreased excretion due to renal failure, adrenal insufficiency, tissue damage, acidosis, and fluid shifts from intracellular to extracellular space.
- It is more dangerous than hypokalemia because high serum potassium levels can cause cardiac arrest.
- Signs and symptoms may include weakness, paresthesia around the mouth, nausea, vomiting, diarrhea, palpitations, peaked T waves on ECG, widened QRS complex, heart block, ventricular fibrillation.
- Treatment focuses on reducing potassium levels and includes administering calcium, sodium bicar
- The document discusses water, electrolyte, and acid-base balance in the human body. It covers topics like fluid compartments, regulation of water balance, electrolyte balance, and hormonal control.
- Key points include that total body water is about 60% of body weight and is distributed in intracellular and extracellular compartments. Water balance is regulated by thirst, ADH, and urination. Electrolyte levels like sodium, potassium, and calcium are also tightly controlled.
- Hormones like ADH, aldosterone, renin-angiotensin system, and atrial natriuretic factor help regulate water and electrolyte levels in response to changes in blood volume, pressure, and os
This document discusses fluid balance and fluid therapy. It begins by defining fluid balance as when water intake equals water loss each day. It then discusses total body water content and its compartments. Key points include that intravenous fluids can be classified as crystalloids or colloids. Common crystalloid fluids discussed include normal saline, Ringer's lactate, dextrose 5%, and Isolyte solutions. Albumin and dextran are presented as examples of colloid fluids. Indications, contraindications, and complications of various intravenous fluids are provided.
This document discusses fluid and electrolyte balance in the human body. It covers the following key points:
- Approximately 60% of the adult body weight is made up of fluid and electrolytes.
- Fluids are regulated through processes like osmosis, diffusion, and filtration. Key organs like the kidneys, heart, lungs, and endocrine glands help maintain fluid homeostasis.
- Electrolyte imbalances like hypokalemia and hyperkalemia are discussed in detail, including their causes, signs/symptoms, and treatment approaches.
- Proper fluid and electrolyte balance is essential for life and is tightly regulated through various physiological mechanisms.
Seminar on fluid and electrolyte imbalanceaneez103
This document provides an overview of fluid and electrolyte balance and imbalance. It defines key terms related to fluids, electrolytes, and body composition. It describes the normal regulation of fluids and electrolytes in the body, including through passive and active transport mechanisms, hormones, and the sensation of thirst. It then discusses various abnormalities in fluid and electrolyte balance that can occur, including deficits, excesses, and shifts of extracellular fluid as well as various electrolyte imbalances.
fluid and electrolyte imbalance
normal physiology of fluid regulation
FLUID IMBALANCES- fluid volume excess, fluid volume deficit, third spacing,
ELECTROLYTE IMBALANCES- hypo and hypernatremia, hypo and hyperkalemia, hypo and hypercalcemia
FLUID ELECTROLYTE IMBALANCES AND ACID BASE IMBALANCES SreethaAkhil
This study examined the relationship between acid-base and electrolyte imbalances and survival outcomes in patients with low Glasgow Coma Scale (GCS) scores admitted to the medical intensive care unit. The study reviewed medical records of 100 patients over 6 months. Metabolic acidosis was present in 67% of patients and mortality was significantly higher in those with low GCS scores. Sodium and chloride levels increased while potassium decreased more in patients with low GCS. Patients with both low GCS and hypernatremia or metabolic acidosis had the highest mortality rate of 71.4%. The results suggest low GCS is associated with worse outcomes, especially when combined with acid-base and electrolyte disorders.
Fluid and electrolyte balance within the body is essential for maintaining health and proper functioning of all body systems. Imbalances can occur when fluid intake exceeds output, leading to fluid volume excess, or when output exceeds intake, resulting in fluid volume deficit. Precise regulation mechanisms aim to keep fluid and electrolytes like sodium, potassium, calcium, and chloride within their normal ranges to support cellular and organ function. Nursing care involves assessing for risk factors, monitoring for signs of imbalance, and treating underlying causes through fluid management, diet, and medication.
SIADH, or syndrome of inappropriate anti-diuretic hormone release, is characterized by high levels of ADH released in the absence of normal stimuli. It is associated with tumors that secrete ADH, such as small cell lung cancer, as well as pulmonary and neurological disorders. SIADH causes water retention through ADH increasing water reabsorption in the kidneys, leading to hyponatremia and hypo-osmolality as blood is diluted. Clinical features range from mild thirst to seizures depending on sodium level. The diagnosis requires lab tests showing low sodium and osmolality with concentrated urine. Treatment focuses on correcting the underlying cause, restricting fluids, and sometimes using demeclocycline or coniv
- The document discusses water, electrolyte, and acid-base balance in the human body. It covers topics like fluid compartments, regulation of water balance, electrolyte balance, and hormonal control.
- Key points include that total body water is about 60% of body weight and is distributed in intracellular and extracellular compartments. Water balance is regulated by thirst, ADH, and urination. Electrolyte levels like sodium, potassium, and calcium are also tightly controlled.
- Hormones like ADH, aldosterone, renin-angiotensin system, and atrial natriuretic factor help regulate water and electrolyte levels in response to changes in blood volume, pressure, and os
This document discusses fluid balance and fluid therapy. It begins by defining fluid balance as when water intake equals water loss each day. It then discusses total body water content and its compartments. Key points include that intravenous fluids can be classified as crystalloids or colloids. Common crystalloid fluids discussed include normal saline, Ringer's lactate, dextrose 5%, and Isolyte solutions. Albumin and dextran are presented as examples of colloid fluids. Indications, contraindications, and complications of various intravenous fluids are provided.
This document discusses fluid and electrolyte balance in the human body. It covers the following key points:
- Approximately 60% of the adult body weight is made up of fluid and electrolytes.
- Fluids are regulated through processes like osmosis, diffusion, and filtration. Key organs like the kidneys, heart, lungs, and endocrine glands help maintain fluid homeostasis.
- Electrolyte imbalances like hypokalemia and hyperkalemia are discussed in detail, including their causes, signs/symptoms, and treatment approaches.
- Proper fluid and electrolyte balance is essential for life and is tightly regulated through various physiological mechanisms.
Seminar on fluid and electrolyte imbalanceaneez103
This document provides an overview of fluid and electrolyte balance and imbalance. It defines key terms related to fluids, electrolytes, and body composition. It describes the normal regulation of fluids and electrolytes in the body, including through passive and active transport mechanisms, hormones, and the sensation of thirst. It then discusses various abnormalities in fluid and electrolyte balance that can occur, including deficits, excesses, and shifts of extracellular fluid as well as various electrolyte imbalances.
fluid and electrolyte imbalance
normal physiology of fluid regulation
FLUID IMBALANCES- fluid volume excess, fluid volume deficit, third spacing,
ELECTROLYTE IMBALANCES- hypo and hypernatremia, hypo and hyperkalemia, hypo and hypercalcemia
FLUID ELECTROLYTE IMBALANCES AND ACID BASE IMBALANCES SreethaAkhil
This study examined the relationship between acid-base and electrolyte imbalances and survival outcomes in patients with low Glasgow Coma Scale (GCS) scores admitted to the medical intensive care unit. The study reviewed medical records of 100 patients over 6 months. Metabolic acidosis was present in 67% of patients and mortality was significantly higher in those with low GCS scores. Sodium and chloride levels increased while potassium decreased more in patients with low GCS. Patients with both low GCS and hypernatremia or metabolic acidosis had the highest mortality rate of 71.4%. The results suggest low GCS is associated with worse outcomes, especially when combined with acid-base and electrolyte disorders.
Fluid and electrolyte balance within the body is essential for maintaining health and proper functioning of all body systems. Imbalances can occur when fluid intake exceeds output, leading to fluid volume excess, or when output exceeds intake, resulting in fluid volume deficit. Precise regulation mechanisms aim to keep fluid and electrolytes like sodium, potassium, calcium, and chloride within their normal ranges to support cellular and organ function. Nursing care involves assessing for risk factors, monitoring for signs of imbalance, and treating underlying causes through fluid management, diet, and medication.
SIADH, or syndrome of inappropriate anti-diuretic hormone release, is characterized by high levels of ADH released in the absence of normal stimuli. It is associated with tumors that secrete ADH, such as small cell lung cancer, as well as pulmonary and neurological disorders. SIADH causes water retention through ADH increasing water reabsorption in the kidneys, leading to hyponatremia and hypo-osmolality as blood is diluted. Clinical features range from mild thirst to seizures depending on sodium level. The diagnosis requires lab tests showing low sodium and osmolality with concentrated urine. Treatment focuses on correcting the underlying cause, restricting fluids, and sometimes using demeclocycline or coniv
This document discusses fluid and electrolyte homeostasis in the human body. It begins by outlining the significance and components of body fluids, including their composition and functional roles. Homeostasis and disorders related to fluid volume and concentration are then examined. Specific electrolyte imbalances involving sodium, acid-base balance, potassium, calcium, chloride, and magnesium are explored in depth. Signs, symptoms, causes, and treatment approaches are provided for various electrolyte disturbances. The document concludes by discussing fluid therapy and principles of fluid management.
This document discusses intravenous fluid therapy and transfusion therapy. It provides details on fluid compartments in the body, various intravenous fluid solutions including crystalloids, colloids, isotonic, hypotonic and hypertonic solutions. It describes how to assess fluid status and calculate fluid requirements during surgery. Complications of blood transfusion are outlined as well as components of blood that can be transfused. Vigilance is important when administering blood products due to risks of transfusion reactions and disease transmission.
This document discusses fluid therapy and body fluid compartments. It covers the following key points:
1) The human body contains two main fluid compartments - intracellular fluid (ICF) and extracellular fluid (ECF). ECF is further divided into interstitial fluid, intravascular fluid, and transcellular fluid.
2) Fluid movement between compartments is governed by diffusion, osmosis, osmolality, tonicity, and oncotic pressure. Renal, neuroendocrine, and other physiological systems help regulate fluid balance.
3) Perioperative fluid needs include maintenance requirements, replacing deficits from fasting or losses, accounting for third spacing of fluids, and replacing blood loss.
This document summarizes fluid, electrolyte and acid-base balance. It discusses total body fluid volumes and water balance, fluid compartments, intravascular fluid volume, movement of body fluids through filtration, osmosis and diffusion, and factors affecting fluid and electrolyte movement like osmotic pressure and tonicity. It also covers electrolytes in the extracellular fluid, sodium regulation, water regulation, manifestations of fluid and electrolyte imbalances, and acid-base balance.
The document discusses electrolyte imbalances in the human body. It begins by describing the distribution of body fluids between intracellular fluid (ICF) and extracellular fluid (ECF). It then discusses the major electrolytes - sodium, potassium, calcium, magnesium, chloride and bicarbonate - and how they are regulated. Specific electrolyte imbalances like hyponatremia, hypernatremia, hypokalemia, hyperkalemia, hypocalcemia, hypercalcemia and their causes and symptoms are then outlined. The document concludes by briefly mentioning fluid disturbances like hypochloremia and hyperchloremia.
The document discusses fluid and electrolyte homeostasis in the human body. It defines key terms like homeostasis, electrolytes, osmosis, and body water content. It describes the characteristics, functions and normal ranges of important fluids and electrolytes like sodium, potassium, calcium and magnesium. It also discusses electrolyte abnormalities like hyponatremia, hypernatremia, hypokalemia, and hyperkalemia and their potential causes, clinical signs, and treatment approaches.
This document discusses sodium metabolism and disorders of sodium concentration. It provides details on:
- Water distribution in the body and fluid compartments
- Causes and types of hyponatremia, including hypovolemic, hypervolemic, and euvolemic hyponatremia
- Evaluation and management of hyponatremia, including treatment based on severity and rate of sodium correction
- Causes and clinical features of hypernatremia
The document is a comprehensive review of sodium disorders and approaches to diagnosis and treatment of hypo- and hypernatremia.
Hyponatremia- A low sodium concentration in the bloodbhavyamathur0
This document discusses hyponatremia, defined as a serum sodium level below 135 mmol/L. It outlines that hyponatremia is usually caused by an inability to excrete excess water relative to sodium intake. This can be due to various conditions that cause water retention or limit free water excretion by the kidneys. The key steps in evaluating hyponatremia include checking serum and urine osmolality to distinguish types, and urine sodium to help determine volume status. Treatment involves correcting the underlying cause, restricting water intake if excess intake is the issue, and using diuretics or other drugs in some conditions to help restore normal water balance. Rapid correction of sodium levels is also discussed.
Dr. Vijay Kumar discusses fluid management in the emergency department and intensive care unit. He covers the normal regulation of fluid balance, fluid imbalances that can occur in shock states, and indices used to assess successful fluid resuscitation. Both under-resuscitation and overzealous fluid administration can increase patient morbidity and mortality, so fluid therapy must be carefully titrated based on close monitoring of the patient's hemodynamic status and tissue perfusion.
The document discusses fluid and electrolyte homeostasis in the human body. It covers the different fluid compartments, electrolytes, and mechanisms that control fluid and electrolyte movement. Common fluid and electrolyte imbalances like dehydration, edema, and electrolyte disorders are explained along with their causes, signs and symptoms, and nursing management.
Fluid and electrolyte balances and imbalanceskatherina Rajan
This document discusses fluid and electrolyte balance and disturbances. It covers the mechanisms of fluid and electrolyte movement including osmosis, diffusion, and filtration. It then discusses sodium, potassium, calcium, magnesium, chloride, bicarbonate, and phosphate levels and imbalances including causes, clinical manifestations, and nursing interventions for conditions like hyponatremia, hypernatremia, hypokalemia, hyperkalcemia, hypocalcemia, hypercalcemia, hypomagnesemia, and hypermagnesemia. Food sources of important electrolytes are also provided.
This document discusses electrolyte imbalances, focusing on sodium, potassium, calcium, and magnesium. It provides information on total body water percentages in different age groups. It covers the physiology and normal ranges of various electrolytes, as well as daily electrolyte requirements. Factors that can cause electrolyte imbalances like sodium and potassium deficiencies or excesses are explained. The clinical features, evaluation, and management of conditions like hypernatremia, hyponatremia, and hypokalemia are summarized.
1. The document discusses fluid and electrolyte balance and disturbances, focusing on sodium, potassium, fluid volume deficits, and fluid volume excesses. It describes the regulation of body fluid compartments and how electrolyte imbalances can occur.
2. Specific electrolyte imbalances like hyponatremia, hypernatremia, hypokalemia, and hyperkalemia are explained in terms of their causes, clinical manifestations, and nursing management.
3. Critical thinking exercises are provided to help nurses understand how to assess and care for patients experiencing fluid and electrolyte disturbances like hyponatremia and hypokalemia. Monitoring, diet modifications
The document discusses water and electrolyte balance, which is important for homeostasis. The kidney plays a key role in maintaining circulating volume, osmolality, and electrolyte balance. Fluid volume and electrolyte composition can change pre, intra, and postoperatively due to factors like trauma or sepsis. Total body water is about 60% of body weight, with two thirds being intracellular fluid and one third extracellular fluid including plasma and interstitial fluid. Key electrolytes include sodium, potassium, calcium, and proteins. Precise fluid management is important during the pre, intra, and postoperative periods.
The document discusses disorders of water and electrolyte metabolism. It covers homeostasis of water and electrolytes, common electrolyte imbalances seen in disease, and key mechanisms that regulate fluid and electrolyte balance in the body, including thirst, antidiuretic hormone, aldosterone, and osmoreceptors.
An electrolyte balance occurs when the quantities of electrolytes gained by the body equals the amounts lost. The document discusses various electrolytes including sodium, potassium, calcium, and magnesium. It outlines the regulation and imbalance of electrolytes, describing conditions like hypernatremia, hyponatremia, hypokalemia, and hyperkalemia. Symptoms, causes, and normal ranges are provided for different electrolyte imbalances.
Hypernatremia is defined as a plasma sodium concentration >145 mEq/L. It is usually caused by a water deficit rather than sodium gain. Common causes include impaired thirst, diarrhea, insensible losses from fever/ventilation, and renal losses from osmotic diuresis or diabetes insipidus. Symptoms range from none in chronic cases to neurologic issues like altered mental status. Treatment involves gradually correcting the sodium level by about 10-12 mEq/L/day using oral or IV water while monitoring for complications like cerebral edema. Replacing volume deficits and identifying underlying causes are also important.
The document discusses fluid and electrolyte imbalances in the body. It covers the major fluid compartments, how fluids move between compartments, and the functions of various electrolytes including sodium, potassium, calcium, magnesium, and others. It defines abnormalities such as hyponatremia, hypernatremia, hypokalemia, hyperkalemia, and their typical causes and treatments.
This document discusses fluids and electrolytes in surgical patients. It covers the distribution of fluids in the body, third spacing of fluids, daily fluid balance, classification of IV fluids including crystalloids and colloids, fluid management in the pre-operative, intra-operative and post-operative periods, parenteral nutrition, and electrolyte regulation with a focus on sodium regulation and treatment of hyponatremia. The key aspects of fluid management in surgical patients and correction of fluid and electrolyte imbalances are summarized.
Hypernatremia is a serum sodium level over 145 mEq/L, occurring in 1% of hospitalized patients with high mortality regardless of acute or chronic onset. It can be caused by hypovolemia due to fluid losses exceeding intake, euvolemia from excess skin and lung losses, or hypervolemia from concentrated saline or mineralocorticoid excess. Symptoms include GI issues, dry skin and mucosa, neurologic changes like restlessness and seizures, and cardiovascular abnormalities depending on volume status. Treatment involves gradually decreasing sodium levels with hypotonic fluids and restricting dietary sodium intake.
The document discusses fluid and chemical balance in the human body. It covers various topics such as body fluid compartments, electrolytes, fluid transport mechanisms, fluid imbalances, and intravenous fluid administration. Body fluid consists of water, electrolytes, and blood cells and makes up 45-75% of body weight. Fluid is located in two main compartments: intracellular and extracellular fluid. Common fluid imbalances include hypovolemia, hypervolemia, and third spacing.
This document summarizes key concepts about fluids and electrolytes. It discusses how fluids help maintain body temperature and cell shape while transporting nutrients, gases, and wastes. It describes the different fluid compartments in the body and how fluid moves between compartments via passive diffusion, filtration, and active transport. It also discusses the roles and regulation of important electrolytes like sodium, potassium, calcium, and magnesium.
This document discusses fluid and electrolyte homeostasis in the human body. It begins by outlining the significance and components of body fluids, including their composition and functional roles. Homeostasis and disorders related to fluid volume and concentration are then examined. Specific electrolyte imbalances involving sodium, acid-base balance, potassium, calcium, chloride, and magnesium are explored in depth. Signs, symptoms, causes, and treatment approaches are provided for various electrolyte disturbances. The document concludes by discussing fluid therapy and principles of fluid management.
This document discusses intravenous fluid therapy and transfusion therapy. It provides details on fluid compartments in the body, various intravenous fluid solutions including crystalloids, colloids, isotonic, hypotonic and hypertonic solutions. It describes how to assess fluid status and calculate fluid requirements during surgery. Complications of blood transfusion are outlined as well as components of blood that can be transfused. Vigilance is important when administering blood products due to risks of transfusion reactions and disease transmission.
This document discusses fluid therapy and body fluid compartments. It covers the following key points:
1) The human body contains two main fluid compartments - intracellular fluid (ICF) and extracellular fluid (ECF). ECF is further divided into interstitial fluid, intravascular fluid, and transcellular fluid.
2) Fluid movement between compartments is governed by diffusion, osmosis, osmolality, tonicity, and oncotic pressure. Renal, neuroendocrine, and other physiological systems help regulate fluid balance.
3) Perioperative fluid needs include maintenance requirements, replacing deficits from fasting or losses, accounting for third spacing of fluids, and replacing blood loss.
This document summarizes fluid, electrolyte and acid-base balance. It discusses total body fluid volumes and water balance, fluid compartments, intravascular fluid volume, movement of body fluids through filtration, osmosis and diffusion, and factors affecting fluid and electrolyte movement like osmotic pressure and tonicity. It also covers electrolytes in the extracellular fluid, sodium regulation, water regulation, manifestations of fluid and electrolyte imbalances, and acid-base balance.
The document discusses electrolyte imbalances in the human body. It begins by describing the distribution of body fluids between intracellular fluid (ICF) and extracellular fluid (ECF). It then discusses the major electrolytes - sodium, potassium, calcium, magnesium, chloride and bicarbonate - and how they are regulated. Specific electrolyte imbalances like hyponatremia, hypernatremia, hypokalemia, hyperkalemia, hypocalcemia, hypercalcemia and their causes and symptoms are then outlined. The document concludes by briefly mentioning fluid disturbances like hypochloremia and hyperchloremia.
The document discusses fluid and electrolyte homeostasis in the human body. It defines key terms like homeostasis, electrolytes, osmosis, and body water content. It describes the characteristics, functions and normal ranges of important fluids and electrolytes like sodium, potassium, calcium and magnesium. It also discusses electrolyte abnormalities like hyponatremia, hypernatremia, hypokalemia, and hyperkalemia and their potential causes, clinical signs, and treatment approaches.
This document discusses sodium metabolism and disorders of sodium concentration. It provides details on:
- Water distribution in the body and fluid compartments
- Causes and types of hyponatremia, including hypovolemic, hypervolemic, and euvolemic hyponatremia
- Evaluation and management of hyponatremia, including treatment based on severity and rate of sodium correction
- Causes and clinical features of hypernatremia
The document is a comprehensive review of sodium disorders and approaches to diagnosis and treatment of hypo- and hypernatremia.
Hyponatremia- A low sodium concentration in the bloodbhavyamathur0
This document discusses hyponatremia, defined as a serum sodium level below 135 mmol/L. It outlines that hyponatremia is usually caused by an inability to excrete excess water relative to sodium intake. This can be due to various conditions that cause water retention or limit free water excretion by the kidneys. The key steps in evaluating hyponatremia include checking serum and urine osmolality to distinguish types, and urine sodium to help determine volume status. Treatment involves correcting the underlying cause, restricting water intake if excess intake is the issue, and using diuretics or other drugs in some conditions to help restore normal water balance. Rapid correction of sodium levels is also discussed.
Dr. Vijay Kumar discusses fluid management in the emergency department and intensive care unit. He covers the normal regulation of fluid balance, fluid imbalances that can occur in shock states, and indices used to assess successful fluid resuscitation. Both under-resuscitation and overzealous fluid administration can increase patient morbidity and mortality, so fluid therapy must be carefully titrated based on close monitoring of the patient's hemodynamic status and tissue perfusion.
The document discusses fluid and electrolyte homeostasis in the human body. It covers the different fluid compartments, electrolytes, and mechanisms that control fluid and electrolyte movement. Common fluid and electrolyte imbalances like dehydration, edema, and electrolyte disorders are explained along with their causes, signs and symptoms, and nursing management.
Fluid and electrolyte balances and imbalanceskatherina Rajan
This document discusses fluid and electrolyte balance and disturbances. It covers the mechanisms of fluid and electrolyte movement including osmosis, diffusion, and filtration. It then discusses sodium, potassium, calcium, magnesium, chloride, bicarbonate, and phosphate levels and imbalances including causes, clinical manifestations, and nursing interventions for conditions like hyponatremia, hypernatremia, hypokalemia, hyperkalcemia, hypocalcemia, hypercalcemia, hypomagnesemia, and hypermagnesemia. Food sources of important electrolytes are also provided.
This document discusses electrolyte imbalances, focusing on sodium, potassium, calcium, and magnesium. It provides information on total body water percentages in different age groups. It covers the physiology and normal ranges of various electrolytes, as well as daily electrolyte requirements. Factors that can cause electrolyte imbalances like sodium and potassium deficiencies or excesses are explained. The clinical features, evaluation, and management of conditions like hypernatremia, hyponatremia, and hypokalemia are summarized.
1. The document discusses fluid and electrolyte balance and disturbances, focusing on sodium, potassium, fluid volume deficits, and fluid volume excesses. It describes the regulation of body fluid compartments and how electrolyte imbalances can occur.
2. Specific electrolyte imbalances like hyponatremia, hypernatremia, hypokalemia, and hyperkalemia are explained in terms of their causes, clinical manifestations, and nursing management.
3. Critical thinking exercises are provided to help nurses understand how to assess and care for patients experiencing fluid and electrolyte disturbances like hyponatremia and hypokalemia. Monitoring, diet modifications
The document discusses water and electrolyte balance, which is important for homeostasis. The kidney plays a key role in maintaining circulating volume, osmolality, and electrolyte balance. Fluid volume and electrolyte composition can change pre, intra, and postoperatively due to factors like trauma or sepsis. Total body water is about 60% of body weight, with two thirds being intracellular fluid and one third extracellular fluid including plasma and interstitial fluid. Key electrolytes include sodium, potassium, calcium, and proteins. Precise fluid management is important during the pre, intra, and postoperative periods.
The document discusses disorders of water and electrolyte metabolism. It covers homeostasis of water and electrolytes, common electrolyte imbalances seen in disease, and key mechanisms that regulate fluid and electrolyte balance in the body, including thirst, antidiuretic hormone, aldosterone, and osmoreceptors.
An electrolyte balance occurs when the quantities of electrolytes gained by the body equals the amounts lost. The document discusses various electrolytes including sodium, potassium, calcium, and magnesium. It outlines the regulation and imbalance of electrolytes, describing conditions like hypernatremia, hyponatremia, hypokalemia, and hyperkalemia. Symptoms, causes, and normal ranges are provided for different electrolyte imbalances.
Hypernatremia is defined as a plasma sodium concentration >145 mEq/L. It is usually caused by a water deficit rather than sodium gain. Common causes include impaired thirst, diarrhea, insensible losses from fever/ventilation, and renal losses from osmotic diuresis or diabetes insipidus. Symptoms range from none in chronic cases to neurologic issues like altered mental status. Treatment involves gradually correcting the sodium level by about 10-12 mEq/L/day using oral or IV water while monitoring for complications like cerebral edema. Replacing volume deficits and identifying underlying causes are also important.
The document discusses fluid and electrolyte imbalances in the body. It covers the major fluid compartments, how fluids move between compartments, and the functions of various electrolytes including sodium, potassium, calcium, magnesium, and others. It defines abnormalities such as hyponatremia, hypernatremia, hypokalemia, hyperkalemia, and their typical causes and treatments.
This document discusses fluids and electrolytes in surgical patients. It covers the distribution of fluids in the body, third spacing of fluids, daily fluid balance, classification of IV fluids including crystalloids and colloids, fluid management in the pre-operative, intra-operative and post-operative periods, parenteral nutrition, and electrolyte regulation with a focus on sodium regulation and treatment of hyponatremia. The key aspects of fluid management in surgical patients and correction of fluid and electrolyte imbalances are summarized.
Hypernatremia is a serum sodium level over 145 mEq/L, occurring in 1% of hospitalized patients with high mortality regardless of acute or chronic onset. It can be caused by hypovolemia due to fluid losses exceeding intake, euvolemia from excess skin and lung losses, or hypervolemia from concentrated saline or mineralocorticoid excess. Symptoms include GI issues, dry skin and mucosa, neurologic changes like restlessness and seizures, and cardiovascular abnormalities depending on volume status. Treatment involves gradually decreasing sodium levels with hypotonic fluids and restricting dietary sodium intake.
The document discusses fluid and chemical balance in the human body. It covers various topics such as body fluid compartments, electrolytes, fluid transport mechanisms, fluid imbalances, and intravenous fluid administration. Body fluid consists of water, electrolytes, and blood cells and makes up 45-75% of body weight. Fluid is located in two main compartments: intracellular and extracellular fluid. Common fluid imbalances include hypovolemia, hypervolemia, and third spacing.
This document summarizes key concepts about fluids and electrolytes. It discusses how fluids help maintain body temperature and cell shape while transporting nutrients, gases, and wastes. It describes the different fluid compartments in the body and how fluid moves between compartments via passive diffusion, filtration, and active transport. It also discusses the roles and regulation of important electrolytes like sodium, potassium, calcium, and magnesium.
1) The document discusses body fluids and electrolytes, including total body water content, intracellular fluid, extracellular fluid, and the normal exchange between fluid compartments.
2) Volume deficits (dehydration) and volume excess are described, along with their causes, signs and symptoms, and assessment. Ongoing fluid losses are also discussed.
3) Sodium balance and disorders like hyponatremia and hypernatremia are covered, including definitions, causes, and approaches to determining the type and treating each condition.
Here are some potential causes of dilutional hyponatremia:
- Congestive heart failure (CHF) - excess fluid retention
- Renal failure - inability to excrete free water normally
- Syndrome of inappropriate antidiuretic hormone secretion (SIADH) - excessive ADH levels which cause water retention
- Addison's disease - lack of aldosterone leads to sodium and water loss
This document provides an overview of fluids and electrolytes in the human body. It discusses several key points:
- Water comprises 60-70% of total body weight and plays important roles in transport, metabolism, and maintaining homeostasis.
- Electrolytes like sodium, potassium, calcium, and chloride are important for cellular function, nerve impulse transmission, muscle contraction, and acid-base balance.
- Fluid levels and electrolyte concentrations are tightly regulated and can become imbalanced through various causes, resulting in conditions like dehydration, hyponatremia, or hypokalemia.
- Symptoms of electrolyte imbalances depend on which electrolyte is affected but may include muscle cramps
Intravenous fluid administration is an effective method for rapidly delivering large volumes of fluid directly into the bloodstream. It allows for immediate correction of fluid and electrolyte imbalances. The main advantages are precise control over volume and rate of fluid delivery compared to other administration methods. The document discusses the roles and normal ranges of important electrolytes in the body like sodium, potassium, calcium, magnesium, and others. It also covers intravenous fluid types like normal saline, Ringer's lactate, and plasma volume expanders.
This document discusses fluid and electrolyte balance in the body. It covers several key points:
1) Water makes up 55-60% of adult body weight and is essential for life. Loss of 10% body fluid leads to an 8% weight loss and is serious, while a 20% loss is fatal.
2) Body fluids have several important functions including transport, metabolism, temperature regulation, and lubrication. Fluids move between intracellular and extracellular spaces through mechanisms like osmosis and filtration.
3) The body tightly regulates fluid balance through systems like thirst, vasopressin release, the renin-angiotensin system, and aldosterone. Disruptions can cause fluid volume
The document discusses fluids and electrolytes in the human body. It explains that 60% of the body's weight is fluid located in two compartments: intracellular and extracellular. The extracellular fluid is further divided. Loss of extracellular fluid into a third space can cause a decrease in urine output. Electrolytes like sodium, potassium, calcium, and magnesium are discussed. The kidneys and adrenal glands help regulate fluids and electrolytes. Dehydration and overhydration are explained. Diuretics are drugs that increase urine output and are used to treat fluid volume excess. Common types of diuretics include loop diuretics, thiazides, potassium-sparing diuretics, and osmotic diure
The document discusses homeostasis of body fluids. It describes how the body maintains fluid balance through balancing fluid intake and output. Key body fluid compartments include intracellular fluid and extracellular fluid such as interstitial fluid and plasma. Homeostasis relies on mechanisms like osmosis, diffusion and active transport of fluids between compartments. The kidneys play an important role in regulating fluid balance and electrolyte levels through urine output. Imbalances can lead to conditions like edema, with dehydration classified as isotonic, hypertonic or hypotonic based on electrolyte disturbances.
This document discusses fluid, electrolyte and acid-base balance. It describes how the body maintains balance through mechanisms like antidiuretic hormone and aldosterone-renin-angiotensin system. It addresses fluid deficits and excess, and how they impact electrolytes and acid-base balance. Clinical signs and collaborative care approaches are outlined.
Fluid and electrolyte imbalance [autosaved]Jays George
This document discusses fluid and electrolyte imbalance. It begins by explaining the importance of fluid and electrolytes in maintaining homeostasis. It then defines key terms like homeostasis, osmolality, diffusion, isotonic solutions, and active transport. The document goes on to describe different fluid imbalances like extracellular fluid volume deficit, third spacing of fluids, and intracellular fluid volume excess. It also covers various electrolyte imbalances including hypocalcemia, hypokalemia, hyperkalemia, hyponatremia, and hypernatremia. For each imbalance, it discusses etiology, clinical manifestations, laboratory findings, and treatment approaches.
This document provides an overview of fluid management for a patient admitted to the ICU. It discusses fluid types, their components and uses. It describes how to assess a patient's fluid status and calculate fluid requirements. The document outlines fluid monitoring, electrolyte disorders like hyponatremia and hypernatremia, and their management. It emphasizes the importance of maintaining fluid balance and addressing imbalances to support organ function.
The document provides definitions and explanations of terms related to fluid and electrolyte balance. It discusses the normal fluid intake and loss in adults, fluid compartments in the body, mechanisms of fluid transport, electrolyte imbalances including sodium and potassium, types of IV solutions, and classifications and nursing management of burns.
This document provides an overview of fluid and electrolyte imbalance. It defines key terms related to fluid balance and distribution in the body. It describes the regulation of fluid balance through hormones like aldosterone and ADH. Common fluid and electrolyte abnormalities are explained such as dehydration, edema, and various electrolyte imbalances. Treatment approaches are briefly outlined. Overall, the document serves as an introductory seminar covering the basics of fluid and electrolyte balance and potential imbalances in the human body.
Last year by end of the lecture Dr Medinna gave cases to solve for Fluid and electrolytes....
He had a seperate slide for the cases..
Lecture slides are taken from Schwartz Textbook of surgery....
Fluid and electrolytes (celestesversion) 3Celeste Grossi
This document discusses homeostasis and fluid balance. It covers the body's mechanisms for maintaining fluid balance, including the roles of the kidneys, hypothalamus, and heart. It defines key terms like electrolytes, osmolality, and the three fluid compartments. It also examines causes, signs, and treatments of fluid volume deficits and excesses, as well as various electrolyte imbalances. Nursing considerations are outlined for assessing and managing patients with fluid and electrolyte disorders.
The document discusses care of patients with fluid and electrolyte imbalances. It describes various conditions like acidosis, alkalosis, and dehydration. It explains that the body contains two fluid compartments - intracellular and extracellular space. Approximately 60% of body weight is water and electrolytes. Factors like age, gender, and body fat influence fluid levels. The document outlines electrolyte levels in extracellular and intracellular fluids and lists various tests to evaluate fluid status like osmolality, specific gravity, BUN, creatinine, hematocrit, and sodium levels.
The document discusses dialysis as a renal replacement therapy for patients with kidney failure or injury. It describes the process of diffusion and ultrafiltration that occurs during hemodialysis and peritoneal dialysis to remove waste and excess fluid. Complications related to each type of dialysis are also outlined. Nursing considerations are provided for pre-dialysis assessment, monitoring patients during treatment, and post-dialysis care.
This document discusses the amount and composition of body fluids, electrolytes, and the regulation of fluid movement and body fluid compartments. It describes how the kidneys, lungs, gastrointestinal tract, and other mechanisms help regulate fluid volume and balance. Potential fluid volume imbalances like dehydration, fluid volume deficit, and fluid volume excess are explained. Electrolyte imbalances involving sodium, potassium, calcium, and other electrolytes are also summarized.
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The female pelvis is comprised of four bones - the two innominate bones, sacrum, and coccyx. It has several diameters and landmarks that are important for childbirth. The pelvis can be divided into the false pelvis, pelvic inlet, cavity, and outlet. The inlet is defined by the symphysis pubis, sacral promontory, and iliac bones. Its diameters include the true conjugate, obstetric conjugate, and transverse. The cavity and outlet also have anteroposterior and transverse diameters that are measured. Knowledge of the bones, diameters, and landmarks of the female pelvis is essential for midwives during labor and delivery.
This document provides an overview of education concepts including definitions of education, aims of education, concepts of education, philosophies of education, and the impact of social changes on education. It defines education according to different philosophers like Gandhi, Pestalozzi, and Dewey. It outlines the aims of education including utilitarian, knowledge, culture, character development, and more. The concepts of Indian and Western education are presented. Several philosophies of education are described like idealism, realism, naturalism, pragmatism, and modern philosophies. Factors influencing social change and how it impacts education are also summarized.
This document defines nursing as a profession and discusses its key characteristics. It provides definitions of nursing from several sources that describe nursing as caring for individuals' health and assisting them in recovery. The document also outlines concepts in nursing like health, illness, and stress. It states nursing encompasses the art and science of providing preventive, acute, and chronic care while working to promote physical and mental health.
UNIT 1 INTRODUCTION FUNDAMENTALS OF NURSINGVemuJhansi
The document discusses various concepts of health including biomedical, ecological, psychosocial, and holistic concepts. It also discusses the World Health Organization's definition of health as a state of complete physical, mental, social, and spiritual well-being. Multiple dimensions of health are explored including physical, mental, social, and spiritual dimensions. Models of health and illness are presented including the clinical model, role performance model, adaptive model, and agent-host-environment model.
Documentation and reporting are important communication techniques for healthcare providers. Documentation provides a written record of interactions between healthcare professionals and clients, as well as test results, treatments, and client responses. Reporting involves sharing client care information between two or more people. The purposes of client records include communication, legal documentation, research, education, quality assurance, and reimbursement. Effective documentation is accurate, complete, organized, and uses common terminology and abbreviations. Common types of records include nursing assessments, care plans, flow charts, and progress notes.
Isolation precautions are special measures used to prevent the spread of contagious diseases. They include wearing protective equipment like gloves, gowns, goggles and masks. Isolation precautions have two main purposes - to prevent cross-contamination between patients and staff, and to contain infectious disease agents and body fluids. The types of isolation are standard precautions, and transmission-based precautions including airborne, droplet and contact precautions. Healthcare workers must follow basic principles like hand washing and careful disposal of contaminated materials.
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Philippine Edukasyong Pantahanan at Pangkabuhayan (EPP) CurriculumMJDuyan
(𝐓𝐋𝐄 𝟏𝟎𝟎) (𝐋𝐞𝐬𝐬𝐨𝐧 𝟏)-𝐏𝐫𝐞𝐥𝐢𝐦𝐬
𝐃𝐢𝐬𝐜𝐮𝐬𝐬 𝐭𝐡𝐞 𝐄𝐏𝐏 𝐂𝐮𝐫𝐫𝐢𝐜𝐮𝐥𝐮𝐦 𝐢𝐧 𝐭𝐡𝐞 𝐏𝐡𝐢𝐥𝐢𝐩𝐩𝐢𝐧𝐞𝐬:
- Understand the goals and objectives of the Edukasyong Pantahanan at Pangkabuhayan (EPP) curriculum, recognizing its importance in fostering practical life skills and values among students. Students will also be able to identify the key components and subjects covered, such as agriculture, home economics, industrial arts, and information and communication technology.
𝐄𝐱𝐩𝐥𝐚𝐢𝐧 𝐭𝐡𝐞 𝐍𝐚𝐭𝐮𝐫𝐞 𝐚𝐧𝐝 𝐒𝐜𝐨𝐩𝐞 𝐨𝐟 𝐚𝐧 𝐄𝐧𝐭𝐫𝐞𝐩𝐫𝐞𝐧𝐞𝐮𝐫:
-Define entrepreneurship, distinguishing it from general business activities by emphasizing its focus on innovation, risk-taking, and value creation. Students will describe the characteristics and traits of successful entrepreneurs, including their roles and responsibilities, and discuss the broader economic and social impacts of entrepreneurial activities on both local and global scales.
Chapter wise All Notes of First year Basic Civil Engineering.pptxDenish Jangid
Chapter wise All Notes of First year Basic Civil Engineering
Syllabus
Chapter-1
Introduction to objective, scope and outcome the subject
Chapter 2
Introduction: Scope and Specialization of Civil Engineering, Role of civil Engineer in Society, Impact of infrastructural development on economy of country.
Chapter 3
Surveying: Object Principles & Types of Surveying; Site Plans, Plans & Maps; Scales & Unit of different Measurements.
Linear Measurements: Instruments used. Linear Measurement by Tape, Ranging out Survey Lines and overcoming Obstructions; Measurements on sloping ground; Tape corrections, conventional symbols. Angular Measurements: Instruments used; Introduction to Compass Surveying, Bearings and Longitude & Latitude of a Line, Introduction to total station.
Levelling: Instrument used Object of levelling, Methods of levelling in brief, and Contour maps.
Chapter 4
Buildings: Selection of site for Buildings, Layout of Building Plan, Types of buildings, Plinth area, carpet area, floor space index, Introduction to building byelaws, concept of sun light & ventilation. Components of Buildings & their functions, Basic concept of R.C.C., Introduction to types of foundation
Chapter 5
Transportation: Introduction to Transportation Engineering; Traffic and Road Safety: Types and Characteristics of Various Modes of Transportation; Various Road Traffic Signs, Causes of Accidents and Road Safety Measures.
Chapter 6
Environmental Engineering: Environmental Pollution, Environmental Acts and Regulations, Functional Concepts of Ecology, Basics of Species, Biodiversity, Ecosystem, Hydrological Cycle; Chemical Cycles: Carbon, Nitrogen & Phosphorus; Energy Flow in Ecosystems.
Water Pollution: Water Quality standards, Introduction to Treatment & Disposal of Waste Water. Reuse and Saving of Water, Rain Water Harvesting. Solid Waste Management: Classification of Solid Waste, Collection, Transportation and Disposal of Solid. Recycling of Solid Waste: Energy Recovery, Sanitary Landfill, On-Site Sanitation. Air & Noise Pollution: Primary and Secondary air pollutants, Harmful effects of Air Pollution, Control of Air Pollution. . Noise Pollution Harmful Effects of noise pollution, control of noise pollution, Global warming & Climate Change, Ozone depletion, Greenhouse effect
Text Books:
1. Palancharmy, Basic Civil Engineering, McGraw Hill publishers.
2. Satheesh Gopi, Basic Civil Engineering, Pearson Publishers.
3. Ketki Rangwala Dalal, Essentials of Civil Engineering, Charotar Publishing House.
4. BCP, Surveying volume 1
The chapter Lifelines of National Economy in Class 10 Geography focuses on the various modes of transportation and communication that play a vital role in the economic development of a country. These lifelines are crucial for the movement of goods, services, and people, thereby connecting different regions and promoting economic activities.
ISO/IEC 27001, ISO/IEC 42001, and GDPR: Best Practices for Implementation and...PECB
Denis is a dynamic and results-driven Chief Information Officer (CIO) with a distinguished career spanning information systems analysis and technical project management. With a proven track record of spearheading the design and delivery of cutting-edge Information Management solutions, he has consistently elevated business operations, streamlined reporting functions, and maximized process efficiency.
Certified as an ISO/IEC 27001: Information Security Management Systems (ISMS) Lead Implementer, Data Protection Officer, and Cyber Risks Analyst, Denis brings a heightened focus on data security, privacy, and cyber resilience to every endeavor.
His expertise extends across a diverse spectrum of reporting, database, and web development applications, underpinned by an exceptional grasp of data storage and virtualization technologies. His proficiency in application testing, database administration, and data cleansing ensures seamless execution of complex projects.
What sets Denis apart is his comprehensive understanding of Business and Systems Analysis technologies, honed through involvement in all phases of the Software Development Lifecycle (SDLC). From meticulous requirements gathering to precise analysis, innovative design, rigorous development, thorough testing, and successful implementation, he has consistently delivered exceptional results.
Throughout his career, he has taken on multifaceted roles, from leading technical project management teams to owning solutions that drive operational excellence. His conscientious and proactive approach is unwavering, whether he is working independently or collaboratively within a team. His ability to connect with colleagues on a personal level underscores his commitment to fostering a harmonious and productive workplace environment.
Date: May 29, 2024
Tags: Information Security, ISO/IEC 27001, ISO/IEC 42001, Artificial Intelligence, GDPR
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This presentation was provided by Rebecca Benner, Ph.D., of the American Society of Anesthesiologists, for the second session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session Two: 'Expanding Pathways to Publishing Careers,' was held June 13, 2024.
Temple of Asclepius in Thrace. Excavation resultsKrassimira Luka
The temple and the sanctuary around were dedicated to Asklepios Zmidrenus. This name has been known since 1875 when an inscription dedicated to him was discovered in Rome. The inscription is dated in 227 AD and was left by soldiers originating from the city of Philippopolis (modern Plovdiv).
Walmart Business+ and Spark Good for Nonprofits.pdfTechSoup
"Learn about all the ways Walmart supports nonprofit organizations.
You will hear from Liz Willett, the Head of Nonprofits, and hear about what Walmart is doing to help nonprofits, including Walmart Business and Spark Good. Walmart Business+ is a new offer for nonprofits that offers discounts and also streamlines nonprofits order and expense tracking, saving time and money.
The webinar may also give some examples on how nonprofits can best leverage Walmart Business+.
The event will cover the following::
Walmart Business + (https://business.walmart.com/plus) is a new shopping experience for nonprofits, schools, and local business customers that connects an exclusive online shopping experience to stores. Benefits include free delivery and shipping, a 'Spend Analytics” feature, special discounts, deals and tax-exempt shopping.
Special TechSoup offer for a free 180 days membership, and up to $150 in discounts on eligible orders.
Spark Good (walmart.com/sparkgood) is a charitable platform that enables nonprofits to receive donations directly from customers and associates.
Answers about how you can do more with Walmart!"
Level 3 NCEA - NZ: A Nation In the Making 1872 - 1900 SML.pptHenry Hollis
The History of NZ 1870-1900.
Making of a Nation.
From the NZ Wars to Liberals,
Richard Seddon, George Grey,
Social Laboratory, New Zealand,
Confiscations, Kotahitanga, Kingitanga, Parliament, Suffrage, Repudiation, Economic Change, Agriculture, Gold Mining, Timber, Flax, Sheep, Dairying,
Beyond Degrees - Empowering the Workforce in the Context of Skills-First.pptxEduSkills OECD
Iván Bornacelly, Policy Analyst at the OECD Centre for Skills, OECD, presents at the webinar 'Tackling job market gaps with a skills-first approach' on 12 June 2024
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إضغ بين إيديكم من أقوى الملازم التي صممتها
ملزمة تشريح الجهاز الهيكلي (نظري 3)
💀💀💀💀💀💀💀💀💀💀
تتميز هذهِ الملزمة بعِدة مُميزات :
1- مُترجمة ترجمة تُناسب جميع المستويات
2- تحتوي على 78 رسم توضيحي لكل كلمة موجودة بالملزمة (لكل كلمة !!!!)
#فهم_ماكو_درخ
3- دقة الكتابة والصور عالية جداً جداً جداً
4- هُنالك بعض المعلومات تم توضيحها بشكل تفصيلي جداً (تُعتبر لدى الطالب أو الطالبة بإنها معلومات مُبهمة ومع ذلك تم توضيح هذهِ المعلومات المُبهمة بشكل تفصيلي جداً
5- الملزمة تشرح نفسها ب نفسها بس تكلك تعال اقراني
6- تحتوي الملزمة في اول سلايد على خارطة تتضمن جميع تفرُعات معلومات الجهاز الهيكلي المذكورة في هذهِ الملزمة
واخيراً هذهِ الملزمة حلالٌ عليكم وإتمنى منكم إن تدعولي بالخير والصحة والعافية فقط
كل التوفيق زملائي وزميلاتي ، زميلكم محمد الذهبي 💊💊
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2. Fluid and Electrolytes
60% of body consists of fluid
Intracellular space [2/3]
Extracellular space [1/3]
Electrolytes are active ions:
positively and negatively
charged
3.
4.
5. Mechanisms controlling fluid
and electrolyte movement:
1) Electrolyte moves by - Simple diffusion
- Facilitated diffusion
- Active transport
2) Water moves by - Hydrostatic pressure
- Osmotic pressure
6. DIFFUSION
Diffusion is the movement of a substance
from area of higher concentration to one of
lower
concentration
“Downhill
Movement”
7. FACILITATED DIFFUSION
The molecules from an area of high
concentration to one of low
concentration
It is passive. Requires no energy
other than that of the concentration
gradient
Ex- glucose transport into the cell
14. Fluid shifts
If capillary interstitial pressure altered fluid
abnormally shift from one compartment to
another
Shift of plasma to interstitial –
Accumulation of fluid in the interstitial
occurs if venous hydrostatic pressure raises,
plasma oncotic pressure decreases
15. Elevation of venous hydrostatic pressure
– causes fluid overload, heart failure, liver
failure, obstruction to venous return to the
heart
Decrease in plasma oncotic pressure –
results excessive protein loss, deficient
protein synthesis.
Elevation of interstitial oncotic pressure –
trauma, burn, inflammation
16. Shift of interstitial fluid to
plasma
Fluid is drawn into the plasma whenever
there is an increase in the oncotic pressure
Ex- administration of colloids, dextral,
Manito, hypertonic solutions
Increasing the hydrostatic pressure in the
way of causing shift of fluid into the plasma
Ex- wearing stockings
17. Fluid movement between
Extra cellular and intra
cellular:
1. Increased ICF osmolarity (water
deficit)
2. Decreased ESF osmolarity (water
excess)
18. Fluid spacing
The distribution of water:
first spacing – normal distribution of body
water
second spacing – abnormal accumulation
of interstitial fluid Ex- edema
Third spacing – fluid accumulate in a
portion of the body from which it is not
freely. Exchanged with the rest of ECF Ex-
ascites, peritonitis.
21. Nursing Diagnosis and
Goal
Fluid volume excess r/t CHF, excess sodium
intake, renal failure:
Weight gain of 6 lb. in 24 hours; lungs with
crackles in bases bilaterally; 2+ edema in
ankles bilaterally
Goal: Client will have normal fluid volume within
48 hours :
Decreased weight of 1 lb. per day, lung sounds
clear in all fields, ankles without edema
23. Fluid Volume Deficit
Mild – 2% of body weight loss
Moderate – 5% of body weight loss
Severe – 8% or more of body
weight loss
24. Nursing Diagnosis
Fluid volume Deficit r/t
Insufficient intake, vomiting, diarrhea,
hemorrhage m/b dry mucous membranes, low
BP, BUN 28, Na 152, urine dark amber; Intake
200mL/Output 450mL over 24 hours
Goal: Client will have adequate fluid volume
within 24 hours :
Moist tongue, mucous membranes, BUN
between 8-20, Na 135-145, Urine clear yellow,
balanced I/O
25. Fluid Volume Deficit 5
Nursing management
- Restore fluids by oral or IV
- Treat underlying cause
- Monitor I & O at least every 8 hours
- Daily weight
- Vital signs
- Skin turgor
- Urine concentration
27. III. Extra cellular fluid
volume shift
Third space fluid
Definition
“A fluid shift basically a change in
the location of ECF between the
intracellular and interstitial space”
28. Types
vascular fluid to interstitial space
interstitial fluid to vascular fluid
space
(Third space fluid physiologically useless
because it does not circulate nutrients to
cells.)
29. Etiology
Any pathological process that triggers the
inflammatory or ischemic process can
leads to fluid shifting.
Crushing injury
Extensive burns
Acid base imbalance
Bowl obstruction: that reduce protein
absorption can reduce sodium levels
30. Perforated peptic ulcer
Intestinal obstruction
Lymphatic obstruction,
Large venous thrombosis: it impaired fluid
return to the right atrium, thus promoting
third- spacing
Pleural and pericardial shifts are secondary
to inflammatory responses to infectious, non
infectious, autoimmune disorders
31. Risk factors
Client at risk of third space fluids
are those who have sustained
major trauma or major surgery
32. Pathophysiology
Tissue injury
↓
Release of histamine and bradikinin
↓
Increases capillary permeability
↓
Shift of fluid, protein and other solutes to interstitial
space
↓ ↓
1st phase 2sd phase
Hypovolemia Hypervolemia
33. Clinical manifestations
Mostly similar to the manifestations of hypovolemia
because the fluid is not in the vascular system.
Pale and cold limbs
Pallor
Weak and rapid pulse
Hypotension
Increased skin turgor
Decreased level of conscious
Enlargement of peripheral and jugular veins
Crackles
If sever it leads to hypovolemic shock
34. Diagnosis
History
Physical examination
Laboratory tests – if fluid collects and
obstruct any organs, blood, or veins there
is increase hematocrit, sodium, BUN,
urine specific gravity
35. Medical management
Paracenthesis
# If third space causing bowel obstruction
Paracenthesis is done
Replace the fluids
# Hypervolemia – a large volume of isotonic IV
fluids administered to replace intravascular
volume. This is to maintain kidney perfusion.
# Albumin may be given to replace protein lost
from trauma and to promote restoration of
capillary oncotic pressure
36. Stabilize other problems
Diagnosis of sepsis by culture and treatment
is with antibiotics
Vaso active medication to maintain blood
pressure
Repair of bowel obstruction
Treatment of inflammatory bowel disorders –
administer steroids to stabilize the mast cell
membrane
37. Nursing management
Assess the vital signs every 1-8 hrs , if
shock is present assess vital signs every
hour
Monitor IV fluid replacement
Assess for early signs of fluid over load
Measure abdominal girth every 8 hrs in case
of ascites
Monitor urine out put every 1 hr and report
an output less than 30ml / hr
Monitor plasma levels of BUN
38. IV. Intracellular fluid
volume excess
Water intoxication
The cells are quite resistant to
fluid shifts, certain conditions can
lead to an intracellular fluid volume
excess (ICFVE)
39. Causes
Administration of excessive amounts of
hypo-osmolar IV fluids such as 0.45 % NS,
5% D water
Older clients who consume more tap water
without nutrient intake.
Psychiatric disorders (schizophrenia) –
often have compulsive water consumption
behaviors (80% cases)
40. Pathophysiology
Hypo-osmolar fluids in the vessels move by osmosis to
region of higher concentration of sodium in the cells in an
attempt to maintain equilibrium.
Unfortunately too much fluid accumulates in the cells
causing cellular edema.
Cerebral cells absorb hypos molar fluid more quickly
that do other cells.
Thus these cell changes lead to Intracellular fluid
volume excess
41. Clinical manifestations
Increasing intracranial pressure
Altered vital signs : when pressure is
at the level of the hypothalamus and
brain stem
Decreased level of consciousness
Altered papillary changes
43. Management
Medical management
To reduce ICP
Steroids and osmotic diuretics
Administration of IV fluids containing
Nacl, Administration of saline solutions
ex – 5%D, 0.45% Nacl increases
osmolarity
Elevate the head end of the bed 30-45
degrees
44. Nursing management
Perform neurological checks every 1hr
level of consciousness
vital signs
reflexes
papillary responses
Monitor intake and out put hourly
Notify the physician if the client sensorial changes
and if systolic blood pressure less than 100 mmHg
or greater than 150 mmhg
Monitor weight daily
45. Administer antiemetic prophylactic ally – to promote
food and fluid ingestion and to decrease the risk of
vomiting, which worsens the increased ICP
Provide safety measures , if behavioral changes
occur such as confusion or disorientation
Keep the bed in low position with bed side rails
raised
Keep the suction equipment at the bed side in
anticipation of seizures
If the patient has seizures, turn the client to one side
to displace the tongue
Document all phase’s seizures
Monitor increased ICP improving
47. Hyponatremia (Sodium)
Normal range – 135 to 145 m E q/L
- Primary regulator of ECF volume (a loss
or gain of sodium is usually accompanied
by a loss or gain of water)
Sodium level less than 135 m E q/L
48. Critical Thinking Exercise: Nursing
Management of the Client with
Hyponatremia
Situation: An 87 year old man was
admitted to the acute care facility for
gastroenteritis, 2 day duration. He is
vomiting, has severe, watery diarrhea
and is c/o abd cramping. His serum
electrolytes are consistent with
hyponatremia r/t excessive sodium loss.
49. Critical Thinking Exercise: Nursing
Management of the Client with
Hyponatremia 2
1. What is the relationship between
vomiting, diarrhea, and hyponatremia?
2. What s/s should the client be
monitored for that indicate the presence
of sodium deficit?
3. In addition to examining the client’s
serum electrolyte findings, how will the
nurse know when the client’s sodium
level has returned to normal?
50. Hypernatremia
Sodium level is greater than 145 mEq/L
Can be caused by a gain of sodium in
excess of water or by a loss of water in
excess of sodium
51.
52. Critical Thinking Exercise:
Nursing Management of the
Client with Hypernatremia
Situation: A 47 year old woman was taken to
the ER after she developed a rapid heart rate
and agitation. Physical assessment revealed
dry oral mucous membranes, poor skin turgor,
and fever of 101.3 orally. The client’s daughter
stated her mother had been very hungry
recently and drinking more fluids than usual.
Suspecting DM, the practitioner obtained
serum electrolytes and glucose levels, which
revealed serum sodium of 163 mEq/L and
serum glucose of 360 mg/dL.
53. Critical Thinking Exercise:
Nursing Management of the
Client with Hypernatremia 2
1. Interpret the client’s lab data.
2. Why are clients with DM prone to the
development of hypernatremia?
3. What precautions should the nurse take
when caring for the client with hypernatremia?
4. List 4 food items this client should avoid and
why.
5. Identify 3 meds that could have an increased
effect on the client’s sodium level.
55. All About Potassium
Major Intracellular electrolyte
98% of the body’s potassium is inside the
cells
Influences both skeletal and cardiac
muscle activity
Normal serum potassium
concentration –
3.5 to 5.5 mEq/L.
57. Cause
Actual total body potassium loss
Excessive use of diuretics and corticosteroids
Increased secretion of aldosterone Ex Cushing’s
syndrome
Vomiting, diarrhea, Prolonged NG tube suction
Excessive diaphoresis
Renal disease impairing reabsorption of potassium
Inadequate potassium intake – nothing by mouth
Movement of potassium from ECF to ICF
Alkalosis
Hyperinsulism
58. Clinical manifestations
Cardiovascular
Thready, weak, irregular pulse
Peripheral pulse weak
Orthostatic hypotension
ECG changes – ST depression, shallow.
Flat or inverted T wave. Prominent U wave
59. Respiratory
Shallow ineffective respiration that results
in profound weakness of skeletal muscle
of respiration
Diminished breath sounds
Neuromuscular
Anxiety, lethargy, confusion, coma
Skeletal muscle weakness, flaccid
paralysis
Loss of tactile discrimination
61. Management
Monitor cardiovascular, respiratory status
Place the client on a cardiac monitor
Monitor electrolyte value
Administer potassium supplements orally
or IV as prescribed
Oral potassium supplements – should not
be taken on empty stomach
Liquid potassium supplements – should
be taken with juice or other liquids
62. Take the following precautions with IV
administration of potassium
Potassium never given by IV push, IM, Sc
The dilution not more than1mEq / 10ml of solution
After adding potassium to IV solution shake the
bag and invert it to ensure that potassium is
distributed evenly throughout the IV solution
The maximum recommended infusion rate is 5-10
mEq/hr, never exceed 20 mEq / hr
A client receiving more than 10 mEq / hr should be
placed on a cardiac monitor and monitor for
cardiac changes
63. Potassium infusion can cause phlebitis or infiltration. If
it occurs stop the infusion immediately
The nurse should asses the renal function before
administering potassium and monitor intake and
output during administration
Institute safety measures for the client experiencing
muscle weakness
If the client is taking potassium losing diuretic, it may
be discontinued; a potassium sparing diuretic may be
prescribed
Instruct the client about foods that are high in
potassium content
Ex – bananas, carrots, oranges, tomatoes, potatoes.
64. Hyperkalemia
Serum Potassium greater than 5.5 mEq/L
- More dangerous than hypokalemia
because cardiac arrest is frequently
associated with high serum K+ levels
69. Neuromuscular
Early – muscle switches, cramps,
parasthesia
Late – profound weakness, ascending
flaccid paralysis in the arms and legs
Gastrointestinal
Increased motility, hyperactive bowel
sounds
Diarrhea
70. Management
Monitor cardiovascular, respiratory,
neuromuscular, renal status
Place the client on a cardiac monitor
Discontinue IV potassium
Hold oral potassium supplements
Initiate a potassium excreting diuretics if renal
function not impaired
If renal function not impaired, prepare to
administered Na polystyrene sulfonate, a cation
exchange that promotes gastrointestinal
absorption and potassium excretion
71. Prepare the client for dialysis if potassium levels
critically high
Prepare for IV administration of glucose with
regular insulin to move potassium into the cell
Monitor renal function
When client requires blood transfusion – should
receive fresh blood because stored blood elevate
the potassium level because breakdown of older
blood cells release potassium
Teach the client to avoid foods high in potassium
Instruct the client to avoid use of salt substitutes
or potassium containing substances
72. Calcium
More than 99% of the body’s calcium is
located in the skeletal system
Normal serum calcium level is 8.5 to
10mg/dL
Needed for transmission of
nerve impulses
Intracellular calcium is needed
for contraction of muscles
73. Calcium 2
Extracellular needed for blood clotting
Needed for tooth and bone formation
Needed for maintaining a normal heart
rhythm
80. Management
Monitor cardiovascular, respiratory,
neuromuscular status
Place the client on cardiac monitor
Administer calcium supplements orally or IV
When administering calcium IV – warm the
injection to body temperature
Administer medication that increase calcium
absorption
Ex – aluminum hydroxide reduces phosphate
and increase absorption of calcium
81. Vitamin D aids in the absorption of calcium
from the intestinal tract
Provide a quite environment to reduce
environmental stimuli
Initiate seizure precautions
Move client carefully and monitor for signs of
a fracture
Keep 10% calcium gluconate available for
treatment of calcium deficit
Instruct the client to consume foods high in
calcium
Ex- milk, cheese, spinach, yogurt, sardines
88. Management
Monitor cardiovascular, respiratory,
gastrointestinal status
Place the client on cardiac monitor
Discontinue IV infusions of solutions containing
calcium, oral medication containing calcium or
vitamin D
Discontinue thiazide diuretics and replace with
diuretics that enhance the excretion of calcium
Administer medications that inhibit calcium
reabsorption for the bone
Ex – phosphorus, calcitonin, biphosphonates, aspirin
89. Prepare client with severe Hypercalcemia
for dialysis if medications failed to reduce
Monitor signs of fracture
Monitor for flank or abdominal pain
Strain the urine to check the presence of
urinary stones
Instruct the client foods high in calcium
90. Magnesium
- Normal serum magnesium level is 1.5 to 2.5
mg/dL
- Helps maintain normal muscle and nerve
activity
- Exerts effects on the cardiovascular system,
acting peripherally to produce vasodilation
- Thought to have a direct effect
on peripheral arteries and
arterioles
97. Management
Monitor cardiovascular, gastrointestinal,
respiratory status
Place client on a cardiac monitor
Administer magnesium sulfate IV route in
severe cases
Monitor serum magnesium levels
Monitor for deep tendon reflexes
Instruct the client to increase the intake of
foods that contain magnesium Ex- milk, pork,
potatoes, green leafy vegetables, cauliflower.
99. Causes
Increased magnesium intake
Magnesium containing antacids and
laxatives
Excessive administration of magnesium
IV
Decreased renal excretion of
magnesium as a result of renal
insufficiency
102. Management
Monitor cardiovascular, respiratory,
neuromuscular status
Place client on cardiac monitor
Diuretics are prescribed to increase excretion of
magnesium
IV administration of calcium chloride to reverse
the effects of magnesium on cardiac muscle
Instruct the client to restrict magnesium
containing foods
Instruct the client to avoid the use of laxatives
and antacid containing magnesium
103. Phosphorus
- Normal serum phosphorus level is 2.5 to
4.5 mg/dL
- Essential to the function of muscle and
red blood cells, maintanence of acid-
base balance, and nervous system
- Phosphate levels vary inversely to
calcium levels
- High Calcium = Low Phosphate
107. Central nervous system
Irritability
Confusion
Seizures
Hematological
Decreased platelet aggregation
Immunosuppression
108. Management
Monitor cardiovascular, respiratory,
neuromuscular status
Administer phosphorus IV slowly because of
the risks associated with
hyperphosphatemia
Monitor for signs of facture
Instruct the client to increase intake of foods
while decreasing intake of calcium
containing foods
Ex – fish, nuts, pork, beef, chicken.
113. Management
Administer phosphate binding medication that
increase fecal excretion of phosphorus
Instruct the client avoid phosphate containing
medications Ex laxatives, enemas
Instruct the client to decrease intake of
phosphorus
Instruct the client low intake phosphate binding
medication, emphasizing that should be taken
with meals or immediately after the meals
Interventions entail the management of
hypocalcaemia
114. DISORDERS OF ACID
BASE BALANCE
The four general classes of acid based
imbalance are
1. Respiratory acidosis
2. Respiratory alkalosis,
3. Metabolic acidosis, and
4. Metabolic alkalosis.
115. TERMINOLOGY:
Acidosis: any pathological process that
cause a relative excess of acid in the
body
Acidemia: excess acid in the blood
Alkalosis: it indicates a primary condition
resulting in excess base in the body
Alkalemia: most narrow to elevation of
serum PH
116.
117. Critical Thinking Exercise:
Nursing Management of the
Client with Hypokalemia
Situation: A 69 year old man has a
history of CHF controlled by Digoxin and
Lasix. Two weeks ago he developed
diarrhea, which has persisted in spite of
his taking OTC antidiarrheal meds. His
partner transported him to the ER when
she found him lethargic and confused.
Initial assessment of the client reveals
heart rate at 86 bpm, respiratory rate 10,
and blood pressure 102/56 mmHg.
118. Critical Thinking Exercise:
Nursing Management of the
Client with Hypokalemia 2
1. An electrolyte panel shows the client’s
serum potassium is 2.9 mEq/L. Does the nurse
have cause to be concerned about the client’s
serum potassium? Why or why not?
2. What data supports the presence of
hypokalemia in this client?
3. What, if anything, should the nurse do?
4. What foods should the client be advised to
eat that are high in potassium?
119. Calcitonin
- used to lower serum calcium level
- useful for pts with heart disease or renal
failure
- reduces bone resorption
- increases deposit of calcium and
phosphorus in the bones
- increases urinary excretion of calcium
and phosphorus
120. Parathyroid pulls, calcitonin keeps
Parathyroid hormone pulls calcium out of
the bone.
Calcitonin keeps it there.