ROYALTY TELEVISION

1. FUNDAMENTALS
OF NURSING
UNIT:5
FLUID THERAPY
BY JONES H.M –
MBA/DMS
2/28/2021
JONES
H.M
-MBA/DMS
1

2. PRESENTED BY:
BY JONES H.M- MBA/DMS
2/28/2021
JONES
H.M
-MBA/DMS
2

3. Introduction
• Fluid, electrolyte , and acid base balances within
the body are necessary to maintain health and
function in all body systems. These balances are
maintained by the intake and output of water and
electrolytes and regulation by the Renal and
pulmonary systems. Imbalances may result from
factors like altered fluid intake, or prolonged
episodes of vomiting or diarrhea.
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H.M
-MBA/DMS
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4. TERMINOLOGIES RELATED
TO BODY FLUIDS AND
ELECTROLYTES
• Solvent-substance capable of dissolving a solute.
• Solute-Substance that dissolves in a solvent
• Electrolyte-substance whose molecules dissociate
or split into ions when placed in water.
• Osmolarity-measure of total solute concentration
per liter of solution
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H.M
-MBA/DMS
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5. • Isotonic solution-fluid with the same osmolarity as
the interior of the cell
• Hypotonic -solutions where solutes are less
concentrated than the cells
• Hypertonic -solutions where solutes are more
concentrated than the cells
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H.M
-MBA/DMS
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6. DISTRIBUTION OF BODY
FLUIDS
• Water is a major component of our
body’s make up. 60% of an adult
male’s body weight is water while
50% of an adult female weight is
water. 80% of a baby’s weight is
water.
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H.M
-MBA/DMS
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7. DISTRIBUTION OF BODY FLUIDS
Body fluids are distributed into two
distinct compartments, that is
intracellular fluids and extracellular
fluids.
Intracellular fluid comprises of fluid
within body cells. In adults approx.
40% of body weight is ICF.
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H.M
-MBA/DMS
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8. Extracellular fluid is all the fluid outside
a cell. It is divided into smaller
compartments : interstitial fluid( lymph),
intravascular fluid( blood plasma) and
transcellular fluids( CSF, pleural,
peritoneal, and synovial fluids.
Extracellular fluid makes up 20% of the
body weight.
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H.M
-MBA/DMS
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9. Functions of body water
• Transport of nutrients and
electrolytes to cells
• Dissolving and carrying waste
products away from the cell
• Regulation of body temperature
• Acts as a medium for food digestion
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H.M
-MBA/DMS
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10. IONIC COMPOSITION OF
BODY COMPARTMENTS
Plasma
(mmol/L)
Interstitial
fluid
(mmol/L)
Intracellul
ar fluid
(mmol/L)
Na+ 142 144 10
K+ 4 4 160
Ca2+ 2.5 2.5 1.5
Mg2+ 1.0 0.5 13
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H.M
-MBA/DMS
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11. Cl- 102 114 2
HCO3
- 26 30 8
PO4
2- 1.0 1.0 57
SO4
2- 0.5 0.5 10
Organic
acid
3 4 3
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H.M
-MBA/DMS
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12. REGULATION OF BODY
FLUIDS
Body fluids are regulated by fluid
intake, hormonal control and fluid
output.
Fluid intake is regulated primarily
through thirst mechanism. The thirst
control center is located in the
hypothalamus in the brain.
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H.M
-MBA/DMS
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13. • Fluid intake regulated by the
thirst control center in the
hypothalamus.
• Average intake for an
adult=2200-2700mls per day
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H.M
-MBA/DMS
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14. Hormonal regulation
Antidiuretic hormone (ADH) is released in
response to blood osmolarity. It works directly on
the renal tubules making them more permeable to
water thereby causing more water to return to the
systemic circulation.
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H.M
-MBA/DMS
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15. • Aldosterone is released by the Adrenal
cortex. in response increases plasma
potassium levels . it acts on the distal
portion of the renal tubule to increase
the reabsorption of Na and the
secretion and excretion of potassium
and hydrogen.
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H.M
-MBA/DMS
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16. FLUID OUTPUT REGULATION
• Output occurs through four organs of water loss,
kidneys, skin , lungs and gastrointestinal tract.
• Kidneys produces and excretes between 1200-
1500mls of urine per day
• Skin loses water through sweat.
On average 500-600mls of fluids is lost through
the skin.
• Lungs expires on average 400mls of water per day
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H.M
-MBA/DMS
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17. ASSESSMENT OF FLUID
REQUIREMENTS.
• History taking. The history will
reveal any risk factor that may cause
disturbance of fluid and electrolyte
balance.
• Physical assessment . You look out for
signs of fluid deficit and fluid excess .
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H.M
-MBA/DMS
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18. Fluid volume Deficit:
• Sunken eyes.
• Cold clummy skin.
• Loss of skin turgor.
• Dry mucus membranes.
• Weak pulse.
• Low Blood pressure.
• Oliguria or anuria.
• Decreased body temperature.
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H.M
-MBA/DMS
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19. Fluid volume excess:
• Periorbital oedema
• Papilledema
• Dyspnoea with crackles
• Increased heart rate.
• Distended neck veins.
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H.M
-MBA/DMS
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20. TYPES OF FLUIDS
• The types of fluids used in fluid
therapy are oral fluids and
intravenous fluids. If the loss is mild,
oral rehydration is recommended and
if fluid loss is severe intravenous
therapy is administered.
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H.M
-MBA/DMS
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21. • IV solutions available for use fall into
the following categories: isotonic,
hypotonic and hypertonic
• The decision as to which solution to
use depends on the specific fluid and
electrolyte imbalance.
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H.M
-MBA/DMS
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22. Dextrose in water solutions
• Dextrose 5% isotonic
( dextrose is quickly metabolized,
leaving free water to be distributed
evenly in all fluid compartments)
• Dextrose 10% Hypertonic.
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H.M
-MBA/DMS
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23. Saline solutions
• 0.45% sodium chloride Hypertonic
• 0.9% sodium chloride Isotonic
• 3%-5% sodium chloride
Hypertonic.
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H.M
-MBA/DMS
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24. Dextrose in saline solutions
• Dextrose 5% in 0.9% sodium chloride
Hypertonic
• Dextrose 5% in 0.45% sodium
chloride Hypertonic
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H.M
-MBA/DMS
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25. Multiple Electrolyte Solutions
• Ringers Lactate Isotonic
• (It contains sodium, potassium,
calcium, chloride, and Lactate.)
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H.M
-MBA/DMS
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26. FLUID BALANCE CHART
• Fluid balance is an essential tool in
determining hydration
• A fluid balance chart is tool devised to monitor
fluid balance .
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H.M
-MBA/DMS
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27. When to start fluid balance?
• Actual or potential dehydration
• Commencing IV fluid
• Routine post op management
• Acutely ill patients.
• Fluid restriction
• Cardiac failure
• Liver failure
• Acute renal failure
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H.M
-MBA/DMS
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28. CALCULATION OF RATE OF FLUIDS
FLOW AND ADMINISTRATION OF
INTRAVENOUS INFUSION.
• Drops /minute= Total volume to be infused X drops per/min on a
giving set over the Total time for infusion in minute.
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H.M
-MBA/DMS
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29. Drops /minute= Total volume to be infused X drop
factor
Total time for infusion in minutes
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H.M
-MBA/DMS
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30. CLASS EXERCISE
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H.M
-MBA/DMS
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31. • After the IV infusion is secured and IV
line is patent the nurse must regulate
the rate of infusion according to
physicians orders. There is need to
observe client hourly to determine IV
therapy and restoration of fluid and
electrolyte balance.
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H.M
-MBA/DMS
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32. RECORDING AND
MAINTAINING FLUID
BALANCE CHART.
• In maintaining of a fluid balance chart
you record all fluid intake and output in a
period of 24hours.
• Intake includes all liquids taken by mouth
(e.g. ice cream, soup, juice, and water),
through NG tube, and , IV fluids.
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H.M
-MBA/DMS
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33. • Output includes fluid loss
through urine, diarrhoea,
vomitus, gastric suction, and
drainage from postsurgical
wounds (for surgical patients).
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H.M
-MBA/DMS
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34. Insensible Loss
• The process whereby fluids are lost
through sweating, breathing and so on
• New fluid balance charts will have an
averaged amount stencilled into the
output
• Insensible loss is added to the patients
output
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H.M
-MBA/DMS
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35. Completing fluid balance
• The nurse must sign to say he/she
has started the chart
• You record the amount of fluid
ordered, the period of time it is
supposed to run and the Rate of flow
calculated.
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H.M
-MBA/DMS
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36. • Complete the total intake
• Complete the output
• Add in the insensible loss
• Add the output & insensible loss together
• Subtract the output from the intake to enable the
final amount in the balance box
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H.M
-MBA/DMS
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37. • The nurse completing the chart and
working out the balance has to sign
for completion at the end of the 24
hour period.
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H.M
-MBA/DMS
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38. Total
Intake
(a)
Total Output Balance
(a-d)
Output (b) Insensible
(c)
Both b & c
(d)
1863 1925 600 2525 - 662
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H.M
-MBA/DMS
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39. THE END
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H.M
-MBA/DMS
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