The document discusses body fluids and electrolytes. It covers the functions of fluids and electrolytes in the body, fluid compartments, factors affecting fluid balance, and disturbances in fluid and electrolyte balance like edema, dehydration, hyponatremia, hypernatremia, hypokalemia, hyperkalemia, and other electrolyte imbalances. It provides information on assessment and nursing management of various fluid and electrolyte disorders.

1. Nio Cruzada Noveno, RN, MAN, MSN Fluids & Electrolytes

3. Renal Disorders [email_address] FLUIDS and ELECTROLYTES FLUIDS and ELECTROLYTES BODY FLUIDS ICF ECF 40% TBW 20% TBW P IS Distribution of Body Fluids: 50-70% of total body weight; infant [70-80%], elderly [45-50%] 60-kg man TBW = 0.6 x 60 kg = 3.6 L ICF = 0.4 x 60 kg = 24 L ECF =12 L 3L 9L

5. FLUID EXCHANGE BETWEEN BODY FLUID COMPARTMENTS Osmotic Pressure Gradient Oncotic P (Colloid osmotic P) Capillary P (Hydrostatic P) Renal Disorders [email_address] FLUIDS and ELECTROLYTES ICF ECF P ISF

13. Renal Disorders [email_address] FLUIDS and ELECTROLYTES Volume Disorders 2° Alteration in Sodium Balance Expansion Isotonic Inc N No net change Isotonic fluid ingestion Hypertonic Inc Dec ICF  ECF Sea water ingestion Hypotonic Inc Inc ECF  ICF Hypotonic IVF Contraction Isotonic Dec N No net change Diarrhea Hypertonic Dec Dec ICF  ECF Diabetes insipidus Hypotonic Dec Inc ECF  ICF Addison’s dse Volume ECF ICF Water Conditions Disorder Vol. Vol. Shift

15. ELECTROLYTE Composition Electrolyte Conc Plasma (mEq/L) ISF ICF Sodium, Na + 142 141 10 Potassium, K + 5 4.1 150 Calcium, Ca ++ 5 4.1 - Magnesium, Mg ++ 3 3 40 (155) Chloride, Cl - 103 115 15 Bicarbonate, HCO 3 - 27 29 10 Biphosphate, HPO 4 - 2 2 100 Sulfate, SO 4 - 1 1 20 Protein 16 1 60 Organic foods 6 3.4 - (155) Renal Disorders [email_address] FLUIDS and ELECTROLYTES

51. ASSESSMENT Burn Evaluation Chart Renal Disorders [email_address] B U R N S 9% 9% 9% Front= 18% Back= 18% 18% 18% 1%

60. ACID-BASE DISORDERS Renal Disorders [email_address] Disorder Clinical manifestation Compensation Respiratory acidosis ↑ Paco 2 , ↑ or normal HCO 3 - , ↓ pH Kidneys eliminate H + and retain HCO 3 - Respiratory alkalosis ↓ Paco 2 , ↓ or normal HCO 3 - , ↑ pH Kidneys conserve H + and eliminate HCO 3 - Metabolic acidosis ↓ or normal Paco 2 , ↓HCO 3 - , ↓ pH Lungs eliminate CO 2 and conserve HCO 3 - Metabolic alkalosis ↑ or normal Paco 2 , ↑HCO 3 - , ↑ pH Lungs hypoventilate to ↑ Paco 2 , kidneys conserve H + excrete HCO 3 -

65. Interpretation Renal Disorders [email_address] UC PC FC pH ↓ or ↑ ↓ or ↑ normal HCO 3 - ↓ or ↑ normal ↓ or ↑ ↓ or ↑ Paco 2 ↓ or ↑ normal ↓ or ↑ ↓ or ↑

66. Nio Cruzada Noveno, RN, MAN, MSN Fluids & Electrolytes