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    Fluid and Electrolyte REVIEWER

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    Marc De Jesus
    This document provides an overview of fluid and electrolyte balance, including: - The body is composed primarily of water and electrolytes, which have many critical functions in homeostasis. - Fluid volume problems and electrolyte imbalances can cause various clinical manifestations depending on the specific imbalance. - Acid-base imbalances can be respiratory or metabolic in nature, and cause shifts in pH levels that also produce distinct signs and symptoms. - Assessment of fluid and electrolyte status involves examination of urine output and composition, as well as lab tests to identify any irregularities.

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    Fluid and Electrolyte REVIEWER

    Uploaded by

    Marc De Jesus
    174 views7 pages
    This document provides an overview of fluid and electrolyte balance, including: - The body is composed primarily of water and electrolytes, which have many critical functions in homeostasis. - Fluid volume problems and electrolyte imbalances can cause various clinical manifestations depending on the specific imbalance. - Acid-base imbalances can be respiratory or metabolic in nature, and cause shifts in pH levels that also produce distinct signs and symptoms. - Assessment of fluid and electrolyte status involves examination of urine output and composition, as well as lab tests to identify any irregularities.

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    Fluid and Electrolyte REVIEWER.docx

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    This document provides an overview of fluid and electrolyte balance, including: - The body is composed primarily of water and electrolytes, which have many critical functions in homeostasis. - Fluid volume problems and electrolyte imbalances can cause various clinical manifestations depending on the specific imbalance. - Acid-base imbalances can be respiratory or metabolic in nature, and cause shifts in pH levels that also produce distinct signs and symptoms. - Assessment of fluid and electrolyte status involves examination of urine output and composition, as well as lab tests to identify any irregularities.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    174 views7 pages

    Fluid and Electrolyte REVIEWER

    Uploaded by

    Marc De Jesus
    This document provides an overview of fluid and electrolyte balance, including: - The body is composed primarily of water and electrolytes, which have many critical functions in homeostasis. - Fluid volume problems and electrolyte imbalances can cause various clinical manifestations depending on the specific imbalance. - Acid-base imbalances can be respiratory or metabolic in nature, and cause shifts in pH levels that also produce distinct signs and symptoms. - Assessment of fluid and electrolyte status involves examination of urine output and composition, as well as lab tests to identify any irregularities.

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    You are on page 1of 7

    Fluid and Electrolyte REVIEWER

    Basics (7)
    - Processes
    - Assessment
    - Dx test
    Fluid Volume Problems (3)
    Electrolyte imbalances (7)
    Acid-Base Imbalance (12)

    BASICS
    -​
    - Body is composed of: WATER AND ELECTROLYTES
    Homeostasis: Normal volume, composition, distribution, and
    pH of body fluids
    FUNCTIONS OF WATER IN BODY
    1. Hydrates brain cells
    2. Lubricate skin and tissues
    3. Helps digestion and metabolic functions
    4. Eliminates toxins
    5. Provides elasticity to muscles and joints
    6. Reduces water retention
    7. Generates energy
    8. Oxygenates blood and lungs
    9. Fluidifies blood and reduce arterial pressure
    10. Regulates body temperature
    11. Prevents loss of calcium
    ACCORDING TO LEMONE
    1. Provides a medium for the transport and exchange of nutrients
    and other substances 

    2. Provides a medium for metabolic reactions 

    3. Regulation of body temperature 

    4. Provides form for body structure; acts as a shock absorber 


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    5. Provides insulation 

    6. Acts as a lubricant 

    TOTAL BODY FLUID
    60% - total body weight
    100% - fetus
    80% - baby at birth
    70% - Normal adult
    50% - elderly person

    FACTORS INFLUENCING AMOUNT OF BODY WATER


    1. Age
    2. Gender
    3. Body fat

    ELECTROLYTES
    Cations: (+)
    Anions: (-)
    FUNCTIONS
    1. Assist in water regulation
    2. Regulate/maintain acid-base
    3. balance
    4. Contribute to enzyme reactions
    5. Essential for neuromuscular activity

    *Intracellular Fluid/Compartment
    - K is the most abundant cation
    - PO4 is the most abundant anion
    *Extracellular Fluid/Compartment
    - Na is the most abundant cation
    - Cl is the most abundant anion
    *Electrolytes are expressed in terms of mEq/L – a measure of
    the ions chemical activity or its power.

    -Men has more water


    -Body composition: Water, electrolytes, molecules

    -study about osmolarity and osmolality

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    -Normal levels sodium, potassium, calcium EVERYTHING and
    units
    -Osmosis, Diffusion

    Hypertonic: shrink
    Hypotonic: swell
    Isotonic:

    What process does not increase water?


    Specific gravity?
    Fluid volume deficit: weak and fray, dry, poor skin turgor, dry
    mucus, cold clammy, flat, CVP: low
    Fluid volume excess: High BP, pulse, temp could be high, moist
    skin, distended neck vein, tout/ edematous, CVP: high.

    Possible cause fluid volume excess: drinking too much water,


    increase sodium intake, liver cirrhosis, nephrotic syndrome,
    heart failure
    Possible cause fluid volume deficit: diarrhea, diabetes insipidus,
    DM,

    -Edema grading
    Fluid accumulation: electrolytes go down, dilution of
    electrolytes, water intoxication

    -Hyponatremia: results in brain swell so give hypertonic


    -Hypernatremia: HYPOTONIC

    If pseudohyperkalemia : RETEST
    What is medical management: Kayexillate, insulin with glucose,
    insulin dextrose (brings back K back to the cell)

    Hypocalcemia: CAUSED BY: hypoparathyroidism, surgical


    removal or damage of the parathyroid, MANIFESTATION:
    everything is sensitive, spasm, tachycardia, tetany, chvostek,
    diarrhea, breathing problems TREATMEANT: calcium
    gluconate, vit D, calcium rich food, green leafy vegetables

    Hypercalcemia: everything is slow CAUSED by:

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    hyperparathyroidism, immobility, cancer of the bones
    MANIFESTATIONS: constipation, depression of breathing,
    behavioral changes Tx: Calcitonin, diuretics, phosphate

    NO MAGNESIUM NO CHLORIDE

    CHVOSTEK - CHEEK TRASSEU - HAND

    ABG Analysis: Allen’s test. Normal values pH, CO2, HCO2,


    Oxygen

    Respiratory Acidosis: asthma, copd, shallow breathing


    ACCUMULATION OF CO2, Kidney will reabsorb carbonate
    MANIFESTATIONS: Hyperventilation, tachycardia, warm
    flushed feeling, lethargic, coma, death Tx: Oxygen
    supplementation, bronchodilators, semi-fowlers, narcotics
    antagonist, Sodium bicarbonate

    Respiratory alkalosis: Caused by: hyperventilation. Anxiety,


    aspirin overdose MANIFESTATIONS: decreased cerebral blood
    flow, numbness tingling sensation, hypocalcemia (Spasm), less
    hydrogen more protein bound, Tx: SHALLOW BREATHING,
    breathe slowly, salt,

    Metabolic acidosis: Caused by: diarrhea, diuretics, fistula,


    aspirin overdose, ketoacidosis from DM, Tx: Sodium
    bicarbonate, increase fluid, insulin

    Metabolic alkalosis: caused by: vomiting MANIFESTATIONS:


    same as respiratory alkalosis Tx: ACIDIC stuff, cranberry,
    sodium bicarbonate

    KIDNEY: Size: 10cm length 5cm in width 2.5 thickness


    Reddish brown. Layers: renal cortex, medulla, hilus

    Renal cortex has: nephrons


    Medulla: tubules

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    Pelvis: calluses

    Protective layers: outer renal fascia, adipose tissue, capsules

    ASSESSMENT: Urine: Amber, 4.5-8 (pH), aromatic, no


    glucose, no ketones, 2-3 RBS, <5 WBC, clear

    Urinalysis: delay: fridge, or cool box

    History taking: Pain in flank, dull : KIDNEYS STUDY PAINS

    UTI
    Cause: E.Coli
    Risk: shorter urethra MANIFESTATIONS: backpain, Dysuria,
    pyuria, fever and chills, dehydration, frequency, urgency,
    hesitancy Tx: increase fluid 2-3L, acid ash diet, Management:
    Pyridium (DISCOLORATION ORANGE COLOR, if skin and
    sclera becomes orange: discontinue), Hot compress,

    RENAL Carcinoma: STUDY THE STAGES, Tx: Nephrectomy,


    radiation, chemotherapy NEPHRECTOMY: NORMAL
    OUTPUT, radical. TOTAL Nephrectomy: less output but after 1
    day: normal output

    Glomerulonephritis: Acute: BY GABS: BUN and Creatinine


    increase in blood decrease in urine. Mx: increase fluid intake,
    antibiotic, corticosteroids, low sodium, low protein (azotemia),
    low potassium

    Nephrotic syndrome: hypoproteinuria, hyperlipidemia, WHAT


    IS THE OTHER TRIAD?? Normal to hypotension. DIET:
    Moderate protein, low fat, low sodium (because of anasarca)
    care with anasarca? No adhesive, turning, positioning

    SIGNS OF SHOCK: Increase raas, hypotension, tachycardia,


    tachypnea, fast then eventually slow, cold clammy skin,

    Chronic renal failure: GRADE?


    CAUSE: agn, nephrotic syndrome, pre-renal, intra-renal, post-

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    renal (STUDY THIS TOO BITCH)

    STAGE 4: ENDSTAGE --- HEMODIALYSIS: weigh client,


    V/S, care for fistula: listen for bruit and feel for thrill, fistula has
    to mature 1-6 weeks, no jewelry, watch, no constrictive clothes,
    no cuff

    What is hemodialysis indicated to? Uncontrolled acidosis,


    hyperkalemia, excessive edema
    Hemodialysis can correct hyperkalemia, acidosis, increased
    BUN and creatinine, NOT ANEMIA, NOT IMMUNE
    SUPPRESSION,
    COMPLICATIONS: loss of water, disequilibrium,
    hypoelectrolytes TX: RRT (criteria for recipient: should live
    longer after transplant, should not have immune problem or
    cancer, should not be too old or young… FOR DONOR:
    compatibility, no cancer, no diseases, psychosocial should be
    intact. DEAD: continuous kidney circulation, not old, no
    infection, no cancer, no diseases)

    Bladder cancer: MANIFESTATION: Painless hematuria XRAY,


    CT SCAN, MRI CYSTOSCOPHY
    Right after cystoscophy: pinkish urine 1-2 days. If chills,
    infection. Watch out for infection.
    Bladder cancer can affect psychosocial status: anxiety, change in
    role, presence of stoma. STOMA:When younger 40, use body
    image disturbance. If 50: situational low self-esteem.

    CALCULI: CAUSES OF EACH TYPES! MANIFESTATIONS:


    Pain – first concern. XRAY, With dye, check for allergies,
    WITH IVP: ENEMA, NPO FOR 8 HOURS, CHECK FOR
    IODINE. POST: increase fluid,

    Peritoneal dialysis: introduce – 10-15mins of 2L and stay for


    20mins taken out in 10mins. WEIGH, V/S. During outflow:
    dialesate should be clear yellow. If cloudy, infection. If
    brownish, poop perforation. Board like abdomen: peritonitis.
    During outflow, if not 2L and stops, turn client from side to side.

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