Fluid and Electrolytes - Fluids & Electrolyte An Overview...

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Fluids & Electrolyte
An Overview
Qiana Ross, PhD(c), MSN, RN
Academic Success Coach • Chamberlain College of Nursing

FLUID AND
ELECTROLYTE
BALANCES

DISTRIBUTION OF BODY FLUIDS
Body fluids are distributed in two distinct
compartments:
1.Extracellular fluids[ECF] Which includes interstitial fliud &
intravascular fluid
2.Intracellular fluids[ICF]

COMPOSITION OF BODY FLUIDS
The fluids circulating throughout the body in extracellular
and intracellular fluid spaces contain
1.Electrolytes
2.Minerals
3.Cells

FLUID, ELCTROLYTE AND ACID-BASE
IMBALANCES

FLIUD IMBALANCES
The five types of fluid imbalances that may occur are:

ETIOLOGY AND RISK FACTORS of
DEHYDRATION
•
Severe vomiting
•
Diaphoresis
•
Traumatic injuries
•
Third space fluid shifts
[percardial, pleural,
pertonial and joint cavities]
•
Fever
•
Gatrointestinal suction
•
Ileostomy
•
Fistulas
•
Burns
•
Hyperventilation
•
Decreased ADH secretions
•
Diabetes insipidus
•
Addison’s disease or
adrenal crisis
•
Diuretic phase of acute
renal failure
•
Use of diuretics
•
SIADH

CLINICAL MANIFESTATION
•
Thirst
•
Muscle weakness
•
Dry mucus membrane; dry
cracked lips or furrowed
tongue
•
Eyeballs soft and sunken
(severe deficit)
•
Apprehension ,
restlessness, headache ,
confusion, coma in severe
deficit
•
Elevated temperature
•
Tachycardia, weak thready
pulse
•
Peripheral vein filling> 5
seconds
•
Postural systolic BP falls
>25mm Hg and diastolic
fall > 20 mm Hg , with
pulse increases > 30
•
Narrowed pulse pressure,
decreased CVP&PCWP
•
Flattened neck veins in
supine position
•
Weight loss
•
Oliguria(< 30 mlper hour)
•
Decreased number and
moisture in stools

LABORATORY FINDINGS
)

MANAGEMENT
Mild fluid volume loss can be corrected with oral fluid
replacement
-if client tolerates solid foods advice to take 1200 ml to
1500ml of oral fluids
-if client takes only fluids, increase the total intake to 2500
ml in 24 hours

Management of Hyperosmolar fluid volume
deficit
•
Administration of hypotonic IV solution
•
If the deficit has existed for more than 24 hours, avoid
rapid correction of fluid

EXTRACELLULAR FLUID VOLUME EXCESS
•
ECFVE is increased fluid retention in the intravasular and
interstitial spaces

ETIOLOGY AND RISK FACTORS
•
Heart failure
•
Renal disorders
•
Cirrhosis of liver
•
Increased ingestion of high sodium foods
•
Excessive amount of IV fluids containing sodium
•
Electrolyte free IV fluids
•
SIADH,Sepsis
•
decreased colloid osmotic pressure
•
lymphatic and venous obstruction
•
Cushing’s syndrome & glucocorticoids