Body fluid with n cell

Intracellular
Fluid with in cell
Extracellular
Found in blood
vessels
Interstitial fluid 25% (the
third space)
surrounding cells,
including lymph
Transcellular fluids
Lymph, digestive
tract, sweat,
cerebrospinal

Electrolytes and imbalances
Sodium (Na) Major cation of extracellular fluid
Hyponatremia
orthostatic hypotension
Hypernatremia
flushed skin, dry mucous
membranes
Potassium (K)
Hypokalemia
Muscle cramps BP oliguria
Hyperkalemia
Patients at risk: decreased renal
function, in metabolic acidosis,
taking potassium supplements
Chloride (Cl)
Hyperchloremia
Usually associated with metabolic
acidosis
Hypochloremia
Usually occurs when sodium is lost
because chloride most frequently
bound with sodium






Calcium (Ca)
Hypocalcemia
intake of vit D
Hypercalcemia
intake of vitamin D
Magnesium (Mg
2+
)
Important in heart, nerve, and
muscle function
Hypomagnesemia
usually from vomiting
and diarrhea
Hypermagnesemia
excessive use of
magnesium
osmolality of intracellular
fluid and extracellular
fluid tends to equalize
because of the constant
shifting of water

Age-Related Changes Affecting
Fluid Balance
Total body water declines with age;
greatest loss from the intracellular
fluid compartment
Antihypertensive, diuretics, and
antacids can also contribute to
imbalances


Diagnostic Tests and Procedures
Hematocrit
Creatnine
BUN
Albumin
Serum electrolytes

Intravenous therapy
Isotonic
NS (0.9% saline)
DW5
LR
Hypotonic
NS
Hypertonic
3% NS
D10W
5% D in LR
Colloids
Dextran
Albumin
Hetastarch

Infiltration
Caused by leakage
S/S: pain or burning
Paleness and puffiness or
feel hard and cool
Excess Fluid Volume
S/S: BP, bounding pulse,
edema
Ineffective Tissue Perfusion
Risks of emboli from blood
clots, air, broken catheters
Air can enter the
bloodstream if the infusion
system is opened
Catheters
catheter threaded through
the tunnel and into the
subclavian vein
cannulas and the tubing are
usually changed every 48-
72 hours


Fluids and
Electrolytes
Ch. 14
&
Intravenous
therapy
Ch. 18

Respiratory Acidosis pH<7.35 &PaCO2>45
Hypoventilation Hypoxia
Shallow breathing, K+,
Respiratory Alkalosis pH>7.45 &PaCO2<32
Deep breathing, hyperve
ntilation, tachycardia, lethargy & confusion.

Metabolic Acidosis pH<7.35 & HCO3<20
Kussmaul respiration, severe diarreah,
N,V,D, muscle twitching
Metabolic Alkalosis pH>7.45 & HCO3>26
Severe vomiting, tremors, muscle cramps