Body Fluid o Na-K pump

o ATP
 Water  Passive Transport
 Electrolytes o Osmosis- water from lesser
concentration to higher area of
Total body fluid
concentration
 60% of Total Body Weight  Osmolarity- the amount of solutes per
 Fetus-100% liter of solution
 Baby-80%  Osmolality- the number of solutes per
 Normal Adult-70% kilogram of water (by weight)
 Eldely-50%  Hypertonic- high salt, low H20 cell is
shriveled
3 Factors influencing amount of body water  Hypotonic- low salt, high H20 cell is
bloated
1. Age- fetus has most, elderly has least
 Isotonic- equal amount of salt and H20
2. Gender- males have more muscle= more
 Diffusion- movement of solutes from an
water
area of higher concentration to an area
3. Body Fat- more fat, less water
of low concentration
Electrolytes  Filtration
o Hydrostatic pressure- pushing
 Cations (+) charged fluid out, made by the pumping
 Anions (-) charged action of the heart
 Functions o Osmotic pressure- pulling fluid
o Regulate water balance in
o Regulate acid-base balance
o Contribute to enzyme reactions Fluid Homeostasis/ Homeostatic Mechanisms
o Used for neuromuscular activity
 Baroreceptors-responds to changes in
 Intracellular Fluid- fluids within the
circulating blood volume and regulate
cells
SNS and PSNS activities
o K= most abundant cation
 Osmoreceptors- sensation of thirst,
 Normal: 3.5-5.0
stimulated due to an increased
o PO4= most abundant anion
osmolality
 Normal: 2.5-4.5
 Antidiuretic Hormone- VASOPRESSIN
 Extracellular Fluid- fluids outside the
o Secreted in conditions causing
cells
increased osmolality and
o Na= most abundant cation
decreased blood volume
 Normal: 10-14
o Determines whether urine
o Cl= most abundant anion
excreted is concentrated or
 Normal: 3-4
diluted
 Normal I&O is 2300ml/day
 RENIN-ANGIOTENSIN-
Regulation of Body Fluid compartments ALDOSTERONE SYSTEM (RAAS)

 Active Transport
 o Renin- an enzyme that converts
angiotensinogen into
angiotensin I
o Aldosterone- released by the
adrenal gland to regulate
sodium balance
Laboratory Test for Evaluating Fluid Status
 Urine Studies
o Urine Osmolality/ Osmolarity:
provides information about
water and dissolved particles
across fluid compartment
membranes
o Urine Specific Gravity: the
reflection of the concentration
ability of the kidneys; ability to
excrete/ conserve water
 Blood Studies
o BUN- the balance between urea
production/ excretion
 Normal: 10-120
o Serum Creatine- reflects
Glomerular Filtration Rate
 Normal 0.7-1.4
o Serum Osmolaity- reflects
concentration of sodium
 Normal: 280-300
o Hematocrit- volume % of Red
Blood Cells in whole blood
 42-52% (male)
 35-47% (female
HYPOVOLEMIA- Fluid Volume Deficit
 Predisposing factors
o Inadequate replacement
o Excessive fluid loss
 Clinical manifestations
o Acute weight loss
o Decreased skin tugor
o Oliguria- small amounts of
urine
o Weak/rapid HR
o Flattened Neck Veins
o Pale
o Thirst
o Decreased LOC
o Orthostatic Hypertension
 Diagnostic Tests
o Urine Specific Gravity-
increased
o Osmolality-increased
o BUN-increased
o Hct-increased
o Hgb-decreased
o Electrolytes-both
o CVP
 Nursing/Medical management
o Increase fluid intake
o Give electrolyte solutions
o Use isotonic Fluids to expand
plasma vol.
HYPERVOLEMIA- Fluid Volume Excess
 Predisposing factors
o Nephrotic syndrome
o Liver cirrhosis
o Water Intoxicaion
 Clinical manifestations
o Edema
o Weight gain
o Distended neck/ peripheral
veins
 Medical Management
o Fluid management
o Restrict sodium in diet
 Pharmacologic Therapy
o Thiazide diuretics
o Loop diuretics
 Nursing management
o Provide egg crate mattress
o Not presence of crackles or
decreased breath sounds