Electrolyes - Foundations

How much body weight is composed of water?

50-60%

What is Intracellular Fluid?

Fluid within the cell that helps with cell mechanisms

What is Extracellular fluid?

About 30% of body total water and helps with fluid outside the cell

What is considered Intravascular Extracellular fluid?

Plasma

What are Infants in danger of?

Dehydration due to a higher ECF fluid

How is intake of fluid regulated?

The thirst mechanism in the hypothalamus, stimulated but intracellular dehydration

How much water is ingested by food?

20%

What are sensible losses?

output measurements that we can physically measure. Ex: Drainage, Poo, Pee

What are insensible losses?

output measurements that we cannot physically measure Ex: Sweat, breathing

What is a Positive Fluid Balance?

Fluid intake is exceeding fluid output meaning we are holding onto to much fluids Ex: Edema, Pulmonary Congestion, HTN, Worsening Heart or Renal Failure

What is Negative Fluid Balance?

Fluid output is exceeding our intake. May indicate dehydration or fluid loss Ex: Hypotension, Electrolyte Imbalance, Decreased perfusion, risk of acute kidney injury

What is the calculation for Net Fluid Balance?

INTAKE - OUTPUT = NFB

What is osmosis?

Osmosis is the movement of water (solvent) from an area of low concentration to higher concentration. Primary method of bodily fluid transport

What is Isotonic?

Fluid that had an equal osmolarity so there is no change Ex: 0.9% NaCl, Lactate Ringers

What is Hypotonic?

Fluid that makes fluid move into the cell Ex: Pure water into the vein

What is Hypertonic?

Fluid that draws solvents out of the cell causing them to shrivel Ex: 1% NaCl

When would the need for Isotonic fluids be justified?

Someone with a low vascular volume, ECF replacement w/o pulling from the cell itself Ex: Trauma Patients

When Hypotonic fluids justified?

When there is intracellular dehydration and there must be rehydration Ex: .45% Saline for Diabetic Ketoacidosis, Hyperosmolar hyperglycemia state

When should Hypotonic fluids not be given?

Trauma Patients, Burn Patients, Those with intercranial swelling, and patients with Liver Dysfunction

When are hypertonic fluids justified?

When a patient has severe Hyponatremia, Brain Swelling ICP, Interstitial and Intravascular dehydration Ex: .3% or 0.5 Sodium Chloride, D10,D5, D5 ½ NS

What is Fluid Volume Deficit?

Hypovolemia, Dehydration that results in a loss of ECF, an Isotonic fluid loss, and Interstitial fluids may move into the vascular as a way to recompensate

What are causes of FVD?

Excessive Nausea, Vomiting, Diarrhea, Excessive sweating w/o replacement, kidney disease

What does FVD present like?

Hypotension, Tenting skin turgor, Dry mucous membranes and dry skin, High HR Temp and Thirst, Altered LOC, Weight Loss, Weaker pulses, and Oliguria (Decreased Urine Output)

What is FVD in Third Space Fluid shift?

Excess accumulation of fluids into interstitial fluids, a shift of body fluids to transcellular compartments

What are causes of FVD Third Space Fluid shift?

Hyponatremia, Burns, an acute intestinal obstruction, liver failure, heart failure, crush injuries

What is Fluid Volume Excess?

An Excessive retention of water and sodium in the ECF

What is sodium’s role in the electrolyte system?

Chief Electrolyte of ECF

What is normal sodium range?

135-145 mEq/L

How is sodium entering the body?

Table salt, Added salt in processed foods

How is Sodium exiting the body?

Through the GI Tract (Poo), Kidneys (Pee), Skin (sweat)

What is Hyponatremia?

Serum Sodium Levels <135 mEq/L, CRITICAL VALUE <120

What are signs of Hyponatremia?

Confusion, Hypotension, edema, muscle cramps/weakness, dry skin, muscular twitching, seizure, N/V, urine specific gravity <1.010

What is Hypernatremia?

>145 mEq/L of serum sodium

What are causes of Hypernatremia?

Excess water loss or an excess amount of sodium (Higher concentration of sodium in vascular)

What is the Normal Chloride levels?

97-107 mEq/L

Where is a major amount of

What are causes of Fluid Volume Excess?

CKD, Heart Failure, Hypotonic fluid administration, burns, excessive fluid intake