F&E 1

Kidney

major organ in F&E regulation

adult: 60%

infant: 70-80%

ilan total body fluids sa normal adult & infant?

Fat tissue

_________ is essentially free of water

Intracellular

Extracellular

2 major components of body fluids

Intracellular

• inside the cell

• 2/3 of the total body fluids

• contains solutes such as oxygen, electrolytes, glucose

• provides a medium in which metabolic processes of the cell take place

Extracellular

• outside the cell

• 1/3 of the total body fluids

• has two compartments: intravascular and interstitial

Intravascular

20% of the Extracellular Fluid, found within the vascular system, inside the veins, arteries, etc.

Interstitial

75% of the Extracellular Fluid,

surrounds the cell

Other compartments of Extracellular Fluid (ECF)

5% of the Extracellular Fluid

Lymph & transcellular fluid such as CSF, pericardial, peritoneal, pleural, etc..

IONS

charged particles in the body

cations

• Positive ions

• Sodium, potassium, calcium, magnesium, hydrogen

anions

• negative ions

• chloride, bicarbonate, phosphate, sulfate

Electrolytes

• substances that GIVE IONS when dissolved in water

• substances that are capable of conducting electricity

• measured in mEq/L (milliequivalent per liter)

milliequivalent

• chemical combing power of the ion

• capacity of CATION (+) to combine with ANIONS (–) to form MOLECULES

Cations - potassium & magnesium

Anions - phosphorus & sulfate

what are the cations and anions present in INTRACELLULAR (inside the cell)

cations - sodium

anions - chloride & bicarbonate

what are the cations and anions present in EXTRACELLULAR (outside the cell)

Third-space fluid shift or third spacing

loss of Extracellular fluid into a space

Solvent

component of a solution that can dissolve a solute

Solute

• substance that can be dissolve in liquid

• can be crytalloids (salts that easily dissolve readily into true solutions) or colloids (do not readily dissolve like protein and glucose)

Osmolality

concentration of solutes in body fluids

Tonicity

osmolality of one solution in relation to another solution

Isotonic

• has the same osmolality as ECF (blood, intravascular)

• ex: Normal Saline or 0.9 sodium chloride or PNSS

• it stays where i put it, no fluid shifting

• good choice for fluid replacement

hypertonic solution

• have higher osmolality as ECF (blood, intravascular)

• ex: 3% sodium chloride

• causes fluid in the CELLS go into the ECF = cell shrinks

• maalat pinasok mo diba? kasi 3% SODIUM chloride sya, eh yung isotonic 0.9% lang sya kaya walang nangyayaring fluid shifting,

• ending, pupunta saknya yung water kasi remember that salt PULLS water.

Hypotonic solution

• lower osmolality than ECF

• ex: 0.45% Sodium Chloride

• cell SWELLS

• ito naman mas less sya kaysa kay isotonic na 0.9% usually, edi ang mangyayari is pupunta sya sa LOOB ng cell kasi mas maalat na yung cell compared sa pinasok mo dahil 0.45% sodium chloride lang sya..

• salt pulls water

Osmotic pressure

power of a solution to pull water accross a semipermeable membrane

Diffusion-passive transport

movement if molecules from and area of higher concentration to lower solution concentration

Osmosis-passive transport

Movemeny of molecules from an area of low solute concentration to higher solute concentration

ganto yung nangyayari sa hypertonic and hypotonic

Filtration

fluid and solutes move together across a membrane from an area of higher pressure to and area of lower pressure

Hydrostatic pressure

the pressure exerted by a fluid within a closed system on the walls of the container in which it is contained

Active transport

• the movement of solutes across cell membrane from less concentrated solution to a more concentrated one

• need ng carrier sa labas ng cell membrane para mapasok sa loob ng cell membrane

Antidiuretic hormone

• produced by the hypothalamus and stored in posterior pituitary gland

• secreted when there is an ECF volume deficit or and increased osmolality (increased solutes)

• promotes water reabsorption from distal tubules of the kidney

• ANTI-ihi sis

Aldosterone

• secreted from the adrenal cortex

• promotes sodium, chloride, and water reabsorption from the renal tubules

Renin

• Decreased renal blood flow

• produced in kidneys when BP is low, Salt levels too low, blood loss

Thirst

indicator of fluid need

Sodium

promotes water retention

Protein, albumin

increases colloid osmotic (oncotic) pressure in favor of fluid retention

Lymphatics

promotes the return of water and protein from the interstitial space to the vascular space

300-500 ML

approximate amount of sweat every day

400-500 ML

approximate excretion of water through normal breathing

1000-1500 ML

kidneys excretion of body water daily, UO

Extracellular fluid volume deficit

loss of body fluid from the interstitial and/or intravascular spaces

Extracellular fluid volume excess

Increased fluid in either the interstitial and/or intravascular spaces

Edema

• abnormal retention of fluid in the interstitial space

• Sodium retention is the frequent cause

135-145 mEq/L

normal values of sodium

95-105 mEq/L

normal values of chloride

3.5-5 mEq/L

normal levels of potassium

8.5-10.5 mg/dL

Normal values of calcium

1.5-2.5 mg/dL

normal values of magnesium

Trousseau sign

• BP cuff lagay, inflated 20mmHg ABOVE the systolic BP

• if may flexion sa wrist, adduction of thumbs/fingers, basta pag may nangyari, saan positive

• one of the s/sx of hypocalcemia & hypomagnesemia

Chvostek’s sign

• tapping facial muscle tapos pag may nagtwitch sa lips, positive for?

• one of the s/sx of hypocalcemia & hypomagnesemia

Colloids

• contain proteins or other molecules of higher molecular weight that tend to remain intravascular for long periods of time

• large molecules

Crystalloids

• solutions made by dissolving crystals into water

• Good fluid replaces and are categorized by tonicity

• hypotonic, hypertonic, isotonic

Infiltration

• escape of fluid into the subcutaneous tissue

Phlebitis

Inflammation of the vein

thrombus

blood clot

embolus

foreign body or air in the circulatory system

Speed shock

body’s reaction to substance injected into the circulatory system TOO RAPIDLY

Fluid overload

condition caused when too large volume of fluid infuses into the circulatory system

infection

an invasion of pathogenic organism in the body