altered fluid and electrolyte balance

charged particles dissolved in body fluids

electrolyte imbalance

electroneutrality determines balance

varied concentration

transport based on energy

electrolyte transport

hypo/hypernatremia

sodium imbalance

hypo/hyperkalemia

potassium imbalance

hypo/hyperchloremia

chloride imbalance

hypo/hypercalcemia

calcium imbalance

hypo/hypermagnesemia

magnesium imbalance

hypo/hyperphosphoremia

phosphorus imbalance

60% of body weight

water

40% of body weight

formed components

ultravascular and interstitial

compartments of fluid balance

osmosis, reabsorption, titration

processes of fluid balance

hydrostatic, osmosis, thirst, renin-angiotensin, aldosterone, ADH, tonicity

other fluid balance methods

hemorrhage and dehydration

hypovolemia

water intoxication and edema

hypervolemia

liver disease: interference of local blood flow and hepatocyte damage > caused by hepatitis and alcohol abuse

cirrhosis

ascites, abdominal discomfort, sodium retention, hyponaturemia, increased size of abdomen

clinical manifestations of cirrhosis

abdominal girth measurement and body weight, lab analysis > cardiac, liver and renal function, ascitic fluid analysis

diagnostic criteria for cirrhosis

paracentisis, diuresis, intravenous albumin

treatment for cirrhosis

sodium imbalance and negative fluid balance caused by decreased fluid intake and increased fluid output

dehydration

sunken eye, less urine and tears, dry mucous membranes, increased capillary refill time

clinical manifestations of dehydration

fluid intake and output, urine and stools, lab analysis of electrolytes and creatinine, bicarb and blood urea

diagnostic criteria for dehydration

correction of electrolyte imbalance: oral or IV rehydration

treatment for dehydration

altered calcium balance and decreased blood calcium levels (negative feedback loop)

hypoparathyroidism

hair dryness, nail breakage, skin dryness, bone loss, muscle cramps and seizures

diagnostic criteria for hypoparathyroidism

UA for calcium, blood calcium, phosphorus, magnesium

diagnostic criteria for hypoparathyroidism

calcium, carbonate, citrate supplements, vitamin D, recombinant parathyroid hormone

treatment for hypoparathyroidism

mix acids and bases to resist pH change: weak acids and bases

buffer systems

reacts in seconds

plasma

reacts in minutes to excrete CO2

respiratory system

reacts in hours or days to produce, absorb, and excrete acids and bases

renal system

bicarb, protein, potassium-hydrogen, resp buffer system

plasma buffer systems

eliminates H+ ions and preserves bicarbs: potassium-hydrogen exchange and chloride-bicarb exchange

renal buffer systems

deficit of HCO3- > less secretion of acid by kidneys, loss of bicarb, and increase in Cl-

metabolic acidosis

anorexia, nausea, vomiting, flushed skin, decreased HR

clinical manifestations of metabolic acidosis

pH <7.35

labs for metabolic acidosis

excess HCO3- > less H+ more HCO3-, loss of Cl-

metabolic alkalosis

asymptomatic but related to hypokalcemia

clinical manifestations of metabolic alkalosis

pH > 7.45

labs for metabolic alkalosis