FLUID IMBALANCES
FLUID: B. ACTVE TRANSPORT
<60% an
of adult'sbody ngt. cell moves substances across a membrane
>70kg male 60%x50kg 42 L
throughAto because:
=
=
>tomaintain homeostasis >
they be too large
may
>unable to dissolve fat
ensure
>to
adequate tissue perfusion in the core
7
>help transport nutrients, gases
& wastes more
uphill againsttheir concentration
>to have normal function of
cells and the gradient.
body as
a whole MPES:
>to helpmaintain body temp solventfor
OSMOSIS:montof
1) con-
FLUID DISTRIBUTION centration to concentration
42 L 3rd fluid shift
space
loss of into
ECF that
a
space
-
contribute to
Extracellular does
*
between
Intracellular
not
equilibrium
ICE& ECF
Frid Fluid
1/3
-
ascites, burns, etc.
TBW
of
2
ofTW
(112) 128 L)
REGULATION BODY
OF FLUID
interstitial plasma transcellular 1.) KIDNEY:
regulates primarily through
fluid wine
fluid (1/4)3.5L third ICSF, tears, synovial, output
(3(4)10.52 intraocular) I20 balance
>regulates Na &
Arterial venous 2)ENDOCRINE REGULATION:
12%) (3%) >thirstmechanism -
hypothalamus (center)
JADH -
increase HO
reabsorption on
TRANSPORT MECHANISMS:
collecting duct
A. PASSIVE TRANSPORT > Aldosterone
-
↑ Na & retention
water
w/energy input
> in the distal
nephions
K excretion
>high to low GFR:125 colmin
I TYPES: filtrates:H20 electrolytes
1) DIFFUSION:moxtofmobcules 3)Renin- Angiotensin Aldosterone system (RAAS
from concentration to concentration powerful defense
againstshock
>most
involvement-pogans
2) FITRADON:mon'tofmolecules
from
pressure a
to
pressure
multisystem andsee
Exchange On
of & CO2 bet. pulmonary ↓wine
output (630cc/ur)
(liver)
capillaries & alveoli
Angiotensin 1
10:ventilation:filtration suxtoglomania apparatus (kidneys)
20:alveolar:diffusion Angiotensin
Converting
poon a Renin substrates (lungs)
O2=elastase:inflation
Rizyme
alliI02:anti-elastase: defation
·
a cortex Aldosterone onNa H20
Angiotensin
↑ Heart) blood
Vasoconstrictor ↑ . OR. BP. C.0s volume
4) Gastro-intestinal regulation: FLUID VOLUME EXCESS:
>digests food & absorbswater CHYPERXOLEMIA)
>about200mL of 10 is excreted in the PRINCIPLES:
faces/day >9 intake, normal output
Heart &
5) Blood vessel Functions >normal intake, low
output
7
>pumping action heartarticulates
of blood no output
throughkidneys CAUSES:
2) Lungs ORGAN
FAILURE =
renal
>insensible loss
through HIGHSODIUM INTAKE Oral / N
water
perspiration
-
INAKE & OUTUT: PROBLEMS
ENDUCRINE
> 2.6 L / day > SIADH (ADH)
CUSHNG'S I ALDOSTERONE)
>
>essential:measurable:sensible
>non-essential:estimated:insensible IATROGENIC
CLINICAL MANIFESTATON:
FLUID VOLUME DEFICIT >distented neck veins >
no
CHYPOXOLEMIA) >
tachycardia > SOB /wheezing/crackles
PRINCIPLES: >of > PCVP
gain
intake COMPLICATIONS:
>
output, normal
>normal output, intake 1) BP
I
intake dyspnea
(
decreased intake
prolonged
ICHF
>no or or 2.
bilateral crackles
CAUSES: 3.
Pulmonary edema
>
vomiting > osmotic diuresis (DM)
pink frothy
sputum
>diarrhea >3rd
space fluid
shift (burns 4) Edema (common manifestation of EVE
hemorrhage (>10% (BV) Realized/ generalized
> Gl
suctioning (lavage)
-
>
>
diaphoresis Global causes:
> DI(dADH) altered HP [9Hp)
> Addison'sDs. Inaldosterone) altered cop (bcOP)
CLINICAL MANIFESTAMONS:
Mgt: dimetics
restriction
>ngt. loss:(c
Ig
=
>fluid
>oliguria >elevation of extremities
concentrated ( 101-1,025 selastic
specific gravity compression stocking
>
mine
>postural hypotension >paracentesis
> flattened neck veins
>dialysis
>
decreased CUP atrium MEDICAL MGT:
measures
pressure on
-
central line:subclavian vein SVC-RA > Discontinue administration of Na solid
a. Manometer:4-10 mml20 >
Dinretics
b. REstrictfind & saltintake
Gauge:7-14 mmltg
7
>muscle weakness / cramps >
Dialysis
ASSESS: NURSING MGT:
>
180, ut, CUP, LOC, breath sounds, > Measure I && > Promote rest (favors
skin color >weigh DAILY diuresis/venous return
flid:NSS, D5W
Fluid supplement F8E:LR ta
> Assess breath sounds
MILD:oral > Monitor degree of edema
AUTE/ SEVERE: F8E&G:D5LR
ambulatory -
feet& ankles
WINSS
BT
ISOTONIC bleeding: bedridden-sacral areas
nee
