NSG 107 -2b Fluids and Electrolytes

NSG 107 -2b Fluids and Electrolytes

NSG 107 -2b Fluids and Electrolytes

• Body fluids-vital to all forms of life
• help maintain body temperature, cell shape, and help transport nutrients, gases, and wastes.
• Many major organs collaborate to maintain the proper balance of fluid.
• To maintain balance, the amount of fluid gained during the day must equal the amount lost.
• This is a critical part of nursing care.

Organs and their Role in Electrolyte Balance

• Kidneys – Regulate Na + and K + balance. Recommended daily Na + intake: 2 Grams.
• Lungs and Liver – Regulate Na + and water balance and blood pressure
• Heart – secretes ANP, causing Na + excretion.
• Sweat glands – excrete Na +, K +, Cl-, and water in sweat.
• GI Tract – absorbs and secretes fluids and electrolytes.

Maintaining fluid and electrolyte balance

• Concentration and composition of fluids must be nearly constant, resulting in homeostasis.
• Kidneys and adrenal glands play major role.
• Antidiuretic hormone released from our from posterior pituitary gland regulates osmotic pressure of extracellular fluid by regulating amount of water reabsorbed by kidneys.

Fluid and Electrolyte Balance

• Body fluid compartments- Adult

–Intracellular fluid: fluid within cells

• Extracellular fluid: fluid outside cells

–Interstitial fluid -lymph

–Intravascular fluid; plasma

–Transcellular fluids – in specialized compartments of the body

• CSF, Digestive juices, synovial fluids these are not calculated in I and O normally

Intake and Output – fluid gains and losses

Average fluid intake

Adult: 2500 mL/day (Range: 1800 to 3600 mL/day)

Sources: food and liquids

Fluid elimination

Sources : Urination, bowel elimination, perspiration, breathing

Insensible losses: sweat, exhaled air

Fluids & Electrolytes

Insensible Fluid losses are fluid loses from the skin and lungs; they are referred to as insensible losses because they can’t be measured or seen. Losses from evaporation of fluid through the skin are fairly constant but depend on a person’s total body surface area.

Sensible losses are fluid losses from urination, defecation, wounds, and other means. They are referred to as sensible losses because they can be measured. A typical adult loses about 150 to 200 ml/ day of fluid through defecation. In cases of severe diarrhea, losses may exceed 5,000 ml/ day (Wait & Alouidor, 2011).

Control of Fluid Balance

• Pressure Sensors
• Antidiuretic Hormone

The primary control of water in the body is through pressure sensors in the vascular system that stimulate or inhibit the release of antidiuretic hormone (ADH) from the pituitary gland.

Control of Fluid Balance

• Antidiuretic hormone (ADH) (also called vasopressin)
• ADH made by hypothalamus, stored and released by posterior pituitary gland
• ADH decreases amount of water lost from kidneys (conserve water), reducing the concentration of electrolytes
• ADH causes constriction of peripheral blood vessels, increasing blood pressure.
• ADH is released in response to stimuli like a rise in concentration of electrolytes in the blood or a decrease in blood pressure/volume.
• Such stimuli occurs when a person sweats excessively or is dehydrated.

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