CONCEPTS OF FLUID AND ELECTROLYTE BALANCE
ELECTROLYTES:
Substance that, on dissolving in solution, ionizes that is, some of its molecules split or dissociate into electrically charged atoms or ions.
The metric system is used to measure the volumes of the fluids-liters (L) or milliliters (mL).
The unit of measure which expresses the combining activity of an electrolytes is the milli equivalent (mEq)
Milliequivalents provide information regarding the anions and cations number available to combine with other anions or cations.
BODY FLUID COMPARTMENTS:
Fluids in the each of the body compartments contains electrolytes.
For the normally functions, it is necessary for the body cells to have fluids and electrolytes in the right compartments and in the right amounts.
Whenever an electrolyte moves out of a cell, another electrolyte moves in to take its place.
The number of cations and anions must be the same for homeostasis to exist.
Compartments are separated by the semi-permeable membrane.
THERE ARE THREE TYPES OF COMPARTMENTS.1. INTRAVASCULAR COMPARTMENTS, 2. INTRACELLULAR COMPARTMENTS, 3. EXTRACELLULAR COMPARTMENTS.
INTRAVASCULAR COMPARTMENTS defined as fluid which is inside a blood vessel.
INTRACELLULAR COMPARTMENT refers to all fluids inside the cells.
EXTRACELLULAR COMPARTMENT refers to fluid outside the cells. It also includes the INTERSTITIAL FLUID, which is the fluid between cells, lymph, bone, connective tissue, water and transcellular fluid.
THIRD-SPACING: accumulation and sequestration of the trapped extracellular fluid in an actual or potential body space as a result of disease or injury. Fluid may be trapped in body spaces such as the pericardial, pleural, peritoneal, or joint cavities; the bowel; the abdomen; or within soft tissues after trauma or burns. ASSESSMENT OF THE INTRAVASCUALR FLUID LOSS IS DUFFICULT which is caused by the third spacing. It may not become apparent until AFTER ORGAN MALFUNCTION OCCURS.
EDEMA: is an excess accumulation of the fluid in the interstitial space. It occurs as a result of the alterations in oncotic pressure, hydrostatic pressure, capillary permeability, and lymphatic obstruction.
WHAT ARE THE TYPES OF EDEMA?
TWO TYPES: 1. LOCALIZED EDEMA, 2. GENERALIZED EDEMA
Localized edema occurs as a result of traumatic injury from accidents and surgery, local inflammatory processes, or burns.
GENERALIZED EDEMA also known as ANASARCA. It is an excessive accumulation of fluid in the interstitial space throughout the body. It occurs as a result of conditions such as cardiac, renal, or liver failure.
BODY FLUID
Body fluids transport the nutrients to the cells and carry waste products from the cells.
In adult it is about 60% of the body weight, in older adults it’s about 55% and in the infant its amount is nearly 80% of the body weight.
Thus, there is higher risk of fluid and electrolyte problems in infants and older adults as compared to the younger adult.
INFANTS AND OLDER ADULTS NEED TO BE MONITORED CLOSELY FOR FLUID IMBALANCES.
BODY FLUID TRANSPORT
1.DIFFUSION: It is the process of spreading of a solute through a solution or solvent.
SOLUTE is the substance that is dissolve.
SOLVENT is the solution in which the solute is dissolved.
Diffusion of a solute spreads the molecules from an area of the higher concentration to an area of lower concentration. A permeable membrane is allowing substances to pass through it without restriction.
2. OSMOSIS: It is the process of movement of the solvent molecules across a membrane from lower to higher concentration of the solution.
SELECTIVE OR SEMIPERMEABLE MEMBRANE is that which only allow the water to pass but not all solute.
OSMOTIC PRESSURE is the force or pull that draws the solvent from a less concentrated solute into more concentrated solutes through a semipermeable permeable membrane.
3. FILTRATION: It is the movement of solutes and solvents by hydrostatic pressure from an area of higher pressure to the lower pressure.
4.HYDROSTATIC PRESSURE: It is the force exerted by the weight of a solution.
At the ARTERIAL END of the capillary, the hydrostatic pressure is higher than the osmotic pressure: thus, fluids and diffusible solutes moves out of the capillary.
At the VENOUS END of the capillary, the hydrostatic pressure is lower than the osmotic pressure: thus, fluids and some solutes move in the capillary.
5. OSMOLALITY: It is the number of osmotically active particles per kilogram of the water. It is the concentration of the solution.
In the body, osmotic pressure is measured in milliosmoles(mOsm)
The normal osmolality of the plasma is 275 to 295 mOsm/kg.
MOVEMENT OF THE BODY FLUID:
Body compartments are separated by the cell membranes and capillary walls.
If the body loses more electrolytes than fluids, as can happen in diarrhea, then the extracellular fluid contains fewer electrolytes or less solute than the intracellular fluid.
Define isotonic, hypotonic, hypertonic solutions and osmotic pressure?
ISOTONIC SOLUTION: When the solutions on both sides of a selectively permeable membrane have established equilibrium or are equal in concentration. It has same osmolality as body fluids.
HYPOTONIC SOLUTION: When a solution contains a lower concentration of salt or solute than another, more concentrated solution. It has less salt or more water than an isotonic solution. It has lower osmolality than body fluids.
HYPERTONIC SOLUTION: When a solution contains a higher concentration of solutes than another, less concentrated solution. It has high osmolality than body fluids.
OSMOTIC PRESSURE: It is the force that draw solvent from a less concentrated solute into a more concentrated solute via selectively permeable membrane. The amount of the osmotic pressure is determined by the concentration of the solutes in the solutions.
ACTIVE TRANSPORT: For the movement of the ion via membrane from an area of lower concentration to an area of higher concentration, active transport is required.
WHAT ARE THE SUBSTANCES WHICH TRANSPORTED ACTIVELY THROUGH THE CELL MEMBRANE?
Sodium, Potassium, Calcium, Iron and Hydrogen, some of the sugars and the amino acids are those substances which transported actively via cell membrane.
BODY FLUID INTAKE AND OUTPUT
BODY FLUID INTAKE: Water enters in the body through the three sources 1. orally ingested liquids, 2. water in the foods, 3. water formed by the oxidation of foods.
About 10mL of the water is released by the metabolism of each 100 calories of fat, carbohydrates, or proteins.
BODY FLUID OUTPUT: Water lost through the skin is called INSENSIBLE LOSS.
- INSENSIBLE LOSS: the individual is unaware about water loss.
- The amount of the water lost by the perspiration depend upon the temperature of the environment and of the body.
- Water lost from the lungs is called insensible loss and is lost through expired air that is saturated with water vapor. Its amount depends upon the rate and depth of the respiration.
- Large amount of water is secreted into the gastrointestinal tract, but almost all of this fluid is reabsorbed.
- Severe diarrhea results in the loss of large quantities of fluids and electrolytes.
- KIDNEY plays important role in regulating fluid and electrolytes balance and excrete the largets quantity of fluid.
- The quantity of fluid excreted by the kidneys is determined by the amount of water ingested and the amount of waste and solutes excreted.
- As long as all organs are functioning normally, the body is able to maintain balance in its fluid content.
THE CLIENT WITH DIARRHEA IS AT HIGHER RISK FOR FLUID AND ELECTROLYTE IMBALANCE.
WHAT IS HOMEOSTATSIS?
It is term that indicates the relative stability of the internal environment.
IF CLIENT HAS A FLUID AND ELECTROLYTE IMBALANCE. THE NURSE MUST CLOSELY MONITOR THE CLIENT’S CARDIOVASCULAR, RESPIRATORY, NEUROLOGICAL, MUSCULOSKELETAL, RENAL, INTEGUMENTARY, AND GASTROINTESTINAL STATUS.
HAVE YOU KNOW ABOUT THE PROPERTIES OF ELECTROLYTES AND THEIR COMPONENTS?
- ATOM: smallest part of an element that still has the properties of the element.
- It is composed of particles known as proton, neutron, electron
- Proton means positive, neuron means neutral, and electron means negative.
- Protons and neutrons are in the nucleus of the atom: therefore, the nucleus is positively charged.
- Electrons carry negative charge and resolve around the nucleus.
- MOLECULES: Two or more atoms that combine to form a substance.
- ION: It is an atom that carries electrical charge because it has gained and lost electrons.
- CATION: It is an ion that has given away or lost electrons and therefore carries a positive charge.
- ANION: It is an ion that has gained electrons and therefore carries a negative charge.
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