Fluids and ElectrolytesFluids and ElectrolytesNursingNursing
PAUL E. MANAIG, MAEd. M.D
To maintain good health, a balance of fluids and electrolytes, acids and bases must be normally regulated for metabolic processes to be in working state.
A cell, together with its environment in any part of the body, is primarily composed of FLUID. Thus fluid and electrolyte balance must be maintained to promote normal function.
Fluids and Electrolytes Outline
Fluids Electrolytes Acids and Bases
3 concepts
THE BODY FLUIDS A solution of solvent and solutes Our body is made up of fluids and
solids About 50-60% of the body weight is
WATER In a 70 Kg adult male: 60% X 70= 40-
42 Liters Note that 1 kg body weight= 1 liter of
water
THE BODY FLUIDS
The body has two major compartments:
1 Intracellular
2. Extracellular
Intracellular
THE BODY FLUIDS
The Extracellular can be divided into:– Intravascular
- Interstitial– Trans-cellular
THE BODY FLUIDS
The Proportion of Body Fluids
Intracellular fluid
40%
Interstitial
15%
Intravascular
5% Transcellular
1-2%
The Intracellular Fluid
Found inside the cell surrounded by a membrane
This is compartment with the highest percentage of water in adults
The Extracellular Fluid Fluid found outside the cells
1. INTERSTITIAL FLUIDFound in between the cells
2. INTRAVASCULAR FLUIDFound inside the blood vessels and
lymphatic vessels 3. TRANSCELLULAR FLUID
Found inside body cavities like pleura, peritoneum, CSF
Fluid Compartment in the Body
VolumeAdult Male (L)
Male (%) Female (%)
Infant (%)
Intracellular Fluid 28 40 33 40
Extracellular Fluid Plasma Interstitial Fluid Other
15(4.5)
(10.5)
20(4)
(15)(1)
17(4)(9)(1)
30(4)
(25)(1)
TOTAL Water 43 60 50 70
FLUID BALANCE
TOTAL BODY WATER (AS PERCENTAGE OF BODY WEIGHT) IN RELATION TO AGE AND SEX
AGE MALE FEMALE
UNDER 18 65% 55%
18-40 60% 50%
40-60 50-60% 40-50%
OVER 60 50% 40%
Functions of Body Fluids Transporter of nutrients, wastes,
hormones, proteins and etc Medium or milieu for metabolic
processes Body temperature regulation Lubricant of musculoskeletal joints Insulator and shock absorber
Composition of body fluids Composed of solute, solvents,
Electrolytes, proteins, etc Plasma and interstitial fluids contain
essentially the same electrolytes and solutes, but plasma has a higher protein content
The major ICF electrolytes are potassium, phosphates and magnesium
The major ECF electrolytes are sodium, bicarbonates and chloride
Sources of Fluids: Fluid Input
1. Exogenous sources– Fluid intake- water from foodstuffs– IVF– Medications– Blood products
2. Endogenous sources– By products of metabolism– secretions
Fluid Output: Fluid LossesRoutes of Fluid outputUrineFecal lossesSweat
Insensible losses though the skin and lungs as water vapor
Sensible losses
Sources and Losses of Water
Sources (mL) Losses (mL)
Liquids 1200 Urine 1400
Solid foods 1000 Feces 200
Cell metabolism 300 Insensible losses Lungs Skin
400500
TOTAL 2500 2500
Regulation of Extracellular Fluid Composition
Homeostasis requires that the intake of substances such as water and electrolytes equal their elimination.
Over a long period, the total amount of water and electrolytes in the body does not change unless the individual is growing, gaining weight, or losing weight.
The regulation of water and electrolytes involves the coordinated participation of several organ systems, especially the uroexcretory system.
Control of Fluid Balance is maintained By:
1. Thirst mechanism in the hypothalamus.
2. Antidiuretic Hormone (ADH)
3. Aldosterone
Fluid Dynamics
The movement of fluids (solutes and solvents) in the body compartment
DiffusionOsmosisFiltrationActive transport
The Concept of TONICITY
This is the concentration of solutes in a solution
Reflected by the concentration of the Sodium
The Concept of TONICITY
A solution having the same tonicity as that of body fluid or plasma is considered ISOTONIC– 0.9% NaCl
The Concept of TONICITY
A solution with high solute concentration is considered as HYPERTONIC
A solution with low solute concentration is considered as HYPOTONIC
Helpful Hints
In a HYPERTONIC solution, fluid will go out from the cell, the cell will shrink
In a HYPOTONIC solution, fluid will enter the cell, the cell will swell
In an ISOTONIC solution, there will be no movement of fluid.
Fluid Dynamics
The movement of fluids (solutes and solvents) in the body compartment
DiffusionOsmosisFiltrationActive transport
DIFFUSION
The movement of SOLUTES or particles in a solution from a higher concentration to a lower concentration
If a sugar is placed in plain water, the glucose molecules will dissolve and diffuse distribute in the solution
OSMOSIS
The force that draws water or solvent from a less concentrated solution into a more concentrated solution through a semi-permeable membrane
The pressure that draws water inside the vessel which is more concentrated is called Osmotic pressure
OSMOSIS
A special type of osmotic pressure is exerted by the proteins in the plasma.
It is called ONCOTIC PRESSSURE (COLLOID Pressure)
FILTRATION
The movement of both solute and solvent by hydrostatic pressure, ie, from an area of a higher pressure to an area of a lower pressure
An example of this process is urine formation
Hydrostatic pressure
Hydrostatic pressure is the pressure exerted by the fluid against the container
Increased hydrostatic pressure is one mechanism producing edema
Active transport
This is the movement of solutes across a membrane from a lower concentration to a higher concentration with utilization of energy
Example is the Sodium-Potassium pump- a primarily active transport process
FLUID EXCESS: Edema
Occurs in the extracellular compartment and may be isotonic, hypotonic, or hypertonic
Edema – refers to an excessive amount of fluid in the interstitial compartment, which causes swelling or enlargement of the tissues.
CAUSES OF EDEMA:
1.Increased capillary hydrostatic pressure
2.Loss of plasma proteins (albumin).
3.Obstruction of the Lymphatic circulation
4.Increased capillary permeability
Effects of Edema:
1.Local area of swelling
2.Pitting edema
3.Significant increased in body weight
4.Functional impairment
5.Pain
6. Arterial circulation may be impaired
FLUID DEFICIT: Dehydration
Refers to insufficient body fluid resulting from inadequate intake or excessive loss or a combination of the two.
Causes of Dehydration:
1.Vomiting and diarrhea
drainage or suction of any portion of Digestive system
2. Excessive sweating with loss of sodium and water
3. Diabetic ketoacidosis with loss of fluid, electrolytes and glucose in the urine
4. Insufficient water intake an elderly or unconscious person
Effects of Dehydrartion:
1.Dry mucous membranes in the mouth/decreased skin turgor
2.Lower blood pressure, weak pulse, and a feeling of fatigue, and
3.Increased hematocrit, indicating a higher proportion of red blood cells compared to water in the blood.
Compensatory Mechanisms:
1.Increasing thirst
2.Increasing the heart rate
3.Constricting the cutaneous blood vessels leading to pale and cool skin,
4.Decreasing urine output (water retention) leading to high specific gravity of urine (more concentrated) as a result of renal vasoconstriction and increased secretion of ADH and Aldosterone.
Comparison of Signs And Symptoms of Fluid Excess and Fluid Deficit
Fluid Excess (edema) Fluid Deficit (Dehydration)
Localized swelling (feet, hands, periorbital area, ascites)
Sunken, soft eyes
Pale, gray, or red skin color Decreased skin turgor, dry mucous membranes
Weight gain Thirst, weight loss
Slow, bounding pulse, high blood pressure
Rapid, weak, thready pulse; low b lood pressure; orthostatic hypotension
Lethargy, possible seizures Fatigue, weakness, dizziness, possible stupor
Pulmonary congestion, cough, rales Laboratory values Decreased hematocrit Decreased serum sodium Urine: Low specific gravity, high volume
Increased body temperature Laboratory values Increased hematocrit Increased electrolyte or (variable) Urine: High specific gravity; low volume
Regulation of Body fluid balance
1. The Kidney Regulates primarily fluid output by
urine formation Releases RENIN Regulates sodium and water balance
Regulation of Body fluid balance
2. Endocrine regulation Regulates primarily fluid intake by thirst
mechanism ADH increase water reabsorption on
collecting duct Aldosterone increases Sodium
retention in the distal nephron ANF Promotes Sodium excretion and
inhibits thirst mechanism
Regulation of Body fluid balance
3. Gastro-intestinal regulationThe GIT digests food and absorbs
water Only about 200 ml of water is
excreted in the fecal material per day
The ELECTROLYTES
Electrolytes are charged ions capable of conducting electricity and are solutes in all compartment
The ELECTROLYTES
Sources of electrolytesFoods and ingested fluids Medications IVF and TPN solutions
The ELECTROLYTES
Functions of Electrolytes Maintains fluid balance Regulates acid-base balance Needed for enzymatic secretion and
activation Needed for proper metabolism and
effective processes of muscular contraction, nerve transmission
The ELECTROLYTES
ECF and ICF vary in their electrolyte distribution and concentration
Cation and Anion
CATIONS- positively charged ions; examples are sodium, potassium, calcium
ANIONS- negatively charged ions; examples are chloride and phosphates
Cation and Anion
The major ICF cation is potassium (K+); the major ICF anion is Phosphates
The major ECF cation is Sodium (Na+); the major ECF anion is Chloride (Cl-)
Ions
Factors which influence the concentration of water and solutes inside the cells:– Transport mechanisms– Permeability of the cell membrane– Concentration of water and solutes in the extracellular fluid
Ions
NORMAL VALUES AND MASS CONVERSION FACTORS
Normal Plasma Values Mass Conversion
Sodium (Na+) 135 – 145 meq/L 23 mg = 1 meq
Potassium (K+) 3.5 – 5.0 meq/L 39 mg = 1 meq
Chloride (Cl-) 98 – 107 meq/L 35 mg = 1 meq
Bicarbonate (HCO3-) 22 – 26 meq/L 61 mg = 1 meq
Calcium (Ca2+) 8.5 – 10.5 mg/dL 40 mg = 1 mmol
Phosphorus 2.5 – 4.5 mg/dL 31 mg = 1 mmol
Magnesium (Mg2+) 1.8 – 3.0 mg/dL 24 mg = 1 mmol
Osmolality 285 – 295 mosm/kg -
Sodium
Dominant extracellular ion. About 90 to 95% of the osmotic pressure of the
extracellular fluid results from sodium ions and the negative ions associated with them.
Recommended dietary intake is less than 2.5 grams per day.
Kidneys provide the major route by which the excess sodium ions are excreted.
Sodium
In the presence of aldosterone, the reabsorption of sodium ions in the loop of Henle is very efficient. When aldosterone is absent, the reabsorption of sodium in the nephron is greatly reduced and the amount of sodium lost in the urine increases.
Also excreted from the body through the sweat mechanism.
Sodium
Primary mechanisms that regulate the sodium ion concentration in the extracellular fluid:– Changes in the blood pressure– Changes in the osmolality of the extracellular fluid
Sodium Regulation
NORMAL Na+
INCREASED SODIUM
DECREASED SODIUM
Increased ADH secretion, Decreased urine volume and increased plasma
volume
Decreased aldosterone secretion, decreased sodium reabsorption
DECREASED SODIUM
INCREASED SODIUM
Decreased ADH secretion, Increased urine volume and decreased plasma
volume
Increased aldosterone secretion, increased sodium reabsorption
Potassium
Electrically excitable tissue such as muscle and nerves are highly sensitive to slight changes in extracellular potassium concentration.
The ECF concentration of potassium must be maintained within a narrow range for tissues to function normally.
Potassium
Aldosterone also plays a major role in regulating the concentration of potassium ions in the ECF.
Circulatory system shock resulting from plasma loss, dehydration, and tissue damage causes extracellular potassium ions to become more concentrated than normal. In response, aldosterone secretion increases and causes potassium secretion to increase.
Potassium Regulation
NORMAL K+
INCREASED POTASSIUM
DECREASED POTASSIUM
Increased aldosterone secretion with increased potassium secretion by the kidneys and increased potassium in
urine
DECREASED POTASSIUM
INCREASED POTASSIUM
Decreased aldosterone secretion with decreased potassium secretion by the
kidney and decreased potassium in the urine
Calcium
Extracellular concentration of calcium ions is maintained within a narrow range.
Increases and decreases in ECF concentration of calcium ions have dramatic effects on the electrical properties of excitable tissues.
Parathyroid hormone (PTH) secreted by the parathyroid glands increases extracellular calcium levels.
Calcium
Calcitonin is secreted by the thyroid gland. It reduces blood levels of calcium when they are too
high.
Calcium Regulation
NORMAL Ca++
INCREASED CALCIUM
DECREASED CALCIUM
Increased Calcitonin secretion with decreased bone resorption
Decreased parathyroid hormone secretion with decreased bone resorption, decreased intestinal
calcium absorption, and decreased kidney calcium reabsorption
DECREASED CALCIUM
INCREASEDCALCIUMIncreased parathyroid hormone
secretion with increased bone resorption, increased intestinal
calcium absorption, and increased renal calcium reabsorption
Phosphate and Sulfate
Phosphate and sulfate are reabsorbed by active transport in the kidneys.
Rate of reabsorption is slow, so that if the concentration of these ions in the filtrate exceeds the ability of the nephron to reabsorb them, the excess is excreted in the urine.
Helpful mnemonics
PI-SO Potassium is inside Phosphate is inside
Sodium is outside Chloride is outside
Regulation of Electrolyte Balance
1. Renal regulation Occurs by the process of glomerular
filtration, tubular reabsorption and tubular secretion
Urine formation– If there is little water in the body, it is
conserved– If there is water excess, it will be eliminated
Regulation of Electrolyte Balance
2. Endocrinal regulation Hormones play a role in electrolyte
regulation Aldosterone promotes Sodium retention
and Potassium excretion ANF promotes Sodium excretion Parathormone promotes Calcium
retention and Phosphate excretion Calcitonin promotes Calcium excretion
and Phosphate excretion
Regulation of Electrolyte Balance
3. GIT Regulation- electrolytes are absorbed and secreted and some are excreted thru the stool
THE CATIONS
SODIUM POTASSIUM CALCIUM MAGNESIUM
SODIUM
Normal range is 135-145 mEq/L Major contributor of plasma
osmolarity
FUNCTIONS 1. participates in the Na-K pump 2. assists in maintaining blood volume 3. assists in nerve transmission and
muscle contraction
POTASSIUM
MOST ABUNDANT cation in the ICF Normal range is 3.5-5.0 mEq/L
FUNCTIONS 1. maintains ICF Osmolality 2. nerve conduction and muscle
contraction 3. metabolism of carbohydrates, fats and
proteins
CALCIUM Majority of calcium is in the bones and
teeth Normal serum range 8.5-10 mg/dL
FUNCTIONS 1. formation and mineralization of
bones/teeth 2. muscular contraction and relaxation 3. cardiac function 4. blood clotting 5. enzyme activation
CALCIUM
Regulation: GIT absorbs Ca+ in the intestine with
the help of Vitamin D Kidney Ca+ is filtered in the
glomerulus and reabsorbed in the tubules
PTH increases Ca+ by bone resorption, Ca+ retention and activation of Vitamin D
Calcitonin released when Ca+ is high, it decreases Ca+ by excretion in the kidney
MAGNESIUM Second to K+ in the ICF Normal range is 1.3-2.1 mEq/LFUNCTIONS 1. intracellular production and
utilization of ATP 2. protein and DNA synthesis 3. neuromuscular irritability
THE ANIONS
CHLORIDE PHOSPHATES BICARBONATES
CHLORIDE The MAJOR Anion in the ECF Normal range is 95-108 mEq/L
FUNCTIONS 1. major component of gastric juice
aside from H+ 2. together with Na+, regulates
plasma osmolality 3. participates in the chloride shift 4. acts as chemical buffer
PHOSPHATES The MAJOR Anion in the ICF Normal range is 2.5-4.5 mg/LFUNCTIONS 1. component of bones 2. needed to generate ATP 3. components of DNA and RNA PTH decreases PO4 in blood by
renal excretion Calcitonin increases renal
excretion of PO4
BICARBONATES
Present both in ICF and ECF Normal range- 22-26 mEq/L
FUNCTIONS 1. regulates acid-base balance 2. component of the bicarbonate-
carbonic acid buffer system
IMBALANCE: EXCESS
1. HYPERNATREMIA More than 145 mEq/L Fluid moves out of cell crenation Etiology:↑ sodium intake, IVF, water
loss in excess of water, diarrhea S/SX: dry, sticky tongue, thirst
IMBALANCE: EXCESS2. HYPERKALEMIA K+ more than 5.0 mEq/L Etiology: IVF with K+, acidosis,
Hyper-alimentation and K+ replacement
ECG: peaked T waves and wide QRS
IMBALANCE: EXCESS3. HYPERCALCEMIA Serum calcium more than 10.5 mg/dL Etiology: Overuse of calcium
supplements, excessive Vitamin D, malignancy, prolonged immobilization, thiazide diuretic
ECG: Shortened QT interval
IMBALANCE: EXCESS
4. HYPERMAGNESEMIA Serum magnesium more than 2.1 mEq/L Etiology: use of Mg antacids, Renal
failure, Mg medications S/SX: depressed tendon reflexes,
oliguria, ↓RR
IMBALANCE: EXCESS
5. HYPERCHLOREMIA Serum chloride more than 108 mEq/L Etiology: sodium chloride excess
IMBALANCE: EXCESS
6. HYPERPHOSPHATEMIA Serum PO4 more than 4.5 mg/dL Etiology: Tissue trauma, chemotherapy.
PO4 containing medications, osteoporosis
IMBALANCE : DEFICIENCY1. HYPONATREMIA Na level is less than 135 mEq/L Water is drawn into the cell cell
swelling Etiology: prolonged diuretic therapy,
excessive burns, excessive sweating, SIADH, plain water consumption
S/SX: nausea, vomiting, seizures
IMBALANCE : DEFICIENCY2. HYPOKALEMIA K+ level less than 3.5 mEq/L Etiology: use of diuretic, vomiting
and diarrhea ECG: flattened , depressed T waves,
presence of “U” waves
IMBALANCE : DEFICIENCY3. HYPOCALCEMIA Calcium level of less than 8.5 mg/dL Etiology: removal of parathyroid gland
during thyroid surgery, Vit. D deficiency, Furosemide, infusion of citrated blood
S/SX- Tetany, (+) Chvostek’s (+) Trousseaus’s
ECG: prolonged QT interval
ACID-BASE CONCEPTS
Acid- substance that can donate or release hydrogen ions–Carbonic acid, Hydrochloric acid
ACID-BASE CONCEPTS
Base- substance that can accept hydrogen ions–Bicarbonate
ACID-BASE CONCEPTS
Buffer- substance that can accept or donate hydrogen–Hemoglobin buffer–Bicarbonate : carbonic acid buffer
–Phosphate buffer
ACID-BASE CONCEPTS
Bicarbonate : carbonic acid buffer Most important buffer system Must maintain the balance of 20:1 Immediate but limited
ACID-BASE CONCEPTS
pHMeasures the hydrogen
concentration in a solutionMeasures the degree of acidity
and alkalinity
Acid and Base
pH measures the degree of acidity and alkalinity. It is inversely related to Hydrogen. Normal ph 7.35-7.45
Decreased pH- ACIDIC-increased Hydrogen—pH below 7.35
Increased pH- ALKALOSIS-decreased hydrogen—pH above 7.45
SUPPLY AND SOURCES OF ACIDS AND BASES
Sources of acids and bases are from:
1. ECF, ICF and body tissues
2. Foodstuff
3. Metabolic products of cells like CO2, lactic acids, ammonia
ABG analysis
This test helps to evaluate gas exchange in the lungs by measuring the gas pressures and pH of an arterial sample
ABG analysis Pre-test: choose site carefully, perform
the Allen’s test, secure equipments- syringe, needle, container with ice
Intra-test: Obtain a 5 mL specimen from the artery (brachial, femoral and radial)
Post-test: Apply firm pressure for 5 minutes, label specimen correctly, place in the container with ice
Nursing care
Explain procedure to the client Obtain a heparinized syringe or vacuum
container tube Perform Allen’s test before obtaining
specimen (assessment of collateral circulation before radial artery puncture)
ABG analysis
ABG normal values PaO2 80-100 mmHg PaCO2 35-45 mmHg pH 7.35- 7.45 HCO3 22- 26 mEq/L O2 Sat 95-99%
Value Normal Acidosis
Alkalosis
pH 7.35-7.45 Below 7.35
Above 7.45
paO2 95-100 mmHg
SaO2 95-98%
paCO2 35-45 mmHg
Respiratory >45
Respiratory<35
HCO3 22-26 mEq/L Metabolic<22
Metabolic>26
remember
a high hydrogen acidic pH is low a low hydrogen alkalosis pH is
high
a high CO2may mean acidic a low CO2 may mean alkalosis
Dynamics of Acid and bases Acids and bases are constantly
produced in the body They must be constantly regulated CO2 and HCO3 are crucial in the
balance A ratio of 20:1 is maintained
(HCO3:H2CO3)
Respiratory and renal system are active in regulation
Ways to balance the acids and bases
ExcretionAcid can be excretedHydrogen can be excreted Bicarbonate can be excreted
Ways to balance the acids and bases
ProductionBicarbonate can be producedHydrogen can be produced Acid can be produced
Ways to balance the acids and bases
Neutralization Acids can be neutralized by bicarbonate Bicarbonate can be neutralized by acids
Regulation of acids and bases
Respiratory SystemRenal SystemBuffer System
Ways to balance the acids and bases
The respiratory system compensates for metabolic problems
CO2 (acid) can be exhaled from the body to normalize the pH in ACIDOSIS
CO2 (acid) can be retained in the body to normalize the pH in ALKALOSIS
Ways to balance the acids and bases
The kidney can compensate for problems in the respiratory system
The Kidney reabsorbs and generates Bicarbonate (alkaline) in ACIDOSIS
The Kidney can excrete H+ excess (Acidosis) to normalize the pH in ACIDOSIS
Ways to balance the acids and bases
The kidney can excrete bicarbonate (alkali) in conditions of ALKALOSIS
The kidney can retain H+ (acid) in conditions of ALKALOSIS
Ways to balance the acids and bases
Chemical buffers can also participate in the balance of acid-base
1. Carbonic acid- bicarbonate buffer 2. Phosphate buffer 3. protein buffer- ICF and hemoglobin
The action is immediate but very limited
FACTORS AFFECTING BODY FLUIDS, ELECTROLYTES AND ACID-
BASE BALANCE
AGE Infants have higher proportion of body
water than adults Water content of the body decreases
with age Infants have higher fluid turn-over due
to immature kidney and rapid respiratory rate
FACTORS AFFECTING BODY FLUIDS, ELECTROLYTES AND ACID-
BASE BALANCE
GENDER AND BODY SIZE Women have higher body fat content
but lesser water content Lean body has higher water content
FACTORS AFFECTING BODY FLUIDS, ELECTROLYTES AND ACID-
BASE BALANCE
ENVIRONMENT AND TEMPERATURE Climate and heat and humidity affect
fluid balance
FACTORS AFFECTING BODY FLUIDS, ELECTROLYTES AND ACID-
BASE BALANCE
DIET AND LIFESTYLE Anorexia nervosa will lead to nutritional
depletion Stressful situations will increase metabolism,
increase ADH causing water retention and increased blood volume
Chronic Alcohol consumption causes malnutrition
FACTORS AFFECTING BODY FLUIDS, ELECTROLYTES AND ACID-
BASE BALANCE
ILLNESS Trauma and burns release K+ in the
blood Cardiac dysfunction will lead to edema
and congestion
FACTORS AFFECTING BODY FLUIDS, ELECTROLYTES AND ACID-
BASE BALANCE
MEDICAL TREATMENT,
MEDICATIONS AND SURGERY Suctioning, diuretics and laxatives may
cause imbalances
Fluid Imbalances
Fluid volume deficit– Occurs when the body lose BOTH
water and electrolytes– HYPOVOLEMIA
Fluid Imbalances
Fluid Volume excess – Occurs when the body retains BOTH
water and electrolytes– Called HYPERVOLEMIA
In Summary
A balance of Fluids, Electrolytes and Acids-Bases is necessary for health and homeostasis
Fluid is a solution of solvent and solutes The body fluid is located in TWO
compartments: Intracellular and Extracellular
In Summary
Most of body fluid is in the intracellular compartment
The movement of fluids is governed by four mechanisms: Diffusion, Osmosis, Filtration and Active transport
50-60% of body weight is water
In Summary
Electrolytes are charged particles in a solution
CATIONS are positive (Na, K, Mg, Ca) ANIONS are negative (Cl, HCO3, PO4) The concentration of these electrolytes
varies in the compartments
In Summary
Potassium (+) and Phosphates (-) =ICF
Sodium (+) and Chloride (-) = ECF
In Summary
Acids are hydrogen donors. Examples are carbonic acid, lactic acid, ketoacid
Alkalis are hydorgen acceptors. Examples are bicarbonate, NaOH
In Summary
Our body fluid is regulated by many mechanisms and body systems: Kidney, Gastro-intestinal tract and Endocrine
FLUID sources are INPUT coming from food, feeding and oral intake
FLUID OUTPUT can occur through excretion of urine, sweat and feces. insensible losses are water vapor
In Summary
The HYPOTHALAMUS regulates intake via the thirst mechanism
The KIDNEY regulates output via urine formation
Other hormones include ADH, aldosterone and ANF
In Summary Imbalances occur in the fluids and
electrolytes:– Hyper if excess– Hypo if deficient
Imbalances occur in the Acids and bases:– Acidosis or Alkalosis– Respiratory or Metabolic
Thank you!!!!