FLUID AND

ELECTROLYTES

Osmolality of intracellular fluid and

extracellular fluid tends to equalize
because of the constant shifting of water.

1. Intracellular
 Fluid with in cell DIAGNOSTIC TESTS AND PROCEDURES
2. Extracellular
 Found in blood vessels  Hematocrit
3. Interstitial fluid 25%
 Creatnine
(the third space)
 Surrounding cells,  BUN
including lymph  Albumin
4. Transcellular fluids  Serum electrolytes
 Lymph, digestive tract,
sweat, cerebrospinal

ELECTROLYTE IMBALANCES ACID - BASE IMBALANCES

1. Sodium (Na) Major cation of
1. Respiratory Acidosis
extracellular fluid
a. Hyponatremia a. pH<7.35
 orthostatic hypotension b. PaCO2>45
b. Hypernatremia c. Hypoventilation →
 flushed skin, dry mucous Hypoxia
membranes
2. Potassium (K) d. Shallow breathing, ↑K+
a. Hypokalemia
 Muscle cramps ↓BP oliguria 2. Respiratory Alkalosis
b. Hyperkalemia a. pH>7.45
 Patients at risk:
decreased renal function,
b. PaCO2<32
in metabolic acidosis, c. Deep breathing,
taking potassium hyperventilation,
supplements
3. Chloride (Cl) tachycardia, lethargy
a. Hyperchloremia & confusion.
 Usually associated with
metabolic acidosis 3. Metabolic Acidosis
b. Hypochloremia
a. pH<7.35
 Usually occurs when sodium
is lost because chloride b. HCO3<20
most frequently bound with c. Kussmaul respiration,
sodium
severe diarreah,
4. Calcium (Ca)
a. Hypocalcemia N,V,D, muscle
 ↓intake of vit D twitching
b. Hypercalcemia
↑ intake of vitamin D 4. Metabolic Alkalosis
5. Magnesium (Mg2+)
a. pH>7.45
a. Hypomagnesemia
b. HCO3>26
 usually from vomiting and
diarrhea
c. Severe vomiting,
b. Hypermagnesemia tremors, muscle cramps
 excessive use of magnesium