FLUID AND ELECTROLYTE IMBALANCE FOUNDATIONAL CONCEPTS AND ASSESSMENTS A) KEY ELEMENTS UNDERLYING FLUID AND ELECTROLYTE IMBALANCE
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Course
NURSING
Institution
NURSING
FOUNDATIONAL CONCEPTS AND ASSESSMENTS
A) KEY ELEMENTS UNDERLYING FLUID AND ELECTROLYTE IMBALANCE
1) THE CELL MEMBRANE
CELL
smallest autonomous functional unit of the body
in its fetal form it is undifferentiated, but as growth continues the cell differentiates into specific
tissue type...
A) KEY ELEMENTS UNDERLYING FLUID AND ELECTROLYTE IMBALANCE
1) THE CELL MEMBRANE
CELL
➢ smallest autonomous functional unit of the body
➢ in its fetal form it is undifferentiated, but as growth continues the cell differentiates into specific
tissue types, forming organs and systems.
CELL WALL
➢ a semipermeable membrane that separates the intracellular from the extracellular
components, allowing for an exchange in an effort for the cell to obtain energy, synthesize
complex molecules, participate in electrical events, and replicate.
Endoplasmic Reticulum Nuclear Membrane
- involved in lipid (fats) and protein - lining of the nucleus
synthesis - encloses the cell nucleus that permits
the passage of proteins and certain
Ribosomes materials
- contains the RNA
Golgi
Nucleus - involved in the secretion in the
- contains the DNA; maintains the intracellular transport
integrity facilitating transcription and
replication processes Cytoplasm
- where most activities of the cell happen
Nucleolus - responsible for the shape of the cell
- largest; most prominent organelle of
the cell Mitochondria
- facilitates signal recognition, facilitates - stores energy; energy currency of the
impulses cell
- the site of transcription and processing
of the ribosomal gene Chloroplast
- where the energy is processed
COMPOSITION
1. PHOSPHOLIPIDS
➢ arranged in one end hydrophilic and the other end hydrophobic
Hydrophylic head (loving water)
➢ faces the outside of the membrane, retaining water and adhering to the neighboring cell
Hydrophobic tail (hating water)
➢ associates with other fatty groups to exclude the hydrophilic groups
,2. PROTEINS
➢ second major component of the cell membrane where most of the functions of the cellular
membrane occur
➢ They transport lipid-insoluble particles acting as carriers to pass these compounds directly
through the membrane. Some proteins form ion channels for the exchange of electrolytes. The
type of protein involved depends on the cell’s function.
3. CELL COAT
➢ long chains of complex carbohydrates make up glycoproteins, glycolipids and lectins that form
the outside surface of the cell. This intricate coat helps in cell-to-cell recognition and adhesion.
FIGURE 1-1 THE CELL MEMBRANE
B) BODY FLUID COMPOSITION
➢ Body fluid is composed of water and various dissolved substances (solutes)
1) WATER
Water is the primary component of body fluids and functions in several ways to maintain normal cellular
function. Water provides a medium for the transport and exchange of nutrients and other substances
such as oxygen, carbon dioxide, and metabolic wastes to and from cells; provides a medium for
metabolic reactions within cells; and assists in regulating body temperature through the evaporation
of perspiration.
Total body water constitutes about 60% of the total body weight, but this amount varies with age,
gender, and the amount of body fat. Total body water decreases from 45% to 50% of total body weight
with obesity and with aging (Porth & Matfin, 2009). Fat cells contain comparatively little water. In the
person who is obese, the proportion of water to total body weight is less than in the person of average
weight; in a person who is very thin, the proportion of water to total body weight is greater than in the
person of average weight. Adult females have a greater ratio of fat to lean tissue mass than adult
males; therefore, they have a lower percentage of total body water.
,Functions:
1. Temperature regulation: controls temperature
2. Transport of materials to/from the cells: maintain homeostasis
3. Aqueous medium for cellular metabolism (provides a medium for metabolic reaction)
4. Assist in food digestion (hydrolysis): saliva, gastric juices, enzymes
5. Acts as solvent in which solute are available for cell function: water is a universal solvent
6. Maintain blood volume: plasma (90% water), RBCs, WBCs and platelets
7. Medium of waste excretion: in a form of sweat, urine, and feces
8. Cushion body parts from injury: CSF cerebrospinal fluid for the spine; synovial fluid for the joints
Factors Affecting Body Water:
1. Age: the amount of water decreases with age
Infant 70-80%
Adult 50-60%
Elderly 45-50%
2. Sex: males have more water because of energy expenditure
Male 60%
Female 50%
3. Body Fats: more fat cells, the lesser water content
Fat cells contains little H2O
*To maintain normal fluid balance, body water intake and output should be approximately equal. The
average fluid intake and output is about 2500ml over a 24-hour period.
INSENSIBLE WATER LOSS
➢ occurs through the skin, lungs and feces
➢ can increase significantly during
1. Exercise;
2. High environmental temperatures;
3. During illnesses that increases respiratory rate, perspiration or GI losses
Table 1-1 Approximate Values of 24-Hour Fluid Gain and Loss of An Adult
Intake (Gain) vs Output (Loss)
H2O (Orally) 1,000 Urine 1500
Water in Food 1,300 Feces 200
Oxidation 200 Perspiration 500
Total 2,500 ml Respiration 300
Total 2,500 ml
2) ELECTROLYTES
Body fluids contain both water molecules and chemical compounds. These chemical compounds can
either remain intact in solution or dissociate into discrete particles.
Electrolytes are substances that dissociate in solution to form charged particle called ions.
Cations (+) are positively charged electrolytes; anions (-) are negatively charged electrolytes.
, ➢ electrically charged particles and is expressed in terms of milliequivalent per liter (mEq/L)
*IONS – dissociated electrolyte particles which carry either (+) (-) charge
(+) charge = cations
(-) charge = anions
4 MAJOR FUNCTIONS OF ELECTROLYTES:
1) Assisting with regulation of water balance
2) Regulating and maintaining acid-base balance
3) Contributing to enzyme reactions
4) Essential for neuromuscular activity
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