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NUR170 Exam Fluid And Electrolytes
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NUR170 Exam Fluid And Electrolytes 2024-2025intracellular (ICF)
lies within the bodies cells and is 2/3rds of total body fluid
Extracellular (ECF)
Compromised of intravascular(plasma), interstitial fluid surrounds cells (lymph),
Transcellular fluid in epithelial line spaces (cerebrospinal fluid, pericardial, pancreatic,
pleural, intraocular, biliary, peritoneal,
and synovial fluid)
Brainpower
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how fluids move through the body compartments
diffusion (high to low concentration solvent), Osmosis (high to low solute), active
transport, and filtration to maintain homeostasis
Dehydration
deficiency of body fluids resulting from inadequate intake or excessive loss
true dehydration: deficiency of body fluids, there is a movement of water from plasma
into the interstitial space
Hypovolemia-isotonic dehydration
fluid loss results in loss of both water and electrolytes leading to a contraction of
circulating blood volume-fluid volume deficit
Compensatory mechanisms for dehydration
increased thirst, (ADH) hormone secretion-conserves fluid, Aldosterone-(retain
,salt/water. increase BP)
Fluid volume deficit/dehydration {extreme}
lead to hypovolemic shock
older peoples increased risk to dehydration
due to multiple physiological factors including decrease in total body mass [including
water], decreased ability to detect thirst
Causes of hypovolemia
excessive GI loss- vomiting, NG suctioning, diarrhea
excessive skin loss- diaphoresis(sweating) w/o water or sodium supplement
excessive renal system loss- diuretic therapy, kidney disease, adrenal insufficiency,
other- third degree burns, hemorrhage or plasma loss, altered intake anorexia, nausea,
impaired swallowing, confusion, NPO
Causes for Dehydration
Hyperventilation or excessive perspiration w/o water replacement, prolonged fever,
diabetic ketoacidosis, inadequate water intake (enteral food w/o water), impaired thirst
sensation, dysphagia, diabetes insipidus (make excessive urine), osmotic diuresis,
excessive salt intake (salty tablet/hypertonic fluid
Onset of Hypovolemia/dehydration- Vitals
Vital signs- hypothermia (hypovolemia), hyperthermia (dehydration), tachycardia,
thready pulse, hypotension or orthostatic hypotension, decreased venous pressure,
tachypnea, Hypoxia (decreased oxygen to tissues)
Onset of Hypovolemia/dehydration- Neuromusculoskeletal
Dizziness, syncope (pass out), confusion, weakness, fatigue, seizures (rapid/severe
, dehydration)
Expected findings for Hypovolemia/dehydration- GI
thirst, dry mucous membranes, dry furrowed tongue, nausea, vomiting, anorexia, acute
weight loss
Expected findings for Hypovolemia/dehydration- Renal
oliguria (decreased production of urine)
Expected findings for Hypovolemia/dehydration- Other Findings
diminished capillary refill, cool, clammy skin, diaphoresis (sweating), sunken eyeballs,
flattened neck veins, absence of tears, decreased skin turgor
laboratory test for hypovolemia/ dehydration
HCT (hematocrit)-elevated in both dehydration and hypovolemia unless loss is
hemorrhage related
Blood osmolarity- (dehydration)-increased hemoconcentration osmolarity (above 295
mosm/Kg)
Urine specific gravity (dehydration)-elevated concentration
Blood sodium-(dehydration) increased hemoconcentration (above 145)
BUN- Elevated (above 25mg/dl) due to hemoconcentration
Dehydration- elevated protein, electrolytes, glucose
Nursing care for dehydration/ hypovolemia
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