Class notes
RNSG 1533 Fluid and Electrolytes Lecture Notes
- Course
- RNSG 1533
- Institution
- San Antonio College
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San Antonio College Department of Nursing EducationGeneric Program Level Two
RNSG 1533 Health Care Concepts II
Fluid and Electrolyte Unit Objectives
Concept – FLUID and ELECTROLYTE BALANCE
Concept Definition
Fluid and Electrolyte Balance is the process of regulating the extracellular fluid volume,
body fluid osmolality, and plasma concentrations of electrolytes.
Exemplars
Dehydration – Gastroenteritis – Elderly and Pediatric
Extracellular Fluid Volume Excess
Hypocalcemia/Hypercalcemia
Hypokalemia /Hyperkalemia - Chronic Renal Failure
Hyponatremia - Syndrome of Antidiuretic Hormone (SIADH) /Hypernatremia –
Diabetes Insipidus (DI)
Hypophosphatemia /Hyperphosphatemia
Hypomagnesemia /Hypermagnesemia
Fluid and Electrolyte Balance
1. Explain the concept of Fluid and Electrolyte Balance (including definition,
antecedents, and attributes).
Fluid and Electrolytes: The process of regulating the extracellular fluid volume, body fluid
osmolality, and plasma concentrations of electrolyte.
Attributes Antecedents
Balanced Intake and output
Potassium 3.5-5.0 mEq/L Fluid & Electrolyte intake and absorption
Sodium 135-145 mEq/L
Normal functioning of Renin- Angiotensin Aldosterone
Total Calcium 8.6-10.2 mg/dL System
Magnesium 1.3-2.3 mg/dL
Phosphorus 2.5-4.5 mg/dL Sufficient cardiac output
Serum osmolality 280-300 mOsm/Kg Adrenal, thyroid, parathyroid, pituitary glands functioning
CVP 2 to 6 mm Hg within normal limits
Regulation of body fluid compartments through osmosis,
diffusion, and active transport.
, San Antonio College Department of Nursing Education
Generic Program Level Two
RNSG 1533 Health Care Concepts II
Fluid and Electrolyte Unit Objectives
2. Identify conditions which place a patient at risk for fluid and electrolyte imbalance.
- Very young
- Very old
- Major GI loses (vomiting, diarrhea, suctioning)
- Dehydration
- Third space shifts
- Blood loss
- Compromised kidney, liver, heart function
3. Identify when fluid and electrolyte imbalance (negative consequence) is developing
or has developed.
- Retention of fluid
- Impaired Neuromuscular Function
- Cardiac Arrhythmias
- Imparted Cerebral Function (confusion, seizure, coma)
4. Apply the nursing process (including collaborative interventions) for individuals
experiencing fluid and electrolyte imbalance and to promote normal Fluid and
Electrolyte Balance.
- Monito I&O’s
- Daily weights
- Administration of oral/ IV fluids
- Diuretics
- Sodium restrictive diets
- Promote rest
5. Describe the distribution of fluids throughout the body.
- Intracellular fluid: 2/3 of body fluid
- Extracellular: 1/3 of body fluid
-Intravascular: Blood Fluid (20%)
-Interstitial: Lymph Fluid (80%)
-Transcellular: CSF, pericardial, synovial
, San Antonio College Department of Nursing Education
Generic Program Level Two
RNSG 1533 Health Care Concepts II
Fluid and Electrolyte Unit Objectives
6. Explain how electrolytes are valuable to the body.
Sodium: Maintans blood pressure and blood volume maintains fluid balance,
affects muscle contraction, transmission of nerve impulses, regulation of acid
base balance as sodium bicarbonate. Regulated by Aldosterone
Potassium: Manages heart and muscle contraction, maintains fluid balance
and Blood Pressure, transmission of electrical impulses in nerve, heart,
skeletal, interstitial, lung tissue. Regulated by kidneys.
Calcium: Major component of bones teeth, role in blood coagulation,
transmission of nerve impulses, helps regulate muscle contraction and
relaxation. Regulated by vitamin D, PTH, Calcitonin.
Magnesium: Nerve, muscle function, neuron communication, heart function,
maintains blood pressure, muscle relaxation, maintains immune system,
bones. Regulated by kidneys.
Phosphate: Building bones, teeth, muscles. RBC & muscle function involved in
acid/base balance, promotes energy storage, carbs, protein, fat metabolism.
Regulated by PTH and kidneys.
7. Differentiate between osmosis and osmolality.
Osmosis: Movement of water from an area of low solute concentration to an area of
high concentration.
Osmolality: Is a measure of the number of dissolved particles in a fluid.
8. Define diffusion, filtration, and sodium potassium pump.
Diffusion: is the passive movement of molecules from an area of high concentration
to an area of low concentration.
Filtration: Movement of water, solutes occur from area of high hydrostatic
pressure to area of low hydrostatic pressure
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