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Interventions for Clients with Fluid and Electrolyte imbalances

Interventions for Clients with Fluid and Electrolyte imbalances. 2. Body Fluid Compartments. 2/3 (65%) of TBW is intracellular (ICF) 1/3 extracellular water 25 % interstitial fluid (ISF) 5- 8 % in plasma (IVF intravascular fluid)

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Interventions for Clients with Fluid and Electrolyte imbalances

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  1. Interventions for Clients with Fluid and Electrolyte imbalances

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  3. Body Fluid Compartments 2/3 (65%) of TBW is intracellular (ICF) 1/3 extracellular water 25 % interstitial fluid (ISF) 5- 8 % in plasma (IVF intravascular fluid) 1- 2 % in transcellular fluids – CSF, intraocular fluids, serous membranes, and in GI, respiratory and urinary tracts (third space) 3

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  6. Fluid compartments are separated by membranes that are freely permeable to water. Movement of fluids due to: hydrostatic pressure osmotic pressure\ Capillary filtration (hydrostatic) pressure Capillary colloid osmotic pressure Interstitial hydrostatic pressure Tissue colloid osmotic pressure 6

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  8. Balance Fluid and electrolyte homeostasis is maintained in the body Neutral balance: input = output Positive balance: input > output Negative balance: input < output 8

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  11. Solutes – dissolved particles Electrolytes – charged particles Cations – positively charged ions Na+, K+ , Ca++, H+ Anions – negatively charged ions Cl-, HCO3- , PO43- Non-electrolytes - Uncharged Proteins, urea, glucose, O2, CO2 11

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  13. Regulation of body water ADH – antidiuretic hormone + thirst Decreased amount of water in body Increased amount of Na+ in the body Increased blood osmolality Decreased circulating blood volume Stimulate osmoreceptors in hypothalamusADH released from posterior pituitaryIncreased thirst 13

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  15. Result: increased water consumption increased water conservation Increased water in body, increased volume and decreased Na+ concentration 15

  16. Fluid Volume Excess Occurs when the body retains both water and sodium in similar proportions to normal ECF. It is also called hypervolemia. Common causes include:- - Excessive intake of sodium chloride - Administering sodium-containing infusions too rapidly Disease processes that alter regulatory mechanisms such as heart failure, renal failure.

  17. Edema Excess interstitial fluid. Edema typically is most apparent in areas where the tissue pressure is low, such as around the eyes, and in dependent tissues (known as dependent edema), where hydrostatic capillary pressure is high. Pitting edema:edema that leaves a small depression or pit after finger pressure is applied to the swollen area.

  18. Electrolyte Imbalances

  19. Hyponatremia

  20. Hypernatremia

  21. Hypokalemia

  22. Hyperkalemia

  23. Hypocalcaemia

  24. Hypocalcemia

  25. Hypocalcemia

  26. A positive Trousseau's sign Muscular contraction including flexion of the wrist and metacarpophalangeal joints, hyperextension of the fingers and flexion of the thumb on the palm

  27. A positive Chvostek's sign. Twitching or contraction of the facial muscles produced by tapping on the facial nerve at specific point

  28. Hypercalcaemia

  29. Hypercalcemia

  30. HypomagnesemiaSigns/symptoms Causes

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