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Alterations in fluid volume. Isotonic fluid volume deficit decrease in the extracellular fluid, including circulating blood volume . Caused by: Impaired intake excessive losses of body fluids osmotic diuresis excessive sweating or when large areas of skin have been damaged
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Alterations in fluid volume Isotonic fluid volume deficit decrease in the extracellular fluid, including circulating blood volume. Caused by: Impaired intake excessive losses of body fluids osmotic diuresis excessive sweating or when large areas of skin have been damaged Third- space losses Manifestations: Weight loss Hypovolemic shock Thirst Urine output decreased Arterial and venous volume decrease
2) Isotonic fluid volume excess • isotonic expansion of the extracellular fluid • Caused by : • Increased sodium intake • decrease in sodium and water elimination by the kidney • Heart failure • Manifestations: • increase in interstitial and vascular fluids • Edema • Puffy eyelids
Alterations in sodium balance 1)Hyponatremia serum sodium concentration below 135 mEq/L. Caused by : decrease in total body sodium with a lesser decrease in body water normal total body sodium content with excess retention of body water excess in body sodium with an even greater excess in body water Manifestations: Cellular swelling (movement of water from extracellular to intracellular) Muscle cramp, weakness, fatigue (Intracellular hypo-osmolality ) Progressive neurologic symptoms Water intoxication
2) Hypernatremia • serum sodium level above 148 mEq/L • Caused by: • excess loss of body water • defect in thirst or inability to drink water • Rapid sodium ingestion with insufficient time for water ingestion. • Manifestations: • Extracellular fluid loss • Cellular dehydration • Thirst • Body temperature elevated • Skin and mucous membrane become dry