Fluid - ANSwater that contains substances such as glucose, mineral salts (electrolytes), and
proteins.
electrolyte - ANSis a compound that separates into ions when it dissolves in water
60% - ANSWhat percent of body weight does water make up for an adult male?
- outside of the cells
- 1/3 total body water
- contains Na, Cl, and HCO3 (Bicarbonate)
- 3 parts: intravascular fluid, interstitial fluid, transcellular fluid (CSF, peritoneal, pleural, synovial)
- ANS- inside the cells
- 2/3 total body water
- balance maintained primarily through the cell membrane's permeability
- contains K, Mg, Phosphates, and Proteins
osmolality - ANSthe concentration of particles in water (particles per kg)
tonicity - ANSthe measure of osmotic pressure gradient between two solutions. It is influenced
by solutes that cannot cross the semipermeable membrane
isotonic - ANSsame concentration as blood
in this type of solution, cells maintain their normal size and ther is no loss or gain of water
hypotonic - ANSmore dilute than blood
in this type of solution, cells swell rapidly and water rushes into them and they may burst
hypertonic - ANSmore concentrated than blood
in this type of solution, cells lose water and shrink
, Age, environment, dietary intake, lifestyle, medications (prescription, OTC, and herbal), recent
surgeries or recent stressful events, GI output, acute illness or trauma, chronic illness - ANSF&E
Assessment: Patient Nursing and Medical History
-Daily weights (use the same conditions each time, good indicator of fluid status)
-Fluid I&O (24 hr Intake and output, compare the intake vs output)
-Laboratory studies (diagnostic electrolyte levels) - ANSName the 3 main physical assessments
of F&E balance
•VS: hypotension, light-headed when sitting or standing à ECV deficit
•Wt: Loss or gain of 2.2 lbs in a 24 hour period à ECV deficit or excess
•Pulse: rapid and thread à deficit; Bounding à excess
•Neck veins: Flat à deficit; Full or distended à excess
•Capillary refill: sluggish à deficit
•Lungs: crackles à excess - ANSWhat would you see in your assessment findings? What would
that indicate? A fluid deficit or fluid excess?
Nursing Diagnosis - ANS-Fluid Imbalance
-Dehydration
-Electrolyte Imbalance
-Acid Base Imbalance
-Lack of Knowledge of Fluid Regimen
Nursing Planning - ANS-Select individualized nursing intervention to maintain or restore fluid
and electrolyte balance
-Consult with pharmacy, dieticians
-Involve patient and family
Goals and Outcomes
Nursing Implementations for Fluid and Electrolyte Imbalances - ANS-Health Promotion
-Acute Care
-Fluid Replacement
-Electrolyte Replacement
-Fluid Restriction
Isotonic Solutions (NS, LR) - ANSWhat type if IV Therapy treats an ECV deficit without entering
cells?
Hypotonic Solutions (1/2 NS) - ANSWhat type of IV Therapy functions to decrease osmolality by
diluting body fluids and moving water into cells?
Hypertonic Solution (3% or 5% NS, D5 1/2NS, D5NS) - ANSWhat type of IV Therapy functions
to increase osmolality rapidly and pull water out of the cell, causing cells to shrivel?
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