Total amount of sodium in the body - Responsible for ECF volume
Total amount of water in the body - responsible for extracellular sodium concentration
ADH secretion - initiated by a change in plasma osmolality or decreases circulating
blood volume/blood pressure
Osmoreceptors - changes in plasma osmolality stimulate these in the hypothalamus
Serum osmolality is calculated as: - 2 x (sodium concentration) + (glucose
concentration/18) + (BUN/2.8)
osmolality - deterred by the total solute concentration in a fluid compartment
tonicity - ability of the combined effect of all the solutes to generate an osmotic deriving
force that causes water movement form one compartment to another
effective osmoles - solutes capable of changing the tonicity; e.g. sodium, glucose,
mannitol and sorbitol
ineffective osmoles - urea
normal body fluid osmolality - 280-294 mOsm/kg
hypertonic - volume depletion or volume excess with increased osmolality
Fluid Volume Deficit - Hypovolemia, water deprivation - confusion, coma, inability to
communicate, loss of thirst, water loss - diarrhea, diabetes insipid, excessive diuresis.
treatment for hypovolemia - give water/stop fluid loss, give slowly, If IV dextrose 5% in
water.
fluid volume excess - hypervolemia, due to compulsive water drinking, renal failure,
congestive heart fails, cirrhosis
clinical manifestations of hypervolemia - cerebral edema with confusions and
convulsions, weakness, nausea, muscle twitching, headache and weight gain
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