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process in which the body maintains balance by constantly adjusting to internal and external stimuli
makes up the large portion of the body. Elderly decreases 45-50% of body weight. r/t decreased muscle mass, smaller fat stores, and decrease in body fluids
inside the cells 2/3 tbf and functions as a stabilizing agent for parts of the cell
outside the cells 1/3 tbf appears mostly in the interstitial fluid and intravascular fluid
Fluid volume shifts
fluid normally shifts between ic and ec compartments to maintain equilibrium between spaces
fluid volume shifts
fluid not lost from body but not available for use in either compartment. considered third spacing
causes of third spacing
burns, peritonitis, bowel obstruction, massive bleeding into or cavity, liver or renal failure
signs/symptoms of third spacing
decreased urine output with adequate intake, increased HR, decreased BP, increased weight, pitting edema
Fluid volume excess
hypervolemia, isotonic expansion of ECF caused by abnormal retention of H2O and Na, fluid moves out of ECF into cells and cells swell
Fluid volume excess causes
cardiovascular-heart failure, urinary-renal failure, hepatic-liver failure,cirrhosis,normal imbalances
Na restrictions, fluid restrictions, closely monitor IVF, push at correct speed to prevent pulmonary edema, if dyspnea or othropnea put in Semi-Fowlers, strict I & Os
Factors of dehydration
diarrhea, vomiting, inappropriate use of diuretics, decreased fluid intake, excessive heat, sweating, fever
thirst, decreasing urine/cease sweating, water moves from ICF to intravascular fluids, body tissues dried out, mental confusion, coma, and severe kidney/liver damaged
signs/symptoms of dehydration
acute weight loss, oliguria, concetrated urine, weak rapid pulse, cap refills time elongated, decreased BP, increased pulse, sensations of thirst, weakness, dizziness, muscle cramps
other causes of water loss
fever,burns, diarrhea, vomiting, NG suctioning, surgery, wound drainage fistulas
solution exerting equal pressures on opposite sides of the membranes, used to expand the ECF compartment
cause the water from within a cell to move to the ECF compartment. Immersion in a hypertonic solutiion will result in shrinkage of blood cells.
immersion in a hypotonic solution will result in swellin of blood cells, hydrate cells and deplete the circulatory system
na-135-145, k 3.5-5.0, ca 4.3-5.3, mg 1.5-1.9, cl 95-108, ph 1.7-2.6, bicarbonate 2.2-2.6
late signs of hypernatremia
edema, restlessness, thirst, hyperreflexia, muscle twitching, irritability, seizures. possible coma
loss of gi secretions, excessive renal excretion of k, movement of k into the cells, prolonged fluid adm without k supplementation, diuretics
skeletal muscle weakness, muscle twitching, paralysis, decreased bp, ekg changes, possible cardiac arrest, n/v, diarrhea, metabolic alkalosis, mental confusion and depression
treatment of hypokalemia
hypertonic glucose solution, monitor, i&0, bowel sounds, vs,cardiac rhythm, myscle strength, digoxin level if neccessary
excessive k intake especially in renal failure, tissue trauma, acidosis, catabolic state
treatment of hyperkalemia
10% calcium gluconate, sodium bicarbonate, 50% glucose solution, kayexalate PO/PR b/c absorb through rectum. stop k supplementts and avoid k in food, fluids, salt substitutes
required for blood coagulation, neuromuscular contraction, enzymatic activity, and strength durability of bones and teeth
signs/symptoms of hypocalcemia
abdominal and/or extremity cramping, tingling and numbness, positive chvostek, trousseau signs, tetany hyperactive reflexes, irritability, reduced cognitve ability, seizures abnormal clotting
treatment of hypocalcemia
high calcium diet or oral calcium salts, iv calcium as 10% cacl or 10% calcium gluconate, close monitoring of serum ca an digitalis levels, vitamin d therapy
restlessness, confusion, dyrhythmias, compensatory hypoventilation, slow resps, diarrhea, n&v
seizures, deep rapid breathing, confusion, hypokalemia, light headedness, tingling of extremities
hypoventilation, rapid and shallow respirations, increased bp, dyspnea, headache,hyperkalemia, cardiac output, disorientation, muscle weakness, hypoxia high pCO2
headache, disorientation, hyperkalemia, changes in LOC, muscle twitching, kussmaul resps low HCO3
chemical buffers, regulate acid, CO2, CO2 + H2CO3 carbonic acid, hyperventilation increasd in co2 inhaled
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