seminar

1. FLUID AND ELECTROLYTE
IMBALANCE

2. Distribution of body fluids
 Intra cellular
 Extra cellular O
 out of total body water two third (40% of bodyweight)
is intracellular fluid & one third (20% of weight) is
intracellular fluid & one third (20% of body weight) is
extracellular fluid.

4. contd….
 Interstitial fluid
 Transcellular fluid
 Intra vascular fluid

5. Movements of body fluids
 Osmosis
 Diffusion
 Filtration
 Active transport

7. osmosis
 Diffusion of fluid through a semi permeable
membrane from a solution with a low solute
concentration to a solution with a higher solute
concentration until there is an equal concentration of
fluid on both sides of the membrane

8. diffusion
 The process by which solutes move from an area of
higher concentration to one of the lower
concentration, without any expending extra energy

9. Active transport
 The physiologic pump that moves fluid from an area of
lower concentration to one of higher concentration;
active transport requires ATP (adenosine
triphosphate) for energy

10. filtration
 : Passage through a filter or through a material that
prevents passage of certain molecules, e.g. capillary
wall, blood–brain barrier, radiographic grid.

11. REGULATION OF ELECTROLYTES

12. Regulation of body fluids

13. Fluid intake

14. Hormonal regulation

15. Lymphatic system
 It plays an important role in returning excess fluid and
protein from the interstitial spaces to the blood
Kidneys
 Maintain fluid volume and the concentration of
urine by filtering the ecf

16. Nervous system
 When ecf increases mechanoreceptors in the wall of
the left atrium respond to atria distension by
increasing cardiac stroke volume and triggering a
sympathetic responses to kidney

17. Fluid imbalances
 Extra cellular fluid volume deficit
Decrease in the interstitial and extra cellular fluid.
Risk factors
Clinical manifestation
management

18. Contd….
 Extra cellular fluid volume excess
 Increased fluid retention,
 Risk factors
 Clinical manifestation
 Management

19.  extra cellular fluid volume shift
 Basically a change in the location of extra cellular fluid
between intra vascular and interstitial fluid

20.  Intra cellular fluid volume excess
 Water intoxication hypo osmolar disorders result from
either water excess or solute deficit and are mainly due
to sodium loss

21. Electrolyte imbalances

23. Clinical manifestation
 Decreased skin burger.
 Dry mucous membrane.

Dry cracked lips or tongue.
 Eye balls sunken & soft.
 Restlessness, Coma in severe deficit.
 Elevated temperature.
 Tachycardia.
 Postural, systolic blood pressure > 15 mm Hg Diastolic fall <
10 mm Hg.
 Weight loss.
 Oliguria (< 30 ml/hr)

25. DIARRHOEA

26. Laboratory findings
:
 Increased Osmolality.
 Increased or normal serum sodium level.
 BUN (> 25 mg/d1)
 Hyperglycaemia (> 120 mg / dl)
 Elevated hematocrit (>55%), Increased Specific gravity.


27. Medical Management:
Pharmacologic Management
:
 An intravenous solution of 5% Dextrose in water (D5W)
or 5% Dextrose in 0.2% saline (D5/0.2% Nacl) may be
prescribed.
 If haemorrhage is the cause of ECFVD blood
replacement may be necessary if blood losses greater
than 1L.
 In situation in which the blood losses are less than
1L, normal saline & lactated Ringers solution may be
used to restore fluid volume.

28. Nursing management

29. NURSING MANAGEMENT