Lecture Notes: Fluid and Electrolyte Management

Key Concepts

• Blood Composition: Includes plasma (liquid) and solid components (erythrocytes, leukocytes, platelets).
• Colloid Oncotic Pressure: Exerted by proteins in blood plasma, pulling water into the circulatory system.
• Crystalloids vs. Colloids:
  • Crystalloids: Diffuse through membranes, fast distribution.
  • Colloids: Larger protein particles that stay in blood vessels, increase osmotic pressure.

Fluid Compartments

• Intracellular Fluid (ICF): Located within cells.
• Extracellular Fluid (ECF): Includes interstitial fluid and intravascular fluid.
• Intravascular Fluid (IVF): Fluid inside blood vessels.

Homeostasis & Fluid Balance

• Homeostasis: Maintaining equilibrium in body fluids.
• Water Balance: 60% of adult body weight is water.
• Fluid Losses: Primarily from kidneys, skin, lungs.
  • Dehydration and Overhydration concerns.

Types of Dehydration

• Hypertonic: Water loss greater than sodium loss.
• Hypotonic: Sodium loss greater than water loss.
• Isotonic: Loss of both sodium and water.

Electrolyte Imbalances

• Hyperkalemia: High potassium levels, can cause cardiac issues.
• Hypokalemia: Low potassium levels, can lead to muscle weakness.
• Hyponatremia: Low sodium levels; symptoms include lethargy and seizures.
• Hypernatremia: High sodium levels; symptoms include hypertension and edema.

Acid-Base Balance

• Regulation: Respiratory and renal systems regulate pH.
• Acidosis: pH below 7.35, increased hydrogen ion concentration.
• Alkalosis: pH above 7.45, decreased hydrogen ion concentration.

Treatment Modalities

• Crystalloids: Used for fluid replacement; cheaper, less risk of viral transmission.
• Colloids: Used for plasma volume expansion; more expensive, risk of bleeding.
• Blood Products: Used for significant blood loss; can carry oxygen.

Nursing Considerations

• Assessment: Monitor fluid and electrolyte balance, vital signs, and laboratory values.
• Monitoring: Watch for signs of fluid overload, electrolyte imbalances.
• Safety: Be cautious of rapid correction of sodium levels to prevent brain damage.

Patient Education

• Dietary Sources: Educate about foods high in potassium and sodium.
• Symptom Monitoring: Inform patients about symptoms of electrolyte imbalances.
• Drug Interactions: Caution against mixing certain diuretics with potassium supplements.

Critical Points

• TBW is crucial for metabolic reactions.
• Colloids require careful administration to prevent fluid overload.
• Balance fluid intake with output for homeostasis maintenance.

Case Study Review

• Assess symptoms like confusion and weakness; monitor infusion rates accurately.