Fluids and Electrolytes

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interstitial fluid: acts as the microenvironment that allows the movement of ions, proteins, and nutrients across the barrier

intravascular fluid: the main fluid here (for blood)

3rd spacing: when increased amounts of fluid reside here (not supposed to)

pleural effusions: fluid around the lungs

ascites: too much fluid im pleural cavities or peritoneal cavity

increasing intravascular volume increases blood pressure

Isotonic solutions:

0.9% NaCl - normal saline

- treats fluid volume deficit, shock, mild hypothermia (low sodium by losing too much by vomiting or diarrhea)

- fluid of choice for CPR

- the only fluid used simultaneously with the administration of blood products

- caution for patients that have cardiac or renal dysfunction

Ringers Lactate - has a lot of electrolytes

- used for burn victims, fluid loss from trauma, acute blood loss due to 3rd space fluid shifts

- not for patients with liver disease

- use caution with patients that have renal dysfunction because it does contain potassium

- not for those with a pH above 7.5

*not tested on ringers solution but know it's a type of isotonic solution*

5% Dextrose in water - no electrolytes but has calories

- good for patients who are short term NPO

hypovolemia: fluid deficit vs. hypervolemia: fluid overload

weight is the most measurable for body fluid

Hypotonic solutions: 0.45% NaCl, 0.3% NaCl, 2.5% dextrose in water

- dilute and lower levels

- good for treating conditions that cause intracellular dehydration

things to look out for: hypotension, fluid volume deficit, dehydration

Hypertonic solutions: 3% NaCl, 5% dextrose in NaCl

- for extreme cases (ICU)

- monitor for fluid overload

- dextrose NaCl is used for cerebral injury

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Colloids:

5% albumin - used in volume expansion, moderate protein replacement, shock

- requires the same monitoring as for blood products

3rd spacing---> albumin infusion---> the fluid shifts into the intravascular space---> increases BP---> administration of furosemide---> helps renal system excrete extra fluid

furosemide is used to lower BP by depleting the volume (diuretic)

plasma administration

Electrolytes:

SODIUM

hypernatremia: water deficit; water take in is less than water loss

major symptom is thirst

hyponatremia: low sodium levels; losing too much (diarrhea and vomiting)

high osmolarity causes dehydration

POTASSIUM

hypokalemia: weakness, tiredness, cramping in arm or leg muscles, palpitations

hyperkalemia: major cardiac issues

potassium affects the heart

CALCIUM

hypocalcemia: nerves fire more easily

hypercalcemia: nerves are less able to fire

PHOSPHORUS

hyperphosphatemia results from the effects of hypocalcemia

symptoms include muscle cramping, tetany, and tingling

hypophosphatemia: muscle dysfunction and weakness

MAGNESIUM

hypermagnesemia: wide QRS complex

hypomagnesemia: life threatening, torsades de pointes