Topic 3 NCM 112

TOPIC 3 - Have lower osmolality than normal
plasma
Parental Fluid and Electrolyte Replacement - Used to prevent or treat cellular
- Intravenous (IV) fluid therapy is dehydration by providing free water to
essential when clients are unable to the cells
take food and fluids orally - Less salt content
- Intravenous fluids enter the systemic - Contraindicated in acute brain injuries
vein of the client because cerebral cells are very sensitive
- From the systemic vein, deoxygenated to free water, absorbing it rapidly and
blood goes to superior and inferior vena leading to cellular edema
cava - Ex. 0.45% NaCI (half Normal Saline) ,
- After introducing the iv fluid in the veins 0.33% NaCl (One Third Normal Saline) ,
the fluid will mix into the blood and it 5% Dextrose in Water (D5W)
will go directly to the heart through the - D5W is isotonic on initial administration
superior and inferior vena cava then to but provides free water when dextrose
the right atrium so that is why you is metabolized, expanding intracellular
should not make the regulation of the iv and extracellular fluid volumes. D5W is
fluid very fast because it will over low avoided in clients at risk for increased in
the heart intracranial pressure (IICP) because it
can increase cerebral edema
Blood circulation
HYPERTONIC SOLUTION
Deoxygenated blood from systemic veins >
Superior and inferior vena cava > Right atrium > - Have higher osmolality than body fluids
Tricuspid valve > Right ventricle > Pulmonic causing water to be pulled from the
valve cells into the vessels, resulting to
increased vascular volume and
Classification of IV Solutions: decreased cell water
- Also used to pull excess fluid from cells
1. Isotonic
and promote osmotic dieresis which
2. Hypotonic- makes the cell swell
causes RBC to shrink.
3. Hypertonic- - makes the cell shrink
- Salt attract water
ISOTONIC SOLUTION - Ex. 5% Dextrose in Normal Saline
(D5NS)
- Same osmolality as normal plasma
- Used to replace ECF losses and to REGULATION OF BODY FLUIDS
expand vascular volume quickly
- Equal salt content
- Ex. Normal Saline (NSS; 0.9 NaCI) ,
Lactated Ringer’s Solution (Plain LR)
HYPOTONIC SOLUTION
- In a healthy person, the volumes and MAINTAINING HMEOSTASIS
chemical composition of the fluid
compartments stay within narrow safe KIDNEYS- primary regulator of body fluids and
electrolytes balances. 135-180 liters of plasma
limits. Iilness can upset this balance so
that body has little or too much fluid. It per day are normally filtered in an adult but
only 1-5 liters of urine is excreted
is also influenced by the person’s
activity and temperature ANTIDIURETIC HORMONE (ADH)
FLUID INTAKE - Regulates water excretion from the
Water in food 1,000 ml kidney
- When serum osmolality rises, ADH is
Water from oxidation 300 ml produced, causing the collecting ducts
to become more permeable to water
Water as liquid 1,200 ml - When serum osmolality decreases, ADH
TOTAL 2,500 ml is suppressed
- It avoids urination
- Other factors affecting ADH: blood
volume, temperature, pain, and some
FLUID OUTPUT
drugs such as opiates, barbiturates, and
Urine (Kidneys) 1,500 ml nicotine
- When ADH increases there would be
Insensible losses oliguria/ less urine output
- Low ADH that will result to polyuria/
-Skin (sweat-100ml) 500 ml
more urine output
Lungs 400 ml
HEART AND BLOOD VESSELS
Feces 100 ml
- Pumping actions of the heart circulates
TOTAL 2,500 ml blood through the kidneys under
sufficient pressure to allow urine
formation
Insensible fluid losses LUNG FUNCTIONS
- Usually not noticeable and measured. It - Through inhalation, lungs remove

occurs in the skin through diffusion and approximately 300ml of water daily in
perspiration the normal adult
- Hyerpnea 9abnormally deep
Obligatory losses
respiration) or coughing increase this
- Certain fluid losses that are required to loss, mechanical ventilation with
maintain normal body function through excessive moisture also decreases it
respiration, kidneys, skin and feces. - If blood flow (perfusion) or pressure to
(approximately 1,300 ml) the kidney decreases, rennin is released
which causes conversion of - Embedded in the thyroid gland;
angiotensinogen to angiosin I, which is regulate calcium and phosphate
then converted ti angiotensin II by balance by means of parathyroid
angiotensin- converting enzyme (ACE) hormone (PTH)
from the lungs - PTH influences bone resorption, calcium
- Low blood flow into the kidney that’s a absorption from the intestines and
signal to secrete rennin calcium reabsorption from the renal
- Angiotensin II acts direvtly on the tubules
nephrons to promote sodium and water - RENIN_ANGIOTENSIN_ALDOSTERONE
retention and it also stimulates the SYSTEM (RAAS)
release of Aldosterone thereby reducing - - specialized receptors in the
urine output and increased blood juztaglomerular cells of the kidney
volume nephrons respond to changes in renal
perfusion
PITUITARY FUNCTIONS
ANTRIAL NATRIURETIC FACTOR (ANF)
- Hypothalamus manufactures ADH,
which is stored in the posterior pituitary - Is released from the cells in the atrium
and released as needed of the heart in response to excess blood
- ADH is a water conserving hormone volume and stretching of the atrial walls
because it causes body to retain water - ANF promotes sodium wasting and act
as a potent diuretic, thus regulating
ADRENAL FUNCTION vascular volume and inhibits thirst, thus
ALDOSTERONE reducing fluid intake
- Mineralocorticoid secreted by the zona BARORECEPTORS

glomerulosa (outer zone) of the adrenal - Small nerve receptors that detect
cortex- increase secretion causes changes in pressure within blood
sodium retention (and thus water vessels and transmit this information to
retention) potassium loss the CNS
- If osmolarity increases > decreased - Responsible for monitoring the
secretion of Aldesterone > decreased circulating vokume, sumpathetic and
reabsorption of Na in distal tubule parasympathetic neural activity as well
- And at the same time Increased ADH as endocrine activities
secretion > conserve water - Aldosterone, decreases flomerular
- EFFECT: decreased urine excretion filtration and increases sodium and
increased urine osmolarity water reabsorption
- In order to prevent osmolarity from
decreasing below normal > increased Functions and Regulation of Electrolytes
aldosterone > increased reabsorption of
Na in distal tubule ELECTROLYTES- are charged ions capable of
conducting electricity. ANION (nega
PARATHYROID FUNCTIONS
Cations: sodium (Na+), potassium (K+), calcium
(Ca+), and magnesium (Mg+)
Anion: chloride (Cl), bicarbonate (HCO3),

phosphate (HPO4), and sulphate (SO4)
- Most electrolytes enter the boy through

dietary intake and are excreted in the
urine
Functions of Electrolyte:
1. Maintaining fluid balance

2. Contributing to acid-base regulation
3. Facilitation enzyme reaction
4. Transmitting neuromuscular reactions

Topic 3 NCM 112

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Topic 3 NCM 112

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TOPIC 3 - Have lower osmolality than normal

Insensible fluid losses LUNG FUNCTIONS

- Usually not noticeable and measured. It - Through inhalation, lungs remove

- Mineralocorticoid secreted by the zona BARORECEPTORS

Anion: chloride (Cl), bicarbonate (HCO3),

- Most electrolytes enter the boy through

1. Maintaining fluid balance

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