N 155 M 5.

1 Fluid & E-Lyte Balance/Imbalance

Language:
1. Homeostasis: Balance of fluid & e-lytes & acid/bases
2. Body Water
a. 60% of a healthy adults wt. is water
b. Babies 70 -80% water
c. Women & elderly less water due to less muscle mass,
adipose tissue does not carry as much water as
muscles
3. Uses of water:
a. Medium for metabolic Rx in cells
b. Transport nutrients, wastes, & other substances
c. Lubricant
d. Insulate & shock absorber
e. One way to regulate & maintain body temp
4. Distribution of body fluids
a. Intracellular Fluid (ICF) fluid in the cells
b. Extracellualr fluid (ECF) fluid outside the cells
i. Intravascular fluid fluid in vascular space
ii. Interstitial fluid (75% of ECF) fluid around cells
iii. Lymph fluid
iv. Transcellular fluid cerebrospinal, pancreatic,
pleural, intraocular, biliary, peritoneal, synovial
5. Composition of body fluids
a. Oxygen
b. Dissolved nutrients
c. Excretory products of metabolism (CO2)
d. Ions charged particles
6. Ions: e-lytes, particles with charges capable of conducting
electricity
a. Cation positive charge = Na+, K+, Ca++, Mg+
b. Anions- negative charge = Cl-, SO4-, HCO3-, Hpo4c. Measured in mEq/L, or mg/dL
i. mEq refers to the chemical combining power of
the ion, the capacity for cations & anions to
combine to form a molecule
d. Labs measure e-lytes in IVF or ECF
e. Major e-lytes in ECF Na+, Cl-, HCO3f. Smaller amt. e-lytes in ICF K+, Ca++, & Mg+

N 155 M 5.1 Fluid & E-Lyte Balance/Imbalance

g. Major e-lytes in ICF K+, Mg+, HPO4-, & SO4-2
7. Osmosis
a. Osmosis: movement of water across a cell membrane,
from less concentrated solution to more concentrated
solution trying to equalize the number of particles on
each side.
b. Solutes substances dissolved in liquid
i. Crystalloids- salts that dissolve readily into true
solutions (D5%W, 0.9% NS)
ii. Colloids- substances such as large proteins that do
not readily dissolve into true solution (Blood
products)
c. Solvent the component of a solution that can dissolve
a solute
d. Water is the solvent in the body
8. Solutes in the body are: e-lytes, oxygen, carbon dioxide,
glucose, urea, amino acids, & proteins. Osmosis occurs
when the concentration of solutes on one side of a
selectively permeable membrane are higher than on the
other side.
a. Osmolality: concentration of solutes in body fluids. The
total solute concentration in a fluid compartment,
measured as parts of solute/kg of water, or rather
miliosmols/kg (mOsm/kg). Na+ biggest contributor to
osmolality in ECF. (2 times the Na+ (sodium) level is
about what your osmolality is)
b. Tonicity refers to osmolality
i. Isotonic: same osmolality as body fluids
ii. Hypertonic: higher osmolality as body fluids
iii. Hypotonic: lower osmolality as body fluids
c. Osmotic pressure: power of a solution to draw water
across a semipermeable membrane. More solutes in a
solution = higher concentration = higher osmotic
pressure ---more of a draw for the water to cross and =
dilute the solution, make it less concentrated.

N 155 M 5.1 Fluid & E-Lyte Balance/Imbalance

d. Plasma proteins exert an osmotic pressure called colloid
osmotic pressure or oncotic pressure pulling fluid in
from the interstitial space to vascular space.
9. Diffusion: continual intermingling of molecules in liquids,
gases, or solids due to random movement of the molecules.
a. Diffusion in the body: through thin membrane via the
split pores of capillary membranes. Rate of diffusion
dependent on the (a.) size of the pores, (b.)
concentration of the solution (c.) temperature of
solution
b. Larger molecules take more energy to move about and
are slower.
c. Molecules move from area of high concentration to area
of lower concentration (Down the pressure gradient)
d. Higher temperatures increase the rate of movement &
diffusion
10.
Filtration: fluid & solutes move together across a
membrane from one compartment to another, from higher
pressure to lower pressure
a. Filtration pressure: pressure in the compartment that
results in movement of fluid & substances dissolved in
fluid out of the compartment.
b. Hydrostatic pressure is the pressure exerted by a fluid
within a closed system on the walls of a container in
which it is contained.
i. Hydrostatic pressure of blood is the force exerted
by blood against the vascular walls. Fluids move
from areas of greater pressure to the area of lesser
pressure.
ii. Plasma proteins (albumin) exert an oncotic
pressure that opposes hydrostatic pressure &
holds fluid in the vascular space. When the
hydrostatic pressure is greater than the oncotic
pressure then water will seep out of the blood
vessels.

N 155 M 5.1 Fluid & E-Lyte Balance/Imbalance

11.
Active Transport: movement of substances against the
concentration (pressure gradient), substances move across a
membranes from a less concentrated solution to a more
concentrated one by active transport. Metabolic energy is
used to do this ---ATP (Adenosine triphosphate).
a. Active transporta substance combines with a carrier
on the outside surface of the cell membrane
(Hitchhiker) and they move to the inside surface of the
cell membrane. Once inside they separate and the
substance goes its merry way. A specific carrier is
required for each substance, enzymes are required for
active transport and energy is expended. Example
sodium potassium pump moves sodium out of cell and
K+ back in.