Prepared by: Kristina Paula P. Dizon, R.N., M.A.N.

Transport of nutrients, hormones, CHON and other molecules to cells Aids in the removal of cellular metabolic wastes products Provides the medium in which cellular metabolism takes place Regulates lubrication of musculoskeletal joints Acts as a component of all body cavities <pericardial fluid, pleura, CSF>

Principal body fluids Solvent responsible for the bodys structures and functions Consists of 45-75% of body weight

Intracellular Fluid
- includes all water and electrolyte inside the cells - 2/3 of the body weight is contained within the cell membranes

Extracellular Fluid
- includes interstitial fluid and intravascular fluid

Extracellular Fluid

- includes interstitial fluid and intravascular fluid

Functions:
Transport nutrients and electrolytes to the cell and waste products for excretion Regulates heat Lubricates and cushions joints Hydrolyzes food for digestion

INTAKE OUTPUT 1,200 1,500 Urine 1,200 1,500 Liquid mL mL Water in food 700 1,000 Feces 100 250 mL mL Metabolism 200 400 mL Insensible Losses: 350 400 mL Skin 350 400 mL Lungs 2,100 2,900 2,100 2,900 TOTAL mL mL

Diffusion Process by which substances such as nutrients and wastes products move between blood and interstitial spaces

Osmosis Movement of water from area of higher concentration to lower concentration

Thirst Mechanism Hormones

Lymphatic System
Nervous System Kidney

Activated by an increase in ECF osmolality related to fluid loss

Hypothalamus thirst center of the brain

Water loss

Na Concentration in the blood

body compensates

stimulation of the hypothalamus

thirst

Mouth becomes dry

Fluid shifts from salivary glands to the blood stream

Antidiuretic Hormone / vasopressin

Stored in the posterior pituitary gland Reduces urinary output Returns fluids to the body rather than excreting them

Aldosterone
Secreted by the adrenal cortex Conserves the bodys sodium Promotes potassium excretion

- It plays an important role in returning excess fluid and CHON from the interstitial spaces to the blood

- Refers to sympathetic response in the kidneys, thus stimulating the kidneys to decrease renal excretion of sodium by both increasing renin release and through a a direct effect in the kidneys

Maintain fluid volume and the connection of urine by filtrating the ECF through the glomeruli Reabsorption and excretion occurs in the renal tubules

1.

Extracellular Fluid Volume Deficit Intracellular Fluid Volume Deficit

2.

3.

Extracellular Fluid Volume Excess

Intracellular Fluid Volume Excess

4.

Cause: 1. Lack of fluid intake Hospitalization / bed bound Dysphagia and risk for aspiration Tube feeding Decreased access to fluids Impaired thirst mechanism

2. Excess fluid Losses Vomiting, diarrhea, fever, hyperglycemia, suctioning, fistula, burns, blood loss, DI

Manifestations: 1. 2. 3. 4. 5. Loss of body weight Changes in I&O Decreased BP Weak pulse Postural hypotension 6. Increased PR 7. Flat jugular vein 8. Elevated body temp 9. Dry mucous membrane 10. Cracked lips 11. Poor skin turgor 12. Muscle weakness

Due to severe DHN Risk fx: older clients, pt with acute water loss

S/Sx: thirst, oliguria, fever, confusion, coma, cerebral hemorrhage

Also known as fluid overload

Has 2 types:

Hypervolemia increased fluid in the vasculature

Third spacing increased fluids in the interstitial space

Etiology:
Simple overloading of fluids <too much IVF> Increased ADH and aldosterone Decreased kidney function CHF Liver cirrhosis Venous disorder Excessive ingestion of fluids and Na

Manifestations:
Edema <respiratory, cardiovascular, generalized> Anorexia Bloating Weight gain

Water intoxication ; cells are resistant to fluid shifting Etiology:

Water excess number of solute is normal but there is water excess Solute deficiency amount of water is normal, but decreased solute

The most common cause is the administration of excessive amounts of hypoosmolar IVF Excessive consumption of tam water without adequate nutrient intake SIADH People with psych. Disorder: schizophrenia

Types
Vascular fluid shifts to interstitial space <hypovolemia> Interstitial fluid shifts to vascular space <hypervolemia>

Third space fluid shifts into the interstitial space and remains there - common sites: pleural cavity, peritoneal space, pericardial sac

Etiology: Increased capillary permeabilty Increased fluid reabsorption Decreased serum CHON Venous obstruction Non-functional lymphatic drainage system

Manifestation: Pallor, cold limbs, weak and rapid pulse, hypotension, oliguria, increased skin turgor, decreased LOC, no changes in weight <IV to IS> crackles, jugular vein distention, bounding pulse, increased bp <IS to IV>