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NUR170 Exam Fluid And Electrolytes

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NUR170 Exam Fluid And Electrolytes 2024-2025


intracellular (ICF)

lies within the bodies cells and is 2/3rds of total body fluid



Extracellular (ECF)

Compromised of intravascular(plasma), interstitial fluid surrounds cells (lymph),
Transcellular fluid in epithelial line spaces (cerebrospinal fluid, pericardial, pancreatic,
pleural, intraocular, biliary, peritoneal,

and synovial fluid)



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how fluids move through the body compartments

diffusion (high to low concentration solvent), Osmosis (high to low solute), active
transport, and filtration to maintain homeostasis



Dehydration

deficiency of body fluids resulting from inadequate intake or excessive loss

true dehydration: deficiency of body fluids, there is a movement of water from plasma
into the interstitial space



Hypovolemia-isotonic dehydration

fluid loss results in loss of both water and electrolytes leading to a contraction of
circulating blood volume-fluid volume deficit



Compensatory mechanisms for dehydration

increased thirst, (ADH) hormone secretion-conserves fluid, Aldosterone-(retain

,salt/water. increase BP)



Fluid volume deficit/dehydration {extreme}

lead to hypovolemic shock




older peoples increased risk to dehydration

due to multiple physiological factors including decrease in total body mass [including
water], decreased ability to detect thirst



Causes of hypovolemia

excessive GI loss- vomiting, NG suctioning, diarrhea

excessive skin loss- diaphoresis(sweating) w/o water or sodium supplement

excessive renal system loss- diuretic therapy, kidney disease, adrenal insufficiency,

other- third degree burns, hemorrhage or plasma loss, altered intake anorexia, nausea,
impaired swallowing, confusion, NPO



Causes for Dehydration

Hyperventilation or excessive perspiration w/o water replacement, prolonged fever,
diabetic ketoacidosis, inadequate water intake (enteral food w/o water), impaired thirst
sensation, dysphagia, diabetes insipidus (make excessive urine), osmotic diuresis,
excessive salt intake (salty tablet/hypertonic fluid



Onset of Hypovolemia/dehydration- Vitals

Vital signs- hypothermia (hypovolemia), hyperthermia (dehydration), tachycardia,
thready pulse, hypotension or orthostatic hypotension, decreased venous pressure,
tachypnea, Hypoxia (decreased oxygen to tissues)



Onset of Hypovolemia/dehydration- Neuromusculoskeletal

Dizziness, syncope (pass out), confusion, weakness, fatigue, seizures (rapid/severe

, dehydration)



Expected findings for Hypovolemia/dehydration- GI

thirst, dry mucous membranes, dry furrowed tongue, nausea, vomiting, anorexia, acute
weight loss



Expected findings for Hypovolemia/dehydration- Renal

oliguria (decreased production of urine)



Expected findings for Hypovolemia/dehydration- Other Findings

diminished capillary refill, cool, clammy skin, diaphoresis (sweating), sunken eyeballs,
flattened neck veins, absence of tears, decreased skin turgor



laboratory test for hypovolemia/ dehydration

HCT (hematocrit)-elevated in both dehydration and hypovolemia unless loss is
hemorrhage related



Blood osmolarity- (dehydration)-increased hemoconcentration osmolarity (above 295
mosm/Kg)



Urine specific gravity (dehydration)-elevated concentration



Blood sodium-(dehydration) increased hemoconcentration (above 145)



BUN- Elevated (above 25mg/dl) due to hemoconcentration



Dehydration- elevated protein, electrolytes, glucose



Nursing care for dehydration/ hypovolemia

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