Patho Exam 1 Review
Chapter 24: Fluid and Electrolyte Homeostasis and Imbalances
Body Fluid Homeostasis * Total
body
o Body fluid is contained in two major compartments
o Extracellular (outside the cells) water decrease
o Intracellular (inside the cells)
with age !
o 2/3 of body fluid is à intracellular
o 1/3 of body fluid is à extracellular due+09
o Intracellular fluid adipose tissue
o Rich in: K+, Mg, inorganic phosphates and proteins
o Low in: Na+ and Cl- ions it muscle
o Extracellular fluid is found in mass
o Between the cells à Interstitial compartment
o In blood vessels à Vascular compartment
o Transcellular fluid (synovial, cerebrospinal, and GI fluids, dense connective
tissue and bone)
o ECF in vascular and interstitial compartment
▪ Rich in: Na+. Cl-, and bicarbonate ions
▪ Low in: K+, Mg, and Phosphate ions
o Vascular portion of ECF contains many proteins and interstitial and
transcellular contains few proteins
o In the adult man body water is about 60% body weight and women is about 50%
because they have a greater proportion of body fat
Fluid intake and absorption
o Fluid intake: entry of fluid into the body by any route
o Oral, Iv, GI
o Fluid intake by drinking is influenced by habit, social factors, and thirst of
→ controls release
o Physiologic triggers of thirst hypothalamus ADH
o Osmoreceptor- meditated thirst: thirst increased osmolality of ECF which
decreased in older adults
o Baroceptor- mediated and angiotensin II-mediated thirst decreased circulating
blood volume
▪ Activate aldosterone
, o Dryness of the mucous membranes
Fluid distribution
o Fluid distribution between the vascular and interstitial compartment is the nest result of
filtration across permeable membranes
o Interstitial to Vascular à colloid osmotic pressure inward
o Vascular to Interstitial à hydrostatic pressure outward
o Fluid between the interstitial and intracellular compartment occurs by osmosis
o Osmotic pressure
Fluid excretion
o Normal fluid excretion occurs through: urinary tract, bowels, lungs, and skin
o Abnormal routes of fluid loss: emesis, tubes in GI, hemorrhage, drainage from fistulas,
wounds, open areas of skin, paracentesis
o GI tubes (NG suction)
Fluid Imbalances
o Extracellular fluid volume (ECV) imbalances: involve a change in the amount (volume)
of the ECF à saline imbalances (disorders of isotonic salt water)
o The concentration of the ECF is normal; there is simply too much or too little of
it
Volume Deficit
o ECV deficit caused by a removal of a
sodium-containing fluid from the body
o Decrease in saline (isotonic salt
water) in the same conc. as the
normal ECF
o The amount of ECF is abnormally
decreased
o Etiology (causes):
o *All causes involve removal of a
sodium containing fluid from the
ECF compartment
o Emesis, Diarrhea (laxatives
overuse/abuse), Gastric suction or intestinal decompression
o Adrenal insufficiency, Extensive diuretic use & Bed rest
o Hemorrhage, massive diaphoresis, third space fluid accumulation,
paracentesis, & burns
o Common ways you lose fluid: urine, sweating, vomiting, & diarrhea
o You DON’T lose fluid through lymph nodes
, o Clinical Manifestations (S/S)
o Sudden weight loss * Acute
loss
A¥}n+ 5"
o
o
Postural blood pressure decreases with concurrent increased HR
Flack neck veins when a patient is supine
around o
o
Prolonged cap refill time
Lightheadedness, dizziness, syncope,
o Oliguria
o Decreased skin turgor, dryness of mucous membranes
o Longitudinal furrows in the tongue
o * Sudden weight loss is a SENSITIVE measure of ECV deficit
Volume Excess
o The amount of ECF is abnormally increased à both the vascular and interstitial
area have too MUCH isotonic fluid
o Etiology (causes)
o Caused by addition or retention of saline (salt water in the same conc. as
normal plasma à saline excess)
▪ Hormone aldosterone cause the kidneys to retain saline
▪ Excessive aldosterone secretion hyperaldosteronem
o Excessive infusion of sodium containing isotonic solutions
▪ Normal saline, ringer infusion, & LR infusion
o Renal retention of sodium and water
▪ Hyperaldosteronism, CHF,
cirrhosis, acute
glomerulonephritis, chronic
end stage renal disease,
Cushing disease &
corticosteroid therapy
o Clinical manifestations
(S/S)
o Sudden weight gain
o Edema
o Bounding pulses
o Neck vein distention in the
upright position
o Crackles in the dependent
portion of the lungs
o Dyspnea, orthopnea, and frothy sputum of PE
Chapter 24: Fluid and Electrolyte Homeostasis and Imbalances
Body Fluid Homeostasis * Total
body
o Body fluid is contained in two major compartments
o Extracellular (outside the cells) water decrease
o Intracellular (inside the cells)
with age !
o 2/3 of body fluid is à intracellular
o 1/3 of body fluid is à extracellular due+09
o Intracellular fluid adipose tissue
o Rich in: K+, Mg, inorganic phosphates and proteins
o Low in: Na+ and Cl- ions it muscle
o Extracellular fluid is found in mass
o Between the cells à Interstitial compartment
o In blood vessels à Vascular compartment
o Transcellular fluid (synovial, cerebrospinal, and GI fluids, dense connective
tissue and bone)
o ECF in vascular and interstitial compartment
▪ Rich in: Na+. Cl-, and bicarbonate ions
▪ Low in: K+, Mg, and Phosphate ions
o Vascular portion of ECF contains many proteins and interstitial and
transcellular contains few proteins
o In the adult man body water is about 60% body weight and women is about 50%
because they have a greater proportion of body fat
Fluid intake and absorption
o Fluid intake: entry of fluid into the body by any route
o Oral, Iv, GI
o Fluid intake by drinking is influenced by habit, social factors, and thirst of
→ controls release
o Physiologic triggers of thirst hypothalamus ADH
o Osmoreceptor- meditated thirst: thirst increased osmolality of ECF which
decreased in older adults
o Baroceptor- mediated and angiotensin II-mediated thirst decreased circulating
blood volume
▪ Activate aldosterone
, o Dryness of the mucous membranes
Fluid distribution
o Fluid distribution between the vascular and interstitial compartment is the nest result of
filtration across permeable membranes
o Interstitial to Vascular à colloid osmotic pressure inward
o Vascular to Interstitial à hydrostatic pressure outward
o Fluid between the interstitial and intracellular compartment occurs by osmosis
o Osmotic pressure
Fluid excretion
o Normal fluid excretion occurs through: urinary tract, bowels, lungs, and skin
o Abnormal routes of fluid loss: emesis, tubes in GI, hemorrhage, drainage from fistulas,
wounds, open areas of skin, paracentesis
o GI tubes (NG suction)
Fluid Imbalances
o Extracellular fluid volume (ECV) imbalances: involve a change in the amount (volume)
of the ECF à saline imbalances (disorders of isotonic salt water)
o The concentration of the ECF is normal; there is simply too much or too little of
it
Volume Deficit
o ECV deficit caused by a removal of a
sodium-containing fluid from the body
o Decrease in saline (isotonic salt
water) in the same conc. as the
normal ECF
o The amount of ECF is abnormally
decreased
o Etiology (causes):
o *All causes involve removal of a
sodium containing fluid from the
ECF compartment
o Emesis, Diarrhea (laxatives
overuse/abuse), Gastric suction or intestinal decompression
o Adrenal insufficiency, Extensive diuretic use & Bed rest
o Hemorrhage, massive diaphoresis, third space fluid accumulation,
paracentesis, & burns
o Common ways you lose fluid: urine, sweating, vomiting, & diarrhea
o You DON’T lose fluid through lymph nodes
, o Clinical Manifestations (S/S)
o Sudden weight loss * Acute
loss
A¥}n+ 5"
o
o
Postural blood pressure decreases with concurrent increased HR
Flack neck veins when a patient is supine
around o
o
Prolonged cap refill time
Lightheadedness, dizziness, syncope,
o Oliguria
o Decreased skin turgor, dryness of mucous membranes
o Longitudinal furrows in the tongue
o * Sudden weight loss is a SENSITIVE measure of ECV deficit
Volume Excess
o The amount of ECF is abnormally increased à both the vascular and interstitial
area have too MUCH isotonic fluid
o Etiology (causes)
o Caused by addition or retention of saline (salt water in the same conc. as
normal plasma à saline excess)
▪ Hormone aldosterone cause the kidneys to retain saline
▪ Excessive aldosterone secretion hyperaldosteronem
o Excessive infusion of sodium containing isotonic solutions
▪ Normal saline, ringer infusion, & LR infusion
o Renal retention of sodium and water
▪ Hyperaldosteronism, CHF,
cirrhosis, acute
glomerulonephritis, chronic
end stage renal disease,
Cushing disease &
corticosteroid therapy
o Clinical manifestations
(S/S)
o Sudden weight gain
o Edema
o Bounding pulses
o Neck vein distention in the
upright position
o Crackles in the dependent
portion of the lungs
o Dyspnea, orthopnea, and frothy sputum of PE
