Body fluid with n cell osmolality of intracellular fluid and

Intracellular extracellular fluid tends to equalize

Fluid with in cell because of the constant shifting of
Intravenous therapy
Extracellular water Isotonic
Found in blood vessels NS (0.9% saline)
DW5
Interstitial fluid 25% (the
LR
third space)
Hypotonic
surrounding cells,
NS
including lymph
Hypertonic
Transcellular fluids
3% NS
Lymph, digestive tract,
D10W
sweat, cerebrospinal Fluids and Electrolytes 5% D in LR
Colloids
Ch. 14 Dextran
& Albumin
Hetastarch
Intravenous therapy
Ch. 18
Electrolytes and imbalances
Infiltration
Sodium (Na) Major cation of extracellular fluid
Hyponatremia Caused by leakage
orthostatic hypotension S/S: pain or burning
Hypernatremia Paleness and puffiness or feel
flushed skin, dry mucous membranes hard and cool
Potassium (K) Excess Fluid Volume
Hypokalemia S/S: BP, bounding pulse,
Muscle cramps BP oliguria edema
Hyperkalemia Ineffective Tissue Perfusion
Patients at risk: decreased renal function, Risks of emboli from blood
in metabolic acidosis, taking potassium clots, air, broken catheters
supplements Air can enter the bloodstream if
Chloride (Cl) the infusion system is opened
Hyperchloremia Catheters
Usually associated with metabolic
Respiratory Acidosis pH<7.35 &PaCO2>45 catheter threaded through the
acidosis
Hypoventilation Hypoxia tunnel and into the subclavian
Hypochloremia
Shallow breathing, K+, vein
Usually occurs when sodium is lost
Respiratory Alkalosis pH>7.45 &PaCO2<32 cannulas and the tubing are
because chloride most frequently bound
Deep breathing, hyperve usually changed every 48-72
with sodium ntilation, tachycardia, lethargy & confusion. hours

Metabolic Acidosis pH<7.35 & HCO3<20

Kussmaul respiration, severe diarreah, N,V,D,
muscle twitching
Metabolic Alkalosis pH>7.45 & HCO3>26
Calcium (Ca) Severe vomiting, tremors, muscle cramps
Hypocalcemia
intake of vit D
Hypercalcemia
intake of vitamin D
Magnesium (Mg2+) Age-Related Changes Affecting Diagnostic Tests and Procedures
Important in heart, nerve, and Fluid Balance
Hematocrit
muscle function Total body water declines with age;
Creatnine
Hypomagnesemia greatest loss from the intracellular fluid BUN
usually from vomiting compartment Albumin
and diarrhea Antihypertensive, diuretics, and antacids
Serum electrolytes
Hypermagnesemia can also contribute to imbalances
excessive use of
magnesium