Role Transition Exam 1 Study Guide
Unit 1 - Fluid and Electrolytes
Major intracellular electrolyte – K
Major extracellular electrolyte –
... [Show More] Na
Maintaining Fluid and Electrolyte Balance
● RAAS – senses hypotension o Vasoconstriction o Aldosterone – Na retention o ADH – H2O retention ▪ Elevated w/ stroke tumor and TBI
o Increase blood flow to vital organs
Serum Values
- Na: 135 to 145 milliequivalents per liter (meq/L).
- K: 3.5 to 5.0 mEq/L
- Cl: 95 to 105 mEq/L
- Mg: 1.5 to 2.5 mEq/L
- PO4: 2.8 to 4.5 mg/dl
- Ca: 8.5 to 10.5 mg/dl
Maintaining Fluid and Electrolyte Balance
- Kidneys
- Play a major role in controlling all types of balance in fluid and electrolytes
- Adrenal glands
- How do they help regulate water balance?
- Through secreting aldosterone – reabsorb sodium / regulates amount of sodium reabsorbed by the kidneys.
- Antidiuretic hormone (ADH)
- How does it help regulate water balance?
- hold on to water – increase in adh – sodium level goes down
-
Solutions
● Isotonic – fluid remains intravascular o ONLY fluid that can be used for bolus o NS, Lactated Ringers
o equal to plasma, NS and lactated ringers .. Give to replace volume in vascular space and low blood volume
● Hypotonic – fluid shifts intracellular → pts with dehydration o Can cause cell rupture o 1/2 NS, D5W
o lower tonicity than plasma – d5w, 0.45NS, cant bolus with it bc it’ll cause increase cerebral pressure / cerebral edema. Cause cell to burse .. Give to pts who are dehydrated.
● Hypertonic – fluid shift intravascular → pts w/ fluid overload or ICP o Dehydrates cells/cell shrinkage o Creates osmotic diuresis – DKA, hyperglycemia o 3% NS, combination fluids (ex: D5 ½ NS)
o d51/2, manitol, give when you want to dehydrate the cells and dump into vascular space to be exreted. Give to those with increased ICP o
● Colloid o Plasma expanders
o Pull fluid from interstitial compartment into vascular compartment o Increases vascular volume rapidly [Show Less]