Balance fluid/electrolyte/acid-base

Electrolyte balance Mineral balance Metal metabolism Acid-base balance Fluid balance Hematologic Mouth Teeth... 

There is no specific antidote. Supportive care should be instituted for all patients with history of serious boric acid exposure. Substantial recent ingestions may benefit from administration of activated charcoal. Fluid and electrolyte balance, correction of acid/base disturbance, and control of seizures are essential to therapy. Hemodialysis has been successfully used to treat acute boric acid poisoning. Sodium bicarbonate may be used for any metabolic acidosis. 

Chapter 6). Prolonged or excessive losses of fluid via the GI tract will affect packed cell volume (hematocrit), plasma total protein, albumin, electrolytes, acid-base balance, and osmolality values as the circulating blood volume adjusts to the fluid loss. Excessive and prolonged salivation may also cause electrolyte perturbations, but to a much smaller extent. Hypo- or hypernatremia may occur depending on the proportional losses of electrolyte to water these electrolyte changes are also reflected by plasma osmolality. There may be significant differences between the measured and calculated plasma osmolality in the presence of hyperlipidemia and hyperproteinemia. 

Urea and electrolytes Urea (Creatinine) Sodium Potassium (hydrogen carbonate) (chloride) Serum or plasma mmoll pmol I mmoll mmoll mmoll mmoll Yes Kidney function Kidney function Fluid and electrolyte balance Potassium homeostasis Acid-base status Acid-base status... 

Kidney maintenance of milieu interieur, fluid and electrolytes, acid-base balance... 

The integrity of mammalian kidneys is vital to body homeostasis, because the kidneys play the principal role in the excretion of metabolic wastes and the regulation of extracellular fluid volume, electrolyte balance, and acid-base... 

Monitoring Monitor changes in fluid balance, electrolyte concentrations, and acid-base balance during prolonged parenteral therapy or whenever the condition of the patient warrants such evaluation. Significant deviations from normal concentrations may require tailoring of the electrolyte pattern. 

Mecftanism of Action Sodium Is a major cat ion of extracellular fluid that controls water distribution, fluid and electrolyte balance, and osmotic pressure of body fluids it also maintains acid-base balance. 

Fluid balance, acid-base balance, blood pressure, electrolytes... 

Acid-base and electrolyte balance High therapeutic dose especially when used in rheumatic fever, stimulates respiration and causes respiratory alkalosis. Reduction in bicarbonate and potassium level reduces the buffering capacity of the extracellular and intracellular fluid. Hypokalemia may lead to dehydration and hypernatremia. They also interfere with carbohydrate metabolism resulting in accumulation of pyruvic acid and lactic acid. 

The electrolytes and acid-base balance should be restored in careful coordination with the renal function. In hyponatraemia, either the fluid intake should be reduced to 700-1,000 ml/day, or a combination of a hypertonic salt solution (3%) and a loop diuretic should be administered intravenously, (s. p. 308) Likewise, an attempt can be made using a combination of diuretics and urea diuresis. Generally, sodium and water intake should be restricted. It is imperative to achieve an even volumetric balance, possibly supported by the cautious intake of fluid. 

Sosa Ledn L A, Hodgson D R, Carlson G P et al 1998 Effects of concentrated electrolytes administered via a paste on fluid, electrolyte, and acid base balance in horses. American Journal of Veterinary Research 59 898-903... 

Sodium is an electrolyte (cation) in extracellular fluid (tissue spaces and vessels) and regenerates and transmits nerve impulses. Sodium affects water distribution inside and outside cells. Sodium also combines readily in the body with chloride (CL) or bicarbonate (HC03) to promote acid-base balance (Ph). 

Once a poisoning has occurred, acid-base balance (anion gap and arterial blood gases), fluid and electrolyte balance, and perfusion should be monitored. Other indicators of organ toxicity such as ALT, AST, bilirubin, prothrombin time, serum glucose and creatinine concentrations, as well as markers of physiologic stress or infection such as leukocytosis, also should be monitored. 

Maintenance of fluid volume, osmolarity, electrolyte balance, and acid-base status are aU regulated in large part by the kidney. Homeostasis of sodium, potassium, chloride, calcium, magnesium, and phosphorus is altered due to changes in urinary excretion that occur in patients with impaired kidney function. A comprehensive discussion... 

Fluid, Electrolyte, and Acid-Base Disorders The volume status of patients with ARF depends primarily on residual urine output and the type of dialysis received, if any. The patient with oliguric ARF will have impaired excretion of sodium and water. In nonoliguric ARF, considerable sodium may be lost in the urine, necessitating replacement to maintain sodium balance. This also applies to the patient who is losing considerable gastric fluids. Patients on CRRT will lose sodium via hemofiltration or dialysis and should be given sodium as part of their CRRT replacement fluid regimen. 

Note that haemodialysis and peritoneal dialysis may relieve many of the symptoms of chronic renal failure and rectify abnormal fluid and electrolyte and acid-base balance. These treatments do not. however, reverse the other metabtilic, endocrine or haematological consequences of chronic renal failure. 

Haemodialysis and peritoneal dialysis will sustain life when other measures can no longer maintain fluid, electrolyte and acid-base balance. The key to... 

The electrolytes—both anions and cations—perform a number of vital roles in maintaining fluid balance and acid-base balance, membrane potentials, muscular functions, and nervous conduction. They act as cofactors in many enzyme-mediated reactions. In addition, calcium and phosphate are the main mineral constituents of the skeleton. 

Sodium, potassium, and chloride, as ions (Na, K, and Gl ), are essential to electrolyte balance in body fluids. Electrolyte balance, in turn, is essential for fluid balance, acid-base balance, and transmission of nerve impulses. Table salt is the principal source of sodium and chloride ions, and dietary deficiencies are unlikely. When there is extreme fluid loss through vomiting, diarrhea, or traumatic injury, electrolytes must be supplied to restore their concentration in body fluids. 

CHAPTER 3 General Nursing Assessments and Diagnostic Tests Related to Fluid, Electrolyte, and Acid-Base Balance 29... 

Fluids and Electrolytes Demystified is a detailed overview of the critical concepts involved in fluid, electrolyte, and acid-base balance and imbalance, collectively one of the hardest topics to master in undergraduate nursing. Fluid and electrolyte balance and acid-base balance have challenged students for ages. Some of the difficulty in understanding this content may lie in the attempt to remember each individual detail or symptom associated with an imbalance combined with the difficulty of mastering the physiology involved in each process. The list of symptoms of imbalance can be extensive there is often duplication and overlap between electrolyte and acid-base imbalances. In Fluids and Electrolytes Demystified, the normal functions are discussed to provide baseline data. The concepts of imbalance are presented individually, but the links between concepts are addressed. The reader is led toward two facts that many of the fluid, electrolyte, and acid-base imbalance symptoms are interrelated and that the imbalances themselves are interlinked. 

Fluids and Electrolytes Demystified is a detailed, easy-to-understand overview of the concepts it focuses on the information that students need most to understand the conditions that result in fluid and electrolyte imbalances. The book emphasizes the most critical information in fluids and electrolytes by discussing the underlying mechanisms involved in maintaining fluid, electrolyte, and acid-base balance and by discussing the factors that fail and result in an imbalance. 

Chapters 1 and 2 are overview chapters that discuss the physiology involved in fluid, electrolyte, and acid-base balance. Chapter 3 discusses the diagnostic tests and basic nursing assessments related to fluid, electrolyte, and acid-base balance. 

Fluids and Electrolytes Demystified is not designed to be an exposure to the entire subject of fluids, electrolytes, and acid-base balance or imbalance. Thus the book does not discuss many cellular and biochemical functions related to total body mechanisms. For additional data, the reader is encouraged to consult a textbook on anatomy and physiology or on pathophysiology. 

Fluids and Electrolytes Demystified is designed to make the concepts associated with fluid, electrolyte, and acid-base balance and imbalance clear and understandable. The key to demystifying the concepts is to see the connections and to make sense of the underlying processes involved, which will lead to an understanding of the imbalances that occur when normal processes fail. 

Fluids and Electrolytes Demystified endeavors to illuminate the aspects of fluid, electrolyte, and acid-base balance that seem elusive and complex by breaking down the elements involved. The repetition of content from the overview chapters to the chapters dealing with imbalances is intentional to enable connections between the basic processes and the imbalances resulting from alterations in those processes. By understanding aspects of the processes involved in maintaining balance, one can more easily understand the imbalances that result when a process is altered or fails. 

We believe that you will find Fluids and Electrolytes Demystified helpful in increasing your understanding of this difficult topic. As you move through course content and eventually prepare to take the nursing licensure exam (NCLEX), we hope that you will use Fluids and Electrolytes Demystified to promote successful completion and continued knowledge and understanding relatedto fluids,electrolytes, and acid-base balance and imbalances. 

If cells are to survive and function normally, the fluid medium in which they live must be in equilibrium. Fluid and electrolyte balance, therefore, implies constancy, or homeostasis. This means that the amount and distribution of body fluids and electrolytes are normal and constant. For homeostasis to be maintained, the water and electrolytes that enter (input) the body must be relatively equal to the amount that leaves (output). An imbalance of osmolality, the amount of force of solute per volume of solvent (measured in miliosmoles per kilogram—mOsm/kg or mmol/ kg), of this medium can lead to serious disorders or even death. Fortunately, the body maintains homeostasis through a number of self-regulating systems, which include hormones, the nervous system, fluid-electrolyte balance, and acid-base systems. Els... 

Organ systems degenerate at different rates, with some (e.g., the nervous system) reducing in function only by 10 to 15 percent from ages 30 to 80 and others (e.g., the kidneys) reducing as much as 60 percent in function. The specific changes noted in senescence that affect fluid, electrolyte, and acid-base balance are as follows. 

Sensory organ function diminishes, most notably the sense of taste, which migh affect dietary intake leading to malnutrition and decreased protein intake with related fluid balance issues, as well as electrolyte imbalance, in addition to anemia that could affect oxygenation and acid-base balance (lactic acidosis). 

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