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    NCM 112-Mod4

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    Samantha Bolante
    Fluid, electrolyte, and acid-base imbalances can occur due to abnormalities in body fluid volume, concentration, or electrolyte composition. Body fluid homeostasis is maintained through balance of intake, distribution between intracellular and extracellular fluid compartments, and excretion primarily through the kidneys which are regulated by hormones like ADH and aldosterone. Abnormalities can cause issues like edema, cell swelling or shrinking, and neurological or cardiac symptoms depending on the specific imbalance.

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    NCM 112-Mod4

    Uploaded by

    Samantha Bolante
    40 views2 pages
    Fluid, electrolyte, and acid-base imbalances can occur due to abnormalities in body fluid volume, concentration, or electrolyte composition. Body fluid homeostasis is maintained through balance of intake, distribution between intracellular and extracellular fluid compartments, and excretion primarily through the kidneys which are regulated by hormones like ADH and aldosterone. Abnormalities can cause issues like edema, cell swelling or shrinking, and neurological or cardiac symptoms depending on the specific imbalance.

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    NCM_112-MOD4

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    Fluid, electrolyte, and acid-base imbalances can occur due to abnormalities in body fluid volume, concentration, or electrolyte composition. Body fluid homeostasis is maintained through balance of intake, distribution between intracellular and extracellular fluid compartments, and excretion primarily through the kidneys which are regulated by hormones like ADH and aldosterone. Abnormalities can cause issues like edema, cell swelling or shrinking, and neurological or cardiac symptoms depending on the specific imbalance.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    40 views2 pages

    NCM 112-Mod4

    Uploaded by

    Samantha Bolante
    Fluid, electrolyte, and acid-base imbalances can occur due to abnormalities in body fluid volume, concentration, or electrolyte composition. Body fluid homeostasis is maintained through balance of intake, distribution between intracellular and extracellular fluid compartments, and excretion primarily through the kidneys which are regulated by hormones like ADH and aldosterone. Abnormalities can cause issues like edema, cell swelling or shrinking, and neurological or cardiac symptoms depending on the specific imbalance.

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    © All Rights Reserved
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    of 2

    FLUID, ELECTROLYTES AND A serum sodium concentration below the lower limit

    ACID BASE IMBALANCES of normal


    DR. MARIA LOURDES CULLA – BAÑAGA RN, Cells swell
    MAN 2 Primary causes:
    ASSOCIATE PROFESSOR - A gain of relatively more water than salt
    * Prolonged or excess release of ADH
    Abnormalities in Body Fluid * Water intake that exceeds normal limit
    Volume: too much (excess) or too little (deficit) - A loss of relatively more salt that water
    Concentration: altered Clinical Manifestations:
    Electrolyte composition of body fluid: too much (hyper - Malaise
    or too little (hypo) - Anorexia
    Can cause clinical problems or death - Nausea
    Occur as a result of many different pathophysiologic - Vomiting
    conditions - Headache
    Body Fluid Homeostasis
    Body fluid Hyponatremia
    - Pertains to water within the body and the Cell Swelling
    particles dissolved in it
    2 major body fluid compartments Hypernatremia
    - Extracellular fluid: outside the cell Serum sodium concentration above upper limit of
    * 1/3 body fluid in adults normal
    * Infants have more extracellular fluid as Cells shrivel
    compared to intracellular Clinical Manifestations:
    - Intracellular fluid: inside the cell - Thirst
    * 2/3 body fluid in adults - Low urine output
    - Confusion
    - Seizures
    Body Fluid Homeostasis - Coma
    - Death
    Fluid Excretion Hypernatremia
    Urinary Tract Shriveled Cells
    - Largest volume excreted Edema
    Bowels Excess fluid in interstitial compartment
    - Normal bowel function - May be a manifestation of excess
    - Increases with diarrhea extracellular fluid volume
    Lungs - Increased capillary hydrostatic Pressure: too
    - Exhalation much volume; from inflammation
    Skin - Increased interstitial fluid osmotic pressure:
    - Visible sweat inflammation causes protein to leak out from
    - Insensible perspiration vascular permeability

    Fluid Excretion Principles of Electrolyte Homeostasis


    Electrolytes
    Amount of fluid excreted in the urine is controlled - Ionized salts dissolved in water
    primarily by hormones - Most clinically important
    - Antidiuretic hormone (ADH) * Sodium
    - Aldosterone * Potassium
    - Natriuretic peptides ( ANP and BNP) * Calcium
    Fluid Distribution * Magnesium
    Volume Deficit * Chloride
    Caused by removal of a sodium containing fluid from * Bicarbonate
    the body * Phosphate
    Clinical Manifestation: Electrolyte Excretion
    - Lightheadedness Occurs through urine, feces, sweat
    - Dizziness Influenced by hormones
    - Orthostatic hypotension Abnormal Electrolyte Loss:
    - Hypovolemic shock - Vomiting
    Volume Excess - Nasogastric suction
    Opposite of extracellular volume deficit - Paracentesis
    Amount of extracellular fluid is abnormally increased - Hemodialysis
    Vascular and interstitial areas have too much fluid - Wound drainage
    Clinical Manifestations: - Fistula drainage
    - Dyspnea Hypokalemia
    - Pulmonary Edema Decreased potassium ion concentration in
    - Neck Vein Distention extracellular fluid
    Hyponatremia Etiology
    - Decreased intake: usually in conditions
    that cause a decreased oral intake Hyperphosphatemia
    - Increased excretion: usually renal but can be Increase in phosphate concentration above the upper
    through feces, sweat, GI tract ( emesis, limit of normal
    diarrhea), diuretics Etiology
    Clinical Manifestations: Altered smooth, skeletal, - Increased phosphate intake or absorption
    cardiac muscle function due to hyper-polarization of * Excessive use of phosphate –
    resting membrane potential. Hypoactivity containing enemas or laxatives
    Hyperkalemia
    Rise of serum potassium Increased neuromuscular excitability
    Etiology - Causes hypocalcemia signs and
    - Increased potassium intake: rapid excessive symptoms
    IV `infusion
    - Decreased potassium excretion: oliguria,
    potassium sparing diuretics, drugs that
    reduce aldosterone effects or are nephrotic
    Clinical Manifestations: Muscle dysfunction due
    to depolarization of resting membrane
    potential hyperactivity
    Hypocalcemia
    Serum calcium concentration drops below the lower
    limit of normal
    - Poor diet
    - Lack of Vitamin D
    - Hypoparathyroidism
    - Increased Ca2+ excretion
    Decreases the threshold potential, causing hyper-
    excitability of neuromuscular cells resulting in:
    - Muscle twitching and cramping
    - Paresthesias
    Hypercalcemia
    Occurs when the serum calcium concentration rises
    above the upper limit of normal
    - Vitamin D overdose
    - Hyper parathyroidism
    - Decreased Ca2+ excretion
    Causes decreased neuromuscular excitability
    - Muscle weakness
    - Diminished reflexes
    - Cardiac dysrhythmias
    Hypomagnesemia
    Serum magnesium concentration below the lower limit
    of normal
    Etiology
    - Decreased magnesium intake or absorption:
    chronic alcoholism, malnutrition, ileal resection

    Clinical Manifestation: Increased neuromuscular


    excitability from excessive amount of
    acetylcholine
    Hypermagnesemia
    Serum magnesium concentration above upper limit of
    normal
    Etiology
    - Increased magnesium intake or absorption:
    laxatives , antacids

    Depression of neuromuscular function related to


    decreased release of acetylcholine at
    neuromuscular junctions
    Hypophosphatemia
    Present when phosphate decreases below normal limit
    Clinical manifestations often not observed until severe
    – lack of ATP for cells
    - Confusion, stupor
    - Seizures
    - Coma
    - Impaired cardiac function

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