Fluids Electrolytes Suffolk County （液体电解质萨福克县）.pptVIP

Stressors AffectingFluid Electrolyte Balance NUR 101 FALL 2008 LECTURE # 15 #16 K. Burger, MSEd, MSN, RN, CNE Body Fluids Water= most important nutrient for life. Water= primary body fluid. Adult weight is 55-60% water. Loss of 10% body fluid = 8% weight loss SERIOUS Loss of 20% body fluid = 15% weight loss FATAL Fluid gained each day should = fluid lost each day (2 -3L/day average) What is the minimum output per hour necessary to maintain renal function? Functions of Body Fluid Medium for transport Needed for cellular metabolism Solvent for electrolytes and other constituents Helps maintain body temperature Helps digestion and elimination Acts as a lubricant Mechanisms of Fluid Gain and Loss Gain Fluid intake 1500ml Food intake 1000ml Oxidation of nutrients 300ml(10ml of H20 per 100 Kcal) Loss “Sensible”Can be seen.Urine 1500mlSweat 100ml “Insensible”Not visible.Skin (evaporation) 500mlLungs 400mlFeces 200ml Regulation of Fluids Hypothalmus –thirst receptors (osmoreceptors) continuosly monitor serum osmolarity (concentration). If it rises, thirst mechanism is triggered.+Vasopressin (AKA ADH )– increasing H20 reabsorption Pituitary regulation- posterior pituitary releases ADH (antidiuretic hormone) in response to increasing serum osmolarity. Causes renal tubules to retain H20. Thirst is a late sign of water deficit Regulation of Fluids (continued ) Renal regulation- Nephron receptors sense decreased pressure (low osmolarity) and kidney secretes RENIN. Renin – Angiotensin I – Angiotensin II Angiotensin II causes Na and H20 retention by kidneys AND….. Stimulates Adrenal Cortex to secrete Aldosterone which causes kidneys to excrete K and retain Na and H20. Consider This…. The Geriatric Client-normal physiological aging results in decreased thirst mechanism decreased # of sweat glands decreased renal function-there also may be decreased mobility and/or cognitive function which impacts their abil