NCM 103- FLUIDS AND

ELECTROLYTES
FLUIDS AND ELECTROLYTES
- Greater percentage of a lean individual’s body weight than an
obese individual
 Average Daily Fluid intake of an Adult
SOURCE AMOUNT (ML)

Oral Fluids 1200-1500

Water in Food 100

Water as by product of 200

food metabolism
Total 2400-2700
 Average Daily Fluid output of an Adult

ROUTE AMOUNT (ML)

URINE 1400-1500

INSENSIBLE LOSSES
Lung 350-400
Skin 350-400
Sweat 100

Feces 100-200

Total 2300-2600
Sodium (Na+)
➢ is the most abundant cation in ECF and a major
contributor to serum osmolality.

➢ Normal serum sodium levels are 135 to 145 mEq/L.

➢ Sodium functions largely in controlling and regulating

water balance.
POTASSIUM
Potassium (K+) is the major cation in ICF, with only a small
amount found in the ECF.
➢ normal serum potassium levels are 3.5 to 5.0 mEq/L.

CALCIUM
Calcium (Ca2+) in the body is stored in the skeletal system, with a relatively small
amount in extracellular fluid.

➢ Although the calcium outside the bones and teeth amounts to only about 1% of the
total calcium in the body, it is vital in regulating neuromuscular function, including
muscle contraction and relaxation, as well as cardiac function.
MAGNESIUM
Magnesium (Mg2+) is found primarily in the skeleton and ICF
➢ it is the second most abundant intracellular cation.
➢ It is important for intracellular metabolism, particularly in the production and use of ATP.
➢ necessary for protein and DNA synthesis within the cells.
➢ normal serum level of 1.5 to 2.5 mEq/L.

CHLORIDE
Chloride (Cl−) is the major anion of ECF
➢ normal serum levels are 95 to 108 mEq/L.
➢ functions with sodium to regulate serum osmolality and blood volume.
➢ major component of gastric juice as hydrochloric acid (HCl)
➢ It also acts as a buffer in the exchange of oxygen and carbon dioxide in RBCs.
➢ Chloride is found in the same foods as sodium.
PHOSPHATE
Phosphate (PO) is the major anion of ICF.
➢ It also is found in ECF, bone, skeletal muscle, and nerve tissue.
➢ Normal serum levels of phospate in adults range from 2.5 to 4.5 mg/dL.

BICARBONATE
➢ Bicarbonate (HCO3) is present in both ICF and ECF.
➢ Primary function is regulating acid–base balance as an essential component of the
body’s buffering system.
The normal pH of arterial blood is between 7.35 and 7.45
- Major buffer in ECF if the bicarbonate(HC03) and the carbonic
acid (H2CO3),
- The amounts of bicarbonate and carbonic acid in the body
vary;
- the pH drops, and the client has a condition called acidosis.
- the pH rises and the client has alkalosis.
➢ The lungs help regulate acid–base balance by eliminating or retaining
carbon dioxide (CO2).

Carbon dioxide levels in the blood are measured as

➢ PCO2, the partial pressure of the dissolved CO2 in venous blood

➢ PaCO2, the partial pressure of the dissolved CO2 in arterial blood
➢ Normal PaCO2 is 35 to 45 mmHg.
➢slower to respond to changes, requiring hours to days to
correct imbalances,
➢The kidneys maintain acid–base balance by selectively
excreting or conserving bicarbonate and hydrogen ions.
➢normal serum bicarbonate level is 22 to 26 mEq/L.
FACTORS AFFECTING BODY FLUID, ELECTROLYTES
AND ACID - BASE BALANCE
CALCIUM
➢ Normal Range – 8.5 – 10.5 mg/dl
➢ Hypocalcemia- calcium deficit less than 8.5 mg/dl
➢ Chvostek’s sign
➢ Trousseau’s sign
➢ Hypercalcemia – calcium excess more than 10.5 mg/dl
NURSING MANAGEMENT
ASSESSING
➢NURSING HISTORY
➢PHYSICAL ASSESSMENT
➢CLINICAL MEASUREMENT
✓ Daily weights
✓ Vital signs
✓ Fluid intake and output
➢ LABORATORY TEST