FLUID and ELECTROLYTE BALANCE

Anatomy

Compartments of the Body and Distribution of Water by Weight

    

Plasma 5% Interstitial 15% Intracellular 40% TOTAL 60% Fat, protein, carbohydrate, minerals (SOLIDS) remaining 40%

Electrolytes
 

 

Chemicals dissolved in the body fluid Distribution has important consequences for the ultimate balance of fluids NaCl found mostly in ECF K and phosphate main ions in ICF

ELECTROLYTE DISTRIBUTION Electrolyte Extracellular meq/liter Intracellular meq/liter Function fluid balance, osmotic pressure Neuromuscular excitability acid-base balance bones, blood clotting enzymes

Sodium

142

10

Potassium

100

Calcium Magnesium

5 2

123

Total Positive ions

154

205

Electrolyte Distribution Extracellular meq/liter Intracellular meq/liter

Electrolyte

Function fluid balance, osmotic pressure acid-base balance osmotic pressure energy storage protein metabolism

Chloride Bicarbonate Proteins Phosphate Sulfate Total Negative ions

105 24 16 2 1

2 8 55 149 -

154

205

Fluid Exchange Process (Fluid Compartments)



Movement of water and electrolytes occurs through membranes and cell walls Permeability is controlled by the size of pores in response to pressure and hormones

Fluid Exchange Process (Tissues)



Blood plasma contains water, ions, nutrient molecules (glucose, AA, protein, lipids) and waste molecules Transported from blood capillaries to interstitial fluid to cell and back again by diffusion, filtration, osmosis and active transport

Diffusion


Ions and molecules flow from an area of higher concentration to area of lower concentration

Filtration


Pressure causes water, ions, and molecules to move from an area of higher pressure to an area of lower pressure

Active Transport


 

Water and/or ions and molecules are carried by a larger molecule or a vacuole on a cell wall Requires specific enzymes and energy Ex. Active transport is needed to get potassium ions into the cells since diffusion will not work as the concentration of potassium is highest in the cells

Osmosis
 

Water only flows from a dilute solution to a more concentrated solution Water flows from a solution of low osmotic pressure (hypotonic) to a solution of higher osmotic pressure (hypertonic) If two solutions have identical osmotic pressures, they are isotonic

Fluid Excess - Edema

Exchange Process Effected 1. Increased blood pressure results in increased filtration from plasma. 2. Increased permeability of capillaries results in too large a loss of ions and protein from plasma. 3. Loss of plasma protein results in lower osmotic pressure in plasma. 4. Retention of salts especially total body sodium caused by decreased excretion in urine from low blood pressure prevents effective filtration. Increased water is retained to maintain osmotic pressure. 5. High venular pressure prevents return of water by osmosis to plasma. 6. Blockage of lymphatic drainage Clinical Condition Hypertension

Local inflammation caused by injury.

Kidney disease (cirrhosis); Malnutrition

Kidney disease associated with low blood pressure; Congestive heart failure

Phlebitis, obesity, varicose veins Local inflammation.