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Lecture 5

NURSING 2LA2 Lecture Notes - Lecture 5: Fad Diet, Tachycardia, Weight Gain


Department
Nursing
Course Code
NURSING 2LA2
Professor
Ruth Hannon
Lecture
5

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Module 5: Fluid and Electrolyte Imbalances
Objectives
At the conclusion of this self-study module, students should be able to:
describe the mechanisms of fluid balance and imbalance at the capillary level
discuss Na+ and H2O balance and imbalances in terms of physiologic mechanisms,
possiblecauses, manifestations, and possible diagnostic measures and treatment
describe disorders of K+ balance
briefly discuss disorders of calcium, phosphate, and magnesium balance
This lecture will focus primarily on fluid imbalances rather than the mechanisms of maintaining
fluid balance that you studied last year in Anatomy and Physiology. The presentation will help
you to link physiology and pathophysiology to clinical situations to what you might assess and to
what interventions might be appropriate.
Are You Ready For This Unit?
To understand fluid and electrolyte imbalances, you need to know how the body regulates fluid
balance.
Renal physiology;
The basics of fluid balance;
And the basics of electrolytes in body fluids.
It’s important that you remember your Anatomy and Physiology. It would be helpful for you to
review renal physiology (including glomerular filtration and tubular reabsorption and secretion),
the basics of body fluid balance (including fluid compartments and the regulation of fluid gains
and losses), and to review the basics of electrolytes distribution and functions.
Resources For Review
Tortora&Derrickson, 12th edition, Chapters 26 and 27
See attachment: Anatomy and physiology lectures on renal physiology and fluids and
electrolytes
o“Tubular Function.pdf”
o“Creating urine and measuring renal function.pdf”
Porth Pathophysiology, 1st Canadian edition, chapter 30
More Resources For Review
Diffusion
Active Transport
Osmosis
oClick here (on the link below) to review and test your knowledge
http://www.merlot.org/merlot/viewMaterial.htm?id=417233
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Diffusion, Osmosis and Active Transport (From the link above)
Introduction
Fluids and solutes move continually throughout the body
in order to maintain homeostasis.
Cellular Movement
Membranes that separate the intracellular, interstitial and
intravascular compartments are semipermeable. Some,
but not all, solutes are able to pass through these
membranes. Three forms of cellular movement are shown
below.
Diffusion
Passivetransport of
solutes across cell
membranes from an
area of higher
concentration
to one of lower
concentration.
This movement
continues until
equilibrium is
reached on both
sides of the
membrane.
Osmosis
Passive transport of
fluid across cell
membranes from an
area of higher
concentration to one of
lower concentration.
This movement
continues until
equilibrium is reached
on both sides of the
membrane.
Active Transport
Active transport of
solutes across cell
membranes from an area of lower concentration to one of higher concentration. Like swimming
upstream, this requires energy – in this case, adenosine triphosphate (ATP).
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Pressures:
Hydrostatic
Colloidal osmotic (oncotic)
oClick here to review and test your knowledge
http://www.merlot.org/merlot/viewMaterial.htm?id=417242
Inside the Body: Fluid Pressures and Processes (From the link above)
Heres your challenge: Fluid in your body is constantly in motion in an attempt to maintain
balance, or homeostasis. Many types of illness can upset this balance by creating fluid excess or
deficit in the intravascular or interstitial compartments.
Goal: Your body’s goal is to prevent the accumulation of fluid in these compartments.
How is this achieved? Your body has to ensure that fluid leaving circulation and the amount of
fluid returning to circulation is equal.
Let’s shift gears for a moment and compare the soaker hose to a capillary. Both are long, narrow,
flexible tubes with hollow centers. Both are semipermeable. Both have clearly defined ends
where fluid enters and exits. Just as you controlled the flow of water in this exercise, your body
controls the continuous movement of water, nutrients and waste products between the capillary
and the interstitial space.
This movement is regulated by two pressures, and two processes. We’ll talk about the pressures
first, and then describe the processes.
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