Fluid, Electrolyte, and Acid-Base Imbalances

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Fluid, Electrolyte, and Acid-Base Imbalances Chapter 17 Cindy Tynes, MSN, RN-BC Lewis: Medical-Surgical Nursing, 9th Edition HOMEOSTASIS • Body fluids and electrolytes play an important role in maintaining a stable internal environment of the body. • Adaptive responses keep the composition and volume of body fluids and electrolytes within the narrow limits of normal to maintain homeostasis and promote health. • Many diseases and their treatments have the ability to affect fluid and electrolyte balance and alter homeostasis. WATER CONTENT OF BODY • Water is the primary component of the body, about 60% of the body weight in the adult but decreases with age. • The two major fluid compartments in the body are intracellular fluid (ICF), or inside the cells, and extracellular fluid (ECF), or outside the cells. ECF is composed of interstitial fluid, plasma, and transcellular fluids. ELECTROLYTES • Electrolyte composition varies between the ECF and ICF, though the overall concentration of the electrolytes is approximately the same in the two compartments. TABLE 17-­1 NORMAL SERUM ELECTROLYTE VALUES **** MUST KNOW*** Electrolyte Bicarbonate (HCO3−) Chloride (Cl−) Phosphate (PO43−)* Potassium (K+) Magnesium (Mg2+) Sodium (Na+) Calcium (Ca2+) (total) Calcium (ionized) Reference Interval 22 -­‐26 mEq/L (22-­‐26 mmol/L) 96-­‐ 106 mEq/L (96-­‐106 mmol/L) 2.4 -­‐4.4 mg/dL (0.78-­‐1.42 mmol/L) 3.5 -­‐5.0 mEq/L (3.5-­‐5.0 mmol/L) 1.5-­‐ 2.5 mEq/L (0.75-­‐1.25 mmol/L) 135-­‐ 145 mEq/L (135-­‐145 mmol/L)

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