ECF is further divided into the

Intracellular fluid constitutes intravascular space, interstitial space

about 2/3 of this amount, ECF and transcellular space.
Loss of ECF into a space that does not
accounts for the other 1/3. contribute to equilibrium between the
ICF and ECF is referred to as a third-
space fluid shift.
 Help regulate
body temp

Carry cellular
Transport waste
nutrients & products to
gases excretion
sites
 Body fluid

Intracellular Extracellular
40% 20%

Interstitial
fluid Intravascular
fluid 5%
20%
a. An electrolyte is a substance that dissociates
and forms ions when mixed with water.

b. Potassium and phosphate are the major

electrolytes in ICF.

c. Sodium and chloride are the major

electrolytes in ECF.
Osmosis involves fluid shifting semi-permeable membrane
from an area of low solute concentration to an area of higher
solute concentration
Diffusion passive transport; involves fluid movement from an
area of high solute concentration to one of lower solute
concentration .
Filtration refers to removal of particles from a solution
through the movement of fluid across a membrane or other
partial barrier
Active transport an energy (ATP) requiring process that
transports ions across the cell membrane against a
concentration gradient
1. Fluid loss constantly occurs as a normal result of bodily
functions
2. The kidneys normally produce a fluid output of 1-2 L
daily.
3. Sensible and insensible losses from the skin

4. The lungs cause insensible loss

5. Losses from the GI tract normally range from 100 to 200

ml/day.
1. Renal system
The kidneys reabsorb bicarbonate (HCO3), secrete
hydrogen ions (H+) in proximal and distal tubules and
produce ammonia

2. Cardiovascular system
Normal ABG values reflecting homeostasis include:
- pH 7.35 7.45
- partial pressure of oxygen (PO2) 80-100 mmHg
- partil pressure of carbon dioxide (PCO2) 35 45
mmHg
- HCO3 22-26 mEq/L
3. Pulmonary system
Maintains acid-base balance by controlling CO2 and carbonic
acid (H2CO3) excretion
PCO2 is the most powerful respiratory stimulant, followed
by pH, then PO2.

4. Buffer System
HCO3 buffer system is regulated by the kidneys; they can
generate HCO3 ions and reabsorb them from the renal
tubular cells.
The H2CO3 buffer system is regulated by the lungs, they do
so by adjusting ventilation in response to the amount of CO2
in the blood.
 Pituitary gland secretes ADH,
which promotes water retention.

5.
Endocrine
System

The parathyroid glands secrete The adrenal cortex produces

parathyroid hormone, which regulates aldosterone, which causes sodium
calcium and phosphate balance retention and potassium loss
Deficit Excess

Weight loss Weight gain

Elevated
Thready PR BP/Bounding
pulse

Sunken eyes,
dry
conjunctivae
 Hypotonic Solution
Isotonic Solution the solute
solute concentration is concentration of a
about equal to that of hypotonic solution is
serum. less than that of
serum.

Hypertonic Solution
concentration is higher
than that of serum.
 Isotonic
solutions
Solution has the same solute concentration as
normal blood plasma and other body fluids.

Solution stays where it is infused, inside the blood

vessel

Expands the intravascular compartment

Solution maintains the body fluid balance

 Isotonic
solutions

Lactated Ringers (LR)

Ringers

Normal Saline (0.9% NACL)

Dextrose 5% in water (D5W)

Intralipids

D5 NS 5% Dextrose and 0.2 NaCL

Nursing Considerations
Monitor patient for signs of fluid overload
especially in patients with CHF and
hypertension.
Hypotonic
solutions

Solution has a lower osmolarity than serum

Solution causes a fluid shift out of the blood

vessels into the cells and interstitial spaces

Solution hydrates cells while reducing fluid in

the circulatory system

Ex: NSS (0.45% NaCL)

Nursing considerations
Administer cautiously
Solution can lower blood pressure
Do not give if these solutions if the patient is
at risk for:
ICP from cerebrovascular accident
Head trauma
Neurosurgery
Hypertonic
solutions

Causes the solute concentration of the serum to increase pulling fluid

from the cells and the interstitial compartment into the blood vesels.

Reduces the risk of edema, stabilizes blood pressure and regulates

urine output/
Hypertonic
solutions

D10Water
D50W
D5 NS
D5NS
D5LR
Nursing considerations
Monitor your patient for circulatory overload
Solution can be irritating to the vein