fluid and electrolytes college version..

A college subject about the fluids, and electry

1. Al- Rawdah University College fluid and electrolytes Medical surgical 1 Prepared by Basel akleek

2. Objectives To recognition of the fluid volume disturbance . To discus the Electrolytes imbalance .

3. Hypovolemia Hypovolemia refers to a decrease in fluid volume in the body . It can happen due to blood loss or loss of body fluids, such as water. Blood loss can result from external injuries, internal bleeding, or specific obstetric emergencies.  Diarrhea and vomiting  are common causes of body fluid loss. Extensive burns, excessive perspiration, and the use of diuretics all cause body fluid loss. Inadequate fluid intake can also contribute to  dehydration  and hypovolemia. In order to maintain bodily functions and preserve homeostasis , the body requires a specific amount of blood and other bodily fluids. An imbalance caused by hypovolemia results in a decreased ECF volume, which can adversely affect several organ systems.

4. Hypovolemia >>>>>> hypovolemic shock Hypovolemia describes a significant loss of fluid from the body. If you develop hypovolemia, your body first tries to compensate for the volume loss by increasing your heart rate and the strength of heart contractions. It also constricts the peripheral blood vessels, which are vessels outside of the chest or abdomen. Constricting these blood vessels helps preserve blood flow to vital organs, like the brain, heart, and kidneys. However , when blood volume drops to a level where blood cannot reach the body’s organs, they can no longer function properly. Tissue cannot receive oxygen and nutrients, and waste is not carried away. At this stage, the condition becomes hypovolemic shock.

5. What causes hypovolemia? blood loss from external injury or  internal bleeding . persistent or severe diarrhea and  vomiting extensive burns excessive sweating taking diuretics being on dialysis   adrenal disorders such as Addison’s disease   Serious or life threatening causes of hypovolemia ectopic pregnancy , a life threatening pregnancy  growing outside the uterus internal bleeding , often from the gastrointestinal tract large burns Ruptured aortic aneurysm  or other vascular abnormalities serious injury or trauma

6. What are the signs and symptoms of hypovolemia ? fatigue Dizziness Weakness leg cramps dry mucous membranes rapid breathing rapid heart rate low blood pressure loss of skin elasticity decreased urine output Symptoms of hypovolemic shock Confusion chest pain Abdominal Pain agitation or  irritability extreme sleepiness or lack of responsiveness cold skin Hypotension Tachycardia

7. How is hypovolemia treated? Because hypovolemia can quickly progress to hypovolemic shock and cause organ damage, prompt treatment for early signs of hypovolemia is critical. Treatments at this initial stage include: Oral rehydration drinks ( mild hypovolemia ) . Colloid solutions : These are intravenous (IV) fluids that contain complex sugarsand proteins. Crystalloid solutions: These are IV fluids that contain electrolytes most often sodium chloride or a mixture of sodium chloride. Other examples include sodium lactate, potassium chloride, or calcium chloride in water. Vasopressors: These are medications that constrict blood vessels and increase blood pressure.

8. When hypovolemia progresses to hypovolemic shock, blood can no longer reach vital organs. This is a life threatening emergency that requires immediate treatment to prevent organ damage. To treat hypovolemic shock, researchers recommend a rapid infusion of a crystalloid solution and to not using vasopressors once someone is in shock. However, in some cases when the shock is not responsive to crystalloid infusion, doctors may administer vasopressors as well.

9. Treatments for haemorrhagic shock blood plasma transfusion cryoprecipitate transfusion, which provides fibrinogen, a protein required for clotting platelet transfusion red blood cell transfusion crystalloid solutions colloid solutions

10. Hypervolemia is a condition in which there is too much fluid in the blood. It is also known as fluid overload. Although the body does need plenty of fluid to remain healthy, too much can cause a dangerous imbalance.

11. Causes : Several factors can cause hypervolemia. One is having too much salt in the body. Excess sodium causes the body to retain water to dilute the sodium. When you are healthy, the body rebalances sodium and water to handle this retention. The body excretes the excess sodium and water. The kidneys are responsible for reabsorbing or excreting sodium and fluid depending on the body’s needs. Congestive heart failure: This condition is a common cause of fluid overload. It occurs when the heart cannot effectively pump blood to the kidneys. Without enough blood to filter, the kidneys cannot perform the way they should. Kidney failure: Kidney failure is advanced kidney disease. As kidneys fail, they can no longer remove excess fluid and waste from the body. This can result in fluid overload. Liver cirrhosis: This is permanent liver damage that can lead to liver failure. The liver filters blood to remove toxins. With cirrhosis, the liver cannot filter the blood properly. This signals the kidneys to increase blood pressure, which in turn causes the kidneys to retain sodium and water. Fluid overload can also occur after receiving intravenous fluids, during your menstrual cycle, or during pregnancy.

12. symptoms headache high blood pressure and heart problems muscle cramps unexplained and rapid weight gain swelling in the extremities or face (edema ) abdominal swelling (ascites ) , which is common with liver problems shortness of breath caused by fluid in the lungs

13. Treatment typically address the underlying condition to treat hypervolemia. Treatment may include diuretics, which are medications that increase fluid loss through urination. If kidneys are not functioning properly, dialysis can remove excess fluid mechanically. someone with heart failure may need to take steps to manage their condition in addition to taking diuretics. diuretics may not work for people with severe kidney problems. Some people will need renal replacement therapies, such as dialysis or hemofiltration. People with heart, kidney, or liver conditions may also need to follow a reduced-salt diet. This helps keep sodium levels within normal limits, which helps avoid hypervolemia. People with congestive heart failure may need to limit the amount of fluid they drink each day. A doctor can recommend the proper amounts of fluid and salt intake based on an individual’s health history.

14. Electrolytes imbalance Sodium imbalances > hypo and hyper natremia Potassium imbalances > hypo and hyper kalemia Calcium imbalances > hypo and hyper calcemia Magnesium imbalances > hypo and hyper magnesemia

15. Hyponatremia is a term for having a blood sodium level that is lower than normal. If you have blood tests, you’ll see it listed as “sodium” or “Na+” in your lab results. Sodium is found mostly in the body fluids outside the cells. Sodium is an electrolyte (mineral). It is very important for maintaining blood pressure. Sodium is also needed for nerves, muscles, and other body tissues to work properly . When the amount of sodium in fluids outside cells drops below normal, water moves into the cells to balance the levels. This causes the cells to swell with too much water. Brain cells are especially sensitive to swelling, and this causes many of the symptoms of low sodium. With low blood sodium (hyponatremia), the imbalance of water to sodium is caused by one of three conditions : Euvolemic hyponatremia -- total body water increases, but the body's sodium content stays the same Hypervolemic hyponatremia -- both sodium and water content in the body increase, but the water gain is greater Hypovolemic hyponatremia -- water and sodium are both lost from the body, but the sodium loss is greater

16. caused by: Burns that affect a large area of the body Diarrhea Diuretic medicines (water pills), which increase urine output and loss of sodium through the urine Heart failure Kidney diseases Liver cirrhosis Sweating Vomiting

17. symptoms Confusion, irritability, restlessness Convulsions Fatigue Headache Loss of appetite Muscle weakness, spasms, or cramps Nausea, vomiting Possible Complications Decreased consciousness, hallucinations or coma Brain herniation Death

18. treatment The cause of low sodium must be diagnosed and treated. If cancer is the cause of the condition, then radiation, chemotherapy, or surgery to remove the tumor may correct the sodium imbalance. Other treatments depend on the specific type of hyponatremia may include : Fluids through a vein (IV) Medicines to relieve symptoms Limiting water intake

19. hypernatremia refers to sodium levels in the blood being too high. Two common causes of hypernatremia are not enough fluid intake and too much water loss. In rare cases, consuming too much sodium can cause hypernatremia.

20. symptoms excessive thirst fatigue confusion changes in mood muscle twitching spasms seizures coma Complications Without treatment, hypernatremia can lead to serious complications. One of the most dangerous is a brain hemorrhage, which stems from veins in the brain rupturing.

21. Hypokalemia when the amount of potassium in your blood is too low. Normal levels of potassium . You need potassium to keep your muscles, nerves and heart working well. You also need potassium for a healthy digestive system and bone health. Low levels of potassium can affect these important functions in your body. Over time, low levels of potassium in your body can cause effects such as abnormal heart rhythms, muscle weakness and even paralysis.

22. causes hypokalemia : an excessive loss of potassium in the digestive tract. This may be due to frequent vomiting, diarrhea or laxative use. Eating disorders, such as bulimia nervosa. Excessive sweating (hyperhidrosis). Alcohol use disorder. Water pills (diuretics). Diuretics can cause too much potassium to be expelled through urine. Other medications such as insulin, certain antibiotics and corticosteroids. Chronic kidney disease. Rarely, not getting enough potassium due to a poor diet.

23. symptoms of hypokalemia : Constipation . Heart palpitations. Extreme tiredness (fatigue). Muscle weakness and spasms. Tingling and numbness Muscle twitches. Muscle cramps. Severe muscle weakness, leading to paralysis. Low blood pressure (hypotension). Lightheadedness or faintness. Abnormal heart rhythms (arrhythmias). Excessive urination (polyuria). Excessive thirst (polydipsia).

24. Treatment a mild case of hypokalemia, healthcare provider will prescribe a potassium supplement that you’ll take by mouth. in moderate or severe healthcare provider may give potassium through vein (intravenously).

25. hyperkalemia is the medical term for high potassium levels. There are often no symptoms, but it can be a sign of kidney disease, dehydration, diabetes complications, and many other health conditions. Treatment will depend on the cause.

26. Causes Chronic kidney disease Uncontrolled or untreated diabetes Taking certain medications Heart disease . Injury Burns or other severe injuries can cause damage to tissues that results in the body releasing extra potassium into the blood. Higher potassium intake Dehydration

27. symptoms of high potassium : heart attack. Feeling tired or weak Feeling sick to the stomach (nausea) Muscle pains or cramps Trouble breathing, unusual heartbeat, chest pains

28. What are the complications of high potassium : Having too much potassium in your blood can be dangerous. Potassium affects the way your heart's muscles work. When you have too much potassium, your heart may beat irregularly, which in the worst cases can cause heart attack.

29. Treatment for high potassium goal of treatment for high potassium levels is to help your body get rid of the excess potassium quickly and to stabilize your heart. Hemodialysis Medications : Diuretics , Resin calcium gluconate calcium chloride insulin and glucose, or insulin alone for people with hyperglycemia (high blood sugar) sodium bicarbonate

30. Hypocalcemia Hypocalcemia happens when the level of calcium in the blood (not the bones) is too low. Calcium is one of the most important and common minerals in your body. Most of your body’s calcium is stored in your bones, but calcium is needed in your blood as well. The calcium in your blood helps your nerves work, helps make your muscles squeeze together so you can move, helps your blood clot if you are bleeding and helps your heart work properly. If you don’t consume enough calcium in your diet, your body takes calcium from your bones to use in your blood, which can weaken your bones. Hypocalcemia happens when there are low levels of calcium in your blood, not your bones.

31. The levels of calcium in your blood and bones are controlled by two hormones called parathyroid hormone and calcitonin. Vitamin D also plays an important role in maintaining calcium levels because it’s needed for your body to absorb calcium. parathyroid glands secrete a hormone that triggers: Your bones to release calcium into your blood Your digestive tract to absorb more calcium Your kidneys to excrete less calcium and activate more vitamin D, which plays a vital role in calcium absorption

32. causes hypocalcemia ? Hypoparathyroidism Vitamin D deficiency Kidney failure (renal failure Certain medications Hypomagnesemia

33. Symptoms Muscle cramps, especially in your back and legs. Brittle nails. Confusion. Irritability or restlessness.. Tingling in your lips, tongue, fingers and/or feet. Muscle aches. Muscle spasms in your throat that make it difficult to breathe (laryngospasm). Stiffening and spasms of your muscles (tetany). Seizures. Abnormal heart rhythms (arrhythmia). Congestive heart failure.

34. treatment Oral calcium supplements are the most common treatment for hypocalcemia. Treating the cause of hypocalcemia is just as important as treating the hypocalcemia itself.

35. Hypercalcemia is a condition in which the calcium level in your blood is above normal.

36. Causes hyperparathyroidism Cancer Severe dehydration. Medications. Supplements. Taking excessive amounts of calcium or vitamin D supplements

37. Symptoms excessive thirst and frequent urination. stomach upset, nausea, vomiting and constipation. bone pain and muscle weakness. confusion, lethargy and fatigue. palpitations and fainting, arrhythmia Complications Kidney stones. Kidney failure. Nervous system problems. (confusion, dementia and coma ) Abnormal heart rhythm (arrhythmia). Hypercalcemia can affect the electrical impulses that regulate your heartbeat, causing your heart to beat irregularly.

38. Treatment If your hypercalcemia is mild, you and your doctor might choose to watch and wait, monitoring your bones and kidneys over time to be sure they remain healthy. For more severe hypercalcemia, your doctor might recommend medications or treatment of the underlying disease, including surgery or Medications

39. hypomagnesemia is a condition in which the amount of magnesium in the blood is lower than normal. Every organ in the body, especially the heart, muscles, and kidneys, needs the mineral magnesium. It also contributes to the makeup of teeth and bones. Magnesium is needed for many functions in the body. This includes the physical and chemical processes in the body that convert or use energy (metabolism).

40. causes Alcohol use Burns that affect a large area of the body Chronic diarrhea Excessive urination (polyuria) Kidney tubule disorders Malabsorption syndromes, such as celiac disease and inflammatory bowel disease Malnutrition Pancreatitis (swelling and inflammation of the pancreas) Excessive sweating

41. Symptoms Abnormal eye movements (nystagmus) Convulsions Fatigue Muscle spasms or cramps Muscle weakness Numbness

42. Complications Untreated, this condition can lead to: Cardiac arrest Respiratory arrest Death

43. Treatment Magnesium by mouth or through a vein Medicines to relieve symptoms

44. Hypermagnesemia is a condition that develops when the amount of magnesium in your blood is too high. Magnesium is a mineral that helps your heart, muscles, and nerves work normally. It also helps strengthen your bones.

45. causes Kidney failure Overdose of magnesium supplements Medicines such as antacids, laxatives, and prescription pain Tissue breakdown caused by large burns Diseases such as hypothyroidism

46. symptoms Nausea and vomiting Muscle weakness Facial flushing (warmth and redness) Slow or irregular heartbeat Headache Drowsiness, lightheadedness, dizziness, or fainting Slowed reflexes Breathing slower than usual Muscle paralysis

47. Treatment depends on the cause of your hypermagnesemia . You may need to stop taking supplements or medicines that contain magnesium. You may need treatment for medical conditions that are causing increased levels of hypermagnesemia . Dialysis may be needed if you have kidney failure.

48. T hanks