fluid and electrolyte

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r monitoring and maintaining the concentrations of electrolyte. sodium regulation sodium is the most abundant cation in the ecf (90% of all extra-cellular cation) and so determines the osmolality of the plasma. normal plasma osmolality is approximately 285-295) mmol/l. regulation increase in sodium content of the ecf administration of sodium bicarbonate for the correction of an acidosis may result in hypernatraemia since sodium bicarbonate solutions may contain sodium at the concentration in excess of the physiological. primary hyperaldosteronism (conn’s syndrome) where there is excessive aldosterone. similar findings may be seen in cushing syndrome where there is excess cortisol production, which has weak mineral corticosteroid activity. urine osmolality and sodium concentration may be of value in the differential diagnosis of hypernatraemia. clinical feature of hypernatraemia: gives features of dehydration. hyponatraemia hyponatraemia is a significant fall in serum sodium concentration .the reference range of 135-145 mmol/l. causes of hyponatraemia retention of water …

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generalized oedema have an increase in both total body sodium and water. hyponatraemia due to sodium loss sodium loss occurs in cases of: vomiting diarrhea fistula uriniary loss addison disease due to reduced aldosterone. use of drugs such spirnolactone. patients become hyponatraemia because of deficiency in ionic sodium containing fluid replaced only by water either orally or intravenously. potassium control: potassium is controlled by aldesterone, cortisol, acth and adh. as well as intake aldesterone and cortisol and acth facilitate potassium loss through urine excretion. the concentration of potassium in serum is between 3.5-5.0 mmol/ liter. cellular uptake of potassium is stimulated by insulin. there is a reciprocal relationship between potassium and h hydrogen ion. thus hyperkalemia is associated with non-respiratory acidosis and vise-versa. changes in serum potassium concentration: hyperkalemia hyperkalaemia is the commonest and most serious electrolyte emergency encountered in clinical practice. hyperkalaemia causes muscle weakness, which may be associated …

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iting diarrhea fistula suction. renal losses: e.g. some renal disease, and administration of diuretics or increased aldesterone production. alkalosis: which causes shift of potassium from: e c f to the i c f. congestive heart failure. ketoneamia. hepatic cirrhosis. siadh clinical effects of hypokalaemia: severe muscle weaknesses hyporeflexia cardiac arrhythemia denoted by e c g changes. causes metabolic alkalosis.

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fluid and electrolyte fluid and electrolyte water and electrolyte regulation; introduction: the balance of water and electrolytes is needed to the management of any patient who is seriously ill. measurement of sodium, potassium, urea creatinine and bicarbonate is the most commonly requested biochemical profile and yields a great deal of information about a patient fluid and electrolytes and renal function. the balance of water water is the major body constituent (70%) in a 70kg man the total body water amounts to about 42 liters distributed between the intracellular compartment (icf) about 30 liters and the extra cellular compartment (ecc) amounts to 12 liters. the ecf include plasma 3liters and interstitial fluid (9 liters). the balance of water is brought about …

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