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Body Fluid
Body fluid
The
total body fluid is about 60% of the
total body weight.
In the average 70 kg body weight it is
about 42 liters.
Increase the percentage of fat in the
body decreases the % of water.
Women contain less water than men
because have more body fat.
Body fluid compartment
Extra cellular fluid :It is about 14 liters:
plasma 3 liters.
Interstial fluid in spaces between cells 10 L
Transcellular 1-2liters.
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Intra ocular space
Synovial , peritoneal ,pericardial spaces.
Cerebrospinal fluid .
Body fluid
Intra cellular fluid
 Equal 28 liters.
 It is the fluid inside the cells.
 It contains high Concentration of K &less
concentration of Na.
 Also it contains large amount of
magnesium and phosphate.
Regulation of fluid
transportation
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The most common routes for transporting
materials to and from intracellular
compartments are (the fluid and materials
transport across semipermiable membrane) :
1- osmosis
2- diffusion
3- active transport
4- filtration
1- Osmosis

Through the process of osmosis , the
solvent , the water passes from an area of
lesser solute concentration and more
water to an area of greater solute
concentration and less water until
equilibrium is established .
Osmosis
2- Diffusion

Is the tendency of solute to move freely
throughout a solvent .The solute
(materials ) moves from an area of higher
concentration to an area of lower
concentration
2- Diffusion
3- Active Transport

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Is a process that requires energy for the
movement of substances through cell
membrane from an area of lesser solute
concentration to an area of higher solute
concentration .
Adenosine triphosphate (ATP) stored in all
cells , is released from a cell and supplies
energy for solute movements in and out of
the cell.
4- Filtration

Is the passage of fluid through a
permeable membrane .Passage is from an
area of high pressure to an area of lower
pressure
Daily
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intake of water (by two main sources):
Ingested in the form of water or liquid which
add about 2100ml/day to the body fluid
Synthesized as a result of metabolism and it is
about 200ml/day.
Daily

Body water
loss of body water:
Evaporation 700ml
Urine 1400 ml
Sweat 100 ml
Feces 100ml
Types of Solutions
1.
Isotonic solution

2.
Hypotonic solution

3.
The water concentration in IC&ECF is equal and solutes can
not enter or leave the cell.
There are less solutes less osmotic pressure so water enter
the cell and it swell.
Hypertonic solution
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High solutes ,high osmotic pressure so water leave the cell
and cell shrink.
Solution of NaCL 0.9%and glucose 5%are isotonic so it is
important in clinical medicine because the cell neither swell
nor shrink.
Water Balance
Is
maintained in the body by adjusting water
input and water output.
Control of water input:
Stimulated by thirst sensation.
 Thirst sensation occurs as a result of:

Hypertonicity.
 Hypovolemia.

Water loss
Drink
Increase
plasma
osmolarity
Stimulation of
thirst center
In
Hypothalamus
Control of water loss
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It is controlled by controlling the volume of urine.
Volume of urine is controlled by (ADH)
Anti- diuretic hormone (ADH):
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Synthesized in the hypothalamus.
Stored in the posterior pituitary until it is secreted.
Secretion is stimulated by hypertonicity and
hypovolemia.
Disturbances in body
fluids
1- Fluid Volume Excess
Also it can be defined as hypervolemia , which occurs from an increase in total body
sodium content and an increase in total body water
Causes of hypervolemia
1- excessive fluid intake
2- excessive sodium intake
3- Renal insufficiency or faluire
4- Steroid Therapy
5- Low protein intake or malnutrition
6- Decreased cardiac output (heart disease )
7- Head injury
8- Liver disease
9- Sever stress
10 – Hormonal disturbances
Manifestations of Hypervolemia
oWeight gain
oEdema
oBounding pulse
oJugular vein destination
oChange in mental status
oAbnormal breath sound (crackles )
oChanges in breathing pattern
oIntake greater than output
oDecrease hemoglobin or
hematocrit
oOliguria
oSpecific gravity changes
oAzotemia
oChanges in electrolytes
oRestlessness & anxiety
oIncrease blood
pressureShortness of
breath (orthopnea)
Nursing Intervention of
Hypervolemia
1- obtain patient history to ascertain the probable cause of fluids disturbance
2- weight monitoring & evaluate weight in relation to nutritional status
3-I &O chart 4- monitor v/s 5 – evaluate for edema 6- monitor serum electrolytes
Intervention
1- instruct the patient toward the restriction of fluid
2- restrict Na intake
3- Instruct pt to take prescribed diuretics
4- elevate the edematous leg
5- skin care
6- provide information regarding s&s of fluid volume excess
Fluid volume loss
(hypovolemia)
Fluid volume deficit or hypovolemia . Occurs
from a loss of body fluid or shift of fluids into 3rd
space , or from reduced fluid intake
Causes :
Inadequate fluid intake
Fluid loss (diuresis, bleeding , severe diarrhea
Fever , infection which leads to increase
metabolic rate .
Fluid shifts (edema or effusion )
Clinical manifestations of
hypovelmia
Decrease
urine output
Concentrated urine
Output greater than intake
Decrease venous filling
Hemoconcentration
Hypotension
Thirst
Dry m.m
Changes in mental status
Nursing care of hypovolemia
I- Assessment : the same as in hypervolemia
II- Nursing Intervention :
Encourage patient to drink prescribed amount
Administer IV fluid
Administer blood product as prescribed
Provide oral hygiene
Treat the underlying causes (diarrhea, vomiting)
Home work
Define the following :
Hyponatremia
Hypernatermia
Hypocalcemia
Hypercalcemia
Hypokalemia
Hyperkalemia
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