Fluid and Electrolyte Imbalances

Chapter 15


Fluid and Electrolyte Imbalances






Maintaining homeostasis among intracellular fluid, extracellular fluid, and electrolytes is necessary to allow proper cell function. Proper homeostasis depends on the following factors:



Many variables can alter a patient’s fluid and electrolyte balance. These imbalances can further result in numerous clinical manifestations, which can subsequently affect a patient’s functional mobility and activity tolerance. Recognizing the signs and symptoms of electrolyte imbalance is therefore an important aspect of physical therapy management. In addition, the physical therapist must be aware of which patients are at risk for these imbalances, as well as the concurrent health conditions and medical management of these imbalances.



Fluid Imbalance


The total amount of fluid in the body is distributed between the intracellular and extracellular compartments. Intracellular fluid contains approximately two-thirds of the body’s fluid. Extracellular fluid is further made up of interstitial fluid and intravascular fluid, which is the blood and plasma.1–3 Fluid imbalance occurs when there is a deficit or an excess primarily in extracellular fluid.16 Table 15-1 provides an overview of fluid imbalances.



TABLE 15-1


Fluid Imbalances


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ACE, Angiotensin-converting enzyme; BP, blood pressure; BUN, blood urea nitrogen; ECG, electrocardiogram; NPO, nothing by mouth; SIADH, syndrome of inappropriate antidiuretic hormone secretion; ACE, angiotensin-converting enzyme; NSAIDs, nonsteroidal antiinflammatory drugs; PTH, parathyroid hormone.


Data from Huether SE: The cellular environment: fluids and electrolytes, acids and bases. In McCance KL, Huether SE, Brashers VL et al, editors: Pathophysiology, the biologic basis for disease in adults and children, ed 6, St Louis, 2010, Mosby, pp 96-125; The body fluid compartments: extracellular and intracellular fluids; edema. In Hall JE, editor: Guyton and Hall textbook of medical physiology, ed 12, Philadelphia, 2011, Saunders, pp 285-301; Porth CM: Alterations in fluids and electrolytes. In Porth CM, editor: Pathophysiology, concepts of altered health states, ed 6, Philadelphia, 2002, Lippincott, pp 693-734; Gorelick MH, Shaw KN, Murphy KO: Validity and reliability of clinical signs in the diagnosis of dehydration in children, Pediatrics 99(5):E6, 1997; Mulvey M: Fluid and electrolytes: balance and disorders. In Smeltzer SC, Bare BG, editors: Brunner and Suddarth’s textbook of medical-surgical nursing, ed 8, Philadelphia, 1996, Lippincott; Goodman CC, Kelly Snyder TE: Problems affecting multiple systems. In Goodman CC, Boissonnault WG, editors: Pathology: implications for the physical therapist, Philadelphia, 1998, Saunders; Fall PJ: Hyponatremia and hypernatremia: a systematic approach to causes and their correction, Postgrad Med 107(5):75-82, 2000; Marieb EN editor: Human anatomy and physiology, ed 2, Redwood City, CA, 1992, Benjamin Cummings, p 911.

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Jul 12, 2016 | Posted by in MANUAL THERAPIST | Comments Off on Fluid and Electrolyte Imbalances
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