Fluids

Question 1

Water percentages

Answer 1

The amount of water as a percentage within a person decreases with age;

• Newborn; 75% of water
• Average adult; 60% roughly
• Older adult; between 45% & 50%

Question 2

Fluid compartments

Answer 2

• Extracellular fluid (ECF)
• comprises of the fluid between the cells and is also known as interstitial or tissue fluid. it is the plasma (fluid) of the blood and lymph
• Intracellular Fluid (ICF)
• present within all body cells

This is; two thirds ICF & one third ECF in adults, with the opposite in children.

Question 3

Four ways fluids are excreted from the body/ Sensible & insensible fluid losses

Answer 3

Urine via the bladder

Sweat via the skin

Air via the lungs

Faeces via the bowels

Sensible losses;
- this refers to the typical routes of excretion such as urination and defecation

Insensible losses;
- other routes of fluid loss, such as through the skin via sweat and air via the respiratory tract

Question 4

Groups most at risk of fluid depletion

Answer 4

• elderly
• children
• those with mobility concerns
• those in a hotter climate
• those with LDs
• those with dementia
• unconscious patients
• those with mental health problems

Question 5

Typical volumes of drinking vessels

Answer 5

• mug- 20mL
• carton- 240mL
• jug-800mL
• can- 330mL
• water bottle- 330mL
• glass- 250mL
• plastic cup- 150/175mL
• soup bowl- 400mLs (dependends)

Question 6

Fluid balance and physiological parameter recordings

Answer 6

• Blood pressure
• dehydration can result in low blood volume and therefore low blood pressure (less blood to force against the blood vessel walls)
• in severe situations of dehydration, this drop in BP may only be apparent during positional BP readings, showing as postural hypotension when standing from sitting.
• fluid overload such as during IV therapy can cause an increased BP

Pulse
- an increased in pulse rate occurs in fluid volume deficit because there is less fluid in the vascular system (hypovolemia), causing the heart to work harder.

-fluid volume excess also causes a raised pulse, and so adequate monitoring of fluid input and output is vital

Respiration
- the RR, effort and depth can change in response to fluid, electrolyte and acid-base imbalance. E.g. a person with fluid volume excess can develop pulmonary oedema which causes dysnopea; difficulty breathing and a cough with frothy sputum

-dehydration can also cause mucus to become thicker and stickier, making breathing harder and more likely to become ill

Question 7

What are diuretics

Answer 7

Also known as water pills, these can help rid the body of salt (sodium) and water. It is any substance that promotes diuresis; the increased production of urine, with all increasing the excretion of water from the body via the kidneys.

They can also be used to treat the following;

• heart failure
• hypertension
• increased excretion from the body

Furosemide is a type of diuretic that blocks the effects of ADH and therefore increases urine volume