Monika Ysabel I.

Tac-an BSN lll-B

NCM 104 (Fluids & Electrolytes)

Compartments of Body and Distribution of Water by Weight

Compartments Distribution
Interstitial Fluid 25 y y y y

Function
Carry substances between the blood and the tissue cells Excreting waste products Carries nutrients including glucose which is the primary source of energy for cell metabolism Hormones, such as cortisol and thyroxine are also transported around the body in plasma attached to plasma proteins Blood plasma contains inorganic ions which are important in regulating cell function and maintaining homeostasis Contains clotting agents and on exposure to air it will form a clot. Aids healing and stops bleeding. Contains antibodies (gammaglobulins) to help resist/fight off infections In the joints, it serves a lubrication function Transporting medium in that it carries food and oxygen into the cells and wastes and carbon dioxide from the cells. Also maintains the shape And size of each cell in the body.

Plasma

y y

Tran cellular Fluid

y y

Intracellular Fluid

65

y y

Electrolyte Sodium Potassium Calcium Magnesium Total Positive ions 142 5 5 2 154

ELECTROLYTE DISTRIBUTION Extracellular Intracellular meq/liter meq/liter 10 100 123 205

Function fluid balance, osmotic pressure Neuromuscular excitability acid-base balance bones, blood clotting enzymes

Water is the main fluid in the body, total body water is 60% of body weight. It is distributed in 3 main compartments which is separated from each other by cell membranes. The intracellular compartment is found within the cell area meanwhile, the extracellular compartment consists of the interstitial area that is found between and around the cell, inside of the blood vessels (plasma). Electrolyte Distribution Extracellular Intracellular meq/liter meq/liter 105 24 16 2 1 154 2 8 55 149 205

Electrolyte Chloride Bicarbonate Proteins Phosphate Sulfate Total Negative ions

Function fluid balance, osmotic pressure acid-base balance osmotic pressure energy storage protein metabolism

Electrolytes are the chemicals dissolved in the body fluid. The distribution plays an important role in the ultimate balance of fluids.Sodium chloride is found mostly in extracellular fluid, while potassium and phosphate are the main ions in the intracellular fluid.

Intravenous Therapy
Intravenous therapy involves the injection of fluids directly into veins. Considered faster-acting than oral or other forms of medication, intravenous or IV therapy allows medicine to reach the heart quickly, There are many potential uses for IV treatments. For dehydrated or severely malnourished patients, IV fluids can quickly deliver electrolytes, nutrients, and water to the body. Blood and plasma can also be transfused through an IV, in the case of blood loss. Purpose: y To provide or replace necessary fluid, electrolyte, and/or caloric intake y To administer medications, e.g. Antibiotics, analgesics, & chemotherapy y To facilitate an immediate or prolonged action of a drug y To administer blood or blood products. Materials:

Equipment required for insertion of IV cannula: * skin prep solution and dressing pack * cannula * 5 mL syringe - for flushing cannula * normal saline for injection 5 mL * IV site dressing * leur lock one way valve or IV primed IV line

Procedure: To start an IV, first prepare all of your equipment. This will include an IV bag, with connecting tubing, with all the air flushed out of the tubing. 1. Place a tourniquet around the arm. This should be tight enough to block venous blood flow back to the heart, but not so tight that it obstructs arterial flow. 2.Wait long enough for the veins in the hands and arm to fill and become tight. In a normal person, this may take 2-5 minutes. In a dehydrated person or someone in shock, it may take longer. 3.Cleanse the skin of the injection site with alcohol (preferably). If alcohol is not available, use any antiseptic or skin cleaner. Using any cleaning agent (even water) is better than using nothing at all. 4.Use your left thumb to hold the vein in place while you insert the IV needle at a shallow angle (about a 20 degree angle) through the skin and into the vein. 5.As you enter the vein, you will feel a slight "pop." You will know you are in the vein when you see blood returning in the "flash back" chamber. 6.Keep the needle in place with one hand while you push the catheter (which surrounds the needle) further into the vein. This will thread it upstream, securing it into the vein. 7.Once the catheter is completely inserted, hold it in place with one hand while you release the tourniquet and pull the needle straight out with the other hand. Pressing down over the skin where the catheter tip is located will prevent blood from flowing back out the IV catheter before you have a chance to connect the IV tubing. 8.Connect the IV tubing and run in the IV fluids briskly, at first. Then slow it down to a steady drip, drip, drip. If the fluid does not flow freely at the beginning, check the IV tubing to see if there are any valves or other obstruction to flow. If the tubing is wide open, but the IV is dripping only very slowly, you are probably not in the vein. Try again. 9., Put a bandaid over the site, and then tape the tubing in place. 10. Anchor needle firmly in place with the use of a. transparent tape/dressing directly on the puncture site 11. Tape a small loop of IV tubing for additional anchoring; apply splint (ifneeded) Note: Never place unsterile tape directly on IV insertion site, instead placea small piece of sterile OS & then secure it with adhesive tap. 12. Calibrate the IVF bottle & regulate flow of infusion according to prescribed duration. 13. Label on IV tape near the IV site to indicate the date of insertion, type and gauge of IV catheter and countersign. 14. Label with plaster on the IV tubing to indicate the date when to change the IV tubing. 15. Observe patient and report any untoward effect. 16. Document in the patients chart and endorse to incoming shift. 17. Discard sharps and waste according to Health Care Waste Management.

Nursing Health History: Name: Ms. X Birthday: August 9, 1984 Age: 27 years old Sex: Female Address: Pasonanca, Zamboanga City Status: Single Religion: Catholic Dialect Spoken: Tagalog, Bisaya Ethnic Group: Bisaya Educational Attainment: 2nd year Highschool Chief Complaint: Weakness, abdominal pain, dry mucous membranes and loose and watery stool History of Present Illness: Patient experienced abdominal pain and LBM after she ate her dinner. The patient ate uncooked fish and drunk a lot of coffee. She experienced severe pain in her abdomen in the middle of the night and couldnt sleep. She visits the comfort room every hour and verbalized that her stool is loose and watery. In the morning, as observed the patient was weak, pale, dry skin and was extremely thirsty. The patient also vomited for several times, she only ate biscuits and water. Her activity in daily living is quite altered because she feels extremely weak and tired, she wants to lay down and rest all day. The patient took some medications such as Imodium and applied Omega pain killer on her abdomen to alleviate pain. Her weight was monitored and she loss weight and feels really light according to the client. Past history: The patient had some history of diarrhea and fluid loss but she was never hospitalized yet. According to the client, it just subsides as long as she takes medications, it is nothing serious she said but she is quite worried on her weight loss. The had no history of hospitalization, Patient had instances of cough, fever and colds due to the changes of weather and being remedied with over the counter drugs. The client experienced common childhood diseases such as measles when she was 4 months old. She had complete immunizations. The patient has no known allergies to any foods or drugs. Family History; The patient had a familial history of hypertension.