ACID-BASE, FLUIDS, AND ELECTROLYTES
MADE RIDICULOUSLY SIMPLE PDF Free Download
ACID-BASE, FLUIDS, AND ELECTROLYTES MADE RIDICULOUSLY SIMPLE This chapter briefly reviews the physiology that is key to understanding clinical water, electrolyte, and acid-base disorders. This review lays the groundwork for a more complete understanding of the pathophysiology, diagnosis, and treatment of disorders that are discussed in later chapters. A brief summary of renal tubular physiology is presented .
The Body Fluid Compartments
Total body water (TBW) makes up about 60% of body weight in men
and about 50% in women (see Fig. 1-2). These percentages decline with ag-
ing, as the percentage of body fat increases. Approximately 213 of total body water is located in the intracellular compartment and constitutes the intracel-lular fluid volume (ICFV). About 113 of TBW is located in the extracellular compartment and comprises the extracellular fluid volume (ECFV).
The interstitial fluid volume comprises about 314 of the ECFV, and the plasma vol-
ume is about 114 of the ECFV. The plasma volume is maintained to a large
extent by the oncotic effects of plasma proteins. Water passes freely and
rapidly between all these compartments in response to changes in solute con-
centrations to maintain osmotic equilibrium between the compartments.
Therefore, the osmolalities in all compartments are equal.
ACID–BASE, FLUIDS, AND ELECTROLYTES MADE RIDICULOUSLY SIMPLE
Concise handbook on solving problems concerning complex fluid, electrolyte, and acid-base complications. For medical students, interns, residents, nurses and nurse practitioners, and first-year nephrology fellows
Sodium and Water Pathophysiology
The following approach to sodium and water pathophysiology may be
different from what you have studied in the past. I believe it is very important
to assess sodium status (which determines the volume of the extracellular fluid compartment) and water status (which determines the serum sodium concen-
Thus it is very important to ask in each case: “does this patient have l) a problem with sodium, 2) a problem with water, or 3) problems with both sodium and water?” This is a very important concept that will be deloped in this chapter and used to solve complex problems later in the book.
The methods for solving electrolyte problems presented in this book will work consistently for you once you have mastered them. Just follow along and be
sure to do the examples at the end of the chapters.