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Study Guide for

Fluid & Electrolytes


Spring 2014
Why fluids move? .read over the section covering the 3 hormones until you
understand the shifting of fluid and how it occurs. Understanding is much more
important that trying to memorize!
The bodys endocrine system helps control fluid and electrolyte balance by acting
on the kidneys with three primary hormones:
Aldosterone: a hormone secreted by the adrenal cortex whenever the ECF
sodium level is decreased; it prevents sodium and water loss.
o Aldosterone acts on the kidney nephrons and triggers them to reabsorb
sodium and water from the urine back into the blood, increasing blood
osmolarity and blood volume.
o Aldosterone prevents the excessive excretion of sodium by the kidneys
and prevents potassium levels from getting too high.
Antidiuretic hormone: (ADH) regulates water. It is produced in the brain,
stored in the posterior pituitary gland, and controlled by the hypothalamus.
o Osmoreceptors in the hypothalamus detect increases in blood
osmolarity and decreases in blood pressure or blood volume, which
causes ADH to be released from the posterior pituitary gland.
o ADH acts directly on the kidney tubules and collecting ducts, making
them more permeable and thus allowing water to be reabsorbed in the
tubules and returned to the blood, which decreases blood osmolarity.
o When blood pressure, blood volume, or plasma osmolarity (specifically,
the serum sodium level) returns to normal, ADH is inhibited, and the
absorption of water stops.
Natriuretic peptides: hormones secreted by the cells that line the atria
(atrial natriuretic peptide, ANP,) and ventricles (brain natriuretic peptide,
BNP,) of the heart. These hormones are secreted in response to increased
bood volume and blood pressure, which stretch the ehart tissue.
o Natriuretic peptides have the opposite effect of aldosterone: they
inhibit the absorption of sodium and increase glomerular filtration
causing an increase in urine output. As a result, circulating blood
volume and blood osmolarity are decreased.
Electrolyte Balance: understand following conditions thoroughly
Sodium hypernatremia & hyponatremia
Potassium hyperkalemia & hypokalemia
Dehydration: Common causes, assessment findings, interventions and evaluation
assessments
Fluid overload: Common causes, assessment findings, interventions and
evaluation assessments

In your 7th edition Iggy workbook, please work thru Chapter 13. You may save
Magnesium, Calcium, Phosphate, and Chlorine questions until next semester.
Please focus on the above information in your workbook: Fluid balance and shifting,
Electrolyte Balance; potassium & sodium, Dehydration and Fluid Excess (overload).
Please work thru the case studies in the back of chapter 13, except for the
Magnesium case study.

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