Question

write an 500 words essay. choose the article from Medscape under news and perspective on the topic fluid and electrolyte imbalance.

Answer 1

Fluid and electrolyte imbalance occur to some degrees in most patients with a major illness or injury because illness disrupts the normal homeostatic mechanism. Some fluid and electrolyte imbalances are directly caused by Illiness or disease. At other times, therapeutic measures cause or contribute to fluid and electrolyte imbalances. The imbalances are commonly classified as deficits or excesses. In actual situations, more than one imbalance occuring in the same patient is common. For example a patient with prolonged nasogastric suction will lose sodium, potassium, hydrogen and chloride. These imbalances may result in a deficiency of both sodium and potassium, a fluid volume deficit, and a metabolic alkalosis due to loss of HCl.  

ECF volume deficit and ECF volume excess are commonly occuring clinical conditions. ECF volume imbalances are typically accompanied by one or more electrolyte imbalances, particularly changes in the serum sodium level. Fluid volume deficit can occur with abnormal loss of body fluids inadequate intake or a plasma-to -interstitial fluid shift. The term fluid volume deficit should not be used interchangeably with the term dehydration. Dehydration refers to loss of pure water alone without corresponding loss of sodium. The goal of treatment for fluid volume deficit is to correct the underlying cause and to replace both water and any needed electrolytes Balanced IV solutions such as Lactated Fingers solution, are usually given. Isotonic (0.9%) sodium chloride is used when rapid volume replacement is indicated. Blood is administered when volume loss is due to blood loss.

Fluid volume excess may result from excessive intake of fluids, abnormal retention of fluids, or interstitial-to-plasma fluid shift. Although shifts in fluid between the plasma and interstitium do not alter the overall volume of the ECF ,these shifts do result in changes in the intravascular volume

The goal of treatment for fluid volume excess is removal of fluid without producing abnormal changes in the the electrolyte composition or osmolality of ECF. The primary cause must be identified and treated . Diuretics and fluid restriction are the primary forms of therapy. Restriction of sodium intake may also be indicated. If the fluid excess leads to ascites or pleursl effusion, an abdominal paracentesis or thoracentesis maybe necessary.