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Daily Electrolyte Requirements

Fluidselectrolytesandacid basebalance
Fluids, Electrolytes Fluids, Electrolytes and Acidand Acid--Base BalanceBase BalanceTodd A.Nickloes, DO, FACOSAssistant Professor of SurgeryAssistant Professor of SurgeryDepartment of SurgeryDepartment of SurgeryDivision of Trauma/Critical CareDivision of Trauma/Critical CareUniversity of Tennessee Medical Center University of Tennessee Medical Center -- normal ranges of electrolytesDefine normal ranges of electrolytesCompare/contrast intracellular, Compare/contrast intracellular, extracellularextracellular, , and intravascular volumesand intravascular volumesOutline methods of determining fluid and Outline methods of determining fluid and acid/base balanceacid/base balanceDescribe the clinical manifestations of various Describe the clinical manifestations of various electrolyte imbalances.electrolyte imbalances.Normal Plasma Ranges of Normal Plasma Ranges of Acids (Lactate)Organic Acids (Lactate)Total 145 10.5 ProteinNormal Ranges of ElectrolytesNormal Ranges of ElectrolytesSodium (NaSodium (Na++))Range 135 Range 135 --145 145 mEqmEq/L in serum/L in serumTotal body volume estimated at 40 Total body volume estimated at 40 mEqmEq/kg/kg1/3 fixed to bone, 2/3 1/3 fixed to bone, 2/3 extracellularextracellularand available for and available for transtrans--membrane exchangemembrane exchangeNormal daily requirement 1Normal daily requirement 1--2 2 mEqmEq/kg/day/kg/dayChief Chief Ranges of ElectrolytesNormal Ranges of ElectrolytesPotassium (KPotassium (K++))Range 3.5 Range 3.5 --5.0 5.0 mEqmEq/L in serum/L in serumTotal body volume estimated at 50 Total body volume estimated at 50 mEqmEq/kg/kg98% intracellular 98% intracellular concentration of 150 concentration of 150 of 70 concentration of 70 mEqmEq/L/LNormal daily requirement 0.5 Normal daily requirement 0
daily electrolyte requirements
.5 ––0.8 0.8 mEqmEq/kg/day/kg/dayChief intracellular Chief intracellular cationcationNormal Ranges of ElectrolytesNormal Ranges of ElectrolytesIntracellular v Intracellular v composition is differentElectrolyte composition is ++, Mg, Mg++, PO, PO44--, SO, SO44--, and proteins, and ++, Ca, Ca++, Mg, Mg++, , ClCl--, HCO, HCO33--and lactateand lactateCompositions of ions are maintained Compositions of ions are maintained selective permeability of cell membranesselective permeability of cell membranesactive ion pumpsactive ion pumpsMovement of water is passive Movement of water is passive colloid osmotic gradients intravascular v interstitial spaces colloid osmotic gradients intravascular v interstitial spaces (( gradients intracellularlyintracellularlyv v BalanceFluid BalanceCalculation of Calculation of OsmolarityOsmolarityOsmOsm= 2 x [= 2 x [NaNass] + [] + [gluglu/ 18] + [BUN / 2.8]/ 18] + [BUN / 2.8]Normal Normal osmolarityosmolarityis 280is 280--300 300 excretion are the driving and excretion are the driving forces for forces for osmolarityosmolarityCalculating TBW deficitCalculating TBW deficitTBWD males = [(140 TBWD males = [(140 ––SNaSNa++) x 0.6 x IBW (kg)]/ 140) x 0.6 x IBW (kg)]/ 140TBWD females = [(140 TBWD females = [(140 ––SNaSNa++) x 0.5 x IBW (kg)]/ 140) x 0.5 x IBW (kg)]/ 140Fluid BalanceFluid BalanceHereHere’’s a tricks a trickFor every 3.5 For every 3.5 mEqmEqthe Nathe Na++is over 140, there is an is over 140, there is an estimated free water deficit of 1 L.estimated free water deficit of 1 L.Normal PhysiologyNormal PhysiologyTotal body waterTotal body water60% IBW of males60% IBW of males5050--55% IBW of females55% IBW of femalesdirectly related to muscle directly related to muscle mass (70% water)mass (70% water)inversely related to fat inversely related to fat content (10% water)content (10% water)This is why witches floatThis is why witches .
Tip of the day: drink coconut h2o daily for electrolyte benefits. Coconut is also naturally alkaline.Plain is best but they do come flavored
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