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CURRENT Medical Diagnosis & Treatment 2013
Chapter 21. Electrolyte & Acid-Base Disorders
Sections: Assessment of the Patient, Disorders of Sodium Concentration, Hyponatremia, Hypernatremia, Volume Overload, Hyperosmolar Disorders & Osmolar Gaps, Hyperosmolality with Transient or No Significant Shift in Water, Hyperosmolality Associated with Significant Shifts in Water, Disorders of Potassium Concentration, Hypokalemia, Hyperkalemia, Disorders of Calcium Concentration, Disorders of Calcium Concentration: Introduction, Hypocalcemia, Hypercalcemia, Disorders of Phosphorus Concentration, Disorders of Phosphorus Concentration: Introduction, Hypophosphatemia, Hyperphosphatemia, Disorders of Magnesium Concentration, Disorders of Magnesium Concentration: Introduction, Hypomagnesemia, Hypermagnesemia, Acid–Base Disorders, Acid-Base Disorders: Introduction, Metabolic Acidosis, Metabolic Alkalosis, Respiratory Acidosis (Hypercapnia), Respiratory Alkalosis (Hypocapnia), Fluid Management.
Topics Discussed: disorder of fluid or electrolyte.
Excerpt:"The diagnosis and treatment of fluid and electrolyte disorders
are based on (1) careful history, (2) physical examination and assessment
of total body water and its distribution, (3) serum electrolyte
concentrations, (4) urine electrolyte concentrations, and (5) serum
osmolality. The pathophysiology of electrolyte disorders is rooted
in basic principles of total body water and its distribution across
fluid compartments.
Total body water is different in men than in women, and it decreases
with aging Table 21–1 Approximately
50-60% of total body weight is water; two-thirds (40% of
body weight) is intracellular, while one-third (20% of
body weight) is extracellular. One-fourth of extracellular fluid
(5% of body weight) is intravascular. Water may be lost
from either or both compartments (intracellular and extracellular).
Changes in total body water content are best evaluated by documenting
changes in body weight. Effective circulating volume may be assessed
by physical examination (eg, blood pressure, pulse, jugular venous
distention). Quantitative measurements of effective circulating
volume and intravascular volume may be invasive (ie, central venous pressure
or pulmonary wedge pressure) or noninvasive..."
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