NLE Foundations of Medical-Surgical Nursing — Fluid, Electrolyte and Acid-Base ImbalancesConcept Map

Concept

Body Fluid Compartments

Sub Concepts

• Total Body Water (60% of body weight)
• Intracellular Fluid (ICF) - 2/3 of total body water
• Extracellular Fluid (ECF) - 1/3 of total body water
• Plasma (Intravascular)
• Interstitial Fluid
• Osmosis and Osmotic Gradients

Relationship To Central

Foundational anatomical basis for understanding fluid distribution and movement

Concept

Fluid Volume Imbalances

Sub Concepts

• Fluid Volume Deficit (Hypovolemia)
• Fluid Volume Excess (Hypervolemia)
• Third-spacing
• Causes and Risk Factors
• Clinical Manifestations
• Nursing Management

Relationship To Central

Primary disruptions in fluid homeostasis requiring nursing intervention

Concept

Electrolyte Imbalances

Sub Concepts

• Sodium (Na+) Imbalances
• Potassium (K+) Imbalances
• Calcium (Ca2+) Imbalances
• Magnesium (Mg2+) Imbalances
• Chloride and Phosphate Imbalances
• Laboratory Values and Interpretation

Relationship To Central

Critical disruptions affecting cellular function and cardiac rhythm

Concept

Acid-Base Balance

Sub Concepts

• pH Regulation
• Respiratory Component (PaCO2)
• Metabolic Component (HCO3-)
• Respiratory Acidosis
• Respiratory Alkalosis
• Metabolic Acidosis
• Metabolic Alkalosis
• ABG Interpretation (ROME method)

Relationship To Central

Regulation of pH and gas exchange critical to cellular metabolism

Concept

IV Fluid Therapy

Sub Concepts

• Isotonic Solutions
• Hypotonic Solutions
• Hypertonic Solutions
• Fluid Selection Based on Clinical Need
• Administration Rates and Monitoring

Relationship To Central

Therapeutic interventions to restore and maintain fluid and electrolyte balance

Concept

Regulatory Mechanisms

Sub Concepts

• Thirst Mechanism
• Antidiuretic Hormone (ADH)
• Renin-Angiotensin-Aldosterone System (RAAS)
• Atrial Natriuretic Peptide (ANP)
• Kidney Function
• Compensatory Mechanisms

Relationship To Central

Physiologic systems maintaining fluid and electrolyte homeostasis

To

Fluid Volume Imbalances

From

Body Fluid Compartments

Strength

strong

Relationship

Understanding compartmental distribution is prerequisite for recognizing how fluid shifts cause volume deficits or excesses

To

Body Fluid Compartments

From

Regulatory Mechanisms

Strength

strong

Relationship

ADH, RAAS, and ANP control water and sodium movement between compartments and maintain homeostasis

To

Acid-Base Balance

From

Electrolyte Imbalances

Strength

moderate

Relationship

Electrolyte changes like potassium and chloride affect pH; metabolic acidosis causes hyperkalemia through hydrogen-potassium exchange

To

IV Fluid Therapy

From

Fluid Volume Imbalances

Strength

strong

Relationship

IV fluid selection depends on type of fluid loss and underlying pathophysiology; hypovolemia requires isotonic fluids

To

Regulatory Mechanisms

From

Sodium Imbalances

Strength

strong

Relationship

RAAS and ANP regulate sodium reabsorption and excretion; dysfunction leads to hyper- or hyponatremia

To

Acid-Base Balance

From

Potassium Imbalances

Strength

moderate

Relationship

Acidosis causes hyperkalemia; alkalosis causes hypokalemia through intracellular-extracellular potassium shift

To

IV Fluid Therapy

From

Acid-Base Balance

Strength

moderate

Relationship

Choice of IV fluid affects acid-base status; lactated Ringer's buffered differently than normal saline

To

Potassium Imbalances

From

Magnesium Imbalances

Strength

moderate

Relationship

Hypomagnesemia commonly coexists with hypokalemia and makes potassium replacement difficult

To

Electrolyte Imbalances

From

Calcium Imbalances

Strength

moderate

Relationship

Hypocalcemia and hypomagnesemia produce similar neuromuscular signs; both require monitoring

To

Acid-Base Balance

From

Fluid Volume Excess

Strength

weak

Relationship

Hypervolemia from renal failure causes metabolic acidosis; heart failure causes metabolic alkalosis from volume depletion

To

Potassium Imbalances

From

Respiratory Acidosis

Strength

moderate

Relationship

Hypercapnia causes acidosis leading to hyperkalemia through cellular potassium shift

To

Electrolyte Imbalances

From

Metabolic Acidosis

Strength

strong

Relationship

DKA causes metabolic acidosis with hyperkalemia; treatment addresses both acid-base and electrolyte issues

To

IV Fluid Therapy

From

Hypokalemia

Strength

strong

Relationship

Potassium supplementation requires specific IV protocols: dilution, rate limitation 10 mEq/hr, confirmation of renal function

To

Cardiac Monitoring

From

Hyperkalemia

Strength

strong

Relationship

Peaked T waves on ECG indicate life-threatening hyperkalemia requiring immediate protective intervention

To

Neuromuscular Manifestations

From

Hypocalcemia

Strength

strong

Relationship

Positive Chvostek and Trousseau signs indicate hypocalcemia; laryngospasm risk requires airway monitoring

To

Correction Rate Safety

From

Hyponatremia

Strength

strong

Relationship

Slow correction of hyponatremia prevents osmotic demyelination syndrome; maximum 4-6 mEq/L per day

To

Correction Rate Safety

From

Hypernatremia

Strength

strong

Relationship

Slow correction of hypernatremia prevents cerebral edema; water replacement must be gradual

To

Clinical Management

From

ABG Interpretation

Strength

strong

Relationship

ROME method guides identification of primary disorder and appropriate nursing interventions for compensation

To

Osmotic Principles

From

IV Fluid Tonicity

Strength

strong

Relationship

Osmolality determines fluid movement across cell membranes; isotonic fluids don't shift volume, hypotonic pulls into cells, hypertonic pulls out

To

Fluid Volume Deficit

From

Third-spacing

Strength

moderate

Relationship

Fluid shifts from intravascular to interstitial space causing hypovolemia without actual fluid loss from body