Fluid and electrolyte balance is a dynamic process that is crucial for life.

Potential and actual disorders of

fluid and electrolyte

balance occur in every setting, with every disorder, and with a variety of changes that affect well people
(eg, increased fluid and

sodium loss with strenuous exercise and high environmental temperature; inadequate intake of fluid
and electrolytes) as well as

those who are ill.

Fundamental Concepts

The nurse needs to understand the physiology of fluid and electrolyte balance and acid–base balance to
anticipate, identify, and

respond to possible imbalances in each. The nurse also must use

effective teaching and communication skills to help prevent and

treat various fluid and electrolyte disturbances.

AMOUNT AND COMPOSITION

OF BODY FLUIDS

Approximately 60% of a typical adult’s weight consists of fluid

(water and electrolytes). Factors that influence the amount of

body fluid are age, gender, and body fat. In general, younger

people have a higher percentage of body fluid than older people,

and men have proportionately more body fluid than women.

Obese people have less fluid than thin people because fat cells

contain little water.

Body fluid is located in two fluid compartments: the intracellular space (fluid in the cells) and the
extracellular space (fluid

outside the cells). Approximately two thirds of body fluid is in the

intracellular fluid (ICF) compartment and is located primarily in

the skeletal muscle mass.

The extracellular fluid (ECF) compartment is further divided

into the intravascular, interstitial, and transcellular fluid spaces.

The intravascular space (the fluid within the blood vessels) contains
plasma. Approximately 3 L of the average 6 L of blood volume is

made up of plasma. The remaining 3 L is made up of erythrocytes,

leukocytes, and thrombocytes. The interstitial space contains the

fluid that surrounds the cell and totals about 11 to 12 L in an ad