18/05/2026
Fluid & Electrolyte Balance
Medical-Surgical Nursing / Physiology
(ফ্লুইড ও ইলেক্ট্রোলাইট ব্যালেন্স)
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Introduction
What is Fluid & Electrolyte Balance?
Fluid and electrolyte balance means maintaining the correct amount of water and electrolytes in the body for normal body function.
(শরীরের স্বাভাবিক কার্যক্রম ঠিক রাখতে শরীরে সঠিক পরিমাণ পানি ও ইলেক্ট্রোলাইট বজায় রাখাকে fluid & electrolyte balance বলে।)
This topic is very important in:
Medical-surgical nursing
ICU care
Emergency nursing
Cardiac care
NCLEX & BPSC exams
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Body Fluid Compartments
শরীরের তরলের অংশসমূহ
The human body contains about 60% water.
(মানবদেহের প্রায় ৬০% পানি।)
Two Main Compartments
Compartment Description Bangla
Intracellular Fluid (ICF) Fluid inside cells কোষের ভিতরের তরল
Extracellular Fluid (ECF) Fluid outside cells কোষের বাইরের তরল
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Functions of Body Fluids
শরীরের তরলের কাজ
1. Transport nutrients
(পুষ্টি পরিবহন)
2. Remove waste products
(বর্জ্য অপসারণ)
3. Maintain blood pressure
(রক্তচাপ নিয়ন্ত্রণ)
4. Regulate body temperature
(শরীরের তাপমাত্রা নিয়ন্ত্রণ)
5. Help nerve & muscle function
(স্নায়ু ও মাংসপেশির কাজ করতে সাহায্য)
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Electrolytes
ইলেক্ট্রোলাইট কী?
Electrolytes are minerals carrying electrical charges.
(ইলেক্ট্রোলাইট হলো বিদ্যুৎ পরিবাহী খনিজ পদার্থ।)
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Important Electrolytes
Electrolyte Normal Range Main Function Bangla
Sodium (Na⁺) 135–145 mEq/L Fluid balance শরীরের পানি নিয়ন্ত্রণ
Potassium (K⁺) 3.5–5 mEq/L Cardiac function হার্টের কাজ নিয়ন্ত্রণ
Calcium (Ca²⁺) 8.5–10.5 mg/dL Muscle contraction মাংসপেশি সংকোচন
Magnesium (Mg²⁺) 1.5–2.5 mEq/L Neuromuscular function স্নায়ু-মাংসপেশির কাজ
Chloride (Cl⁻) 96–106 mEq/L Acid-base balance এসিড-বেইস ব্যালেন্স
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Sodium Balance
Sodium (Na⁺)
Functions
Maintains fluid balance
Controls blood pressure
Helps nerve impulse transmission
(সোডিয়াম শরীরের পানি, রক্তচাপ ও স্নায়ুর কাজ নিয়ন্ত্রণ করে।)
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Hyponatremia
Hypo = Low
Sodium below 135 mEq/L
(রক্তে sodium কমে গেলে তাকে hyponatremia বলে।)
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Causes
কারণ
Vomiting
Diarrhea
Excess sweating
Diuretics
Heart failure
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Signs & Symptoms
লক্ষণ
Headache
Confusion
Muscle cramps
Weakness
Seizures
(মস্তিষ্কে পানি জমে confusion ও seizure হতে পারে।)
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Nursing Management
নার্সিং ব্যবস্থাপনা
Monitor sodium level
Restrict water intake
Administer IV saline
Monitor neurological status
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Hypernatremia
Sodium above 145 mEq/L
(রক্তে sodium বেড়ে গেলে hypernatremia হয়।)
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Causes
Dehydration
Fever
Burns
Diabetes insipidus
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Signs & Symptoms
Thirst
Dry mouth
Restlessness
Seizure
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Nursing Care
Give fluids
Monitor intake-output
Monitor mental status
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Potassium Balance
Potassium (K⁺)
Functions
Maintains cardiac rhythm
Muscle contraction
Nerve conduction
(পটাশিয়াম হার্ট ও মাংসপেশির কাজের জন্য গুরুত্বপূর্ণ।)
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Hypokalemia
Potassium below 3.5 mEq/L
(রক্তে potassium কমে গেলে hypokalemia বলে।)
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Causes
Vomiting
Diarrhea
Diuretics
NG suction
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Symptoms
Muscle weakness
Constipation
Arrhythmia
Fatigue
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ECG Changes
Flat T wave
ST depression
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Nursing Care
Give potassium supplements
Monitor ECG
Encourage potassium-rich foods
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Potassium Rich Foods
Banana
Orange
Spinach
Potato
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Hyperkalemia
Potassium above 5 mEq/L
(রক্তে potassium বেড়ে গেলে hyperkalemia বলে।)
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Causes
Renal failure
Burns
Tissue destruction
Excess potassium intake
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Symptoms
Muscle weakness
Cardiac arrhythmia
Cardiac arrest
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ECG Changes
Tall peaked T wave
Wide QRS complex
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Emergency Treatment
Calcium gluconate
Insulin + glucose
Sodium bicarbonate
Dialysis
(এটি emergency condition কারণ cardiac arrest হতে পারে।)
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Calcium Imbalance
Calcium (Ca²⁺)
Functions
Bone formation
Muscle contraction
Blood clotting
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Hypocalcemia
Calcium low
Symptoms
Tetany
Muscle spasm
Positive Chvostek sign
Positive Trousseau sign
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Hypercalcemia
Calcium high
Symptoms
Bone pain
Kidney stone
Weakness
Confusion
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Magnesium Imbalance
Hypomagnesemia
Symptoms
Tremor
Seizure
Hyperreflexia
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Hypermagnesemia
Symptoms
Hypotension
Bradycardia
Respiratory depression
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Fluid Volume Deficit
Dehydration
Causes
Vomiting
Diarrhea
Burns
Hemorrhage
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Symptoms
Dry skin
Tachycardia
Hypotension
Low urine output
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Nursing Care
IV fluids
Daily weight
Monitor vital signs
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Fluid Volume Excess
Causes
Heart failure
Kidney failure
Excess IV fluids
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Symptoms
Edema
Crackles
Hypertension
Dyspnea
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Nursing Care
Fluid restriction
Diuretics
Oxygen support
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Acid-Base Balance
এসিড-বেইস ব্যালেন্স
Normal blood pH = 7.35–7.45
Condition pH
Acidosis Below 7.35
Alkalosis Above 7.45
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Respiratory Acidosis
Cause
CO₂ retention due to hypoventilation.
Causes
COPD
Respiratory depression
Symptoms
Drowsiness
Confusion
ABG Finding
pH < 7.35,\ PaCO_2 > 45
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Respiratory Alkalosis
Cause
Excess loss of CO₂ due to hyperventilation.
Causes
Anxiety
Fever
Pain
Symptoms
Tingling
Dizziness
ABG Finding
pH > 7.45,\ PaCO_2 < 35
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Metabolic Acidosis
Causes
Diabetic ketoacidosis
Renal failure
Severe diarrhea
Symptoms
Kussmaul respiration
Weakness
ABG Finding
pH < 7.35,\ HCO_3^- < 22
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Metabolic Alkalosis
Causes
Vomiting
Excess antacid use
Symptoms
Muscle cramps
Tetany
ABG Finding
pH > 7.45,\ HCO_3^- > 26
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Important ECG Changes
Condition ECG Change
Hypokalemia Flat T wave
Hyperkalemia Peaked T wave
Hypocalcemia Prolonged QT
Hypercalcemia Short QT
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Important Nursing Responsibilities
Monitor intake & output
Check daily weight
Monitor ECG
Assess mental status
Monitor lab values
Administer IV fluids safely
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20 MCQs with Answers & Explanations
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1. Which electrolyte is most important for cardiac rhythm?
(হার্টের rhythm নিয়ন্ত্রণে সবচেয়ে গুরুত্বপূর্ণ electrolyte কোনটি?)
A. Sodium
B. Potassium
C. Calcium
D. Chloride
Answer
✅ B. Potassium
Explanation
Potassium controls cardiac electrical activity and rhythm.
(Potassium হার্টের rhythm নিয়ন্ত্রণ করে।)
❌ Sodium mainly controls fluid balance.
❌ Calcium helps muscle contraction.
❌ Chloride maintains acid-base balance.
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2. Normal sodium level is:
(স্বাভাবিক sodium level কত?)
A. 125–130 mEq/L
B. 130–135 mEq/L
C. 135–145 mEq/L
D. 145–155 mEq/L
Answer
✅ C. 135–145 mEq/L
Explanation
This is the normal sodium range needed for proper fluid balance.
(এটি sodium এর স্বাভাবিক মাত্রা।)
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3. Which ECG change occurs in hyperkalemia?
(Hyperkalemia তে কোন ECG change দেখা যায়?)
A. Flat T wave
B. Peaked T wave
C. ST depression
D. Prolonged QT
Answer
✅ B. Peaked T wave
Explanation
Hyperkalemia causes tall peaked T waves.
(Hyperkalemia তে peaked T wave দেখা যায়।)
❌ Flat T wave occurs in hypokalemia.
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4. A patient with severe diarrhea is at risk for:
(তীব্র diarrhea হলে রোগী কোন imbalance এ ঝুঁকিতে থাকে?)
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hypernatremia
Answer
✅ B. Hypokalemia
Explanation
Diarrhea causes potassium loss from the body.
(Diarrhea তে potassium শরীর থেকে বের হয়ে যায়।)
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5. Which condition causes respiratory acidosis?
A. Anxiety
B. COPD
C. Vomiting
D. Hyperventilation
Answer
✅ B. COPD
Explanation
COPD causes CO₂ retention leading to respiratory acidosis.
(COPD তে CO₂ জমে respiratory acidosis হয়।)
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6. Positive Chvostek sign indicates:
A. Hyperkalemia
B. Hypocalcemia
C. Hypernatremia
D. Hypermagnesemia
Answer
✅ B. Hypocalcemia
Explanation
Low calcium increases neuromuscular excitability.
(Calcium কমে গেলে muscle twitching হয়।)
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7. Normal blood pH is:
A. 6.8–7.0
B. 7.1–7.2
C. 7.35–7.45
D. 7.5–7.8
Answer
✅ C. 7.35–7.45
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8. Which symptom occurs in hypernatremia?
A. Thirst
B. Tetany
C. Bradycardia
D. Flat T wave
Answer
✅ A. Thirst
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9. Which food is rich in potassium?
A. Rice
B. Banana
C. Bread
D. Apple
Answer
✅ B. Banana
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10. Which sign indicates fluid volume excess?
A. Dry skin
B. Edema
C. Hypotension
D. Weak pulse
Answer
✅ B. Edema
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11. Kussmaul respiration occurs in:
A. Respiratory alkalosis
B. Metabolic acidosis
C. Hypernatremia
D. Hypocalcemia
Answer
✅ B. Metabolic acidosis
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12. Hyperkalemia may cause:
A. Tetany
B. Cardiac arrest
C. Dry mouth
D. Hyperactivity
Answer
✅ B. Cardiac arrest
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13. Which organ mainly regulates electrolyte balance?
A. Liver
B. Kidney
C. Pancreas
D. Spleen
Answer
✅ B. Kidney
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14. Which electrolyte mainly controls extracellular fluid?
A. Potassium
B. Sodium
C. Calcium
D. Magnesium
Answer
✅ B. Sodium
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15. Flat T wave occurs in:
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hypernatremia
Answer
✅ B. Hypokalemia
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16. Which condition causes metabolic alkalosis?
A. Diarrhea
B. Renal failure
C. Vomiting
D. COPD
Answer
✅ C. Vomiting
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17. Which sign occurs in dehydration?
A. Edema
B. Crackles
C. Tachycardia
D. Hypertension
Answer
✅ C. Tachycardia
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18. Peaked T wave is seen in:
A. Hypokalemia
B. Hyperkalemia
C. Hypocalcemia
D. Hypernatremia
Answer
✅ B. Hyperkalemia
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19. Which imbalance causes muscle spasm and tetany?
A. Hypernatremia
B. Hypocalcemia
C. Hyperkalemia
D. Hypermagnesemia
Answer
✅ B. Hypocalcemia
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20. Priority nursing intervention in severe hyperkalemia is:
A. Give banana
B. Restrict sodium
C. Monitor ECG
D. Encourage exercise
Answer
✅ C. Monitor ECG
Explanation
Hyperkalemia can cause fatal arrhythmia and cardiac arrest.
(Hyperkalemia প্রাণঘাতী arrhythmia করতে পারে, তাই ECG monitoring জরুরি।)
