الفهرس 
Definitions, etiology and assessment findings for fluid
The different types of fluid and electrolyte imbalancesOnly 14 pages are availabe for public view
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Abstract
Fluid imbalances are common in clinical setting . The elderly are at the highest risk for life- threatening complications that can result from either fluid overload or dehydration if is not treated, lack of sufficient blood volume will cause multiple organ failure. The brain, kidneys and heart must be adequately supplied with blood function properly. Multiple organ failure then results in death, acute fluid overload typically results in C.H.F. As the fluid builds up in the heart, the heart is not able to properly function as a pump .The fluid then backs up into the lungs, causing pulmonary edema and lead to death , hyponatremia is another life – threatening complication, respiratory arrest or coma can lead to death If not corrected hypokalemia can result in death from dysrhythmias, respiratory failure and arrest or coma, cardiac dysrhythmias and respiratory failure can occur in severe hyperkalemia, causing death, seizures, respiratory failure or cardiac failure can occur due to hypocalcemia renal or urinary calculi. The aim of this study is to assess the associates of fluid and electrolyte imbalance among the hospitalized elderly medical patients, and to determine the factors that might contribute to such fluid and electrolyte imbalance among the hospitalized elderly medical patients, and identify the different types of fluid and electrolyte imbalance among the hospitalized elderly medical patients. The study was conducted in the medical departments of Shebien –El-Kome Teaching and Menoufiya University Hospitals. The study sample includes 100 hospitalized elderly medical patients subjects consisted of 44 males and 56 females. Their age ranged between 65 years old to 85 years old. The mean age was 68.9 ± 6.2 years old, the mean weight 75.9 ± 11.1kgm, the mean height 157.3 ± 10.9cm and the mean of length of hospital stay 8.1 ± 5.7/days. Two structured formats were used to collect data pertinent to the study. The first was a structured interview sheet covers demographic data and medical data, the second was fluid and electrolyte monitoring data sheet. Finding of the present study were as follows:- (6%) had ascities due to, hypertension, C.H.F., liver disease, (70%)) hypertension and heart failure and (24%) having renal failure and hypertension (89%) of the sample married. (88%) used diuretics with and without doctor order, (6%) used enema, (93%)/week used salt in diets. Findings revealed that majority (56%) of the studied group were females and (44%) were males. Their age ranged between 65-85 years old (66%), married (89%), from rural areas (30%) and diagnosed as having chronic heart failure and hypertension (70%), there length of hospital stay was from 7-10 days with a mean days of (8.13 ± 5.7) day, on positive fluid balance (77%) and receiving potassium syrup, One – Alpha , Calcimate (6%), diuretics with and without doctor order (88%) and were complaining of polyurea (80%) during admission, thirst (59%), weight gain (18%), profuse sweating (88%), vomiting and abdominal distension (88%), difficulty of breathing (98%) and tingling and numbness of extremities (99%) on admission. The most obvious indicators of fluids and electrolyte imbalances at the 2nd assessment among hospitalized elderly medical patients are potassium deficit (X = 3.18 ± 0.2)mEq/L, sodium excess (X = 149.5 ± 18.9)mEq/L, calcium deficit (X = 8.54 ± 4.4)mEq/L, tachycardia (pulse rate X = 115.07 ± 9.6)b/min, dry mucous membrane (98%), cracked and fissured tongue (98%), postural hypotension (86%), flattened T wave (99%) depressed ST segment (89%) pale and clammy skin (98%), muscle cramps (90%), pitting edema of the leg (60%). Off the most important contributing factors to fluid and electrolyte imbalances; increase salt intake (70-66%), diuretics (88-88%), profuse sweating (88-86%), vomiting (88-88%), difficulty in breathing (98-98%), anorexia and nausea (82-88%), diarrhea (42-66%), disorientation (6-6%). The length of hospital stay was found to be in positive correlation with serum sodium level (r = 0.44 , p < 0.05)during the 2nd assessment. Vital signs during 1st and 2nd assessment among hospitalized elderly medical patients showed that , there was no statistical significance except pulse was highly significance t = 48.46 and P < 0.001 .During 1st and 2nd assessment of edema the foot circumference was highly significance t- value = 3.66, P < 0.001 X2 =33.32 P < 0.001.