Electrolytes Flashcards
fluid intake requirements
male = 3500 mL/day female = 2700 mL/day
20% gained from food alone
fluid output
urine = 1500-2000 mL/day
skin, lung, feces = about 300 mL/each/day
urination leads to loss of which electrolytes?
sodium, potassium
hypovolemia
loss of fluid AND electrolytes
dehydration
loss of fluid
risks for hypovolemia
emesis excessive gastric suction diarrhea sweating excessive urination third spacing blood loss poor intake
risks for dehydration
hyperventilation
fever
diabetic ketoacidosis
enteral feeding w/poor water intake
signs and symptoms of hypovolemia and dehydration
dry skin/mucous membranes excessive thirst poor skin turgor decreased urine output hypotension tachycardia tachypnea dizziness, confusion, fatigue, syncope weight loss slow capillary refill sunken eyes (fontannels for infants) no tears
hypervolemia
excess water AND sodium which increases blood volume
overhydration
excess water > electrolytes
hemodilution d/t imbalance of H20
risks for hypervolemia
heart failure
poor kidney function
hypertonic fluid admin
excessive sodium intake
risks for overhydration
head injuries
anesthesia
syndrome of inappropriate antidiuretic hormone secretion (SIADH)
replacing loss w/H20 not electrolytes
signs and symptoms of hypervolemia and overhydration
high BP bounding pulse tachycardia confusion, muscle weakness pale, cool skin edema, ascites crackles weight gain dyspnea JVD
lab test specific to FVD
glucose
lab tests specific to FVE
ABG, creatinine
major electrolytes
sodium potassium calcium magnesium chloride phosphorus bicarbonate
sodium
135-145 mEq/L
ECF
regulates fluid volume
reabsorbed by kidneys
hyponatremia
water moves INTO the cell, causing cellular swelling
hypernatremia
water moves OUT of cell, causing cellular dehydration
S/S sodium imbalance
tachycardia hypoTN HA, confusion decreased DTR hyperactive bowel, abdominal cramps N/V
potassium
35-5 mEq/L
ICF
regulates muscle contraction, cardiac conduction
eliminated by kidneys
S/S hypokalemia
weak, irregular pulse hypoTN muscle cramping confusion premature ventricular contractions, flattened T waves, ST depression hypoactive bowel sounds N/V/D
S/S hyperkalemia
slow, irregular pulse decreased DTR confusion ventricular fibrillation, peaked T waves, widened QRS, cardiac arrest diarrhea
calcium
9-10.5 mg/dL
regulates bone and muscle health
S/S hypocalcemia
numbness, tingling muscle spasms hyperactive DTR facial twitch (Chvostek's sign) BP cuff twitch (Trousseau's sign) prolonged QT interval and ST hyperactive bowel, diarrhea seizures
S/S hypercalcemia
decreased DTR bone pain dysrhythmias increased risk of blood clots lethargy, confusion
magnesium
1.3-3.1 mEq/L
alcoholism, laxative abuse huge causes of hypomagnesemia
S/S hypomagnesemia
hyperactive DTR muscle tetany Chvostek Trousseau seizures hypoactive bowel, constipation tachycardia HTN
alcoholism, laxative abuse may cause
S/S hypermagnesemia
decreased DTR muscle paralysis decreased RR bradycardia lethargy
laxatives containing Mg may cause
chloride
ECF
bound to other ions (like sodium)
phosphate
ICF
bound w/calcium in teeth and bones, but has inverse relationship w/Ca2+
bicarbonate
ICF and ECF
acid base balance regulated by kidneys; produced to act as a buffer
blood pH
nml 7.35-7.45
acidosis <7.35
alkalosis >7.45
pCO2
respiratory pH control
nml 35-45
resp acidosis (CO2 retention) >45
resp alkalosis (excessive ventilation) <35
HCO3
bicarbonate pH control
nml 22-26
met acidosis <22
met alkalosis >26
