Fluid and Electrolyte Concepts Flashcards
- What are the signs and symptoms of dehydration?
Weight loss, dry mucous membranes, decrease in urinary output with concentrated urine, dry
skin with poor skin turgor, tachycardia, thirst.
- Treatment: PO and/or IV fluid replacement, electrolyte replacement as needed
- What are the signs and symptoms of fluid volume overload?
Weight gain, edema, distended neck veins (JVD), tachycardia, crackles in lungs
- Treatment: restrict intake of fluids (IV and PO), sodium restriction, diuretics
- Define the following terms and give examples of when each would be most appropriate.
- Isotonic fluids
- Hypotonic fluids
- Hypertonic fluids
- Isotonic fluids: equal tonicity (0.9% N/S), (D5W), (LR)
- Uses: treat dehydration, during surgery, and shock
- Hypotonic fluids: cells SWELL, fluids will cause fluid to move out of the area where hypotonic
fluid is and enter the cell. (0.33% N/S, 0.24%, 0.45%), (D2.5W) - Uses: hyperosmolar hyperglycemia, DKA, pediatric patients
*Hypertonic fluids: cells SHRINK, fluids will pull other fluid into area where hypertonic fluid is,
vascular space. (3% N/S), (D10W, D50W)
- Uses: serious hyponatremia, cerebral edema, severe hypoglycemia
- What substances are crystalloid?
Glucose and electrolytes
- What are colloid?
Proteins, albumin
- What medications can affect calcium levels?
- Long term antacid use with calcium as the main ingredient (calcium carbonate) ↑ca+
- Bisphosphonates, aminoglycosides, anticonvulsants ↓ ca+
Electrolyte Abbreviation Normal
Range
Hyper Hypo Special Notes/Signs and
Symptoms
Sodium
Na or Na+ = major anion of the extracellular fluid
135-145
> 145 = Hyper (extreme thirst) “FRIED”
< 135 = Hypo “SALT LOSS”
* Sodium imbalances give us fluid imbalances and neurological impairment
- Can cause personality changes, Headache, Confusion, Lethargy
- Treat with fluid replacement
- “FRIED”: Fatigue, Restless,
Increased reflexes, Extreme
thirst (primary symptom),
Decreased urine output - “SALT LOSS”: Seizures &
stupor, Abdominal cramping,
Lethargy, Tendon reflexes
diminished, Loss of urine &
appetite, Orthostatic
hypotension, Spasm of the
muscles, Shallow respirations
(very late sign)
Electrolyte Abbreviation Normal
Range
Hyper Hypo Special Notes/Signs and
Symptoms
Potassium
K or K+ = major anion of the intracellular fluid
3.5-5
> 5.0 “MURDER”
< 3.5 “7 L’s”
- Potassium imbalances may
cause muscle cramps,
weakness, nausea, diarrhea,
frequent urination, dehydration,
low BP, confusion, irritability,
paralysis, and changes in heart
rhythm.
- “MURDER”: Muscle
weakness, Urine output little to
none, Respiratory failure (late),
Decreased cardiac contractility,
Early muscle twitches and
cramps, Rhythm changes (tall T
wave) - “ 7 L’s”
Lethargic
Limp muscles
Low shallow breathing
Leg cramps
Low BP & HR
Lots of urine
Lethal dysrhythmia
Electrolyte Abbreviation Normal
Range
Hyper Hypo Special Notes/Signs and
Symptoms
Calcium
Ca or Ca+
8.2-10.2
>10.2 “WEAK”
< 8.2 “CRAMPS”
- Most abundant mineral in the human body.
- Highest concentration in bones and teeth
- Calcium toxicity is rare but can occur
- Symptoms: anorexia, nausea, vomiting, and constipation.
- A positive Chvostek sign or Trousseau sign can indicate hypocalcemia
- “WEAK”: Weak muscles,
ECG changes, Absent reflexes,
Kidney stones - “CRAMPS”: Convulsions,
Reflexes, Arrhythmia, Muscle
spasms, Positive signs,
Sensation or numbness
Electrolyte Abbreviation Normal
Range
Hyper Hypo Special Notes/Signs and
Symptoms
Magnesium
Mg or Mg+
1.6-2.2
< 2.2 “LETHARGIC”
> 1.6 “TWITCH”
-One of the principal cations
present in the intracellular
fluid.
- It is an essential part of many
enzymes systems associated
with energy metabolism.
ANTIDOTE = Calcium
-Must check deep tendon
reflexes
- Torsade’s De Pointe
(abnormal rhythm)
- “TWITCH”: Trousseaus,
Weakness, Increased tendon
reflexes, Torsade’s de Pointe,
Calcium, and potassium low,
Hypertension - “LETHARGIC”: Lethargic,
ECG changes, Tendon reflexes
diminished, Hypotension,
Arrhythmias, Red hot face, GI
complains, Impaired breathing,
Confusion
