fluid and electrolyte disorders Flashcards
hourly intake for children
4mL/kg is 10kg
2mL/kg is 11 to 20 kg
1mL/kg is 21+kg
Extracellular fluid excess aka “Saline imbalances”- disorder of isotonic salt water
-caused by addition or retention of isotonic saline, excessive secretion of normal aldosterone cause kidney to retain saline which can lead to CHF
manifestations:
- bounding pulse, neck vein distension, crackles in lungs, dyspnea, sudden weight gain, edema, othopnea
- infants have fontanel
ECV deficit: dehydration and diarrhea
caused by removal of a sodium containing fluid from extracellular compartment. Includes GI secretion, renal secretion, 2nd and 3rd degree burns, ascites ( fluid in 3rd space of body).
Manifestation:
- sudden weight loss, decrease bp with increase hr, flat neck veins, lightheartedness, dizziness, decrease skin turgor, hard stools, sunken eyeballs
- infants have fontanel
body fluid concentration
disorders of concentration and primarily affects by sodium concentration. Serum sodium concentration reflect osmolarity of blood.
hypoatremia
cell swells, excess of water, hypotonic syndrome
-caused by excess water gain than salt, can be min or max, loss of salt than water
manifestation:
- mild central nervous system dysfunction
- anorexia
- nausea
- vomiting
- headache
- several manifestation include confusion, lethargy, seizure, coma
hyperatremia
cell shrink, water deficit, serum salt concentration above upper limit of normal.
-Caused by ECF having too little water for amount of sodium present, cells shrivel
Manifestation:
- thirst, oliguria, confusion, lethargy
- severe include seizure, coma, death
clinical dehydration
combination of 2 fluid disorders: extracellular volume deficit, hyperatremia, too small a volume of fluid in extracellular compartment and too concentrated body fluids
-caused by vomiting, diarrhea, knowledge deficit about salt and fluid replacement
manifestation: depends on severity
- mild has normal skin turgor, pulse, bp
- mod. has decreased skin turgor
- severe has poor skin turgor, tachycardia, low bp
- bp decrease with increase hr
- lightheadedness, dizziness, flat neck veins
- sunken fontanel
hypokalemia
decrease in potassium ion concentration in ECF
-caused by decreased oral intake, shift into ICF, increase excretion in renal, feces, sweat, GI tract ( diarrhea, diuretics)
clinical manifestation:
-distension, decrease bowel sound, paralytic ileus ( gut stops moving), skeletal muscle weakness, ectopic beats, dysrhythmia, polyuria
hyperkalemia
increase potassium concentration above 5 mEq/L
-caused by increase potassium intake, rapid IV infusion of potassium from cell to ECF: acidosis, decreased potassium excretion, oliguria, potassium sparing diuretics, drugs that reduce aldosterone
manifestation:
- mild include cramp, diarrhea
- late to severe include muscle weakness, ascending in lower extremities, cardiac dysrthythmia and cardiac arrest
plasma calcium
ionized calcium ( only unbound ionized form)
- normal range is 4 to 5 mg/dl
- imbalanced caused by alteration in plasma concentration of unbound ionized calcium
Hypocalcemia
serum calcium level below lower limit of normal, cause no cardiac contraction
- unbound ionized calcium in blood LOWER than calcium bind in plasma protein
- manifestation include carpal spasm, pedal spasm, tetany, seizure, dysrthymnia, muscle twitching
Hypercalcemia
increase calcium intake/absorption, vitamin D overdose, shift of calcium from bone to extracellular fluid (hyperparathyrodism), decrease calcium secretion
manifestation include muscle weakness, anorexia, nausea, fatigue, polyuria, constipation, headache
Edema
excess of fluid in the interstitial department, may be a manifestation of ECV excess.
-Caused from a increase hydrostatic capillary pressure from cell into interstitial fluid OR decrease in forces that move fluid from interstitial’ compartment into the capillaries
