Fluid and Electrolyte part 4 Flashcards
What is the normal sodium level?
135-145
Does the sodium level tell you how much sodium is on the body?
No, it tells you how much sodium there is compared to water (osmolality)
What does sodium play a major role in?
-nerve impulses and muscle contraction
Where does water move in hypernatremia?
from ICF to ECF
-cell shrinks
What is dehydration?
When extracellular fluid volume deficit and hypernatremia occur at the same time
- ECF volume deficit (hypovolemia)
- body fluids are too concentrated
- Identify causes and symptoms associated
with:
-Hypernatremia?
Causes: loss of more water than salt, gain of more salt than water,
- cell shrinks (cellular dehydration)
- impaired LOC, kidney disease, meds, IV fluids
- sodium elevated >145
- Identify causes and symptoms associated
with:
-Hyponatremia?
- gain of more water than salt, loss of more salt than water. Cell swells
- sodium <135
What is isotonic fluid used for?
- stays in vascular compartment
- expands only extracellular fluid
- ideal to replace ECF volume deficit (blood loss, surgery, dehydration, extracellular loss)
What are examples of isotonic fluids?
- 0.9% NaCl
- Lactated Ringers (contains: NA, K, Ca, Cl and lactate)
- D5W: 5% dextrose in water
What is a hypotonic fluid used for?
- water moves from ECF to ICF by osmosis
- treats pt’s with hypernatremia (intracellular dehydration), DKA, hyperglycemia
- usually maintenance fluids
- monitor mentation
What is a hypertonic fluid used for?
- treats hyponatremia, cerebral edema (trauma pt’s), pt’s who need electrolytes but have fluid overload (heart failure or severe edema)
- draws fluid out of the cell into the extracellular
- Monitor: BP, lung sounds, serum sodium levels
What are the hypertonic solutions?
-3% NaCl
-5% NaCl
-D10W
(greater than 0.9% NaCl and D5W)
What are the hypotonic solutions?
-0.45%, 0.33%, 0.2% NaCl
-D2.5W
(less than 0.9% NaCl and D5W)
