fluid and electrolytes Flashcards
Indications of dehydration
dry mucous membranes
tongue furrows (grooves on top)
chronic dehydration
Hyponatremia levels
level below 135
level less than 115 is critical
hyponatremia etiology (causes)
vomiting, diarrhea, burns, GI suctioning, renal disease, heart failure, adrenal insufficiency
hyponatremia manifestations (symptoms)
edema, muscle cramps, weakness, tremors, muscle twitching
hyponatremia management
0.9% normal saline IV, promote safety, increase sodium rich foods
hypernatremia levels
sodium level greater than 145
level greater than 160 is critical
hypernatremia etiology (causes)
inappropriate use of oral electrolyte solution
impaired thirst mechanism
corticosteroids can cause hypernatremia
hypernatremia symptoms
sweating, confusion, muscle twitching, seizures, diarrhea
hypernatremia assessment
assess level of consciousness
hyperkalemia levels
potassium level greater than 5.3
level above 7 is critical
hyperkalemia etiology (causes)
renal failure, adrenal insufficiency, starvation, acidosis
hyperkalemia manifestations (symptoms)
peaked t waves, dysrhythmias, cardiac arrest, paresthesia
hyperkalemia management
sodium polystyrene sulfonate (kayexolate) po or enema, Insulin which causes potassium to move into cells
hypokalemia levels
potassium less than 3.5
critical level below 2.5
hypokalemia etiology (causes)
vomiting, alkalosis, gastric suctioning, corticosteroid, potassium-depleting diuretic, long term iv fluid without added potassium
hypokalemia manifestations (symptoms)
dysrhythmias, anorexia, muscle cramps, suppressed insulin secretion, decreased bowel sounds, ileus, digoxin toxicity
hypokalemia management
replacement of potassium IV or po
hypocalcemia levels
calcium level below 9
hypocalemia etiology (causes)
renal failure (big cause), alkalosis, large volume of titrated blood in a transfusion
hypocalcemia manifestations (symptoms)
bradycardia, hypotension, trousseau (shaking), chvostek (twitching), numbness, tingling, muscle cramps, confusion, lip and face spasms
hypocalcemia management
Iv replacement at moderate rate
magnesium levels
1.8-3.0
magnesium roles in the body
energy production, protein synthesis, neuromuscular function
60% found in bones 40% found in muscles
fluid overload
hemoglobin and hematocrit decreased
dehydrated
hemoglobin and hematocrit higher, fluid is more concentrated
fluid volume deficit and dehydration diagnostic test
electrolyte panel, elevated BUN, urine specific gravity
fluid volume deficit and dehydration clinical therapies
oral hydration, IV fluids 0.9% normal saline
fluid volume deficit and dehydration lifespan considerations
low birth weight and tachypenic
sodium level
135-145
assist in osmotic pressure
potassium level
3.5-5.0
plays role in cellular depolarization and repolarization
calcium levels
9-11
calcium roles in the body
blood clotting, bone and teeth formation, control of muscle contractions
calcium levles are controlled by
vitamin D, calcitonin, parathyroid hormone
system effects of fluid volume deficit and dehydration
neuro- altered mental status
urinary- increase in specific gravity
cardio- tachycardia, hypotension, high hematocrit
fluid volume deficit and dehydration initial sign
thirst
