Fluid and Electrolytes Flashcards
Normal value for Na+
136-145 mEq/L
Normal value for K+
3.5-5.0 mEq/L
Normal values for Cl-
98-106 mEq/L
Normal values for CO2
22-26 mEq/L
Normal values for Ca+
9-10.5 mEq/L
Normal values Mg+
1.3-2.1 mEq/L
Normal values for PO4- (phospate)
2.7-4.5 mg/dL
Normal values for Serum osmality
280-295 mOsm/kg
Normal value for BUN
10-20 mg/dL
Normal value for Creatinine
0.7-1.5 mg/dL
Normal value for hematocrit
Male: 44-52%
Female: 39-47%
Normal value for glucose
70-110
Antidiuretic hormone (ADH) regulates
the osmolality of the body by influencing how much water is excreted in urine. Synthesized in hypothalamus
Renin-Angiotensin-Aldosterone System regulates
ECF volume by influencing how much Na+ and water are excreted in urine. Also regulates BP
Specialized cells in the kidneys release the enzyme
Renin. which converts angiostensinogen to angiostensin I, which other enzymes in the lung capillaries convert into angiotensin II
Functions of Angiotensin II
vasoconstriction, stimulation of aldosterone release from the adrenal cortex
Aldosterone
circulates the kidneys, causes resorption of Na+ and water
Causes of Fluid volume alterations
Vomiting, diarrhea, fistulas, GI suction, anorexia, inability to obtain fluids
S/S of FVD (Fluid volume deficit)
weight loss tachycardia oliguria, dark yellow urine weak rapid pulse absence of sweat and tears thirst Increased BUN/Creatinine and hct
Fluid volume deficit
Na+ and water intake less than output
Fluid volume excess
expansion of ECF. Na+ and water intake greater than output (retention)
Causes of fluid volume excess (FVE)
Too much salty foods
CHF, Renal failure
Excessive admin of Na+ containing fluids
S/S of FVE (fluid volume excess)
weight gain edema crackles distended veins Decresed BUN/ hct
Hyponatremia
< 135
Water gain, loss of Na+
Causes of hyponatremia
excessive ADH Diuretics Sweating Loss of GI fluids (diarrhea, vomit) Excessive D5W (IV dextrose in water) Adrenal insufficiency
Manifestations of hyponatremia
Anorexia N and V Headaches Lethargy, muscle weakness, confusion Increased ICP Abdominal cramping
Hypernatremia
> 145
Na+ gain, water loss
Causes of hypernatremia
Water deprivation Difficulty swallowing fluids Overuse of table salts Heat stroke Watery diarrhea Hypertonic tube feedings with no water supplements
Manifestations of hypernatremia
Extreme thirst Dry flushed skin Swollen tongue Fever, restlessness Confusion, weakness Sticky mucous membranes
Most predominant electrolyte intracellular
Potassium (neuromuscular function)
Foods high in potassium
Apricots, oranges, banana, dried fruit, cantaloupe, raisins
Hyperkalemia
> 5
High potassium concentration
Causes of hyperkalemia
Increased K+ intake Impaired renal function Salt substitutes Acidosis Trauma tissue
Manifestation of hyperkalemia
Nausea, diarrhea
Muscle weakness, paralysis
Cardiac arrest and dysrhythmias
Narrow T-waves, lower QT interval
Functions of calcium
Major component of strong teeth and bones
Regulates muscle contraction/relaxation
Blood coagulation
Sedative action on nerves
Hypocalcemia
<8.6
abnormally low calcium concentration
Causes of hypocalcemia
Hypoparathyroidism Pancreatitis Vitamin D deficiency Chronic diarrhea Alkalosis Large amounts of citrated blood
Manifestations of hypocalcemia
Muscle spasms/tingling/twitching
Positive Chvostek and Trousseau sign
Hyperactive reflexes
Seizures, confusion
Hypercalcemia
> 10
abnormally high concentration of calcium
Causes of hypercalcemia
Cancer Hyperparathyroidism Prolonged immobilization Bone tumors Thiazide diuretics
Manifestations of hypercalcemia
Anorexia N/V Constipation Fatigue Diminished reflexes Confusion Severe thirst, polyuria Personality change, confusion
Hypomagnesemia
<1.5
abnormally low magnesium concentration
Causes of hypomagnesemia
Malnutrition Alcoholism Chronic diarrhea/ laxative use Pancreatitis Impaired absorption
Manifestations of hypomagnesemia
Hyperexcitability w/ muscle weakness Insomnia Muscle cramps, tremors tetany Dysphagia, laryngeal stridor Hyperactive reflexes Disorientation
Hypermagnesemia
> 2.7
high magnesium concentration
Causes of hypermagnesemia
Renal failure
Adrenal insufficiency
Untreated diabetic ketoacidosis
Manifestations of hypermagnesemia
Lethargy Hypoactive reflexes Bradycardia Hypotension Facial flushing Flaccid muscle paralysis Decreased rate/depth of respirations Absence of DTR
Hypophosphatemia
<2.7
low concentration of phosphorus
Causes of hypophosphatemia
Malnutrition
Alcoholism
Prolonged hyperventilation
Manifestations of hypophosphatemia
Irritability, apprehension Weakness, numbness Paresthesia Confusion, seizures Muscle weakness Respiratory problems
Hyperphosphatemia
> 4.5
high concentration of phosphorus
Causes of hyperphosphatemia
Renal failure
Chemotherapy
High phosphorus intake
Manifestations of hyperphosphatemia
Soft tissue calcification
Tetany
Decreased Ca+ levels
How much potassium is excreted via kidneys?
80%
Which is more dangerous?
a. Hyperkalemia
b. Hypokalemia
Hypokalemia
Foods high in calcium
Dairy products
Green leafy vegtables
Foods high in sodium
Processed meats
Canned vegetables
Snacks
Low sodium diet
No processed meats
No meat, cheese, butter
No canned vegetables
Patients taking diuretics need
Potassium supplement
Presence of U waves, depressed ST segment and biphasic T wave can be found in
Hypokalemia
Best treatment for hypokalemia
Early prevention
What should you use when giving potassium thru IV? Why?
Neutralizer, to prevent pain
If patient can resist pain, have concurrent administration with IV fluids
If a patient does not have kidney function you cannot
give potassium thru IV
Calcium antagonizes
Potassium (removes potassium)
Parathyroid hormone increases or decreases calcium?
increases
Calcitonin increases or decreases calcium?
decreases
Calcium has an inverse relationship with
Phosphorus
When calcium increases, phosphorus
decreases
What is tetany
Sustained contraction of muscles
Hypercalcemia has a ___% mortality without _______
50%
Prompt treatment
Thiazide diuretics retain
Calcium
Main manifestation of hypercalcemia
Muscular weakness
Uncoordination
Foods high in magnesium
Bananas
Legumes
Nuts
Chocolate
Absence of DTR (deep tendon reflexes) is seen in
Hypermagnesimia (lower motor neuro problem)
Functions of Na+
Controls water distribution
Muscle contraction
Nerve transmission
Functions of K+
Neuromuscular function
Skeletal and cardiac muscle activity
Functions of phosphorus
Muscle, RBC, and nervous system function
Function of potassium
Neuromuscular function
Skeletal and cardiac muscle activity
Causes of hypokalemia
Vomiting Diarrhea Alkolosis Diuretics (Lasix, thiazides) Steriods, PCN NGT suction
S/S of hypokalemia
Cardiac/ resp arrest Anorexia N/V Muscle weakness Low bowel motility Sensitivity to digoxin Depressed ST segment Prominent U wave
Foods high in phosphorus
Milk
Meat
Processed foods
Hypokalemia
<3.5
low serum potassium
