fluid & electrolyte imbalances Flashcards
refers to serum sodium level that is less than 135 mEq/L
hyponatremia
serum sodium level higher than 145 meq/L
Hypernatremia
indicates a deficit in total potassium stores
Hypokalemia
refers to a potassium level greater then 5.0 mEq/L
Hyperkalemia
serum level below 8.6 mg/dl
hypocalcemia
calcium level greater than 10.2 mg/dl
hypercalcemia
refers to below-normal serum magnesium concentration
hypomagnesemia
indicated by a value below 2.5 mg/dl
hypophosphatemia
serum levels over 2.3 mg/dl
hypermagnesemia
serum phosphorus level that exceeds 4.5 mg/dl
hyperphosphatemia
Complications of Fluid & Electrolyte Imbalances
(DCSC)
Dehydration
Cardiac overload
SIADH
Cardiac arrest
result of a fluid volume deficit
dehydration
result of fluid volume excess if left untreated may cause
cardiac overload
a disorder of impaired water excretion caused by the inability to suppress secretion of ADH
SIADH (Syndrome of Inappropriate Secretion of Antidiuretic Hormone)
too much potassium administered can lead to…
Cardiac arrest
Assessment and Diagnostic Findings
(BHPSEA)
BUN
Hematocrit
Physical Examination
Serum Electrolyte levels
ECG
ABG Analysis
may be decreased in FVE due to plasma dilution
BUN (Blood Urea Nitrogen)
FVD are greater than normal because there is a decreased plasma volume
Hematocrit levels
Necessary to observe the signs and symptoms of the imbalances
Physical Examination
Measurement of electrolyte levels should be performed to check for presence of an imbalances
Serum Electrolyte Levels
changes can also contribute to the diagnosis of fluid and electrolyte imbalance
ECG
may reveal acid-base Imbalances
ABG Analysis
Medical Management
(TIADN)
-Treatment of fluid & volume imbalances needs accuracy to avoid consequences that can result in complications
-Isotonic electrolyte solutions
-Accurate I&O
-Dialysis
-Nutritional therapy
These solutions are used to treat the hypotensive patient with FVD because they expand plasma volume
isotonic electrolyte solutions
accurate and frequent assessment of I&O should be performed when therapy should be slowed or increased to prevent volume deficit or overload
accurate I&O
it is performed to remove nitrogenous wastes and control potassium and acid-base balance, and to remove sodium and fluid
Dialysis
Treatment of fluid and electrolyte imbalances should involve restrictions or enforcement of the concerned electrolyte
nutritional therapy
Pharmacologic therapy
(ADIC)
AVP receptor agonists
Diuretics
IV calcium gluconate
Calcitonin
these are new pharmacological agents that treat hyponatremia by “stimulating free water excretion”
AVP Receptor agonist
Decrease in fluid volume in FVE, …. are administered
Diuretics
if serum potassium levels are dangerously elevated, it may be necessary to administer….
IV Calcium gluconate
Can be used to lower the serum calcium level and is particularly useful for patients with heart disease or heart failure who cannot tolerate large sodium loads
Calcitonin
its principal function is to enhance conservation of water by increasing the permeability of collecting ducts to water. It is also a potent vasoconstrictor and exerts a direct constrictive action on specific smooth muscle receptors
AVP/Vasopressin
