Fluids and Electrolytes Flashcards
SODIUM LAB VALUE
135-145
POTASSIUM LAB VALUE
3.5-5
PHOSPHORUS LAB VALUE
2.5-4.5
CALICUM LAB VALUE
9-11
MAGNEISUM LAB VALUE
1.5-2.5
CHLORIDE
95-105
Potassium:
Priority: Pumps the heart and muscles
vital role in cell metabolism, nerve impulses, cardiac and muscle tissues, and acid base imbalances
Hyperkalemia S/S
Heart - TIGHT & CONTRACTED 1ST elevation and Peaked T waves
2 Severe = Vfib or Cardiac Standstill!
3 Hypotension, Bradycardia
GI TRACT - TIGHT & CONTRACTED
1 Diarrhea
2 Hyperactive bowel sounds NEUROMUSCULAR
- TIGHT & CONTRACTED Paralysis in Extremities Increased DTR
Profound Muscle Weakness, (General Feeling of heaviness)
Hypokalemia S/S
<3.5 mEq/L
weak, irregular pulse
orthostatic hypotension
shallow respirations
anxiety, lethargy
HEART - LOW & SLOW
1 Flat T waves, ST depression, & prominent U wave
MUSCULAR - LOW & SLOW
1 Decreased DTR
2 Muscle cramping
3 Flaccid paralysis (paralyzed limbs)
GI - LOW & SLOW
Decreased motility, hypoactive to absent bowel sounds, Constipation
Abdominal distention
Paralytic ileus, paralyzed intestines! PRIORITY for SB0 (small bowel obstruction)
Hypernatremia S/S
> 145 mEq/L
big and bloated
confused, irritable, restless
increase BP and fluid retention
pitting edema
decrease urine output
thirsty
- SKIN
FLUSH ‘’Red & Rosy’’ EDEMA ‘’waterbed skin’’ LOW GRADE FEVER - POLYDIPSIA EXCESS THIRST
- LATE SERIOUS SIGNS:
SWOLLEN dry tongue-NCLEX
GI = nausea & vomiting-NCLEX INCREASED muscle tone NCLEX
Hyponatremia S/S
SALT LOSS
stupor coma
anorexia
lethargy
tachycardia
limp muscles
orthostatic hypotension
seizures
stomach cramping
Hyperphosphatemia S/S
tetany, muscle cramps, numbness and tingling of extremities and around moth and hyperreflexia
Hypophosphatemia
decreased LOC, confusion, muscle weakness, pain, neuropathy
Sodium:
found in the ECF, essential for acid base, fluid balance, active and passive transport, irritability and conduction of nerve muscle tissues
Phosphorus:
mostly in bones and teach as calcium phosphate, function of muscle, red blood cells, and the nervous system. Excretion requires adequate kidney function
Chloride
Sodiums sidekick: maintains the blood pressure, blood volume and the PH balance
Hyperchloremia S/S
> 105
nausea and vomiting, swollen dry tongue, confusion
Hypochloremia
<95
excessive diarrhea, vomiting, and sweating and fever
Magnesium
mag mellows the muscles
Hypermagnesemia
> 2.5
Cardiac: calm and quiet
heart block, prolonged PR intervals
Vitals: bradycardia, hypotension
Deep tendon reflexes: calm+quiet
Lungs: calm and quiet as well, depressed shallow respirations
Gi: calm/quiet, hypoactive bowel sounds
Hypomagnesemia
- CARDIAC - BUCK WILD!
EKG: ST depression, T wave inversion
SEVERE = V fib
VITALS = Tachycardia - DEEP TENDON REFLEXES - BUCK WILD
Hyporeflexia - increased DTR - EYES - BUCK WILD
Abnormal eye movements (nystagmus) - GI - BUCK WILD Diarrhea
Calcium
keeps the bone, blood, and beats(heart) strong
Hypercalcemia
> 11
SWOLLEN & SLOW -
MOANS, GROANS & STONES
1. CONSTIPATION
2. BONE PAIN
3. STONES Renal Calculi (kidney stones)
4. DEEP TENDON REFLEXES
-Decreased DTR
-Severe muscle weakness
Hypocalcemia
<9
T - Trousseau’s
T - Twerking arm with BP cuff on C - Chvostek’s
C - Cheek smile when touched
-Diarrhea
-Circumoral tingling
-Weak bones
NORMAL SALINE (NS) USES
-0.9 % NaCl in water
-crystalloid solution
-isotonic
-increases circulating plasma volume when red cells are adequate
-shock
-fluid replacement in patients with DKA
-hyponatremia
-blood transfusions
-resuscitation
-metabolic alkalosis
-hypercalcemia
NORMAL SALINE (NS) SPECIAL CONSIDERATIONS
- do not use patients with heart failure, edema, or hypernatremia
-replaces losses without altering fluid concentrations
-helpful for Na+ replacement
1/2 Normal Saline
-0.45 % NaCl in water
-crystalloid solution
-Hypotonic (154 mOsm)
-water replacement
-raises TFV
-hypertonic dehydration
-sodium and chloride depletion
-gastric fluid loss from nasogastric suctioning or vomiting
1/2 Normal Saline CONSIDERATIONS
-0.45 % NaCl in water
-crystalloid solution
-Hypotonic (154 mOsm)
USE CAUTIOUSLY may cause cardiovascular collapse or increase in intracranial pressure
-dont use in pts with liver disease, trauma, or burns
-useful for daily maintenance of body fluids
-establishing renal function
-fluid replacement for pts who dont need extra glucose (diabetics)
Lactated Ringers (LR)
normal saline with electrolytes and buffers
replaces fluid and buffers PH
hypovolemia due to third shift spacing
dehydration
burns
lower GI tract fluid loss
acute blood loss
Lactated Ringers (LR) CONSIDERTIONS
normal saline with electrolytes and buffers
-has similar electrolyte content with serum but does not contain magnesium
- has K+ therefore don’t use to patients with renal failure as it can cause hyperkalemia
-don’t use in liver disease because pt cant metabolize lactate; a functional liver converts it to bicarb
-don’t give to pts PH >75
ISOTONIC
iso=equal
tonic=concentration of solution
meaning: equal concentration inside as well as outside of the cell
They are used to increase the extracellular fluid volume.
The extracellular fluid is lost through blood loss, dehydration (V/D), surgery,
and heat exposure (sweating).
Won’t cause a shift into the intracellular area and prevents the cell from shrinking or expanding.
D5W
-dextrose 5% in the water crystalloid solution
-isotonic in the bag
-physiologically hypotonic
-replaces total fluid volume
-helpful in rehydrating and excretory purposes
-fluid loss and dehydration
-hypernatremia
D5W CONSIDERATIONS
-dextrose 5% in the water crystalloid solution
-isotonic in the bag
-physiologically hypotonic
-it is isotonic and then becomes hypotonic when dextrose is metabolized
-do not use for resuscitation
-caution: pt with renal/cardiac disease can cause fluid overload
HYPOTONIC
has a lower concentration of fluid, sugars, and salt than blood
HYPERTONIC
HIGHER concentration of fluid, sugars, and salt than blood
What is an acid base imbalance?
A blood pH imbalance can lead to two conditions: acidosis and alkalosis. Acidosis refers to having blood that’s too acidic, or a blood pH of less than 7.35. Alkalosis refers to having blood that’s too basic, or a blood pH of higher than 7.45
Intracellular ICF
● Two thirds of body water
● Body fluids within the cell
Extracellular ECF
● One third of body water
● Body fluids outside of the cell membrane
● Further divided into parts
-Intravascular fluid: The liquid part of blood or the plasma
-Interstitial fluid: Located between the cells and outside of the blood vessels
-Transcellular body fluids: Secreted by epithelial cells (cerebrospinal, pleural, peritoneal, synovial fluids)
