Fluids, Electrolytes, Acid/base balances Flashcards
pH range
7.35 - 7.45
respiratory alkalosis
pH > 7.45 PCO2 < 35mmHg symptoms: lightheadedness inability to concentrate numbness and tingling altered LOC
respiratory acidosis
pH < 7.35 PCO2 > 45 mmHg symptoms: sudden changes: increased HR, RR, BP mental changes
metabolic acidosis
pH < 7.35
HCO3 < 22
symptoms:
headache, confusion, drowsiness, decreased BP, CO
increased RR and depth, Dysrhythmias, Shock
metabolic alkalosis
pH > 7.45 HCO3 > 26 symptoms r/t Hypocalcemia and Hypokalemia tachycardia respiratory depression
serum sodium level
135 - 145 mEq/L
serum potassium level
3.5 - 5.0 mEq/L
serum calcium level
8.6 - 10.2 mg/dL
serum magnesium level
1.3 - 2.3 mg/dL
serum phosphate level
2.5 - 4.5 mg/dL
serum chloride level
97 - 107 mEq/L
Hgb values
women: 12 - 16
men: 13 - 18
WBC count
4,500 - 10,000/mm3
BUN
10-20
serum creatinine
0.7 - 1.4
HCT values
males: 42 - 52%
women: 35 - 57%
platelet count
150,000 - 450,000/mm3
urine osmolality and specific gravity
1.01 - 1.025
symptoms of hypervolemia
edema, JVD, abnormal lung sounds (crackles); tachycardia; SOA; wheezing; increase BP, increase HR, increase PP, increase CVP, increase weight, increase urine output; ascites
PCO2 range
35 - 45 mmHg
HCO3 range
22 - 26 mEq/L
PO2 range
80 - 100 mmHg
O2 saturation
95% or above
hyponatremia
< 135 mEq/L
symptoms: N/V, headache, malaise, tachycardia, hypotenstion
causes of hyponatremia
excessive diaphoresis
diuretics
hyperglycemia
hypovolemia labs
increased HCT & Hgb
increased serum & urine osmolality & specific gravity
decrease urine sodium
increased BUN and serum creatinine
hyperkalemia
> 5.0 mEq/L
symptoms: hypotension, PVCs, V-fib, restlessness
EKG: shortened repolarization and peaked T waves
hypervolemia labs
decrease: HCT, Hgb, serum & urine osmolality, urine sodium & specific gravity
causes of hyperkalemia
severe tissue damage
renal failure
certain medications
poor diet
hypokalemia
< 3.5 mEq/L
symptoms: hypotension, AMS, N/V, weakness
EKG: flattened T waves, prolonged PR interval, prominent U waves, ST depression
causes of hypokalemia
low potassium intake
trauma
vomiting/ diarrhea
Digoxin toxicity
hypermagnesemia
> 2.3 mg/dL symptoms: hypotension, drowsiness, decreased respiration and reflex reactions cardiac arrest coma/decreased LOC
causes of hypermagnesemia
DKA
adrenal insufficiency
hypothyroidism
renal failure
hypomagnesemia
< 1.3 mg/dL
symptoms: neuromuscular irritability,
EKG abnormalities: PVCs, flat/inverted T waves, depressed ST segment, prolonged PR, wide QRS ALOC, Insomia
causes of hypomagnesemia
alcoholism
hyperparathrydroidism
hyperadolsteronism
DKA
hypercalcemia
> 10.2 mg/dL
s/s: abdominal pain, dehydration, bone pain, excessive urination
causes of hypercalcemia
overactive parathyoid cancers
hypocalcemia
< 8.6 mg/dL
S/S: cramping, spasms, fatigue, irritability, kidney stones, increased DTRs
causes of hypocalcemia
hypoparathyroidism
vitamin D deficiency
kidney failure
hypovolemia
cause: vomiting, diarrhea, GI suctioning, diaphoresis
S/S: cool, clammy skin, oliguria, concentrated urine, cramps, postural hypotension, AMS, rapid,weak pulse, thirst, N/V, muscle weakness
hypernatremia
> 145 mEq/L
S/S: thirst, bradycardia, irritability, N/V, HTN
cause of hypernatremia
heat stroke burns NPO hyperventilation dehydration
interventions and medical management for hypernatremia
interventions - oral hygiene, increase fluids, decrease sodium intake
medical management - hypotonic electrolyte saline, diet, patient education
interventions and medical management for
hypomagnesemia
interventions - VS, assess muscle tone, fall precautions, bed alarm
medical management - EKG monitor, magnesium supplement, diet, alcohol cessation
interventions and medical management for hyperkalemia
interventions: monitor I&Os, VS, assess for muscle weakness and AMS
medical management - monitor EKG, lasix
interventions and medical management for hypocalcemia
interventions - encourage weight bearing exercises, calcium supplements, neuro checks
medical management - IV CaCl2, diet management
interventions and medical management for hypermagnesemia
interventions - VS, assess reflexes to assess spinal cord
medical management - dialysis and diuretics
interventions and medical management for hyponatremia
interventions - decreased fluids, daily weights
medical management - consult nephrology, hypertonic IV NS
interventions and medical management for hypercalcemia
interventions - low calcium diet, strain urine for stones, encourage mobility, neuro checks
medical management - calcitonin, diuretics
interventions and medical management for hypokalemia
interventions - VS, assess DTRs, monitor rhythm
medical management - monitor EKG, Potassium supplement
major cations
sodium potassium calcium magnesium hydrogen
major anions
chloride bicarbonate phosphate sulfate proteinate ions