Hypochloremia

Question 1

What is hypochloremia?

Answer 1

Serum chloride level less than 97 mEq/L.

Causes include Addison’s disease, reduced chloride intake, GI loss, diabetic ketoacidosis, excessive sweating, fever, burns, medications, and metabolic alkalosis.

Question 2

What are the manifestations of hypochloremia?

Answer 2

Agitation, irritability, weakness, hyperexcitability of muscles, dysrhythmias, seizures, coma.

Question 3

What is the medical management for hypochloremia?

Answer 3

Replace chloride with IV NS or 0.45% NS.

Question 4

What is the nursing management for hypochloremia?

Answer 4

Assessment, avoid free water, encourage high-chloride foods, patient teaching related to high-chloride foods.

Question 5

What is hyperchloremia?

Answer 5

Serum chloride level more than 107 mEq/L.

Normal serum anion gap.

Question 6

What are the causes of hyperchloremia?

Answer 6

Excess sodium chloride infusions with water loss, head injury, hypernatremia, dehydration, severe diarrhea, respiratory alkalosis, metabolic acidosis, hyperparathyroidism, medications.

Question 7

What are the manifestations of hyperchloremia?

Answer 7

Tachypnea, lethargy, weakness, rapid, deep respirations, hypertension, cognitive changes.

Question 8

What is the medical management for hyperchloremia?

Answer 8

Restore electrolyte and fluid balance with LR, sodium bicarbonate, diuretics.

Question 9

What is the nursing management for hyperchloremia?

Answer 9

Assessment, patient teaching related to diet and hydration.