lewis ch 16 fluid and electrolytes Flashcards
S+S hypervolemia (6)
- weight gain
- headache, confusion, lethargy
- hypertension
- JVD
- peripheral edema
- pulmonary edema, crackles
S+S hypovolemia (6)
- weight loss
- increased heart rate
- increased respiratory rate
- decreased skin turgor and delayed cap refill
- decreased urine output
- restless, drowsy, confusion, seizure, coma
possible causes of hypovolemia (3)
- diarrhea
- hemorrhage
- inadequate intake
labs that would reflect hypovolemia
- increased urine specific gravity
- increased BUN
- increased Hct to Hgb ratio
- increased RBCs
most important nursing diagnosis related to hypervolemia
impaired gas exchange
most important nursing diagnosis related to hypovolemia
ineffective tissue perfusion
skin assessment and care for hypervolemia
- cool skin
- edema
- decreased perfusion
- care: elevate
skin assessment and care for hypovolemia
- cool, moist skin
- dry mucous membranes
- care: mouth care
S+S hypernatremia (SALT)
Skin flushed, seizure
Agitation
Low-grade fever
Thirst
treatment for hypernatremia
replace fluids
diuretic for excess sodium
S+S hyponatremia (SALT LOSS)
Stupor/coma
Anorexia, N/V
Lethargy
Tendon reflexes decreased
Limp muscles
Orthostatic hypertension
Seizure
Stomach cramps
treatment for hyponatremia
fluid restriction
loop diuretic
seizure precautions
S+S hyperkalemia
- peaked T wave
- abdominal cramping, diarrhea
- weak or paralyzed skeletal muscles
- increased irritability
treatment for hyperkalemia
diuretics kayexelate dialysis insulin therapy give calcium gluconate
S+S hypokalemia (A SIC WALT)
Alkalosis
Shallow respirations
Irritability
Confusion, drowsiness
Weakness, fatigue
Arrhythmias
Lethargy
Thready Pulse
treatment for hypokalemia
KCl supplements
eat potassium rich foods (banana, OJ, beans, milk, yogurt)
limit licorice intake
S+S hypercalcemia
- hallucinations
- seizure, coma
- bone pain, fractures
- polyuria, dehydration
S+S hypocalcemia
- laryngeal stridor
- chvostek or trousseau sign
- tingling around mouth
treatment hypocalcemia
- rebreathe into paper bag
- oral or IV calcium supplements
S+S hyperphosphatemia
- calcified deposits in soft tissue
- neuromuscular irritability and tetany
treatment hyperphosphatemia
- diuretics
- adequate hydration
- hemodialysis
S+S hypophosphatemia
- CNS depression
- rickets
treatment hypophosphatemia
- supplements
- eating foods high in phosphorus
S+S hypermagnesemia
- lethargy, drowsiness
- N/V
- impaired reflexes
- respiratory and cardiac arrest
treatment hypermagnesemia
- IV CaCl or calcium gluconate
- furosemide
- dialysis
S+S hypomagnesemia
- hyperactive reflexes
- tremors, seizures
- hypocalcemia and hypokalemia
