Fluid Basics
This fluid is found inside the cells.
What is intracellular fluid (ICF)?
Weight loss, dry mucous membranes, decreased urine output, tachycardia, and hypotension are classic findings of this condition.
What is FVD (fluid volume deficit)
What is the normal serum sodium range?
135-145 mEq/L
In what fluid is Potassium generally found?
ICF Intracellular fluid
Magnesium is typically found in the ICF (intracellular fluid). Name where else in the body you will find Magnessium.
Stored in bones
This process causes water to move toward the area with higher solute concentration.
What is osmosis?
Edema, crackles, weight gain, JVD, and hypertension are finding associated with this condition.
What is FVE (fluid volume excess aka fluid volume overload)
A pt's serum sodium is 128 mEq/L. What electrolyte imbalance does this indicate?
Hyponatremia
Hypokalemia and Hyperkalemia can both give your pt dysrhythmias, but which puts them at risk of cardiac arrest?
Hyperkalemia
This magnesium imbalance is associated with malnutrition, vomiting, diarrhea, and increased GI stress.
Hypomagnesemia
This is the major force that pushes water out of the vascular system at the capillary level.
What is hydrostatic pressure?
Name two risk factors for FVD.
Vomiting, Diarrhea, Bleeding, Excessive diaphoresis, Diuretics, Fever, Inadequate fluid intake, Burns, Third spacing
During this sodium imbalance, water shifts into the cells, potentially causing headache, confusion, weakness, nausea, and seizures.
Hyponatremia
Name 2 foods rich in Potassium.
Bananas*, oranges*, potatoes* (with the skin), spinach*, swiss chard, spinach, edamame, raisins, salmon,
Name one role of Magnesium.
Name one role of Calcium.
Mag- Cofactor for more than 300 enzyme reactions, supports normal neuromuscular function, helps regulate muscle contraction and relaxation, helps maintain cardiac rhythm, works with Calcium & vitamin D to support bone health
Calcium- builds and maintains bones/teeth, supports muscle contraction, needed for nerve transmission, essential for blood clotting and cardiac function
1. A solution that has a lower osmolality than plasma. 2. A solution that has a greater osmolality than plasma. What type of solutions is each of these?
1.What is hypotonic? 2.What is hypertonic?
List at least two nursing actions (management) of FVE.
Monitor VS, I&Os, daily weights, lung sounds, restrict sodium and fluids, give diuretics as ordered, elevate HOB and give O2, assess edema, assess for resp distress
Name two roles of Sodium in the body.
Regulates fluid balance and osmolality. Helps maintain BP and blood volume. Essential for nerve impulse transmission (think Sodium/Potassium Pump). Supports normal muscle function.
List two risk factors for Hypokalemia.
List two risk factors for Hyperkalemia.
Hypo-excessive laxative use, malnutrition, V/D, Insulin therapy, Loop diuretics, Prolonged NG suctioning
Hyper- Kidney failure/decreased functioning, K+ sparing diuretics, ACE inhibitors, ARBs, Excess potassium supplements
This electrolyte imbalance is most commonly associated with AKI or CKD.
Hyperphosphatemia
This type of fluid spacing occurs when fluid accumulates in an area and cannot easily exchange with the rest of the ECF.
What is third spacing? (Burns are an example of 3rd spacing)
A pt has vomiting, diarrhea, tachycardia, and orthostatic hypotension. Identify the fluid imbalance and name one appropriate treatment.
Fluid volume deficit, treated with fluid replacement such as oral fluids or isotonic IV fluids
A pt with hyponatremia develops a decreased level of consciousness. What is the priority nursing intervention that should be initiated?
Seizure precautions
You assessments will look alike for hyper or hypo, list at least 4 assessments used to help identify Potassium inbalance.
Nuero status, Vital signs, I&Os, Daily weights, ECG/Telemetry monitoring, Serum Potassium
A pt develops tetany, paresthesia and numbness around the mouth. This electrolyte imbalance causes increased muscle excitability. What is it? And list two other possible signs.
Hypocalcemia. Chovestek/Trousseau sign, Hyperreflexia, Laryngeal/Bronchial spasm, Seizures