Fluids Electrolytes (DSCC)
Terms
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- Intracellular
- fluid found inside cells
- Extracellular
- fluid found outside cells
- Intravascular
- fluid in blood plasma
- Interstitial
- fluid between cells & outside blood vessels
- Electrolytes
- solutes that separate into electrically charged particles called ions when dissolved in a solvent
- Anion
- negatively charged ion
- Cation
- positively charged ion
- Diffusion
- process in which particles in a fluid move from higher to lower concentration
- Osmosis
- movement of a pure solvent thru a differentially permeable membrane from a solution with lower to higher solute concentration
- active transport
- movement across membrane from a less to more concentrated solution which expends metabolic energy
- Filtration
- process by which water & diffusable substances move together in response to fluid pressure from a higher to lower pressure
- Fluid Regulation
- body fluids are regulated by intake, hormonal control, & fluid output
- Intake Regulation
- intake regulated primarily by the thirst mechanism
- Skin Fluid Loss
- regulated by sympathetic nervous system
- Lung Fluid Loss
- regulated by rate & depth of respirations
- GI Fluid Loss
- loss thru feces & disease
- Kidneys
- major regulatory organs of acid-base balance
- Acid-Base Balnace
- metabolic processes maintain a steady balance between acids & bases for optimal cell functioning
- Buffer
- a substance or group of substances that can prevent excessive pH changes by removing or releasing hydrogen ions
- Respiratory Control
- adapt rapidly to imbalance by changing rate & depth of respirations to release or retain CO2
- Renal Control
- kidneys regulate balance by excreting or conserving bicarbonate or hydrogen ions
- Sodium
- body uses to maintain proper extracellular fluid concentration
- Sodium Values
- 135 - 145 mEq/L
- Sodium Sources
- bacon, ham, & processed foods
- Sodium Control
- thirst mechanism, ADH, & kidneys
- Hyponatremia
- deficiency (< 120 mEq/L) of Na in relation to body water
- Hyponatremia Causes
- Na loss (burns, diuretic, perspiration), fluid increase, & pituitary disfunction
- Hyponatremia S/S
- LOC changes, lethargic, skin & mucous dry, tachycardia, hypotension, & N/V
- Hyponatremia Treatment
- Identify cause & correct, regulate Na intake, & administer IV (0.3% NS)
- Hyponatremia Interventions
- monitor LOC, labs, & I&O
- Hypernatremia
- excessive (> 155 mEq/L) Na levels
- Hypernatremia Causes
- Na gain, water loss, & inadequate water intake
- Hypernatremia S/S
- LOC changes, confusion, increased muscle tone, skin dry & flushed, thirsty, N/V, & edematous
- Hypernatremia Treatment
- Dietary control & diuretics
- Hypernatremia Interventions
- monitor LOC, labs, I&O, & frequent oral care
- Potassium Functions
- cardiac, nerve, & muscle function
- Potassium Values
- 3.5 - 5.0 mEq/L
- Potassium Sources
- bananas & orange juice
- Hypokalemia
- deficiency (<2.5 mEq/L)
- Hypokalemia Causes
- insufficient intake, or loss
- Hypokalemia S/S
- muscle cramps, irregular HR, & hyporeflexia
- Hypokalemia Treatment
- identify cause & correct, dilute oral K
- Hypokalemia Interventions
- monitor VS, labs, & dietary intake
- Hyperkalemia
- > 7 mEq/L
- Hyperkalemia Causes
- increased intake, decresed urinary excetion, & renal failure
- Hyperkalemia S/S
- muscle weakness & tingling, bradycardia,
- Hyperkalemia Treatment
- identify & correct, limit intake, & Kayexalate
- Hyperkalemia Interventions
- monitor VS, I&O, restrict intake
- Calcium Functions
- formation & structure of bones & teeth, cell membrane permeability, & blood clotting
- Calcium Control
- negative feedback, dietary intake, & body storage
- Calcium Values
- 8.4 - 10.2 mg/dL
- Calcium Sources
- milk, dairy products, dark leafy veggies
- Hypocalcemia
- < 6 mg/dL
- Hypocalcemia Causes
- insufficient intake, improper absorption, excessive losses
- Hypocalcemia S/S
- muscle spasms, tetani, Chevostek's sign, Trousseau's sign, increased risk of bleeding & bruising
- Hypocalcemia Treatment
- Ca & Vit D supplements
- Hypocalcemia Interventions
- monitor cardiac functions
- Hypercalcemia
- > 13 mg/dL
- Hypercalcemia Causes
- excessive intake, thyroid & parathyroid conditions, & cancer
- Hypercalcemia S/S
- decreased DRTs, heart block, disarrythmias, N/V, & flank pain,
- Hypercalcemia Treatment
- loop diuretic,
- Hypercalcemia Interventions
- monitor Ca levels, VS, & cardiac finctions
- Magnesium Functions
- neuromuscular conduction, cardiac function, & blood clotting
- Magnesium Values
- 1.2 - 2.6 mg/dL
- Magnesium Sources
- green leafy veggies, oatmeal, chicken, tuna, & raisins
- Hypomagnesemia
- < 1 mg/dL
- Hypomagnesemia Causes
- Mg loss, inadequate intake, steroid use
- Hypomagnesemia S/S
- disorientation, confusion, Chvostek's & Trousseau's signs, tachycardia, & sudden cardiac death
- Hypomagnesemia Treatment
- Mg w/ antacids containing Mg, IV Mg w/ a dilute
- Hypomagnesemia Interventions
- monitor cardiogram, muscle spasms, reflexes, & Ca tests
- Hypermagnesemia
- > 5.0 mg/dL
- Hypermagnesemia Causes
- increased intake
- Hypermagnesemia S/S
- decreases DRTs, lethargic & c/o parathesia, irregular HB (bradycardia), & disarrythmias
- Hypermagnesemia Treatment
- Mg, IV Ca gluconate is Mg antagonist. Stop all meds w/ Mg
- Hypermagnesemia Interventions
- monitor LOC, cardiograph, & neuro functions
- Phosphorous Functions
- interdependent w/ Ca, required for muscle function, primary buffer to maintain urinary pH
- Phosphorous Control
- parathyroid hormone
- Phosphorous Values
- 2.5 - 4.5 mg/dL
- Phosphorous Sources
- milk, cheese, egg yolks, meat, & fish
- Hypophosphatemia
- < 1.0 mg/dL
- Hypophosphatemia Causes
- decreased P, Al antacid overuse, & hyperthyroidism
- Hypophosphatemia S/S
- LOC, seizure activity, decreased reflexes & parathesia, generalized fatigue & muscle weakness, & high risk of bleeding
- Hypophosphatemia Treatment
- increased dietary intake & IV w/ K & P
- Hypophosphatemia Interventions
- monitor LOC, bleeding, & respirations
- Hyperphosphatemia
- > 4.5 mg/dL
- Hyperphosphatemia Causes
- renal failure & high use of P laxatives/enemas
- Hyperphosphatemia S/S
- muscle spasms, tetani, & tachycardia
- Hyperphosphatemia Treatment
- limit intake
- Hyperphosphatemia Interventions
- monitor respiratory, cardiac, labs, muscles, & stool colors
- Chloride Values
- 98-106 mEq/L
- Chloride Sources
- diet high in salt
- Hypochloremia Causes
- r/t GI loss, diuretics, & aggressive diaphoresis
- Hypochloremia S/S
- neuromuscular twitching
- Hypochloremia Interventions
- monitor respirations
- Hyperchloremia Causes
- r/t dehydration
- Hyperchloremia S/S
- LOC & lethargy
- Assessment Lifestyle
- dietary habits, stress, job, activity level, & work indoor or outdoor
- Assessment Weight
- sudden changes & intentional or unintentional
- Assessment I&O
- any changes in fluid intake more/less
- Assessment Preexisting diseases
- kidney problems
- I&O
- NOT A MEASUREMENT OF BODY FLUID VOLUME!!! WEIGHT IS BEST WAY TO CHECK