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fluid/electrolyte
| Question | Answer |
|---|---|
| Intracellular fluid | Fluid within the cells 70% of total body water 40% of body weight |
| Extracellular fluids | Fluids outside the cell intravascular: inside vessels vs. interstitial: surrounds cells outside vessels 30% of total body water 20% of body weight |
| Transcellular fluids | Contained within the epithelial lined spaces technically ECF examples: cerebrospinal, pericardial, synovial, intraocular, pleural fluids |
| Intake | regulated by thirst mechanisms in hypothalamus stimulated by intracellular dehydration |
| intake daily | 2600 mL/day 2300 mL ingested 300 mL metabolism (product of protein, fat, and carb metabolism) |
| Output | should be equal to input 2600 mL/day 1600 mL sensible 1000 mL insensible |
| Sensible loss | CAN be measured (urination, defecation, wounds) |
| Insensible loss | CANNOT be measured (sweat, breathing, skin) |
| Third space fluid shift | 1. ECF leaves intravascular space 2. ECF accumulates in trancellular or interstitial compartment 3. fluid gets trapped, causing FVdeficit in intravascular space |
| Fluid volume overload (HYPERVOLEMIA) | too much fluid going in with failure to eliminate |
| FVO causes | excessive water and sodium intake loss of body fluids (compensation) intake>required Medications Fever third-spacing |
| Clinical manifestations FVO | pitting edema bounding pulse tachycardia and tachypnea increased BP crackles in lungs JVD weight gain |
| FVO nursing interventions | Daily weights monitor I & O vital signs labs |
| FVO treatment | Fluid restriction Sodium restriction Meds |
| Fluid volume deficit (HYPOVOLEMIA) | inadequate fluid intake no water, no salt, or both |
| FVD causes | Loss of body fluids Input<output Medications third-spacing |
| Clinical manifestations FVD | Skin turgor decrease dry mucous membranes tachycardia thready pulse orthostasis fatigue/weakness prolonged cap refill weight loss |
| FVD weight loss | 5-10% decrease = mild 15%+ = severe |
| FVD nursing interventions | daily weights monitor I and O vital signs lab values |
| FVD treatment | increase PO intake IV fluid replacement Blood products Antiemtics, antidiuretics Antibiotics |
| Sodium function and range | Regulates extracellular fluid loss 135-145 mEq/L severe hyponatremia: 120 mEq/L |
| Hyponatremia causes | Medications chronic/severe vomiting or diarrhea drinking excess water (dilution) excess alcohol intake heart/kidney/liver problems severe burns |
| Hyponatremia symptoms | Confusion Hypotension tachycardia muscle cramps weakness nausea/malaise dry skin |
| Hyponatremia treatment | decrease water intake sodium replacement medication changes |
| Hypernatremia causes | Medications Loss of body water gastroenteritis vomiting prolonged suction excessive sweating CKD diabetes impaired thirst response |
| Hypernatremia symptoms | Restlessness/agitation weakness disorientation delusions/hallucinations seizures edema brain damage swollen dry tongue flushed appearance |
| Hypernatremia treatment | IVF replacement diet changes |
| Potassium function and normal range | Intracellular electrolyte that aids in transmission of electrical impulses, heart and muscle contractions 3.5-5.0 mEq/L |
| Hypokalemia causes | VPPS Medications (laxatives, antibiotics, diuretics) cardiac conditions GI loss metabolic alkalosis excessive alcohol use CKD diabetic ketoacidosis folic acid deficiency excessive sweating |
| Hypokalemia symptoms | Muscle weakness leg cramps fatigue decreased DTR constipation dysrhythmia |
| Hypokalemia treatment | IV potassium replacement |
| Hyperkalemia causes | Medications (potassium chloride, heparin, ACE inhibitor, NSAIDS, potassium sparing diuretics) Renal failure dehydration diabetes burns packed RBC transfusion acidosis sepsis |
| Hyperkalemia symptoms | Muscle weakness paresthesia paralysis cardiac arrest increased DTR diarrhea |
| Hyperkalemia treatment | Dialysis Insulin Resin medications (GI removal) Diet changes |
| Calcium function and normal ranges | Regulation of muscle contraction and nerve impulses, bones, and clotting 8.9-10.5 mg/dL |
| Hypocalcemia causes | Medications (diuretics, stimulant laxatives) low vit D menopause hypoparathyroidism renal disease multiple blood transfusions hypermagnesemia or hyperphosphatemia sepsis low albumin |
| Hypocalcemia symptoms | Numbness and tingling of fingers, mouth, feet tetany muscle cramps seizures |
| Hypocalcemia treatment | Supplements diet change |
| Hypercalcemia causes | Medications (calcium, diuretics, lithium carbonate) bed rest cancer hyperparathyroidism Vit D toxicity renal failure |
| Hypercalcemia symptoms | Abdominal Groans painful Bones Kindey Stones psychiatric Moans fatigue Overtones |
| Hypercalcemia treatment | Phosphate loop diuretics dialysis |
| Magnesium function and normal ranges | Metabolism of carbohydrates and proteins, neuromuscular function and vasodilation 1.3-2.1 mEq/L |
| Hypomagnesemia causes | Medications Crohn's/celiac/NG tube with suction decreasing intestinal absorption diarrhea pancreatitis kidney dysfunction excessive alcohol use DM type 2 malnutrition sever burns hypokalemia, hypercalcemia |
| Hypomagnesemia symptoms | Muscle weakness nausea diarrhea tremors tetany seizures cardiac arrhythmias hyperactive DTR respiratory paralysis |
| Hypomagnesemia treatment | supplements correction of C or K imbalances |
| Hypermagnesemia causes | Medications (laxatives, antacids, antipsychotics) renal failure decreased GI motility trauma acidosis hypothyroidism |
| Hypermagnesemia symptoms | N/V constipation weakness/lethargy flushing hyPOactive DTR respiratory depression/bradycardia/hypotension coma cardiac arrest |
| Hypermagnesemia treatment | IV calcium diuretics IVF |
| Phosphate function and normal level | Promotes energy storage, muscle, and RBC function 2.5-4.5 mg/dL |
| Hypophosphatemia causes | Malnourishment ETOH DKA hyperventilation absorption problems diuretic use |
| Hypophosphatemia symptoms | Weakness constipation slurred speach dysphagia respiratory depression paresthesia irritability confusion seizures coma |
| Hypophosphatemia treatment | supplements |
| Hyperphosphatemia causes | Kidney failure hypoparathyroidism |
| Hyperphosphatemia symptoms | Hyperreflexia tetany anorexia diarrhea deceased mental status dysrhythmia |
| Hyperphosphatemia treatment | diet changes calcium carbonate |
Created by:
mdedobbe