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KF - F&E

Fluid and Electrolytes

1kg (2.2lbs) 1 liter of fluid
Isotonic IV solutions treatment of vascular system fluid deficit - prevent fluid shift btw compartments - ex. NS, LR, D5W
Hypotonic IV solutions treatment of intracellular dehydration - shift fluid from ECF to ICF - ex. 1/2NS
Hypertonic IV soultions used only when serum osmolality is critically low - shift fluid from ICF to ECF - ex. 10% dextrose, D5W1/2NS, (anything with dextrose)
Fluid Volume Deficit hypovolemia-isotonic and dehydration, elevated Hct, spec. gravity and osmolarity, draw BUN, creatinine. administer fluids
Fluid Volume Overload hypervolemia-isotonice, and overhydration-osmolar, sx: crackles, dyspnea, JVD, hemodilution, pitting edema. administer diuretics
Hypokalemia Sx: muscle weakness, fatigue, N/V, dysrhythmias, flat T waves RF: GI loss, diuretics, aminoglycosides, decreased intake
Hyperkalemia Sx: muscle crampsl weakness, paralysis, bradycardia, dysrhythmias, tall T waves. RF: tissue injury, k sparing diuretics, renal failure, adreanl insufficiency, increased intake
Hyponatremia Sx: weakness, lethargy, confusion, seizures, coma. RF: GI loss, SIADH, adrenal insufficiency, diuretics, water intoxication, decreased intake. TX: admin IVF (hypertonic), seizure pre.
Hypernatremia Sx: thirst, dry mucous membranes, restless, weak, ortho hypotension, muscle irritability, seizures, coma RF: water deficit, GI loss, DI, increased intake Tx: isotonic IVF, seizure pre
Hypocalcemia Sx: tetany, crampsl paresthesias, dysrhythmias, Trousseau's/Chvostek's sign, seizures RF: hypoparathy, hypomg, RF, Vit D def, loop diuretics TX: calcium has inverse relationship with phosphorus
Hypercalcemia Sx: de. DTRs, muscle weakness, dysrhythmias, confusion, anxiety, lethargy/coma RF: hyperparathy, malignant dx, immobilization, vit D excess, thiazide diuretics, lithium Tx: pt at increased risk of Fx
Hypomagnesemia Sx: in. DTRs, tetany, cramps, dysrhythmias, Trousseau's/Chvostek's sign, agitation, confusion RF: alcoholism, pancreatitis, hypoCa, hypoK, insulin resistance, DKA Tx:seizure pre, swallow eval, IV Mg
Hypermagnesemia Sx: de. DTRs, hypotension, drowsiness, bradycardia, bradypnea, coma, cardiac arrest RF: RF, excessive Mg therapy, adrenal insufficiency, laxative abuse Tx: IV calcium gluconate, temp pacemaker, mech vent
Hypophosphatemia Sx: muscle weakness, de. DTRs, calciuria/renal stones, dysrhythmias, confusion, anxiety, lethargy/coma RF: alcoholism, chromic diarrhea, starvation, vit. D def.
Hyperphosphatemia Sx: tetany, cramps, paresthesias, dysrhythmias, Trousseau's/Chvostek's sign, seizure RF: RF, chemo, in. vit. D/Phos Tx: aluminum hydroxide with meals
Created by: kmf06007