Electrolytes
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| How does the gastrointestinal system regulate water balance? | Primarily by oral intake.
Reabsorption and secretion accounts for 8,000 mL/day. Diarrhea/vomiting cause losses.
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| How does insensible and sensible water loss regulate water balance? | Insensible = lung/skin vaporization (water only)
Sensible = sweating, fever (water + electrolytes)
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| What are treatments of fluid volume excess? | Treat the cause; give diuretics; limit intake of fluids and sodium
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| What are causes of fluid volume excess? | Too much intake with too little output
Shift from interstitium to plasma
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| What are treatments for fluid volume deficit? | Treat the cause; increase intake; hydrate with IV (lactated ringers, NS, blood)
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| What are clinical manifestations of fluid volume deficits? | Lethargy, dry mucous membranes, decreased skin turgor, tachycardia, hypotension, decreased urine output
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| What are causes of fluid volume deficit? | Too little intake and too much output
Fluid movement from plasma to interstitium (edema)
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| What are clinical manifestations of hyperphosphatemia? | Precipitates in joints, arteries, skin, kidneys and cornea
Neuromuscular irritability, tetany
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| What are treatments of hypomagnesemia? | Mild: Oral supplement
Severe: IV or IM supplement
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| What are sources of calcium? | Primarily bone and secondary diet
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| What are clinical manifestations of fluid volume excess? | Dyspnea, peripheral edema, increased heart rate, JVD, weight gain, lethargy, hypertension, lethargy
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| What are clinical manifestations of hypophosphatemia? | Often asymptomatic if mild
CNS depression, confusion, muscle weakness, pain, dysrhythmias
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| What are causes of hypermagnesemia? | Increased intake with decreased renal function
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| What are clinical manifestations of hypermagnesemia? | Lethargy, drowsiness, N/V (early), loss of DTR, somnolence, cardiac arrest
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| What are treatments of hypermagnesemia? | Prevention is key; calcium chloride and calcium gluconate oppose the effects of magnesium on cardiac muscle
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| What are clinical manifestations of hypomagnesemia? | Confusion, hyperreflexia, tremors, seizure, cardiac dysrhythmias
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| What are causes of hypercalcemia? | Hyperparathyroidism, increased vitamin D, malignancy, prolonged immobility
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| What are causes of hyperphosphatemia? | Renal failure, chemotherapy, excessive milk ingestion, vitamin D excess
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| What are treatments of hypophosphatemia? | Mild: oral supplement, increased intake of dairy products
Severe: sodium phosphate or potassium phosphate IV
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| What are treatments of hyperphosphatemia? | Identify and treat cause; restrict dairy products, correct hypocalcemia and provide hydration
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| What are some clinical manifestations of hypercalcemia? | Depressed reflexes, bone pain, fractures, renal calculi
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| What are some treatments of hypercalcemia? | Furosemide (Lasix), hydration by IV and PO, calcitonin
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| What are functions of magnesium? | Metabolism of carbohydrates and protein.
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| What are sources of magnesium? | Bone is major source.
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| How is magnesium balance obtained? | Maintained by GI absorption and renal excretion; similar to calcium balance (PTH)
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| What are magnesium levels associated with? | Magnesium levels are associated with potassium and calcium levels.
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| What are causes of hypomagnesemia? | Starvation, prolonged fasting, vomiting, diarrhea, NG suction, chronic alcoholism, diabetes mellitus
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| What are causes of hypocalcemia? | Insufficient intake, hypoparathyroidism, elevated phosphorus, vitamin D deficiency, acute pancreatitis, chronic renal failure (not reabsorbing)
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| How is calcium balance maintained? | Parathyroid hormone, vitamin D, calcitonin
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| What are the clinical manifestations of hypocalcemia? | Fatigue, extremity numbness, muscle cramps, hyperreflexia, tetany, Chvostek's sign, Trousseau's sign.
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| What are treatments of hypocalcemia? | Identify and treat underlying cause; calcium supplements
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| What are functions of phosphorus? | Primary ion in ICF; essential to function of muscles, RBCs, and nervous system; tooth and bone structure; cellular glucose uptake and use, metabolism
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| What are sources of phosphorus? | Bone and dietary
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| How is balance of phosphorus maintained? | Requires adequate renal function
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| With what is the phosphorus level associated? | The phosphorus level has a reciprocal relationship with the calcium level.
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| What are causes of hypophosphatemia? | Decreased intake, malabsorption syndrome, alcohol withdrawal, phosphate binding antacids
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| What are functions of calcium? | Involved in transmission of nerve impulses, muscle contractions, blood clotting, and teeth and bone formation
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