Adult 1 fluid and electrolytes

function of sodium

control/regulate ECF, muscle contraction, transmission of nerve impulses, acid/base balance, serum osmolality

how is sodium regulated

sodium-potassium pump, Renin-Angiotensin-Aldosterone system, elimination and reabsorption by kidneys

cause of hyponatremia

loss of sodium (Gi tract, diuretics, adrenal insufficiency), gain of water (water intoxication, excessive administration of D5W), diseases like SIADH

symptoms of hyponatremia

nausea/vomiting, lethargy, confusion, muscle cramps, muscle twitching, seizures, coma

interventions of hyponatremia

monitor I/O, assess HI/neuro symptoms, give isotonic sodium-containing solutions, seizure precautions, avoid free water

pneumonic for hyponatremia

Salt Loss, stupor, anorexia, lethargy, tendon reflexes (<), limp muscles, orthostatic hypotension, seizures, stomach cramps

causes of hypernatremia

inadequate water intake, excess water loss, ingestion of large amounts of salt, excessive parenteral fluids containing sodium

Symptoms of hypernatremia

thirst, dry mucous membranes, disorientation, hallucinations, lethargy, irritability, seizures, coma

Interventions for hypernatremia

monitor fluid loss/gain, restrict dietary sodium, asses neurologic status, administer water, IV fluids without sodium

Hypernatremia pneumonic

fried salt, flushed skin, restless, increased BP, edema, Decrease urine output, skin dry, agitation, low grade fever, thirst

function of potassium

control intracellular osmolarity, cellular enzyme activity, transmit electrical impulses, acid-base balance

how is potassium regulated

aldosterone, shifts between ICF and ECF

causes of hypokalemia

vomiting, diarrhea, gastric suction, potassium wasting diuretics, poor intake, polyuria

symptoms of hypokalemia

fatigue, nausea and vomiting, muscle weakness, arrhythmias, nocturia, postural hypotension, muscle tenderness

pneumonic for hypokalemia

a sic walt= alkalosis, shallow respirations, irritability, confusion, weakness, arrhythmia, lethargy, thready pulse

causes of hyperkalemia

decreased potassium secretion (renal failure), potassium-sparing diuretics, hypoaldosteronism, high intake, shift out of cells (acidosis, tissue trauma, malignant cell lysis)

symptoms of hyperkalemia

muscle weakness, arrhythmias, paresthesia's of face, tongue, feet, hands, nausea, colic, diarrhea

what is the cocktail to intervene for hyperkalemia

insulin, dextrose 5%, calcium chloride, kayexelate

pneumonic for hyperkalemia

murder= muscle weakness, urine (oliguria/anuria), respiratory distress, decrease heart contractility, ECG changes (tall T waves), reflexes (< or absent)

function of calcium

transmit nerve impulses, regulate muscle contraction and relaxation, blood coagulation

what helps calcium get absorbed

Vitamin D

how is calcium regulated

parathyroid hormone and calcitonin

causes of hypocalcemia

hypoparathyroidism, malabsorption, vit D deficiency, acute pancreatitis, excessive blood products, alkalotic state

symptoms of hypocalemia

Trousseau's, Chvostek's, numbness and tingling, seizures, laryngeal muscle spasms, extreme muscle cramps

Pneumonic for hypocalcemia

Cats= convulsions, arrhythmias, tetany, spasms/stridor

causes of hypercalcemia

hyperparathyroidism, cancer, prolonged immobilization, large doses of vit D, overuse of calcium supplements, thiazide diuretics

Symptoms of hypercalcemia

muscle weakness, tiredness constipation, nausea and vomiting, renal stones, cardiac arrest

pneumonic for hypercalcemia

back me= bone pain, arrhythmias, cardiac arrest, kidney stones, muscle weakness, excessive urination

treating hypercalcemia

fluids, loop diuretics, calcitonin

function of magnesium

metabolizes carbs and proteins, neuromuscular function, vasodilation

how is magnesium regulated

parathyroid hormone

causes of hypomagnesemia

insufficient intake, intestinal malabsorption, diarrhea, gi suction, acute pancreatitis, PPI therapy

symptoms of hypomagnesemia

neuromuscular irritability/excitability, increased reflexes, seizures, tachyarrhythmia, mental changes

causes of hypermagnesemia

renal failure, adrenal insufficiency, excessive administration

symptoms of hypermagnesemia

everything is depressed, flushing of skin, hypotension, depressed rr, drowsiness, hypoactive reflexes, and muscle weakness

causes of fluid volume deficit

fluid loss via diarrhea, vomiting, hemorrhage, polyuria, shift from plasma to interstitial fluid, inadequate intake

causes of fluid volume excess

excess fluid intake, abnormal fluid retention, shift of fluid from interstitial fluid into plasma fluid

what do you want to measure with fluid volume imbalances

daily weight and I/Os

What body systems do we want to asses with fluid volume imbalances

cardiovascular, respiratory, skin

ABG normal ranges

pH=7.35-7.45, PaCO2= 35-45, HCO3= 22-26, PO2=80-100, SaO2=95-100

pH is normal, but both CO2 and bicarb are abnormal

fully compensated

pH, CO2 and bicarb are abnormal

partially compensated

CO2 or Bicarb are abnormal...not both, pH is abnormal

uncompensated

substance containing hydrogen ions that can be liberated or released

acid

substance that can trap hydrogen ions

base