Fluid/Electrolyte

What are the normal sodium levels?

135-145 mEq/L

What are the normal calcium levels?

9-11

What are cations?

positively charged ions

What are anions?

negatively charged ions

How much of your body is water?

60%

What are things water helps with?

lubricant, transports, regulates temperature, shock absorber, rehydrates

What are examples of cations?

Sodium (Na+)

Potassium (K+)

Calcium (Ca++)

Magnesium (Mg++)

What are examples of anions?

chloride, bicarbonate, phosphate, sulfate

Should we push potassium?

NOOOOOOOO

What is a solute?

the substance that is dissolved

What is osmosis?

movement of water from less concentrated to more concentrated

What is a solvent?

the substance that dissolves the solute

What is tonicity?

osmolality of a solution

What is a isotonic solution?

Same osmolality as fluid

What is a hypertonic solution?

Solute concentration is greater than that inside the cell; cell loses water ( CELL SHRINKS )

What is a hypotonic solution?

Solute concentration is less than inside of the cell, cell expands

What is osmotic pressure?

power of solution to draw water across membrant

What is diffusion?

The movement of particles from an area of high concentration to an area of low concentration.

What is ATP?

Adenosine Triphosphate - ENERGY - is required for active transport.

What is ADH?

Anti-diuretic hormone

Alcohol makes you ____ ADH ( lack, have excess)

Lack

If you are dehydrated the hypothalamus ________ ADH excretion. ( increases, decreases)

Increases

Where is potassium stored in the body?

cells

Where is calcium stored in the body?

bones and teeth

What kinds of foods are high in sodium?

Canned foods, bacon, processed food, table salt

Why should people on potassium sparing diuretics not have salt substitutes?

Salt substitutes have potassium in them and could lead to hyperkalemia ( excess potassium)

Where can you get calcium from? ( foods )

Milk, cheese, dark leafy greens, seafood

What vitamin helps you absorb calcium?

Vitamin D

What does sodium do?

controls and regulates volume of body fluids

When sodium is too high or too low what should we think of?

Neurological changes

What should we think of when we hear potassium?

think cardiac, skeletal, neuromuscular activity

What does calcium help us do?

helps blood clot, muscle contraction, and relaxation, cardiac function

What is the normal lab value for magnesium?

1.5-3.0

What are normal lab values for chloride?

95-105 mEq/L

What are the normal lab values for phosphate?

2.4-4.5

What is hypovolemia?

low blood volume

What is hypervolemia?

increased blood volume

What is hyponatremia?

low sodium

What is hypernatremia?

A serum sodium level that exceeds 145 mEq/dL.

What is osmotic demyelination?

in cases of chronic hyponatremia, you do not wanna raise the sodium too quickly which can lead to cerebral edema and death

What are foods high in potassium?

tomato, spinach, potato, broccoli, squash, kiwi, mango, orange, dried fruits, nuts, meat

What is polystyrene sulfonate?

Makes potassium be excreted in feces

How do we check if someone is retaining fluid?

Daily weights, I & O

What does phosphate help do?

essential for functioning muscles, nerves, red blood cells

Stress can _____ ADH. ( increase/decrease)

Increase

What are some causes of fluid loss?

GI suctioning, vomitting, diarrhea, hemorrhage, heavy sweating

What are some symptoms of dehydration?

Low bp, tachycardia, dry mucous membranes, pale/cool skin, lethargy, skin tenting

What are things we can use to treat patients with dehydration.

if less severe -water/sports drink/ pedialyte

if more severe- normal saline/ lactated ringerr

What are symptoms of dehydration with infants?

irritability, depressed fontanels, no tears, dry mucous membranes

What are some lifespan considerations with pregnant women considering dehydration

Losing fluids from morning sickness, blood loss from spontaneous miscarriage

What are some lifespan considerations with older adults considering dehydration

changes in mental status, lack of access to fluids ( if they are bed bound), they have decreased thirst sensation

If someone is dehydrated what would their capillary refill be like?

More than three seconds

What is fluid volume excess caused by?

excess water and sodium intake

What are some conditions that cause you to retain both sodium and water?

heart failure, cirrhosis, renal failure, adrenal gland disorder, stress

What are symptoms of excess fluid volume?

weight gain, bounding pulse, cough, moist crackles, edema, decreased hematocrit, and BUN, tachycardia, high blood pressure, JVD

What hormone assists in regulating serum sodium balance?

Aldosterone

How can hypernatremia happen?

dehydration, impaired thirst mechanism, profuse sweating, diabetes

What are symptoms of hypernatremia?

observe for headache, nausea, vomiting, increased blood pressure,confusion, decreased LOC, seizure, coma

How can hyponatremia happen?

Diuretic use, renal disease, vomitting/ diarrhea, excessive GI suctioning, burns, heart failure,

What are symptoms of hyponatremia?

edema, muscle cramps, abdominal cramps, weakness, anorexia, muscle twitching, neurological symptoms,

How can hyperkalemia happen?

renal failure, potassium sparing diuretic use, excessive potassium intake, acidosis, burns

What can hyperkalemia cause?

cardiac arrest, dysrthmias, muscle cramping, decreased bowel sounds

What could we give someone to treat hyperkalemia?

polystyrene sulfonate,calcium gluconate, insulin and glucose, and in some cases albuterol, and diuretics if renal excretion is normal

How can hypokalemia happen?

severe vomitting, alkalosis, gastric suctioning

How can hypercholemia happen?

Diarrhea, renal failure, metabolic acidosis, respiratory alkalosis

What are symptoms of hypercholemia?

Kassmaul respirations, weakness, increased thirst

What are treatments of hypercholemia?

Dialysis, diuretics, iv fluids

How does hypocholemia happen?

loss of body fluid, vomitting/ diarrhea

What are symptoms of hypocholemia?

parathesia of the face, extremities, muscle spasms, tingling

How does hypercalcemia happen?

Hyperparathyroidism, bone malignancy, drug toxicity

What are symptoms of hypercalcemia?

fatigue, weakness, decreased deep tendons reflexes, polyuria, kidney stones, cardiac dsyrthmias

How can hypocalcemia happen?

decreased parathyroid hormone, elevated phosphorus, decreased magnesium levels, Hypoalbuminemia

What are symptoms of hypocalcemia?

Bradycardia, hypotension, hyperactive reflexes, confusion

What is Trousseau sign?

Carpal spasm when blood pressure cuff is left inflated above systolic BP

Indicates hypocalcemia

What is Chvostek sign?

facial twitch after tapping nerve on side of head

What can we do to treat hypocalcemia?

Increase dietary intake, vitamin D supplements

What are the normal lab values for magnesium?

1.5-3.0

What does magnesium help with?

role in energy production, protein synthesis, neuromuscular function

How can hyper magnesia happen?

Bowel disorders such as IBS, over use of laxatives that CONTAIN magnesium, renal insufficiency

What are symptoms of hyper magnesia?

decreased deep tendon reflexes, flaccid muscle tone

How can hypomagneisa happen?

malabsorption, poor dietary intake, laxative abuse

What are symptoms of hypo magnesia?

muscle cramps, increased anxiety, fatigue, high bp, decreased sleep and appetite

How can hyperphosphatemia happen?

Excessive intake

How can hypophosphatemia happen?

Alcoholism, excessive antiacid intake, low vitamin D intake, high calcium intake

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