BMS Final: Electrolytes

Hemoglobin Normal range:

• Male: 14-18 g/dL

• Female: 12-16 g/dL

Hematocrit Normal range:

• Male: 42-52%

• Female: 37-47%

Blood Urine Nitrogen (BUN) Normal range:

10-20 mg/dL

Creatinine Normal range:

• Male: 0.6-1.2 mg/dL

• Female: 0.5-1.1 mg/dL

What is Perfusion?

Delivery of blood to the capillary bed of an organ or tissue

What is Ischemia?

Reduction in blood supply to any tissue or organ, causing a shortage of oxygen

What is fluid balance?

Fluid Intake - Fluid Output = Fluid balance

What hormones help regulate fluid & electrolyte balance?

• Aldosterone

• Anti-Diuretic Hormone

• Natriuretic Peptides (ANP & BNP)

The RAAS System

• Triggered by decreased tissue perfusion to the kidneys

• Aldosterone leads to the retention of water & sodium and increases blood volume & blood pressure

• Kidneys sense a drop in BP & release renin=renin turns into A1-ACE from the lungs turn A1 into A2-A2 causes vasoconstriction that increases BP-stimulates the adrenal glands to release aldosterone-promotes reabsoprtion of sodium & water & releases potassium

Anti-diuretic hormone

Released when blood volume is decreased to help increase water absorption in the kidney

Natriuretic Peptides (BNP, ANP)

Hormones released from the heart in states of fluid overload

Fluid Volume Overload (Hypervolemia) S/S

• Edema

• Angioedema

• JVD

• HTN

• SOB

• HF

• Tachycardia

• Weight gain

• Anxiety

• Crackles (Lungs)

Fluid Volume Deficit (Hypovolemia) S/S

• Oliguria

• Diaphoresis

• Hypotension

• Cyanosis

• Tachypnea

• Fatigue

• Thirst

• Dry Mouth

• Skin Tenting

• Tachycardia

• Dizzy

Electrolyte Imbalance

• Intake: food

• Output: Kidney excretion or reabsorption

Electrolyte Imbalance Cause

• Change in fluid intake/output

• Actual loss of electrolytes or retention

Electrolyte Imbalance Risk Factors

• Elderly

• Chronic Kidney Disease

• Endocrine disorders

• Drugs that alter fluid/electrolyte balance

Summary of Nursing Care

• Monitor

  • Labs

  • VS

  • Cardiac rhythm

  • I&O

  • Weight

• Admin. Meds properly

• Educate

  • Meds

  • Diet

  • Follow up with HCP

  • S/S to report