Fundamentals Fluid Balance and Electrolytes

Minimum daily fluid requirement formula

• 1st 10kg = ________mL/kg

• 2nd 10kg = ________ mL/kg

• remaining weight = ________mL/kg

100, 50, 20

Why must weight be converted before calculation? 

The formula requires kilograms

Fluid inside cells; 67% of body water

intracellular fluid

 Fluid outside cells; 25% of body water

extracellular fluid

Plasma within blood vessels; 8% body water

intravascular fluid

Fluid between cells

interstitial fluid

CSF, pleural, peritoneal, and synovial fluids are all examples of…

transcellular fluids

The Hemoglobin test measures __________-____________ ___________.

oxygen carrying capacity

Normal male hemoglobin is between _____-_____ g/dL

13.2, 17.3

Normal Female Hemoglobin is between _____-_____ g/dL

11.7, 15.5

Hematocrit measures the ___________ of _______ __________.

percentage of RBC volume

Normal male hematocrit is _____-_____%

39, 50

Normal female hematocrit is _____-_____%

35, 47

Excess fluid volume

hypervolemia

What are 4 causes of hypervolemia?

HF, renal failure, excessive fluids, corticosteroids

Hypervolemia pulse is _______ and ___________.

full, bounding

Hypervolemia lung sounds are ___________.

crackles

Neck veins are ___________ in hypervolemia.

distended

Hypervolemia

• ________ and _______

• increased _____

• __________

edema, SOB, BP, headache

Position for hypervolemia

semi fowlers or fowlers

Key nursing actions for Hypovolemia

• restrict _________

• monitor ____ and ____ and ____________

fluids, I, O, electrolytes

Fluid Deficit

Hypovolemia

What are 5 causes of Hypovolemia?

diarrhea, hemorrhage, fever, poor intake, DKA

Pulse in Hypovolemia is _______ and _______

weak, thready

If urine output is <_____mL/day for Hypovolemia it is CONCERNING

500

What are 4 symptoms of Hypovolemia?

dizziness, AMS, restlessness, lethargy

2 Nursing Interventions for Hypovolemia?

reposition frequently and maintain safety

Goal of IV Therapy

• correct fluid/electrolyte imbalance

• provide _________ access

vascular

fluids that have the same concentration as blood

isotonic fluids

0.9% NS, Lactated Ringer’s are 2 examples of…

isotonic fluids

Isotonic fluids are used for…

volume replacement

Fluids that are more dilute than blood

hypotonic fluids

Hypotonic fluids are used to…

rehydrate cells

0.45% NS, D5 0.45% NS are 2 examples of…

hypotonic fluid

Which fluids are more concentrated than blood?

hypertonic

Hypertonic fluids are used to…

increase vascular volume

3% saline is an example of a…

hypertonic fluid

What is the risk of hypertonic fluids?

fluid overload

NEVER IV push ___________

potasium

IV pushing potassium causes _______ ___________.

fatal dysrhythmias

KCL administration must be _________ and infused _________.

diluted, slowly

Common complaint with KCL administration is _________ or _____ _________.

burning, vein irritation

Normal sodium is between ____-____mEq/L

136, 145

Where is sodium primarily located?

extracellular fluid

Sodium main functions include

• maintaining ________ __________ and ____

fluid balance, BP

Sodium > 145 is considered…

Hypernatremia

What are 5 causes of Hypernatremia?

dehydration, diarrhea, fever, sweating, kidney disease

What are 4 symptoms of Hypernatremia?

thirst, confusion, seizures and dry tongue

What are 3 treatments for Hypernatremia?

water replacement, hypotonic fluids, diuretics

Sodium < 135 is considered…

hyponatremia

What are 4 causes of Hyponatremia?

vomiting, diarrhea, burns, excess water

What are 3 symptoms of Hyponatremia?

headaches, seizures, and confusion

What are 2 treatment options for Hyponatremia?

treating cause and restricting fluids

Normal Potassium is between ____-____ mEq/L

3.5, 5

Potassium is primarily located…

intracellularly

Potassium enables _______ _________ and ________ _________

nerve impulses, muscle contraction

Which organ eliminates potassium?

kidneys

What are 3 causes of Hyperkalemia?

renal failure, ACE inhibitors, tissue breakdown

What are 3 symptoms of hyperkalemia?

weakness, irreg. pulse, cardiac arrest

What are 2 EKG changes that correspond to Hyperkalemia?

Fib and Ventricular Standstill

What are 4 treatments for Hyperkalemia?

insulin, dialysis, diuretics, and kayexalate

Low potassium

hypokalemia

What are 4 causes of Hypokalemia?

diuretics, vomitting, diarrhea, alkalosis

What are 3 symptoms of Hypokalemia?

muscle weakness, constipation, dysrhythmias

What are 2 treatments for Hypokalemia?

IV potassium, potassium supplementation

What is the range for normal Calcium levels?

9-10.5 mg/dL

99% of calcium is stored in… (2)

bones and teeth

What 3 things does calcium do in the body?

muscle contractions, clotting, nerve transmission

Too much calcium

hypercalcemia

What are 3 causes of hypercalcemia?

cancer, immobilization, and hyperparathyroidism

What are 3 symptoms of Hypercalcemia?

constipation, weakness, confusion

What are 2 treatments for Hypercalcemia?

IV fluids with loop diuretics and calcitonin

What is one complication of Hypercalcemia?

kidney stones

low calcium

hypocalcemia

What are 3 causes of hypocalcemia?

vit D deficiency, renal failure and transfusions

What are 3 symptoms of Hypocalcemia?

tingling, cramps, seizures

What are 2 classic signs of Hypocalcemia?

Chvostek and trousseau’s signs

What is a treatment for Hypocalcemia?

calcium supplementation

Normal magnesium range is ____-____ mEq/L

1.3, 2.1

Magnesium regulates _______ and _______ function and ____.

nerve, muscle, BP

high megnesium

hypermagnesmia

What are 2 causes of Hypermagnesemia?

renal failure, Mg antacids

What are 3 symptoms of Hypermagnesemia?

bradycardia, hypotension, and lethargy

What is one severe effect of Hypermagnesemia?

cardiac arrest

What are 2 treatments for Hypermagnesemia?

IV diuretics and treating the cause

low magnesium

hypomagnesemia

What are 3 causes of Hypomagnesemia?

alcoholism, diarrhea, malabsorption disorders

What are 3 symptoms of Hypomagnesemia?

tremors, seizures, hyperreflexia

What is one treatment for Hypomagnesemia?

mg supplementation