ELECTROLYTES

What are the primary body fluids required for homeostasis?

Blood, serum, albumin, urine, bile, hormones, cerebrospinal fluid.

What are the three main mechanisms of fluid movement in the body?

Osmosis, diffusion, filtration, and active transport.

What are the types of intravenous fluids (crystalloids)?

Isotonic: 0.9% Normal Saline, Lactated Ringer’s; Hypotonic: 0.45% Saline, D5 0.45% Saline; Hypertonic: 3% Sodium Chloride, D5NS, D5LRS.

What is the primary function of sodium (Na+) in the body?

Regulates water balance, maintains osmotic pressure, and helps with nerve impulses.

What are the normal serum sodium levels?

135-145 mEq/L.

What causes hypernatremia and its symptoms?

Causes: Impaired thirst, dehydration, profuse sweating. Symptoms: Increased BP, confusion, seizure, coma.

What are the normal potassium (K+) levels, and why is it important?

3.5-5.0 mEq/L; Vital for cardiac, skeletal, and smooth muscle function.

What are the clinical signs of hypokalemia?

Cardiac dysrhythmias, muscle cramps, nausea, vomiting.

What interventions are used to manage hyperkalemia?

Calcium gluconate, Insulin with D50, Sodium bicarbonate, Loop diuretics, Dialysis.

What are the common causes of fluid volume deficit (FVD)?

Vomiting, diarrhea, GI suctioning, diuretic therapy, burns, hemorrhage.

What are the primary signs and symptoms of FVD?

Dry mucous membranes, hypotension, tachycardia, diminished skin turgor.

What diagnostic tests help identify fluid volume deficit?

Serum electrolytes (CMP), High creatinine and BUN, Urine specific gravity.

What are the treatment options for fluid volume deficit?

Oral rehydration (sports drinks), IV fluids (Normal Saline, Lactated Ringer’s).

What causes fluid volume excess (FVE)?

Heart failure, cirrhosis, renal failure, excessive sodium intake, IV fluid overload.

What are the symptoms of fluid volume excess?

Weight gain, edema, JVD, crackles in lungs, hypertension.

What interventions are used to manage fluid volume excess?

Fluid restriction, diuretics, sodium-restricted diet, daily weights.

What diuretics are used to treat fluid overload?

Loop diuretics: Furosemide; Thiazide diuretics: Hydrochlorothiazide; Potassium-sparing diuretics: Spironolactone.

What is the role of magnesium in the body?

Supports neuromuscular function, regulates blood pressure, helps in energy production.

What are the causes of hypomagnesemia?

Malabsorption, alcohol abuse, diuretic use, poor dietary intake.

How is hypocalcemia managed?

Oral calcium carbonate, vitamin D supplementation, IV calcium gluconate for severe cases.

What are common signs of electrolyte imbalances?

Muscle cramps, confusion, fatigue, irregular heart rhythms.

How can electrolyte imbalances be prevented?

Balanced diet, proper hydration, monitoring medications, and electrolyte levels.

What are the normal calcium levels in the blood?

9-11 mg/dL.

What are the signs of hypercalcemia?

Fatigue, kidney stones, constipation, decreased deep tendon reflexes.

What is third spacing in fluid balance?

Fluid shifts to nonfunctional spaces (e.g., edema), leading to hypovolemia.

What are the primary functions of body fluids?

Transport nutrients, regulate body temperature, lubricate joints, and act as a shock absorber.

What are the main electrolytes in the body?

Sodium (Na+), Potassium (K+), Calcium (Ca2+), Magnesium (Mg2+), Chloride (Cl-), Phosphate (PO4 3-), Bicarbonate (HCO3-).

What is osmolality, and why is it important?

Osmolality measures the concentration of solutes in body fluids, influencing fluid movement and hydration status.

What hormones regulate fluid balance?

Antidiuretic hormone (ADH), aldosterone, atrial natriuretic peptide (ANP).

What are common causes of dehydration in older adults?

Decreased thirst perception, medication side effects, impaired mobility, chronic illnesses.

What is isotonic dehydration?

Equal loss of water and sodium, commonly seen in vomiting and diarrhea.

What causes hypotonic dehydration, and what happens to cells?

More sodium loss than water, causing cells to swell; seen in diuretic overuse and kidney disease.

What causes hypertonic dehydration, and what happens to cells?

More water loss than sodium, causing cells to shrink; seen in fever and excessive sweating.

What are the major risk factors for fluid imbalances?

Surgery, chronic diseases, burns, medications (diuretics), aging, and poor dietary intake.

How does the body compensate for fluid volume deficit (FVD)?

Increased heart rate, vasoconstriction, activation of the renin-angiotensin-aldosterone system (RAAS).

How is fluid volume deficit diagnosed?

Through lab tests like hematocrit (high), serum osmolality (high), and urine specific gravity (high).

What are the signs of fluid volume excess in the lungs?

Crackles, dyspnea, orthopnea, and pulmonary edema.

How does heart failure contribute to fluid volume excess (FVE)?

The heart cannot pump effectively, leading to fluid retention and venous congestion.

What is the treatment for severe hyponatremia?

Administration of hypertonic saline (3%) with careful monitoring to prevent rapid correction.

What are the signs of severe hyperkalemia?

Peaked T waves, widened QRS, muscle weakness, and cardiac arrest.

What foods are high in potassium?

Bananas, oranges, potatoes, spinach, and tomatoes.

What is the relationship between calcium and phosphorus?

They have an inverse relationship; when calcium levels increase, phosphorus levels decrease.

What causes hypocalcemia?

Hypoparathyroidism, vitamin D deficiency, renal disease, and low magnesium levels.

What are the classic signs of hypocalcemia?

Trousseau's sign (hand spasm with BP cuff), Chvostek's sign (facial twitching), muscle cramps, tetany.

What are the functions of magnesium in the body?

ATP production, neuromuscular function, blood pressure regulation, and immune support.

What medications can cause hypomagnesemia?

Diuretics, proton pump inhibitors, and laxatives.

What are the causes of hyperphosphatemia?

Chronic kidney disease (CKD), excessive intake of phosphate-rich foods, and tumor lysis syndrome.

What interventions are used for hyperphosphatemia?

Phosphate binders, dietary restriction, and dialysis in severe cases.

What is the normal range for serum osmolality?

275-295 mOsm/kg.

What dietary changes can help manage fluid volume excess?

Low-sodium diet, fluid restriction, avoiding processed foods.

What are early signs of dehydration in infants?

Sunken fontanels, no tears when crying, dry mouth, and decreased urine output.

How does the renin-angiotensin-aldosterone system (RAAS) regulate fluid balance?

It increases sodium and water retention to raise blood volume and pressure.

What are the risks of rapid correction of sodium imbalances?

Osmotic demyelination syndrome (for hyponatremia) and cerebral edema (for hypernatremia).

What is third-spacing, and how is it treated?

Fluid accumulation in nonfunctional spaces (e.g., ascites); treated with diuretics and albumin.

What interventions should be prioritized for a patient with severe dehydration?

IV fluid resuscitation, electrolyte monitoring, and addressing the underlying cause.

What role does bicarbonate play in acid-base balance?

It acts as a buffer to maintain pH homeostasis in the blood.

How does stress affect fluid and electrolyte balance?

Increases ADH secretion, leading to fluid retention and electrolyte disturbances.

What are key nursing assessments for fluid and electrolyte imbalances?

Daily weights, I&O monitoring, skin turgor, capillary refill, mental status, and lab values.

What are insensible fluid losses, and how do they occur?

Losses through the skin and lungs via sweating and respiration, not easily measurable.

Why are older adults at higher risk for dehydration?

Decreased thirst perception, renal function decline, and use of medications like diuretics.