fluids and electrolytes concepts

isotonic iv fluid (amount and types)

270-300, 0.9%NS and LR, for fl replacement

0.9% NS fluid

replaces Na and Cl, 1st to give for hypertension

LR fluid

post trauma or surgery

nursing education for isotonic fluids

watch for hypovolemia

hypertonic IV fluid (amount and types)

above 300, 3% NS and dextrose fluids

3% NS fluid

for severe hyponantremia or ICP

dextrose fluids

D5NS, D5LR, D10, D50, adds calories

nurse teaching for hypertonic fluids

risk of cell dehydration

hypotonic IV fluid (amount ad types)

below 270, 0.45% NS and C5W

0.45% NS fluids

establishes renal function

D5W fluids

free water after dextrose metabolizes

nurse teaching for hypotonic fluids

water intoxication and cerebral edema

fluid volume deficit

dehydration

fluid volume deficit assessment

daily weight and I&O

mild fluid volume deficit

2% weight loss, thirst

marked fluid volume deficit

5% weight loss, extreme thirst, orthostatic hypotension

severe fluid volume deficit

8% weight loss, extreme hypotension

labs for fluid volume deficit

increase HCT, HGB, BUN and Na. urine specific gravity>1.030

diagnosis for fluid volume deficit

inadequate fluid volume, ineffective peripheral tissue proliferation

fluid volume excess

over hydration

cause for fluid volume excess

CHF, renal injury, excess fluid, edema

assessment for fluid volume excess

weight gain, pitting edema, JVD

cardiorespiratory for fluid volume excess

pulmonary crackles, S3 heart sounds, bounding pulse

hemodynamic parameter

CVP 12-15 shows excess pressure

labs for fluid volume excess

osmolarity below 270, decreased HCT, HGB, BUN, and albumin

diagnosis for fluid volume excess

excess fluid volume, impaired gas exchange

what does thiazide cause

hyponatremia and hypokalemia

what do loop diuretics cause

hypokalemia, hypomagnessemia, and hypocalcemia

what do potassium sparing drugs cause

hyperkalemia

what do ACE inhibitors and NSAIDs cause

hyperkalemia

what do steroids cause

Na retention and K loss

what does digoxin cause

hypokalemia

sodium

133-145, watch neuro

hyponatremia

below 133, decrease LOC, seizures

hypernatremia

above 145, thirst, dry membranes

critical sodium levels

blow 115, and above 155

intervention for sodium levels

assess neuro, correct slowly

potassium

3.5-5.3, assess cardiac

hypokalemia

below 3.5, weakness, flat T waves

hyperkalemia

above 5.3, dysrhythmias, peak T waves, wide QRS

critical potassium

never IV push KCl

interventions for potassium

ECG and renal function

calcium

8.4-10.4, assess neuromuscular

hypocalcemia

below 8.4, chvoskes and trosseuses signs, tetany

hypercalcemia

above 10.4, short QT interval, consipation

interventions for calcium levels

IV ca gluconate

magnesium

1.8-2.1, assess muscle

hypomagnesemia

below 1.8, tremors, increase DTR, seizures

hypermagnesemia

above 2.1, hypotension, resp depression

intervention for calcium levels

watch DTR and ECG, IV Mg sulfate slowly

phosphorus

2.5-4.5, inverse with Ca

hypophosorus

below 2.5, decrease LOC, seizures, weak respiratory

hyperphosphorus

above 4.5, tetany, twitches, tingling

chloride

along side with Na and water, 95-108