Fluids and Electrolytes

Potassium

all can cause cardiac arrhythmias - K+ = 3.5-5.0 mEq

Magnesium

all can cause cardiac arrhythmias - Mg++ = 1.5-2.5 mEq

Phosphate and calcium

calcium and phosphate strike a delicate balance

Calcium

all can cause cardiac arrhythmias - Ca++ 8.5-10.5 mg/dL

Hypercalcemia

N&V, increased UO, thirst

Hypocalcemia

Chvostek’s sign, Trousseau’s sign

Phosphate

all can cause cardiac arrhythmias - PO4 = 2.5-5 mg/dL

Electrolyte replacement

intravenous vs. oral replacement - always check electrolyte levels before and after administration and document

Electrolyte binders - K+

given PO, NGT, PR - give 2-3 hours before or after any other drugs - monitor and document K+ levels before and after administration

Examples of electrolyte binders (K+)

Kayexalate Na+ (Na+ retention), Veltassa (patiromer)

SE of electrolyte binders (K+)

constipation, diarrhea, N&V, abdominal pain, bloating, gas, low K+, Mg++, Ca++

Electrolyte binders - PO4

given PO - monitor and document Ca++ and PO4 levels before and after administration

Examples of electrolyte binders (PO4)

Oystercal, PhosLo

SE of electrolyte binders (PO4)

abdominal pain, anorexia, N&V, constipation, confusion, dry mouth, increased thirst/urination

Fluid volume deficit

dehydration - fluid administration = oral, subcutaneous, intravenous

Fluid volume deficit replacement

crystalloids replace volume