SIGNS AND SYMPTOMS

Thready increased Pulse reate: diminished peripheral pulse

Decreased BP, orthostatic / postural hypotension

Flat neck and hand veins in Dependent position

Decreased central venous pressure

Dysrhythmias

FVD : Cardiovascular

Increase rate and depth of respirations

Dyspnea

FVD: Respiratory

decreased CNS activity from lethargy to coma

skeletal muscle weakness

Fever, depending on amount of fluid loss

FVD: Neuromuscular

Oliguria

FVD Renal

Dry skin

Poor turgor, tenting

dry mouth

FVD Integumentary

Decreased motility and diminished bowel sounds

constipation

decreased body weight

thirst

FVD Gastrointestinal

bounding, increased pulse

elevated BP
distended Necka dn hand veins

Elevated central venous pressure

dysrhythmias

FVE: Cardiovascular

Increased respiratory rate (Shallow)

Dyspnea

Moist Crackles

FVE: Respiratory

Altered level of consciousness

skeletal muscle weakness

Headache and visual disturbances

paresthesias

FVE Neuromuscular

Increased if can compensate

decreased if kidney damage is the cause

FVE Renal

Pale cool skin

pitting edema in dependent areas

FVE Integumentary

Increased mobilityu

diarrhea

increased body weight

liver enlargement

ascites

FVE Gastrointestinal

vary in changes in vascular volume

• Normovolemic: Rapid PR, normal BP

• Hypovolemic: thready weak, rapid pulse rate, flat hand and neck veins, normal or low CVP

• Hypervolemic: bounding pulse, BP normal or elevated, CVP normal or elevated

Hyponatremia : Cardiovascular

Shallow, ineffective respiratory movement is a Late manifestation related to skeletal muscle weakness

Hyponatremia Respiratory

• Generalized muscle weakness worse on extremities

• diminished DTR

Hyponatremia Neuromuscular

Headache

Personality changes

confusion

seizures

coma

Hyponatreamia Central nervous system

Nausea

increased motility and hyperactive bowel sounds

abdominal cramping and diarrhea

Hyponatremia gastrointestinal

Increased urinary output

Hyponatremia Renal

<135

Decreased Urine specific gravity

Hyponatreamia lab findings

HR and BP depends on vascular tone status

Hypernatremia Cardiovascular

Pulmonary edema if hypervolemia is present

Hypernatremia Respiratory

Early: spontaneous muscle twitches; irregular muscle contraction

Late: skeletal muscle weakness, DTR diminished or absent

Hypernatremia Neuromuscular

Extreme thirst

HYpernatremia Gastrointestinal

Decreased urine output

Hypernatremia Renal

• dry and sticky tongue and mucus membrane

• Dry and flushed skin

• edema, depending on fluid volume changes

Hypernatremia Integumentary

>145

Increase urinary specific gravity

Hypernatremia Lab findings

thready weak irregular pulse ; weak peripheral pulse

Orthostatic hypotension

dysrhythmias

HYpokalemia; Cardiovascular

• Shallow ineffective respirations

• Diminished breath sounds

Hypokalemia Respiratory

• Anxiet lethargy confusion coma

• Skeletal muscle weakness

• Deep tendon hyporeflexia

• loss of tactile discrimination

• paresthesias

Hypokalemia Neuromuscular

• Decreased motility, hypoactive to absent bowel sounds, paralytic ileus

• nausea, vomiting, constipation, abdominal distention

Hypokalemia GI

<3.5

St depression

Shallow flat inverted T waves

prominent u waves

prolonged QU interval

Hypokalemia lab findings

slow weak irregular heart rate

Hyperkalemia Cadiovascular

Profound weakness leading to respiratory failure

Hyperkalemia respiratory

Early: muscle twitches, cramps, paresthesias (tingling + burning followed by numbness in hand feet, around the mouth)

Late: Profound weakness, ascending flaccid paralysis in the arms and legs (trunk head and respiratory muscles may become affected )

Hyperkalemia Neuromuscular

Increased motility, hyperactive bowel sounds

diarrhea

Hyperkalemia Gastrointestinal

<5.0

tall peaked T waves

Flat p waves

wide QRS

prolonged PR interval

Hyperkalemia Lab findings