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What are the expected cues of dehydration?

Dry mouth, no wet diapers, extreme thirst, minimal urination, fatigue, dizziness, confusion, elevated HR, decreased BP, and urine output less than 30 mL/hr.

What are common causes of dehydration?

Diarrhea, vomiting, insufficient water intake, medication side effects, excessive sweating, burns, and uncontrolled diabetes mellitus.

What are non-pharmacological treatments for dehydration?

Encourage fluids and electrolytes, avoid caffeinated or sugary drinks, consume easy to digest foods (BRAT diet).

What are pharmacological treatments for dehydration?

IV fluids (Normal Saline), replace electrolytes, and medications such as antidiarrheals or anti-emetics.

What are the expected cues of overhydration?

Edema, abnormal heart rate and rhythm, nausea, vomiting, bloated stomach, headache, muscle pain, confusion, crackles, JVD, decreased urine specific gravity, weight gain, hypertension, and bounding pulses.

What are common causes of overhydration?

Endurance sports or exercise, working in extreme heat, low body mass (drinking more than the body can process), certain medications (antidepressants and antipsychotics), chronic kidney disease (CKD), liver disease, congestive heart failure (CHF), excessive sodium intake, and kidney retention of too much water.

What are non-pharmacological treatments for overhydration?

Low sodium diet (renal diet), restricting fluid intake, monitoring intake & output, exercise/weight loss if obese, elevating legs when sitting, and using compression stockings.

What are pharmacological treatments for overhydration?

Diuretics, including Loop Diuretics, Thiazides, Potassium-Sparing Diuretics, and Osmotic Diuretics.

What are some nursing interventions for the short-term goal of overhydration treatment?

Monitor patient vital signs and level of consciousness for improvement; offer a cool, wet towel/rag for nausea and headache; keep patient’s legs elevated; monitor intake & output; administer diuretics per doctor's orders; and record daily weights.

What is a long-term goal for a patient with overhydration?

Patient will verbalize an understanding of risk factors for overhydration by discharge, with a balanced intake and output and stable weight by the follow-up appointment.

What are some nursing interventions for the long-term goal of overhydration treatment?

Educate patients on proper fluid intake based on activities and environment; encourage patients not to hold their urine and discuss other side effects; review medications with patients and highlight those with dehydration as a side effect.

What is a short-term goal for a patient with dehydration?

Patient will show signs of improved hydration by having adequate urine output >30 mL hourly and stable vitals within 48 hours.

What are some nursing interventions for the short-term goal of dehydration treatment?

Monitor urine intake and output every 2 hours; assess patient’s vitals and skin turgor every 4 hours.

What is a long-term goal for a patient with dehydration?

Patient will demonstrate increased hydration by having increased urinary output and moist mucous membranes by discharge.

What are some nursing interventions for the long-term goal of dehydration treatment?

Monitor vital signs every hour; educate the patient and family on the importance of adequate fluid intake and signs/symptoms of dehydration.

What nursing interventions can be taken to monitor dehydration?

Monitor BUN (7-20), Hematocrit, and Urine Specific gravity; monitor vitals, administer fluids, assess for neurologic changes, and intake & output.

What dietary advice is suggested for patients with dehydration?

Encourage avoidance of coffee and monitor fluid intake and output every hour to assess fluid balance.

What nursing interventions can be taken to manage overhydration?

Enforcing fluid restrictions; administering diuretics; educating the patient on signs and symptoms of fluid gain; monitoring inputs and outputs; and recording daily weights.

What is a short-term goal for a patient with overhydration?

Patient will show signs of relief from symptoms (edema, headache, muscle pain, confusion, nausea) within 1 hour and achieve a balanced intake and output with a stable weight by discharge.

What is the conversion from pounds to liters of fluid?

2.2 lbs = 1 kg = 1 liter of fluid.

What is the normal range for sodium (Na)?

135-145 mEq/L

What is the purpose of sodium in the body?

Sodium is essential for regulating water balance, controlling extracellular fluid balance, transmitting nerve signals, aiding muscle contractions, and maintaining acid-base balance.

What are mild and severe symptoms of hyponatremia?

Mild: confusion, edema, dry skin, muscle cramps;

Severe: lethargy, muscle twitching, hyporeflexia, coma, seizures, potential death.

What are mild and severe symptoms of hypernatremia?

Mild: agitation, weakness, restlessness;

Severe: hyperreflexia, delusions, seizures, hallucinations, potential permanent brain damage.

What is the appropriate medical term for low sodium?

Hyponatremia: too little sodium necessary for proper body function.

What is the appropriate medical term for high sodium?

Hypernatremia: too much sodium with not enough water.

What are some food sources high in sodium?

Processed meat/food, salty snacks, canned veggies/soups, fast food, smoked meats and shellfish.

What are the causes of hyponatremia?

Excessive diuretic therapy, nephritis, excessive sweating without sodium replacement, excess water intake (IV or Oral), vomiting, diarrhea, fistula, and adrenal insufficiency  (SIADH - Syndrome of Inappropriate Antidiuretic Hormone).

What are the causes of hypernatremia?

Intake of excessive sodium (rapid infusion of sodium bicarbonate), loss of water due to diarrhea or diabetes insipidus, and conditions that impair thirst or prevent water intake, and also diaphoresis → losing more water than sodium, thus leading to hypernatremia

What are some nursing interventions for hypernatremia?

Monitor serum sodium levels, assess for signs of dehydration, administer hypotonic IV fluids, provide oral fluids if possible, and implement seizure precautions.

What are some signs of dehydration?

Signs of dehydration include dry mouth, poor skin turgor, concentrated and decreased urine output, increased thirst, and dry skin. Severe dehydration may present with hypotension, rapid heart rate, and confusion.

What should be done for patients with hypernatremia regarding salt and water intake?

Limit salt intake and foods high in sodium; increase water intake.

What should be done for patients with hyponatremia regarding sodium intake?

Encourage foods high in sodium, restrict water intake, and administer hypertonic IV saline solutions as ordered. Monitor to ensure that Na+ levels increase by only 4 to 6 mEq/L in any 24-hour period. Increasing too fast can cause brain damage due to osmotic demyelination syndrome (ODS).

What are seizure precautions?

Seizure precautions include padding side rails and ensuring suction equipment is hooked up. Monitor the patient's level of consciousness and perform frequent neurological checks.

True or False: Hypotonic solutions are used to treat sodium deficiency (hyponatremia).

False: Hypotonic solutions dilute sodium levels further and can worsen hyponatremia; hypertonic saline (e.g., 3% saline) is used to treat severe sodium deficiency.

Hypertonic solution

A solution that has a higher solute concentration than inside the cell, causing water to move out of the cell.
Effect: Cells shrink (crenate).
Use: Treats Hyponatremia, edema (swelling) by pulling fluid out of cells and tissues into the bloodstream.
Ex. 3% saline.
Caution: Can cause dehydration or shrinkage of cells if overused.

Hypotonic solution

A solution that has a lower solute concentration than inside the cell, causing water to move into the cell.
Effect: Cells swell and can burst (lyse).
Use: Treats dehydrated cells, such as in diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS). Treats Hypernatremia
Ex. 0.45% saline (half-normal saline).
Caution: Risk of cellular swelling and hypotension; avoid in patients with increased intracranial pressure.

Isotonic solution

A solution that has the same solute concentration as inside the cell; no net water movement.
Effect: Cell size stays the same.
Use: Increases vascular volume without shifting fluid into or out of cells. Common in fluid resuscitation (e.g., trauma, surgery).
Ex. 0.9% saline (normal saline), Lactated Ringer's.
Caution: Overuse can lead to fluid overload.

What is the normal potassium (K+) range?

The normal range for potassium is 3.5–5.0 mEq/L.

What are the main functions of potassium?

Potassium is crucial for heart function, muscle function, nerve signals, fluid balance, and blood pressure.

What is hyperkalemia?

Hyperkalemia is defined as potassium levels greater than 5.0 mEq/L.

What is hypokalemia?

Hypokalemia is defined as potassium levels less than 3.5 mEq/L.

What are some symptoms of hyperkalemia?

Symptoms include EKG changes (dysrhythmias), hypotension, decreased deep tendon reflexes, and loss of muscle tone and contractions

What are symptoms of hypokalemia?

Symptoms include weak and irregular pulse, tachycardia, hyporeflexia, and arrhythmias.

Name some food sources high in potassium.

High potassium foods include bananas, avocados, dates, dark leafy greens, potatoes WITH SKIN, legumes, whole grains, and dairy products.

What are nursing interventions for hyperkalemia?

Monitor cardiac rhythm, serum potassium levels, administer insulin and glucose, and consider dialysis.

What are nursing interventions for hypokalemia?

Increase potassium intake, administer potassium supplements, monitor for muscle weakness and irregular heartbeats, review medications, and treat underlying conditions such as vomiting, diarrhea and kidney disease

What are some causes of hyperkalemia (high potassium)?

Causes include excessive potassium intake, kidney dysfunction, potassium sparing diuretics, diabetes mellitus, Addison's disease, rhabdomyolysis, metabolic disorders, dehydration, alcohol abuse, and certain types of cancer.

What types of medications can lead to hyperkalemia?

Potassium-sparing diuretics (e.g., spironolactone) and medications that cause kidney failure can lead to hyperkalemia.

What are some causes of hypokalemia (low potassium)?

Causes include diuretic medications, diarrhea, vomiting, laxative abuse, excessive sweating, kidney disease, decreased potassium intake, diabetic ketoacidosis, Cushing's syndrome, and certain genetic disorders.

What types of diuretics can lead to hypokalemia?

Potassium-wasting diuretics such as furosemide and any thiazide or loop diuretic can lead to hypokalemia.

What is the normal magnesium (Mg+) range?

The normal range for magnesium is 1.5–2.5 mEq/L.

What are the key functions of magnesium?

Magnesium is essential for the metabolism of carbohydrates and proteins, muscular function, nerve transmission, and cardiovascular system vasodilation.

What are common symptoms of hypermagnesemia?

Symptoms of hypermagnesemia include warm flushed appearance, nausea/vomiting, drowsiness/lethargy, decreased muscle strength, DECREASED DEEP TENDON REFLEXES, hypotension, and dysrhythmias, bradycardia, heart block, slow shallow respirations, respiratory arrest

What are common symptoms of hypomagnesemia?

Symptoms of hypomagnesemia include nausea, constipation, muscle cramps, numbness/tingling in legs/hands, general body weakness, respiratory arrest, tremors, and heart palpitations

What is the medical term for low magnesium?

Hypomagnesemia is the term used for low magnesium levels. Below 1.3

What is the medical term for high magnesium?

Hypermagnesemia is the term used for high magnesium levels. Above 2.3

What are some food sources of magnesium?

Food sources rich in magnesium include green leafy vegetables (swiss chard), seafood (like halibut), nuts (such as cashews), whole grains/wheat, dried fruits, beans, peas, and cocoa.

What nursing interventions can be taken for hypermagnesemia?

Monitor vital signs, assess for respiratory depression, and ensure the patient avoids magnesium-rich foods.

What nursing interventions can be taken for hypomagnesemia?

Monitor vital signs, oxygen sat, respirations, administer magnesium supplements, educate on dietary sources of magnesium, encourage pts to not drink alcohol, and encourage adequate hydration.

What are some causes of low magnesium levels (hypomagnesemia)?

Causes include diarrhea, nasogastric suction, sepsis, burns, tube feedings, and chronic alcohol use.

What are some causes of high magnesium levels (hypermagnesemia)?

Causes include renal failure and excessive magnesium intake from magnesium-containing antacids and/or laxatives.

What role does renal function play in magnesium balance?

Renal function is crucial; impaired kidney function can lead to high magnesium levels due to decreased excretion.

What are the normal ranges for serum calcium?

Normal total serum calcium is 8.5-10.5 mg/dL; normal ionized serum calcium is 4.5-5.1 mg/dL.

What are the primary functions of calcium in the body?

Calcium aids in blood regulation, nerve impulse transmission, bone and teeth development, and muscle contraction and relaxation.

What are potential causes of hypercalcemia?

Causes include increased calcium absorption (excessive intake), decreased calcium excretion (chronic kidney disease, diuretics), bone resorption (fractures), and dehydration.

What are potential causes of hypocalcemia?

Causes include inadequate calcium intake, vitamin D deficiency, lactose intolerance, increased calcium excretion (CKD, diarrhea, wound drainage), and conditions like hyperproteinemia or alkalosis.

What are five nursing interventions for hypercalcemia?

1. Administer IV fluids to encourage hydration and renal excretion of calcium.

2. Administer diuretics as prescribed to promote calcium excretion.

3. Monitor cardiac function for signs of arrhythmias and other complications.

4. Encourage mobility to promote bone health and calcium utilization. (Weight-bearing exercises)

5. Educate the patient about dietary restrictions and the importance of regular lab checks.

What are five nursing interventions for hypocalcemia?

1. Administer calcium supplements or IV calcium gluconate as ordered.
2. Monitor vital signs, particularly heart rate and rhythm.
3. Assess for signs and symptoms of tetany or seizures.
4. Educate the patient about sources of dietary calcium, including fortified foods.
5. Encourage the use of vitamin D supplements as appropriate to enhance calcium absorption.

What are the main signs of hypocalcemia?

Signs include numbness and tingling of fingers, mouth or feet, muscle cramps, tetany, and seizures.

What are the main signs of hypercalcemia?

Signs include nausea, vomiting, constipation, bone pain, excessive urination, thirst, confusion, lethargy, and slurred speech.

What are some calcium-rich foods?

Calcium-rich foods include dairy products like milk, cheese, and yogurt; tofu, leafy green vegetables such as kale and broccoli; fish like sardines and salmon; nuts, sunflower seeds, almonds; and fortified foods like cereals and plant-based milk.

What is the normal range for chloride levels in the blood?

The normal range for chloride levels is 97-107 mEq/L.

What is the purpose of chloride in the body?

Chloride helps maintain osmotic pressure, combines with hydrogen ions to form hydrochloric acid for digestion, maintains pH levels, and regulates body fluids to ensure hydration.

What are the signs and symptoms of hyperchloremia?

Signs of hyperchloremia include tachypnea, weakness, lethargy, diminished cognitive ability, decreased cardiac output, dysrhythmias, and coma.

What are the signs and symptoms of hypochloremia?

Signs of hypochloremia include hyperexcitability of muscles, tetany, hyperactive deep tendon reflexes (DTRs), weakness, and muscle cramps. Severe hypochloremia may result in seizures, coma, or respiratory arrest.

What is hypochloremia?

Hypochloremia is a medical condition where chloride levels are lower than 97 mEq/L.

What is hyperchloremia?

Hyperchloremia is a medical condition where chloride levels are higher than 107 mEq/L.

What are some food sources of chloride?

Food sources of chloride include table salt, processed foods, seaweed, cheese, seafood, and rye bread.

What can cause hypochloremia?

Hypochloremia can result from severe vomiting and diarrhea, drainage of gastric fluid, metabolic alkalosis, diuretic therapy, and burns.

What can cause hyperchloremia?

Hyperchloremia can be caused by metabolic acidosis, hypernatremia (high sodium), increased chloride retention by the kidneys, and hyperparathyroidism.

What are some nursing interventions for managing hyperchloremia?

Nursing interventions for hyperchloremia include limiting sodium intake, administering fluids to flush salt out, and possibly initiating dialysis in renal disease patients.

What are some nursing interventions for managing hypochloremia?

Nursing interventions for hypochloremia include increasing sodium intake, administering fluids such as potassium or sodium chloride, and evaluating medications and potentially reducing diuretic use.

What is the normal range for phosphate levels in the blood?

The normal range for phosphate levels is 2.5-4.5 mg/dL.

What is the purpose of phosphate in the body?

Phosphate buffers hydrogen in acid-base balance, stores energy, aids in carbohydrate/protein/fat metabolism, forms bones and teeth, and helps muscle and red blood cells function.

What are the signs and symptoms of hypophosphatemia?

Signs of hypophosphatemia include DECREASED DTR, muscle weakness, constipation, slurred speech, dysphagia, decreased respiratory effort, paresthesias, irritability, confusion, seizures, and coma.

What are the signs and symptoms of hyperphosphatemia?

Signs of hyperphosphatemia include hyperreflexia, anorexia, muscle weakness, decreased mental status, and dysrhythmias.

What are some nursing interventions for managing hyperphosphatemia?

Nursing interventions for hyperphosphatemia include educating the patient on a low-phosphate diet, encouraging fluid intake to support phosphate excretion, and monitoring for signs of hypocalcemia.

What are some nursing interventions for managing hypophosphatemia?

Nursing interventions for hypophosphatemia include promoting intake of phosphate-rich foods, assessing for muscle weakness and fatigue, and educating the patient on alcohol moderation.

What are food sources high in phosphate?

Food sources high in phosphate include meat, poultry, dairy, whole grains, and seafood.

What causes hyperphosphatemia?

Hyperphosphatemia can be caused by high levels of vitamin D, excessive dietary intake, hypoparathyroidism, and chronic kidney disease (CKD).

What causes hypophosphatemia?

Hypophosphatemia can be caused by malnutrition, hyperparathyroidism, chronic alcoholism, and certain medications.

What is the purpose of an electrolyte blood panel?

The purpose of an electrolyte blood panel is to screen for routine health checks or to determine if there is a fluid imbalance or an imbalance in acid-base levels in the body.

Is there any pre-test or post-test care for an electrolyte blood panel?

No pre-testing or post-testing care is necessary for an electrolyte blood panel.

What are the nursing interventions associated with electrolyte blood panel tests?

Nursing interventions include monitoring intake and output (I&O), electrolyte replacement if necessary, educating the patient to prevent future imbalances, and monitoring vital signs.

What patient education should be provided related to electrolyte balance?

Patients should be educated on the importance of balancing fluids and electrolytes, particularly sodium, potassium, and calcium, as well as signs and symptoms of fluid and electrolyte imbalances.

What is the purpose of a cholesterol level test?

The cholesterol level test measures the amount of cholesterol in the blood, assesses the risk for cardiovascular disease, and is often part of a full lipid panel.

What pre-test care is needed for a cholesterol level test?

Fasting for 9–12 hours is typically required, especially if part of a lipid panel. Avoid high-fat foods and alcohol before the test, and continue medications unless otherwise directed.

What is the normal range for cholesterol levels?

The normal range for cholesterol levels is less than 200 mg/dL.

Is there any post-test care required after a cholesterol level test?

No specific post-test care is required, but patients should resume their normal diet and medications.