Fluid and Electrolyte Balance Pt. 2

Electrolyte Section Only (excluding electrolyte imbalances)

maintain fluid balance, contribute to acid-base regulation, facilitate enzyme reactions, transmit neuromuscular reactions

what are the functions of electrolytes

sodium, potassium, calcium, magnesium, phosphate,chloride

what are the chief electrolytes

chief electrolyte of ECF, regulates fluid volume, helps muscle contraction, transmits nerve impulses

sodium and its function

food, absorbed through GI tract

sodium source

major cation of ICF, regulates cellular water, supports enzyme activity, helps nerve and muscle function, supports heart function

potassium and its function

fruits, vegetables

potassium source

nerve impulses, blood clotting, muscle contraction and relaxation, bone and teeth formation, B12 absorption

calcium and its function

requires vitamin D and normal gastric acidity

calcium absorption

milk, dairy, leafy greens, sardines, anchovies, small fish with bones

calcium sources

metabolizes carbs and proteins, supports enzyme activity, helps neuromuscular function, supports cardiovascular function, promotes vasodilation

magnesium and its function

green leafy vegetables, nuts, seafood

magnesium sources

energy storage, bone and teeth formation, metabolizes carbs, fats, and proteins

phosphate and its function

diary products, other animal products

phosphate sources

maintains blood osmotic pressure, helps product hydrochloric acid, works closely with sodium

chloride and its function

interstitial fluid, lymph, gastric and pancreatic fluids, sweat, bile, saliva

where is chloride found in

Na, K, Mg

electrolytes lost through diuretic use

blood loss (anemia)

what happens when Hgb decreases

blood loss (anemia)

what happens when hct decreases

dehydration

what happens when hgb increases

dehydration

what happens when hct increases

malnutrition, over hydration

what happens when BUN decreases

severe dehydration

what happens when BUN increases

dehydration

what happens when creatinine increases

drugs that accelerate the rate of urine formation and promote water and electrolyte excretion

diuretics

edema, HF, pulmonary edema, liver disease, hypertension

what do diuretics treat

inhibits carbonic anyhdrase found in the kidneys and eyes. increases sodium and water excretion. used for glaucoma, edema, and high-altitude sickness

acetazolamide (Diamox) action and uses

allergies to sulfonamides or thiazides, low sodium or potassium, renal failure

carbonic anhydrase inhibitors contraindications

hypokalemia, paresthesias of extremities, confusion, or drowsiness

carbonic anhydrase inhibitors adverse effects

digoxin (increase the instance of digoxin toxicity, corticosteroids (can worsen hypokalemia)

carbonic anhydrase inhibitors interactions

furosemide (Lasix), torsemide (Demodex), bumetanide (Bumex)

examples of loop diuretics

block sodium and chloride reabsorption in the loop of Henle. increase sodium, chloride, and water excretion

loop diuretic action

edema, hypertension, renal disease, hypercalcemia, pulmonary edema

loop diuretic uses

allergy to loop diuretics, anuria, hepatic coma, pregnancy requires provider assessment

loop diuretic contraindications

dizziness, tinnitus, nausea, vomiting, diarrhea, hypokalemia, hyperglycemia

loop diuretic adverse effects

vancomycin (increases the chance of ototoxicity , digoxin (can worsen hypokalemia), NSAIDS (decrease the effectiveness of loop diuretics)

loop diuretic interactions

osmotic diuretic

what is mannitol (Osmitrol) an example of

increases osmotic pressure, pulls fluid into renal tubules, helps reduce cerebral edema

osmotic diuretic actions

osmotic diuretic uses

osmotic diuretic contraindications

osmotic diuretic adverse effects

osmotic diuretic interactions

helps the body retain potassium, usually used when potassium loss is a concern. spironolactone (Aldactone), amiloride (Midamor), triamterene (Dyrenium)

what are potassium sparing diuretics and examples

reduce sodium reabsorption, increase sodium and water excretion, decrease potassium excretion, generally have a weaker diuretic effect

potassium sparing diuretics action

hypertension, HF, used with loop diuretics to reduce potassium loss

potassium sparing diuretics uses

hyperkalemia, renal impairment

potassium sparing diuretics contraindications

dizziness, headache, muscle cramps, nausea, vomiting diarrhea, hyperkalemia

potassium sparing diuretics adverse effects

lithium (increase lithium levels/toxicity), ACE inhibitors (increase risk of hyperkalemia), potassium supplements (increase risk of hyperkalemia)

potassium sparing diuretics interactions

mild diuretic effect compared with loop diuretic, hydrochlorothiazide (HCTZ), metolazone (Zaroxlyn)

thiazide diuretics (water pills) and examples

inhibit sodium and chloride absorption in the distal tubule, increase sodium and water excreition, can also potassium loss

thiazide diuretics action

hypertension, HF, edema

thiazide diuretics use

hepatic coma, anuria, severe renal failure

thiazide diuretics contraindications

nausea, vomiting, diarrhea, hypokalemia, hyperglycemia, increased uric acid (risk of gout)

thiazide diuretics adverse effects

steroids (worsen hyperglycemia and potassium loss), digoxin (hypokalemia which increases risk of digoxin toxicity), oral hypoglycemics (may decrease effectiveness)

thiazide diuretics interactions

nursing history, physical assessment, fluid I&O, daily weights, lab studies

parameters of assessment

aldosterone, sodium

what does spironolactone block? what does amiloride and triamterene block?