Electrolytes and Fluid Balance

Water's Functions

• Four primary functions:

  • Water balance regulation.

  • Acid-base balance.

  • Nutrient transport.

Electrolytes

Sodium (Na+)

• Function: Water Balance. Water follows Sodium.

• Food Sources:

  • Soups

  • Processed foods

  • Pickles

• Normal Range: 135-145

• Hyponatremia(Deficiency):

  • Neuro changes, confusion, anxiety.

  • Low blood pressure.

  • Muscle weakness, twitching.

  • Weak, thready pulse.

  • Swollen cells.

• Hypernatremia(Excess):

  • Thirst.

  • Seizures, loss of skin turgor.

• Interventions:

Potassium (K+)

• Functions:

  • Maintain blood pressure (BP).

  • Muscle contraction.

  • Irregular heartbeat.

• Food Sources:

  • Bananas

  • Milk

  • Salmon

  • Nuts

  • Seeds

  • Tuna

• Normal Range: 3.5-5.0

• Hypokalemia(Deficiency):

  • Muscle weakness.

  • Weakness

• Hyperkalemia(Excess):

  • Kidney failure.

  • Change peaked T wave. Change in EKG.

Calcium (Ca+)

• Functions:

  • Coagulation.

  • Formation of bones and teeth.

  • Blood clotting.

  • Normal nerve & muscle activity

• Food Sources:

  • Kale

  • Almonds

  • Dairy

  • Spinach

  • Baked Beans

  • Broccoli

• Normal Range: 8.4-10.6

• Deficiency (D):

  • Vitamin D deficiency.

  • Osteoporosis.

• Excess (E):

  • Bone Cancer.

• Calcemia

Magnesium (Mg+)

• Functions:

  • Building bones and teeth.

  • Nerve transmission.

  • Muscle contraction.

• Food Sources:

  • Dark leafy greens

  • Nuts

  • Soybeans

  • Seafood

  • Milk

  • Bananas

• Normal Range: 1.3-2.1

• Deficiency (D):

  • Hypertension.

  • Irregular HR.

  • Preeclampsia.

• Excess: Increases calcium excretion.

• Magnesemia

Fluid Volume Imbalances

Hypovolemia (Fluid Volume Deficit)

• At Risk:

  • Elderly and infants.

  • Immune-compromised individuals

• Signs/Symptoms:

  • Thirst

  • Flat jugular (neck) vein

  • Tachycardia

• Interventions:

  • Give fluids slowly.

  • Administer medications.

  • Monitor weight and labs.

Hypervolemia

• At Risk:

  • Heart failure patients.

  • Elderly, babies.

• Signs/Symptoms:

  • Hypertension.

  • Edema.

  • Bounding pulse, slow & strong

  • Shortness of breath, crackles (lung sounds)

• Interventions:

  • Fluid restriction.

  • Diet change.

  • Diuretics.

  • Daily weight monitoring.

  • Medications, labs

Body Fluids

• Intracellular

• Extracellular

  • Intravascular

  • Interstitial

  • Transcellular

Kidney's Role

• Excrete and filter fluid

Assessment

• Turgor.

• Urine output.

• Intake.

• Daily weights.

• Mucous membranes.

• Lab values 135-150.

• Lung sounds

  • Normal Range: 150-2.1