NUR 306- Electrolytes

FLUID COMPARTMENTS: Intracellular: in cell Intravascular: in vessel Interstitial: in b/w blood vessels and cells. ELECTROLYTES: sodium (sodium attracts water in your blood vessels, increase sodium = increase BP), potassium (help maintain normal levels of fluid inside our cells, increase potassium = decrease BP), magnesium ( helps lower BP), phosphate, calcium, & chloride *AT RISK 4 IMBALANCES: HF, ill pt., Old/ young, Diarrhea/vomiting, Neuro r/t dehydration & malabsorption, alcohol use, diuretics and Trauma/ Burns NORMAL BODY LOSSES: Sensible: Can be measured i.e. urine Insensible: can’t be measured i.e. sweat & stool EXCESS: Sx: Renal failure, decreased cardiac output, excessive IV infusion/fluid intake, excessive sodium intake, EX: “wedding ring is tight, my clothes don’t fit” DEFICIT: Inability to obtain or swallow fluids, extremes of age, vomiting/diarrhea, burns, excessive use of laxatives, excessive diaphoresis, fever EX: “Change in mental status, high temp & HR, decreased BP, cracked lips, dark urine, weight loss DIAGNOSES TERMS: Potassium: hyper(high)/hypo (low) kalemia. Sodium: hyper/hypoatremia. Magnesium: hyper/hypomagnesemia. Loss of Fluids: hypovolemia (which causes third space shift which is decreased oncotic pressure, resulting in dehydration and hemorrhage) Extra FLuids: Hypervolemia ((excess goes to Edema, Eyes, fingers, ankles, sacral, in/around organs) which results in disrupted mech., CKF, CHF, fluid in lungs) Imbalanced Resolved: PO: water intake (encouraged or restricted) MED Admins: Diuretics IVF therapy:hypo/hypertonic, isotonic IV FLUID THERAPY: Hypotonic:has less osmolarity than plasma CAUSES cells to burst, Tx: dehydrated has hypertonic blood uses hypotonic solution, elevates NaCL, maintenance fluids. Solution: 1/3 NS & ½ NS Hypertonic: greater osmolarity than plasma, moves out IVS CAUSES cells to shrink. Tx: electrolytes, hypovolemia (no plasma available), SIADH. Solutions:5% dex in LR & 5% dex in NS. Isotonic: remains in the intravascular compartment with equilibrum. Tx: Electrolytes, hypovolemia, burns. Solutions: LR & Normal Saline. DOCUMENT: daily weight, I/Os, monitior fluid intake (i.e. temps of fluids, types, encourge fluids), restricting fluids (i.e. rational ice, small glasses, salty, oral care, keep busy). FOODS: Increase H2O: citrus, melons, celery. Increase K: bananas, citrus fruits, apricots, broccoli, potatoes, lima beans.Increase Na+: processed foods HYDRATION TESTS: Urine pH (4.6-8.2) & Specific Gravity (1.005-1.030)- LOW: (SG) Renal damage & (UpH) Diarrhea, diabetic ketosis HIGH: (SG) V/D/ dehydration/ heart failure & (UpH) low K, renal failure TESTS: complete blood count (WBC,RBC) and basic metabolic panel (BMP)(electrolytes, fluids, kidneys levels)