Chapter 13 Electrolytes PDF

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Guided Lecture Notes, Chapter 13, Fluid and Electrolytes: Balance and Disturbance Learning Objective 1. Differentiate between osmosis, diffusion, filtration, and active transport.  Introduce the topic of fluid and electrolyte balance, and note that this is a dynamic process necessary for life and homeostasis. Note the role of the nurse in helping patients maintain homeostasis and fluid and electrolyte balance. (Refer to PowerPoint slide 2.)  Describe the distribution of fluid in the body and the factors that influence body normal fluid percentages. (Refer to PowerPoint slide 3.)  Explain each of the fluid compartments. List some examples of transcellular fluid compartments.  Define and describe “third spacing.”  Define and briefly explain the function of body electrolytes.  Define anions and cations. List the major anions and cations.  Note that the electrolyte composition of the different compartments varies, and note which of the listed electrolytes are concentrated in the intracellular or extracellular fluid. (Refer to PowerPoint slide 4.)  Define and explain hydrostatic pressure. Note the differences in hydrostatic pressure that occur related to blood pressure and differences in oncotic pressure related to serum proteins, especially serum albumin. (Refer to PowerPoint slide 5.)  Define the processes of osmosis, diffusion, filtration, and active transport that regulate body fluid balance. (Refer to PowerPoint slides 6.) Learning Objective 2. Describe the role of the kidneys, lungs, and endocrine glands in regulating the body’s fluid composition and volume.  List sources of fluid and electrolyte gain and loss. Other is added under loss to account for pathologic loss related fistula, wounds, and so forth. Note average daily fluid intake and loss by each site. (Refer to PowerPoint slide 7 and 8.)  Describe the role of the kidneys, lungs, and endocrine glands in regulating the body’s fluid composition and volume. Learning Objective 3. Identify the effects of aging on fluid and electrolyte regulation.  Note the effects of aging on the body’s ability to regulate fluid and electrolyte balance, and describe gerontologic considerations related to maintenance of fluid and electrolyte balance. Note that changes that may cause minor problems in younger adults can cause profound changes in older adults and that signs and symptoms of imbalances

may be atypical in this population. Confusion or cognitive impairment is more frequently a symptom. (Refer to PowerPoint slide 9.) Learning Objective 4. Plan effective care of patients with the following imbalances: fluid volume deficit and fluid volume excess, sodium deficit (hyponatremia) and sodium excess (hypernatremia), and potassium deficit (hypokalemia) and potassium excess (hyperkalemia).  List fluid volume imbalances of FVD and FVE. (Refer to PowerPoint slide 10.)  Explain FVD, its causes, risk factors, manifestations, and medical management. Differentiate and define dehydration. (Refer to PowerPoint slides 11 to 13.)  Describe how isotonic, hypertonic, and hypotonic solutions affect fluid movement in the body and electrolyte balance.  Describe the nursing management of FVD. (Refer to PowerPoint slide 14.) 

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Explain FVE, its causes, risk factors, manifestations, and medical management. Emphasize the prevention of FVE. Early detection of potential problems is important. Monitor at-risk patients, especially older adults, and those with renal and cardiac problems. Monitoring of IV solution administration is vital. (Refer to PowerPoint slides 16 and 17.) Describe the nursing management of FVE. (Refer to PowerPoint slide 18.) List the electrolyte imbalances that will be discussed. (Refer to PowerPoint slide 19.) Describe the etiology, clinical manifestations, medical management, and nursing interventions for hyponatremia. (Refer to PowerPoint slides 20 to 22.) Describe the etiology, clinical manifestations, medical management, and nursing interventions for hypernatremia. (Refer to PowerPoint slides 23 to 25.) Describe the etiology, clinical manifestations, medical management, and nursing interventions for hypokalemia. (Refer to PowerPoint slides 26 to 28.) Describe the etiology, clinical manifestations, medical management, and nursing interventions for hyperkalemia. (Refer to PowerPoint slides 29 to 31.)

Learning Objective 5. Describe the cause, clinical manifestations, management, and nursing interventions for the following imbalances: calcium deficit (hypocalcemia) and calcium excess (hypercalcemia), magnesium deficit (hypomagnesemia) and magnesium excess (hypermagnesemia), phosphorus deficit (hypophosphatemia) and phosphorus

excess (hyperphosphatemia), and chloride deficit (hypochloremia) and chloride excess (hyperchloremia).  Describe the etiology, clinical manifestations, medical management, and nursing interventions for hypocalcemia. (Refer to PowerPoint slides 32 to 35.)  Describe the etiology, clinical manifestations, medical management, and nursing interventions for hypercalcemia. (Refer to PowerPoint slides 36 and 37.)  Describe the etiology, clinical manifestations, medical management, and nursing interventions for hypomagnesemia. (Refer to PowerPoint slides 38 and 38 and 9.)  Describe the etiology, clinical manifestations, medical management, and nursing interventions for hypermagnesemia. (Refer to PowerPoint slides 40 and 41.)  Describe the etiology, clinical manifestations, medical management, and nursing interventions for hypophosphatemia. (Refer to PowerPoint slide 42.)  Describe the etiology, clinical manifestations, medical management, and nursing interventions for hyperphosphatemia. (Refer to PowerPoint slide 43.)  Describe the etiology, clinical manifestations, medical management, and nursing interventions for hypochloremia. (Refer to PowerPoint slide 44.)  Describe the etiology, clinical manifestations, medical management, and nursing interventions for hyperchloremia. (Refer to PowerPoint slide 45.) Learning Objective 6. Explain the roles of the lungs, kidneys, and chemical buffers in maintaining acid--base balance.  Note the normal pH and define pH. (Refer to PowerPoint slide 46.)  Explain the basic function of the bicarbonate--carbonic acid buffer system.  Explain the role of the kidneys and the lungs in maintaining acid--base balance. The kidneys regulate bicarbonate concentration, and the lungs, under the control of the medulla, retain or “blow-off” carbon dioxide that regulates carbonic acid in the blood.  Note that respiratory compensation is rapid and that renal compensation is slower; it usually takes hours to days.  Mention other buffer systems used by the body. (Refer to PowerPoint slide 46.)

Learning Objective 7. Compare metabolic acidosis and alkalosis with regard to causes, clinical manifestations, diagnosis, and management.  Describe metabolic acidosis, its causes, manifestations, diagnosis, and management. (Refer to PowerPoint slide 48.)

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Discuss electrolyte imbalances that may occur related to metabolic acidosis and its correction. (Refer to PowerPoint slide 49) Include in the discussion the nursing management of the patient with metabolic acidosis. Describe metabolic alkalosis, its causes, manifestations, diagnosis, and management. Discuss electrolyte imbalances that may occur related to metabolic alkalosis and its correction. Include in the discussion the nursing management of the patient with metabolic alkalosis. (Refer to PowerPoint slides 50 and 51.)

Learning Objective 8. Compare respiratory acidosis and alkalosis with regard to causes, clinical manifestations, diagnosis, and management.  Describe respiratory acidosis, its causes, manifestations, diagnosis, and management. (Refer to PowerPoint slides 52 and 53.)  Note the potential for increased intracranial pressure.  Include in the discussion the nursing management of the patient with respiratory acidosis.  Describe respiratory alkalosis, its causes, manifestations, diagnosis, and management. (Refer to PowerPoint slide 54)  Include in the discussion the nursing management of the patient with respiratory alkalosis. Learning Objective 9. Interpret arterial blood gas measurements.  Explain the basic interpretation of arterial blood gases. (Refer to PowerPoint slide 55)  Direct students to follow discussion using Chart 13-3.  Do several sample arterial blood gas interpretations with the class....