Fluid and Electrolyte Imbalance Chart PDF

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Summary

Lecture notes for the Fluid & Electrolyte Imbalance lecture given by Stewart Bond for the MSE Nursing program (Masters students). Outlines the causes, signs & symptoms, important lab values, and nursing management for common fluid and electrolyte imbalances. ...

Description

Fluid/Electrolyte

Imbalance Hypovolemia

Causes -Excess fluid loss -Decreased intake -Third spacing shif

Body Fluids Hypervolemia

-Excess fluid intake -Increased fluid retention (CHF) -Secondary response to increased sodium content

Hyponatremia

Sodium Hypernatremia

Hypokalemia

Potassium Hyperkalemia

Hypocalcemia

Signs/Symptoms

Lab Values

Management

Weight loss, less & concentrated urine, dizzy,  skin turgor, orthostatic, thirst, confusion, nausea, diaphoretic,  temp

 BUN/creatinine, hgl, hct, specific gravity

Fluid replacement—IV NaCl or blood products

 urine sodium

Monitor I/O, vital signs, weight management

Weight gain, Resp: SOBOE, orthopnea, crackles, wheeze, coughlow O2 JVD,  BP, weak pulse, pitting edema

 hgl and hct, osmolality

Fluid/Sodium restrictions, diuretics, high fowlers

-Water excess (ADH) -Fluid loss -Renal disease -Diuretics

Dry skin,  saliva + BP, h/a, seizures

-Excess water loss or sodium intake -Diabetes insipidus -Heat stroke

Thirst, tonic-clonic seizures, dry mucous membranesHR+BP+temp

-GI loss -Poor nutrition/starvation -Diuretics -Alkalosis

EKG—prominent U wave, lethal ventricular dysrhythmias

-Increased intake -Renal dysfunction -Tissue trauma -Acidosis -Meds -Decreased intake, vit D -Acute pancreatitis

Cardiac dysrhythmia, EKG —peaked T wave, prolonged QRS, limb numb/tingling, GI issues Tetany, seizures, Resp— stridor, bronchospasm,

Monitor I/O, vital signs, weight management

145 mEq/L

Hypotonic solution Sodium restriction Diuretics

5.0 mEq/L

Increase diet intake Monitor renal function and toxicity with digoxin

-IV insulin, sodium bicarb, calcium gluconate to move K+ from ECFICF -kayexelate to increase elimination Increase Ca intake, Vit D supplement

Calcium

Hypercalcemia

Hypophosphatemia

Phosphorus

-Multiple blood transfusions -Alkalosis -Excess Vit D, calcium intake -Certain cancers -Prolonged immobilization -Acidosis -Meds

-Increased renal excretion -Alcohol abuse -Malnutrition/vit D deficient -Alkalosis, DKA -antacids Hyperphosphatemia -Renal failure -Excess intake, Vit D -Excess laxative use -Acidosis -Chemotherapy

Chvostek and Trousseau signs, circumoral numbness and tingling Kidney stones, EKG changes—shortened QT, poor reflexes/memory, bradycardia, confusion, lethargy Neuro sxs—mental status changes, tissue hypoxia, osteomalacia, bleeding disorders, leukocyte alterations

10.2 mg/dL Meds: phosphate, bisphosphonates, calcitonin, loop diuretics Increase intake Prevent infection 4.5 mg/dL Sof tissue calcifications

Decrease intake, hydration, dialysis, hypocalcemia management Meds: aluminum hydroxide, sevelamer...