Hypochloremia and Hyperchloremia Preventatives and Treatments for Basics PDF

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Hypochloremia and Hyperchloremia Preventatives:

Hypochloremia: 1. A decrease in serum chloride is usually followed by a decrease in potassium and sodium. 2. A reduction in hydrochloric acid will cause a decrease of serum chloride. 3. During the initial assessment, it is important to conduct a thorough medical history of the patient. Hypochloremia is known to be associated with kidney disease, heart disease, liver disease, and/or diabetes. Some other predisposing conditions associated with hypochloremia are: hyponatremia, metabolic alkalosis, hypokalemia, prolonged D5W IV therapy. 4. Be aware if the patient has had any acute infections, severe burns, and/or fever. 5. Vomiting, GI suctioning, perspiration, diarrhea, and fistulas may also result in hypochloremia. 6. A nurse should note if the patient is on medications that promote electrolyte loss, such as, diuretics, or promote alkalosis. 7. Most importantly, a person should be well hydrated to prevent hypochloremia.

Hyperchloremia: 1. Hyperchloremia will usually be linked to predisposing conditions such as: fluid and electrolyte imbalances (hypernatremia and metabolic acidosis), drugs that promote chloride retention (IV saline, certain diuretics, salicylate intoxication, corticosteroids, guanethidine, and phenylbutazone). 2. Dehydration may cause hyperchloremia. 3. Hyperaldosteronism, diabetes insipidus, and some cases of hyperparathyroidism will cause hyperchloremia.

Hypochloremia and Hyperchloremia Treatment: Hypochloremia: 1. Administering oral salt tablets. 2. Providing an IV infusion of chloride, such as sodium chloride or potassium chloride if the patient is in critical condition or unable to tolerate the oral salt tablets. 3. Provide the patient with dietary therapy with foods that are high in chloride, such as processed foods, canned vegetables, dates, bananas, cheese, spinach, milk, eggs, celery, crab, fish, olives, and rye.

Hyperchloremia: 1. Decreasing chloride intake, such as stopping all chloride-containing substances used for treatment. 2. The nurse should promote chloride excretion by administering diuretics. 3. The nurse should educate and implement avoiding foods that are high in chloride, and completely restricting processed foods. 4. Hypotonic IV solutions, such as 0.45% NaCl or D5W may be used to balance the patient’s dehydration. 5. IV diuretics may be used to promote chloride loss....