Lect15&16 Fluids&Electrolytes (2)

7/18/2019 Lect15&16 Fluids&Electrolytes (2)

http://slidepdf.com/reader/full/lect1516-fluidselectrolytes-2 1/77

Stressors Afecting

Fluid & ElectrolyteBalanceNUR 101

FALL 2008LECTURE # 15 & #16K. Burger, MSEd, MSN, RN,

CNE



Body Fluids Water= ost i!ortant nutrient "or li"e. Water= !riary #ody $uid.

Adult %eigt is ''()*+ %ater. oss o" -*+ #ody $uid = + %eigt loss SERIOUS

oss o" /*+ #ody $uid = -'+ %eigt loss FATAL

Fluid gained eac day sould = $uid lost eac day0/ (12day a3erage4

Wat is te iniu out!ut !er our necessary toaintain renal "unction5

30ml!"



Fu$%ios o Body Fluid Mediu "or trans!ort Needed "or cellular eta#olis Sol3ent "or electrolytes and oter

constituents

6el!s aintain #ody te!erature 6el!s digestion and eliination Acts as a lu#ricant



'($!)isms o

Fluid *)i )d Loss

*)i

Fluid inta7e -'**l Food inta7e -***l 89idation o"

nutrients 1**l

0-*l o" 6/* !er -**Kcal4

Loss

:Sensi#le;Can #e seen.<rine -'**lS%eat -**l

:nsensi#le;Not 3isi#le.S7in 0e3a!oration4 '**lungs >**lFeces /**l



Regulation o" Fluids

+y,o%!)lmus ?tirst rece!tors 0osorece!tors4

continuosly onitor seru osolarity0concentration4. " it rises, tirst ecanis istriggered.@aso!ressin 0AKA A6 4? increasing 6/* rea#sor!tion

-i%ui%)"y "(.ul)%io( !osterior !ituitaryreleases A6 0antidiuretic orone4 in res!onseto increasing seru osolarity. Causes renaltu#ules to retain 6/*.

irst is a late sign o" %ater deDcit



Regulation o" Fluids

0continued

4 R()l "(.ul)%io( Ne!ron rece!tors

sense decreased !ressure 0lo%

osolarity4 and 7idney secretes RENN.Renin ? Angiotensin ? Angiotensin

A.io%(si II causes Na and 6/*retention #y 7idneys AN..

Stiulates Ad"()l Co"%(/ to secreteAldos%("o( %ic causes 7idneys toe9crete K and retain Na and 6/*.



Cosid(" T!is e *("i)%"i$ Cli(%

(noral !ysiological aging results in

decreased tirst ecanis decreased o" s%eat glands decreased renal "unction

(tere also ay #e decreased o#ilityand2or cogniti3e "unction %ic i!actsteir a#ility to get adeGuate $uid inta7e.



)"i)%ios i Body

Fluids Eld("lyH 6a3e lo%er + o" total #ody

$uid tan younger adults om(H 6a3e lo%er + total #ody

$uid tan en

+4 O 4OU T+IN T+IS IS 77777

Muscle tissue as ore 6/* content 6AN adi!ose

tissue



Fluid Co!artentsI%")$(llul)"

$uid 0ICF4 Fluid inside

te cell 'os% 0/214 o"

te #odyIs+20 is in teICF.

E/%")$(llul)" Fluid0ECF4

Fluid outside te cell. 13 o" #odyIs +20 More !rone to loss 1 ty!esHI%("s%i%i)l $uid

around2#et%een cellsI%")9)s$ul)" 0!lasa4

$uid in #lood 3essels ranscellular ?CSF,

Syno3ial $uid etc



Cosid(" %!is Age 3ariations e9ist in regards to

6/* content o" $uid co!artents n"ants =

)*+ o" 6/* is "ound in ECF>*+ o" 6/* is "ound in CF

Wat igt tis ean in regards to$uid loss "or an in"ant5Re3erse o" adultsJ

n"ant M8RE R8NE to

$uid 8SSJ



Fluid Balance ynaic !rocess

Balance #et%een #ody $uidsand electrolytes Attraction #et%een ions

0electrolytes4 and %ater 0$uids4causes $uids to o3e acrosse#ranes and lea3e teirco!artents.



Sol3ent 06/*4

Mo3eent Cell e#ranes are sei!erea#le

allo%ing %ater to !ass troug

Osmosis( aLor %ay $uidstrans!orted Water si"ts "ro lo%solute concentration to ig soluteconcentration to reac oeostasis0#alance4.



Osmol)"i%y

Concentration o" !articles in solution e greater te concentration 08solarity4 o" a

solution, te greater te !ulling "orce 08sotic!ressure4 Noral seru 0#lood4 osolarity = /*(/'

8SM27g

A solution tat as 66 osolarity is one tat

is O seru osolarity = +4-ERTONIC solution A solution tat as 8W osolarity is one tat

is P seru osolarity = +4-OTONIC solution A solution tat as eGual osolarity as seru

= ISOTONIC solution



6y!ertonic Fluids 6y!ertonic $uids a3e a iger

concentration o" !articles 0ig

osolality4 tan CF is !i.!(" osmo%i$

,"(ssu"( si"ts $uid "ro te

cells into te ECF ere"ore Cells !laced in a

y!ertonic solution %ill s!"i:



6y!ertonic Fluids

<sed to te!orarily treat y!o3oleia

<sed to e9!and 3ascular 3olue Fosters noral B and good urinary out!ut

0o"ten used !ost o!erati3ely4 Monitor "or y!er3oleia J

Not used "or renal or cardiac disease. 6NK ? Wy not5 '+ *.>'+ NS '+ NS

'+ R

-ulmo)"yEd(m)



6y!otonic Fluids 6y!otonic $uids a3e less

concentration o" !articles 0lo%osolality4 tan CF

is lo; osmo%i$ ,"(ssu"(

si"ts $uid "ro ECF into cells Cells !laced in a y!otonic

solution %ill s;(ll



+y,o%oi$ Fluids <sed to :dilute; !lasa

!articularly in y!ernatreia reats cellular d(!yd")%io o not use "or !ts %it increased

C ris7 or tird s!acing ris7

*.>'+NS

*.11+NS



Iso%oi$ Fluid sotonic $uids a3e te sae

concentration o" !articles

0osolality4 as CF 0/Q'(/'8s24

Osmo%i$ ,"(ssu"( is tere"ore te

s)m( inside & outside te cells Cells neiter srin7 nor s%ell in an

isotonic solution, tey stay te s)m(



sotonic Fluid E9!ands #ot intracellular and

e9tracellular 3olue <sed coonly "orH e9cessi3e

3oiting,diarrea

*.+ Noral saline 'W RingerIs actate



O%!(" Osmo%i$ F)$%o"s

ALBU'IN 0 a seru !rotein 4 Al#uin in te seru as osotic !ro!erties

calledcolloid pressure

Al#uin !ulls 6/* "ro te interstitialco!artents into te intra3ascularco!artents 0seru4. 6el!s to aintain B.

ersons %it lo% seru al#uin le3els tend toretain $uid in teir interstitial layers.

Wat a#noral assessents igt you Dnd in

te client %it lo% seru al#uin le3els5 Ed(m)<



+mmm

Wat ty!e o" $uid0y!otonic ? isotonic ? y!ertonic4

igt #e o" #eneDt to tis client%it lo% al#uin le3els5



Cosid(" %!is

Wen tissue inLury occurs, !roteins!atologically lea7 "ro te

intra3ascular s!ace into teintersititial s!ace.

eredH Third spacing

is e9!lains as a signo" te in$aatory !rocess.

EE'A



Solu%( 'o9(m(% i=usio

Mo3eent o" solu%(s "ro igconcentration to lo% concentration

t is a ASSE o3eent 8WN teconcentration gradiant. (requires no energy)

Many #ody !rocesses use difusion.E9a!leH 8/ and C8/ e9cange

Rate is afected #yH concentrationgradiant, !erea#ility(sur"ace area(tic7ness o" e#ranes, and sie o"!articles.

0Fic7Is a%4



Solu%( 'o9(m(% >o%!(" m($!)isms

A$%i9( %")s,o"%( reGuires energy 0A4to o3e "ro lo% concentration to igconcentration 0uphill)E9a!leH Na 2 K !u!

May #e enanced #y carrier olecules

%it #inding sites on cell e#raneE9a!leH lucose0nsulin !rootes te insertion o" #indingsites "or lucose on cell e#ranes4.



Fil%")%io

Sol3ent AN solute o3eent assage "ro an area o" 6ig ressure to an

area o" o% ressure eredH +yd"os%)%i$ -"(ssu"(

E9a!leHArterioles a3e iger !ressure tan CFFluid, o9ygen and nutrients o3e into cellsenules a3e lo%er !ressure tan CFFluid, car#on dio9ide and %astes o3e out o"

cells



Fluid 3olue deDcit F

06y!o3oleia4 Loss o ?o%! +20 )d

(l($%"oly%(s "om ECF Causes includeH

ncreased out!ut, 6eorrage,3oiting, diarrea, #urns,8R

Fluid si"t out o" 3ascular s!ace0 :tird s!acing; 4 into interstitials!aces



eydration

Iso%oi$ d(!yd")%io = 6/* &electrolyte loss in eGual aountsT

diarrea and 3oiting

+y,("%oi$ d(!yd")%io = 6/* loss

greater tan electrolyte lossT e9cessi3e!ers!iration, dia#etes insi!idus



AssessentF ( 6y!o3oleia

C)"dio9)s$ul)"H iinised !eri!eral !ulsesT Guality -@

0tready4 ecreased B & ortostatic y!otension ncreased 6R Flat nec7 & and 3eins in de!endent !osition Ele3ated 6eatocrit 06ct4

*)s%"oi%(s%i)l@ irst ecreased otilityT diinised #o%el sounds,

!ossi#le consti!ation



AssessentF ? 6y!o3oleia0continued4

N(u"omus$ul)"H ecreased CNS acti3ity

0letargy to coa4 ossi#le "e3er S7eletal uscle %ea7ness 6y!eracti3e R

R()lH ecreased out!ut ncreased s!ec gra3 o"

urine Weigt loss 6y!ernatreia

I%(.um(%)"y@ ry out & s7in

oor turgor 0tenting4 itting edea Sun7en eye#alls

R(s,i")%o"y@ ncreased rate and de!t



Nursing iagnosis ( F

($i(% Fluid olum(

R2 loss o" Fluids 3ia 3oitingAEB ele3ated 6ct, dry ucouse#ranes, decreased out!ut,

tirst



lanning ( F

Client %ill deonstrate $uid#alance ae# oist ucous

e#ranes, #alanced & 8easureents, 6ct WN, #y.



nter3entions "orF ( 6y!o3oleia

re3ent "urter $uid loss 8ral reydration tera!y

tera!y MedicationsT antieetics, antidiarreals Monitor C, Res!, Renal, status

Monitor electrolytes ? !ossi#le su!!leent r9 M8N8R WE6 and & 8



NCEU ractice

ntra3enous $uids are ordered "or your client

%o is e9!eriencing diarrea and 3oiting "or

te !ast / days. Wic solution %ould tenurse e9!ect to see !rescri#ed5

a. 'NS

#. *.>'+NSc. '-2/NS

d. R



Fluid olue E9cessFE ( 6y!er3oleia

Fluid o3erload is an e9cess o"#ody $uid ( o9("!yd")%io

E9cess $uid 3olue in teintra3ascular area(!y,("9ol(mi)

E9cess $uid 3olue in interstitials!aces (d(m)



Fluid olue E9cess

CausesH ncreased Na26/8 "(%(%io E9cessi3e i%):( o" Na 08 or 4 E9cessi3e i%):( o" 6/8 0 8 or 4

0Water into9ication4

Syndroe o" ina!!ro!riateantidiuretic orone 0SA64

Renal "ailure, congesti3e eart "ailure



AssessentFE ( 6y!er3oleia

C@ Ele3ated !ulseT >@#ounding, ele3ated B,

distended nec7 & and3eins, 3entricular gallo!0S146y!onatreia

R(s,@ ys!nea, MoistCrac7les,acy!nea

I%(.um(%)"y@ erior#ital edea

itting or Non(!itting edea

*I@ncreased otilityStoac cra!sNausea & oiting

R()l@Weigt gain

ecreased s!ec gra3o" urine

N(u"omus$ul)"@ Altered 8C,

eadace, s7eletaluscle t%itcing



Nursing iagnosis ( FE

Fluid 9olum( e9cess

R2 e9cessi3e 6/* inta7e

AEB con"usion, eadace, uscle

t%itcing, a#doinal cra!s,ele3ated B and 6R, y!onatreia.



lanning ( FE

Client %ill deonstrate $uid#alance #y #alanced & 8

easureents, Seru Na WN,etc. #y .



nter3entionsFE ( 6y!er3oleia

Restore noral $uid #alance,!re3ent "urter o3erload

rug tera!yT diuretics iet tera!yT decrease Na & $uids Monitor inta7e and out!ut 0 & 84

Monitor %eigts Monitor electrolytes Monitor C, Res!, Renal systes



Clinical A!!lication

Vou a3e #een assigned to care "or an *y.o.client aditted %it y!ernatreia tat as

an in"using *.>'+ NS -**l2r 3ia!u! and an ind%elling urinary cateter. At--a you assess an out!ut in te urinarydrainage #ag o" -'*l d7 a#er urine. Vou

also notice tat te client is S8B %iles!ea7ing on te !one to er daugter.

Wat do you tin7 is a!!ening55

Wat %ill you do55



S<MMARV

Want ore n"oration555C6ECK 8< 6E

WEBNKSFor Ca!ter >- on

E8E



Electrolytes

Wor7 %it $uids to 7ee! te #ody ealtyand in #alance

ey are solu%(s tat are "ound in3arious concentrations and easured inters o" illieGui3alent 0EG4 units

Can #e negati3ely carged 0)ios4 or

!ositi3ely carged 0$)%ios4 For oeostasis #ody needsH

otal #ody AN8NS = otal #ody CA8NS



Electrolytes

C)%ios

ositi3ely carged

Sodiu Na@

otassiu K @ Calciu Ca@@

Magnesiu Mg@

@

Aios

Negati3ely carged

Cloride Cl(

os!ate 8>( Bicar#onate

6C81(



Electrolyte Functions

Regulate %ater distri#ution

Muscle contraction Ner3e i!ulse transission Blood clotting Regulate enye reactions 0A4 Regulate acid(#ase #alance



Sodiu Na@

-1'(->'EG2 MaLor Cation Cie" electrolyte o" te ECF Regulates 3olue o" #ody $uids Needed "or ner3e i!ulse & uscle

D#er transission 0Na2K !u!4 Regulated #y 7idneys2 orones



6

6y!er and 6y!o Natreia are te ost

coon electrolyte distur#ances. Wy do

you tin7 tat is5

t is ost a#undant in teEURACE<AR F< and tere"oreore !rone to $uctuation.



6y!onatreia

Seru Na@ P-1'EG2 Results "ro e9cess o" %ater or loss

o" Na@ Water si"ts "ro ECF into cells SS@ a#d cra!s, con"usion, N2,

62A, !itting edea o3er sternu T/@ iet2 tera!y2$uid restrictions



ets tin7 a#out 6y!onatreia

Wat are soe edical conditions tat ay cause adilutional y!onatreia5C6FRenal FailureSA6 0 Cancer, !ituitary traua 4Addisons isease 0 y!oaldosteronis & Na loss 4

Wat are soe conditions tat igt cause actual losso" sodiu "ro te #ody5 losses ? nasogastric suctioning, 3oiting, diarreaCertain diuretic tera!ies

eranent neurological daage can occur %en seruNa le3els "all #elo% --* EG2. Wy56y!otonic en3ironent s%ells cells, increasing C ?

#rain daage



6y!ernatreia Seru Na@O ->'EG2 Results "ro Na@ gained in e9cess o"

6/8 8R Water is lost in e9cess o" Na@ Water si"ts "ro cells to ECF SS@ tirst, dry ucous e#ranes &

li!s, oliguria, increased te! &!ulse,$used s7in,con"usion

T/@ tera!y2diet



etIs tin7 a#out.6y!ernatreia

Wat are soe edical conditions tat ay cause ele3atedseru Na5Renal "ailureia#etes nsi!idus

ia#etes Mellitus 0 y!erglyceic deydration4Cusings syndroe 0y!eraldosteronis4

Wat are soe oter !atient !o!ulations at ris7 "ory!ernatreia5Elderly 0 decreased tirst ecanis 4atientIs recei3ingH(tu#e "eedings(corticosteroid drugs(certain diuretic tera!ies

Seiures, coa, deat y result i" y!ernatreia is le"tuntreated. Wy5

Cells loose $uid into te ECF causing irre3ersi#le celldaage.



Critical in7ing6y!o 2 6y!er Natreia

For te client e9!eriencing

FE & y!onatreia d2t

e9cessi3e inta7e o" %ater,%ic solution %ould

you

e9!ect te !ysician to

order5

a. 'NS

#. NS

c. 'W

d. X NS

For te cliente9!eriencing

F and y!ernatreiad2t e9cessi3e %ater loss,

%ic solution %ould

you e9!ect te !ysician

to order5a. ' X NS

#. 'R

c. 'W

d. X NS



otassiu K@

1.'('.* EG2 Cie" electrolyte o" CF

MaLor ineral in all cellular $uids Aids in uscle contraction, ner3e &

electrical i!ulse conduction, regulates

enye acti3ity, regulates C 6/*content, assists in acid(#ase #alance Regulated #y 7idneys2 orones n3ersely !ro!ortional to Na



6y!o7aleia

Seru le3el P 1.'EG2 Results "ro decreased inta7e, loss 3ia

2Renal & !otassiu de!leting diuretics i"e treatening(all #ody systes afected SS uscle %ea7ness & leg cra!s,

decreased otility, cardiac arrytias T/@ diet2su!!leents2 tera!y

i 7 #



ets tin7 a#out 6y!o7aleia

Wat are soe edical conditions tat ay cause ay!o7aleia5Renal isease 2 C6F 0dilutional4Meta#olic Al7alosisCusings isease 0 Na retention leads to K loss 4

Wat are soe conditions tat igt cause actual losso" !otassiu "ro te #ody5 losses ? nasogastric suctioning, 3oiting, diarreaCertain diuretic tera!iesnadeGuate inta7e ? 0 #ody cannot conser3e K, need 8inta7e4

Cardiac arrest ay occur %en seru K le3els "all#elo% /.' EG2. Wy5ncreased cardiac uscle irrita#ility leads to ACs and



6y!er7aleia

Seru le3el O' EG2 Results "ro e9cessi3e inta7e, traua,

crus inLuries, #urns, renal "ailure SS uscle %ea7ness, cardiac

canges, N2, !aratesias o""ace2Dngers2tongue

T/@diet2eds2 tera!y2 !ossi#ledialysis

t ti 7 # t



ets tin7 a#out 6y!er7aleia

Wat are soe edical conditions tat ay causey!er7aleia5Renal isease=ost coon causeBurns and oter aLor tissue trauaMeta#olic AcidosisAddisonIs isease 0 Na loss leads to K retention 4

Wat are soe conditions tat igt cause !otassiule3els to rise in te #ody5Certain diuretic tera!iesE9cessi3e inta7e ? 0 ina!!ro!riate su!!leents4

Cardiac arrest ay occur %en seru K le3els risea#o3e EG2. Wy5ecreased electrical i!ulse conduction leads to#radycardia and e3entual asystole.

C iti l i 7i



Critical in7ingotassiu additi3es

Wic o" te "ollo%ing inter3entions %ill tenurse underta7e %en adinistering

!arenteral K additi3es5Monitor te site "or !le#itislace on cardiac onitor i" O -* EGAssure o" adeGuate i9ing o" K in solution

Monitor "or ele3ated K le3elsMonitor "or decreased Na le3elsAdinister !otassiu #y slo% !us etod

N E 2 E

R B B B



Calciu Ca@@

>.'('.'EG2 Most a#undant in #ody #utH

+ in teet and #ones Needed "or ner3e transission,

3itain B-/ a#sor!tion, uscle

contraction & #lood clotting n3erse relationsi! %it os!orus itain needed "or Ca a#sor!tion



6y!ocalceia

Seru Ca P >.1EG2 Results "ro lo% inta7e, loo!

diuretics, !aratyroid disorders, renal"ailure SS osteoalacia, EK canges,

nu#ness2tingling in Dngers, uscle

cra!s 2 tetany, seiures, Co3ste7Sign & rousseau Sign

T/@ diet2 tera!y



Co3ste7 rousseau

t ti 7 # t



ets tin7 a#out 6y!ocalceia

Wat are soe edical conditions tat ay causey!ocalceia56y!o!aratyroidis 0lo% 6 le3els = decreased releaseo" Ca "ro #ones4

S2 tryoid surgery 0 lo% Calcitonin = decreased release o"Ca "ro #ones4 Acute !ancreatitisCrons isease6y!er!os!ateia 0 ESRF4

Wat are soe oter conditions tat igt cause lo% Ca5

losses ? nasogastric suctioning, 3oiting, diarreaong ter io#iliationactose intolerance

" y!ocalceia is !rolonged, te #ody %ill utilie storedCa "ro #ones.Wat co!lication igt arise5Fractures 0 late sign 4



6y!ercalceia

Seru Ca O '.1EG2 Results "ro y!er!aratyroidis,

soe cancers, !rolongedio#iliation

SS uscle %ea7ness, renal calculi,

"atigue, altered 8C, decreased otility, cardiac canges T/@ edication2 tera!y

t ti 7 # t



ets tin7 a#out 6y!ercalceia

Wat are soe edical conditions tat ay causey!ercalceia56y!er!aratyroidis 0ig 6 le3els = increased releaseo" Ca "ro #ones4

agetIs iseaseSoe Cancers ? Multi!le MyleoaCronic Alcoolis 0 %it lo% seru !os!orus 4

Wat are soe oter conditions tat igt cause lo% Ca5

E9cessi3e inta7e o" Ca 8R itain E9cessi3e inta7e o" 8C antacids

" y!ercalceia is uncorrected, A #loc7 and cardiacarrest ay occur.



Magnesiu Mg/@

-.'(/.'EG2 Most located %itin CF Needed "or acti3ating enyes,

electrical acti3ity, eta#olis o"car#s2!roteins, NA syntesis

Regulated #y intestinala#sor!tion and 7idney



6y!oagneseia

Seru P -.'EG2 Results "ro decreased inta7e, !rolonged

N8 status, cronic alcoolis & nasogastric

suctioning SS@ uscle %ea7ness, $)"di)$ $!).(s,

ental canges, y!eracti3e re$e9es &oter y!ocalceia S2S.

T/@ re!laceent tera!y restore noral Ca le3els 0 Mg iics Ca4 seiure !recautions



6y!oagneseia

Coon in critically ill !atients

Associated %it ig ortality rates ncreases cardiac irrita#ility and

3entricular dysrytias ( es!ecially in!atients %it recent M

Maintenance o" adeGuate seru Mg as#een so%n to reduce ortality rates !ostM



6y!eragneseia

SeruO/.'EG2 Results "ro renal "ailure,

increased inta7e S2SH $using, letargy, cardiac

canges 0decreased 6R4,decreased

res!, loss o" dee! tendon re$e9es 9H restrict inta7e diuretic r9



Cloride Cl(

'(-*'EG2 Most a#undant anion in ECF Co#ines %it Na to "or salts Maintains %ater #alance, acid(#ase

#alance, aids in digestion 0ydrocoric acid4

& osotic !ressure 0%it Na and 6/*4

Regulated #y 7idneys Follo%s Sodiu 0Na4



6y!ocloreia

Seru le3el )EG2 Results "ro !rolonged 3oiting &

suctioning SS eta#olic al7alosis, ner3e

e9cita#ility, uscle cra!s,

t%itcing, y!o3entilation,decreased B i" se3ere

T/@ diet2 tera!y



6y!ercloreia

Seru le3el O -*)EG2 Results "ro e9cessi3e inta7e or

retention #y 7idneys ? eta#olicacidosis SS Arrytias, decreased cardiac

out!ut, uscle %ea7ness, 8C

canges, KussaulsIs res!irations T/@ restore $uid & electrolyte #alance



os!ate 8>(

/.'(>.'g2dl Needed "or acid(#ase

#alance,neurological & uscle "unction,energy trans"er A & afectseta#olis o" car#s2!roteins2li!ids, B3itain syntesis

Found in te #ones Regulated #y inta7e and 7idneys n3ersely !ro!ortional to Calciu

ere"ore soe regulation #y 6 as %ell



6y!o!os!ateia

Seru le3el P -.EG2 Results "ro decreased intestinal

a#sor!tion and increasede9cretion

SS #one & uscle !ain, ental

canges, cest !ain, res!. "ailure T/@ iet2 tera!y



6y!er!os!ateia

Seru le3elO /.)EG2 Results "ro renal "ailure, lo% inta7e o"

calciu SS@ neurouscular canges 0tetany4, EK

canges, !aratesia(Dngerti!s2out T/@ ietT y!ocalceic inter3entions

MedicationsH !os!ate #inding

e #ody can tolerate y!er!os!ateia"airly %ell B< te acco!anyingy!ocalceia is a larger !ro#leJ



Critical in7ing ( NCEU

e nurse is caring "or a client %it renal"ailure %ose agnesiu le3el is 1.)g2d. Wic o" te "ollo%ing signs%ould te nurse ost li7ely e9!ect tonote in te client #ased on tis Mg le3el5

a. %itcing

#. 6y!eracti3e re$e9esc. rrita#ility

d. oss o" dee! tendon re$e9es



Electrolyte oeostasis

is eans to aintain#alance to control #y

#alancing te dietary inta7e o"electrolytes %it te renale9cretion and rea#sor!tion o"

electrolytes

nter3entions "or F2E



nter3entions "or F2E#alance

Assess !atient care"ully( notecanges

Monitor & 8 0nta7e & 8ut!ut4 Monitor %eigt canges Monitor urine Monitor 3s Monitor la# results and d9 test

Maintain !ro!er tera!y



Suary

Fluid co!artents in te #ody ust#alance

Body systes regulate F&E #alance Assessent o" #ody $uid is i!ortant

to deterine causes o" i#alance

nter3entions "or i#alances are#ased on te cause

Lect15&16 Fluids&Electrolytes (2)

Documents

Transcript of Lect15&16 Fluids&Electrolytes (2)