ATI Electrolyte Imbalances

UNIT 6 NURSING CARE OF CLIENTS WITH FLUID/ELECTROLYTE/ACID-BASE IMBALANCES CHAPTER 44 Electrolyte Imbalances Overview ● Electrolytes are minerals (sometimes called salts) that are present in all body fluids. They regulate fluid balance and hormone production, strengthen skeletal structures, and act as catalysts in nerve response, muscle contraction, and the metabolism of nutrients. ● When dissolved in water or other solvent, electrolytes separate into ions and conduct either a positive (cations – magnesium, potassium, sodium, calcium) or negative (anions – phosphate, sulfate, chloride, bicarbonate) electrical current. ● Electrolytes are distributed between intracellular (ICF) and extracellular (ECF) fluid compartments. Although laboratory tests can accurately reflect the electrolyte concentrations in plasma, it is not possible to directly measure electrolyte concentrations within cells. ELECTROLYTE EXPECTED REFERENCE RANGES Sodium 136 to 145 mEq/L Calcium 9.0 to 10.5 mg/dL Potassium 3.5 to 5.0 mEq/L Magnesium 1.3 to 2.1 mEq/L Chloride 98 to 106 mEq/L Phosphorus 3.0 to 4.5 mg/dL SODIUM IMBALANCES Overview ● Sodium (Na+) is the major electrolyte found in extracellular fluid. ● Sodium is essential for maintaining acid-base balance, active and passive transport mechanisms, and maintaining irritability and conduction of nerve and muscle tissue. ● The expected reference range for serum sodium levels is 136 to 145 mEq/L. ◯ Decreased sodium levels are referred to as hyponatremia. ◯ Elevated sodium levels are referred to as hypernatremia. CHAPTER 44 ELECTROLYTE IMBALANCES 484 RN ADULT MEDICAL SURGICAL NURSING Hyponatremia ● Hyponatremia is a net gain of water or loss of sodium-rich fluids that results in sodium levels less than 136 mEq/L. ◯ Hyponatremia delays and slows the depolarization of membranes. ◯ Water moves from the ECF into the ICF, causing cells to swell (cerebral edema). ◯ Compensatory mechanisms include the renal excretion of sodium-free water. ● Assessment ◯ Risk Factors ■ Causes of hyponatremi