NUR 1021C Fluid and Electrolytes Cheat Sheet

Fluid & Electrolyte Basics III
Fundamentals of Nursing


TEST TIP The MOST deadly conditions are typically the MOST tested conditions, since the main goal of nursing school
is to create safe nurses.


Electrolytes Function HYPER ‘’HIGH’’ Hypo ‘’low’’

Potassium K+ HYPERkalemia HYPOkalemia
P (over 5.0) (below 3.0)
3.5 - 5.0 Priority
Manifestations (S/S)
Heart = HIGH pumps Manifestations (S/S)
P P
RITY 1 - Peaked T Waves & ST Elevation Heart = Low & slow pump
Potassium PRIO Pumps the heart 2 - Severe: V Fib & Cardiac Arrest Causes: - Renal failure 1 - Flat T waves, ST depression & Uwave
Causes:
Potassium 3 - Hypotension & Bradycardia - Low aldosterone Neuromuscular = Low & slow
1 - Shallow Respirations! Most DEADLY Fluid loss/electrolyte loss
Neuromuscular = HIGH Memory Trick for AL


K+
Potassium 2 - Decreased DTR “Where fluids flow, electrolytes goooo!”
1 - Increased DTR A - Adds Sodium 3 - Muscle cramping & flaccid paralysis

K+ 2 - Paralysis & paresthesia (tingling) (paralyzed limbs) Diarrhea, Diuretics,
3 - Muscle weakness (general feeling L - Loses Potassium GI = Low & slow Diet, DKA, Aldosterone
of heaviness) 1 - Constipation
2 - HypOactive bowel sounds
GI = HIGH pumps 3 - Paralytic ileus (paralyzed intestine)
1 - Diarrhea Priority* risk for SBO
2 - Hyperactive bowel sounds




Sodium Na+ S HYPERnatremia HYPOnatremia
Sodium



135 - 145 Sodium (over 145) (below 135)
Maintains: Na+
Manifestations (S/S) Manifestations (S/S)
• Blood Pressure Causes:
Brain = Low & slow
Causes:
Body = Big & Bloated - Low ADH (antidiuretic hormone) - Sweating
Sodium • Blood volume S 1 - Edema (swollen body) DI: Diabetes Insipidus 1 - Headache = Cerebral edema
2 - Mental status changes
- Excess water intake
(running in the extreme heat) TEST TIP
• pH balance
Na+
Swells the body with FLUID 2 - Flushed “red & rosey” skin Think Dry Inside 3 - Seizures & Coma - SIADH (Excess ADH
3 - Increased muscle tone - Rapid respirations Muscular = Low & slow - Vomiting & diarrhea,
4 - Swollen dry tongue - Watery diarrhea - Fatigue & muscle cramps - Diuretics & Diuresis
5 - Nausea & Vomiting - Loss of thirst Respiratory = Low & slow - Diet low in salt
- Low aldosterone
- Respiratory Arrest




Chloride Cl- HYPERchloremia HYPOchloremia
(over 107) (below 97)
NORMAL




97 - 107
HIGH
LOW




Related to sodium Chloride Chloride


Maintains: Cl- Cl-
NEARLY SAME
• Blood pressure AS HIGH SODIUM
Chloride NEARLY SAME AS low SODIUM
• Blood Volume 1 - Swollen dry tongue 1 - Fatigue & muscle cramps
Cl- • pH balance pH 2 - Nausea & vomiting
Metabolic Alkalosis - vomiting
2 - Fever (only difference)




Magnesium Mg+ HYPERmagnesemia HYPOmagnesemia
1.3 - 2.1 M M (over 2.1) (below 1.3)
Magnesium Mellows the muscles

Manifestations (S/S)
Heart = High Mellow Manifestations (S/S)
Magnesium Causes: Heart = Low Mellow - Excited!
Magnesium 1 - Heart block
- Renal failure
1 - Torsades de Pointes TOP TESTED

Mg+
2 - Hypotension, bradycardia & V Fib (ventricular fibrillation) Causes:

Mg+
DTR = High Mellow - Alcoholism DTR = Low Mellow - Excited! - Crohn's disease
- Hyporeflexia (decreased DTR) - Malnourishment - HYPERreflexia (increased DTR) - Celiac disease
Lungs & GI = High Mellow GI = Low Mellow - Excited!
- Depressed respirations - Diarrhea
- Hyperactive bowel sounds
- Hypoactive bowel sounds



Calcium Ca C HYPERcalcemia HYPOcalcemia
Keeps the Calcium


9.0 - 10.5 3 Bs Strong
B - Bone
Calcium (over 10.5) (below 9.0)
B - Blood (clotting) Ca Manifestations (S/S) Manifestations (S/S)
B - Beats (heart) HIGH Calm Causes: Low Calm = Excited!
Causes:
Calcium C 1 - Kidney stones, moans & - Hyperparathyroidism
1 - T - Trousseau’s Sign
Twerking arm when BP cuff on -Hypoparathyroidism



Ca
Inverse Contracts the muscles groans (Renal Calculi) High PTH = High Calcium Tetany: muscle spasms all over
2 - C - Chvostek’s Sign
Low PTH = Low Calcium
2 - Constipation - Cancer Cheeky smile when stroking face - Renal failure TEST TIP
relationship with 3 - Bone pain - Immobility
3 - Diarrhea Chronic kidney disease (CKD)
4 - Weak B’s
Phosphate 4 - Severe muscle weakness Weak Bones = Fractures
Weak Blood clotting = r/f bleeding
& lethargy Weak Beats = Cardiac dysrhythmias




Phosphate - Ca HIGH = Inverse HYPERphosphatemia HYPOphosphatemia
Phosphate Low
3.0 - 4.5 - Ca Low =
relationship with
Calcium
(over 4.5) (below 3.0)
Phosphate HIGH
Manifestations (S/S)
Manifestations (S/S) Think High Calcium signs Causes:
Calcium
Think Low Calcium signs Causes: 1 - Kidney stones, moans & groans - Hyperparathyroidism

Ca 1 - Trousseau’s & Tetany
2 - Chvostek's
- Renal failure TEST TIP
Chronic kidney disease (CKD)
(Renal Calculi)
2 - Constipation
High PTH = High Calcium
- Genetics
- Cancer
3 - Weak B’s (bones, blood, beats) 3 - Bone Pain
Calcium 4 - Severe muscle weakness & lethargy

Ca