Extracellular fluid (ECF)
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One-third of the body's fluid that is located in the compartments outside
the cells.
,Nursing Actions for Calcium Imbalances
Nursing actions for hypocalcemia include the following:
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Administering oral calcium tablets or IV calcium along with vitamin D as
ordered by the health-care provider for hypocalcemia. Safety: IV infusion
of calcium can cause bradycardia and death if administered too rapidly.
Use an infusion pump and assess the IV site and rate of infusion every 30 to
60 minutes.
Monitoring the patient with hypocalcemia for muscle twitching, tetany
(severe muscle spasms), and ECG changes.
Assessing for spasms of the facial muscles and the arms and legs, as well as
tingling around the mouth or tips of the fingers. The patient may become
disoriented and confused.
Being aware that patients suffering from hypocalcemia may also present
with Trousseau's sign (Fig. 29.2) and Chvostek's sign (Fig. 29.3).
Nursing actions for hypercalcemia include the following:
Encouraging fluids and monitoring IV infusions, as ordered, to help lower
the calcium levels.
Monitoring the patient for bradycardia, digestive complaints, and visual
disturbances if also on digitalis (Lanoxin) because high calcium can cause
digitalis toxicity.
How does filtration work in the body?
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The liver filters blood to remove dissolved substances such as medications,
over-the-counter drugs, alcohol, caffeine, and toxins from the blood.
Distribution of body fluids
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Intracellular Fluids
Two-thirds of the body fluids are found within the cells.
Extracellular Fluids
One-third of body fluids is found outside the cells, primarily in two areas:
Interstitial space—the areas surrounding and between the cells. This fluid is
also called tissue fluid or interstitial fluid.
Intravascular space—includes the blood vessels and heart, which hold
blood; the liquid portion of the blood which surrounds and holds the
blood cells is called plasma.
Very small amounts of additional fluids are found in certain body spaces,
such as the cerebrospinal fluid around the brain and spinal cord, the fluids
within the chambers of the eye, and synovial fluid in joints. These are not
significant amounts, however, so they are not considered a part of fluid and
electrolyte balance.
Electrolytes
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●Sodium 135-145 mEq/L
●Potassium 3.5-5.3 mEq/L
●Calcium 8.2-10.2 mEq/L
●Magnesium 1.6-2.2 mEq/L
●Chloride 97-107 mEq/L
●Phosphorus 2.5-4.5 mEq/L
Electrolyte Imbalance Excess:
hyperchloremia
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Signs and symptoms—-Signs of metabolic acidosis, hyperkalemia, and
hypernatremia: ↑ R rate and depth, dyspnea, ↑ P ↓ cardiac output,
arrhythmias, weakness, severe edema, ↓ LOC and coma
Causative factors—↑ Na+ serum level, respiratory alkalosis,
hyperparathyroidism, severe diarrhea, sodium retention caused by head
trauma and ↑ intracranial pressure, renal failure, salicylate overdose,
corticosteroid use, diuretic use, dehydration, metabolic acidosis
Acid-Base Imbalance
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●Acidosis
•Respiratory
•Metabolic
●Alkalosis
•Respiratory
•Metabolic
Fluid Volume deficit (HYPOVOLEMIA)
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One-third of the body's fluid that is located in the compartments outside
the cells.
,Nursing Actions for Calcium Imbalances
Nursing actions for hypocalcemia include the following:
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Administering oral calcium tablets or IV calcium along with vitamin D as
ordered by the health-care provider for hypocalcemia. Safety: IV infusion
of calcium can cause bradycardia and death if administered too rapidly.
Use an infusion pump and assess the IV site and rate of infusion every 30 to
60 minutes.
Monitoring the patient with hypocalcemia for muscle twitching, tetany
(severe muscle spasms), and ECG changes.
Assessing for spasms of the facial muscles and the arms and legs, as well as
tingling around the mouth or tips of the fingers. The patient may become
disoriented and confused.
Being aware that patients suffering from hypocalcemia may also present
with Trousseau's sign (Fig. 29.2) and Chvostek's sign (Fig. 29.3).
Nursing actions for hypercalcemia include the following:
Encouraging fluids and monitoring IV infusions, as ordered, to help lower
the calcium levels.
Monitoring the patient for bradycardia, digestive complaints, and visual
disturbances if also on digitalis (Lanoxin) because high calcium can cause
digitalis toxicity.
How does filtration work in the body?
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The liver filters blood to remove dissolved substances such as medications,
over-the-counter drugs, alcohol, caffeine, and toxins from the blood.
Distribution of body fluids
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Intracellular Fluids
Two-thirds of the body fluids are found within the cells.
Extracellular Fluids
One-third of body fluids is found outside the cells, primarily in two areas:
Interstitial space—the areas surrounding and between the cells. This fluid is
also called tissue fluid or interstitial fluid.
Intravascular space—includes the blood vessels and heart, which hold
blood; the liquid portion of the blood which surrounds and holds the
blood cells is called plasma.
Very small amounts of additional fluids are found in certain body spaces,
such as the cerebrospinal fluid around the brain and spinal cord, the fluids
within the chambers of the eye, and synovial fluid in joints. These are not
significant amounts, however, so they are not considered a part of fluid and
electrolyte balance.
Electrolytes
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●Sodium 135-145 mEq/L
●Potassium 3.5-5.3 mEq/L
●Calcium 8.2-10.2 mEq/L
●Magnesium 1.6-2.2 mEq/L
●Chloride 97-107 mEq/L
●Phosphorus 2.5-4.5 mEq/L
Electrolyte Imbalance Excess:
hyperchloremia
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Signs and symptoms—-Signs of metabolic acidosis, hyperkalemia, and
hypernatremia: ↑ R rate and depth, dyspnea, ↑ P ↓ cardiac output,
arrhythmias, weakness, severe edema, ↓ LOC and coma
Causative factors—↑ Na+ serum level, respiratory alkalosis,
hyperparathyroidism, severe diarrhea, sodium retention caused by head
trauma and ↑ intracranial pressure, renal failure, salicylate overdose,
corticosteroid use, diuretic use, dehydration, metabolic acidosis
Acid-Base Imbalance
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●Acidosis
•Respiratory
•Metabolic
●Alkalosis
•Respiratory
•Metabolic
Fluid Volume deficit (HYPOVOLEMIA)
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