IG: @danedelion tiktok: @daanedelions Fluids and Electrolytes Cram Sheets Your Nursing Ate 1 of 20
Electrolyte Values Laboratory test Normal Value Description
Na+ 136-145 mEq/L
Serum Osmolality 275-290 mOsm/kg Concentration of solutes (sodium) in ECF
Ca++ 8.6-10.2 mg/dL
K+ 3.5-5.0 mEq/L
Urine Osmolality 200-800 mOsm/kg Indicator of urine concentration. (Urea,
creatinine, uric acid)
Mg++ 1.3-2.1 mEq/L
Cl- 97-107 mEq/L Urine Specific Gravity 1.010-1.025 Measures kidney’s ability to conserve or
excrete H20
HPO4- 3.0-4.5 mEq/dL *inc. glucose/protein in urine can give a
falsely elevated specific gravity.
HCO3- 24-31 mEq/L BUN 10-20 mg/dL Inc: dec renal func, GI bleeding,
(3.6 to 7.2 mol.L) dehydration, inc. protein intake, fever,
sepsis
ABG Values Dec: liver dse, low protein diet,
starvation, expanded fluid vol.
(< Acidosis) (>Alkalosis)
pH 7.35 to 7.45 Creatinine 0.7-1.4 mg/dL Increases when renal function decreases
Higher H+ conc. Lower H+ conc. (62-124 mmol/L)
(<alkalosis) (>acidosis)
PaCO2 35 to 45 mmHg Hematocrit 42%-52% men Inc: dehydration, polycythemia
35%-47% women Dec: over hydration, anemia
(< Acidosis) (>Alkalosis)
HCO3 22 to 26 mEq/L
Urine Sodium 75-200mEq/24hrs Inc Na+ intake, inc = inc. Na- excretion
Partially compensated: Uncompensated: (75-200 mmol/24hrs) Dec in circulating fluid volume = Na+ is
• PaCO2 or HCO3 is out of normal • PaCO2 or HCO3 is normal conserved
range • pH is not normal
Urine output 1 ml/kg/hr for all age groups Dec U/O = dehydration, infection, or
• pH is not normal
>30 cc per hr obstruction in urinary tract.
↑ pH ↓pH ↑ pH ↓pH
↓ PaCO2 ↑ PaCO2 ↑ HCO3- ↓HCO3-
Respiratory Respiratory Metabolic Metabolic
alkalosis acidosis alkalosis acidosis
,IG: @danedelion tiktok: @daanedelions Fluids and Electrolytes Cram Sheets Your Nursing Ate 2 of 20
ISOTONIC SOL’N HYPOTONIC SOL’N
Isotonic • Expands ECF 0.45% NaCl (half strength saline) • Provides Na+, Cl, and free water
• Hypovolemic states • Aids in elimination of solute
0.9% NaCl / NS • Resuscitative efforts Na+ 77 mEq/L • Hypertonic dehydration
• Shock Cl- 77 mEq/L • Na+ and Cl- depletion
Na+ 154 mEq/L • DKA 154 mOsm/L • Gastric fluid loss
Cl- 154 mEq/L • Metabolic alkalosis • Not indicated: 3rd spacing and inc. ICP
(Also available c dextrose 5% conc. common) • Hypercalcemia • Administer cautiously; may cause fluid shifts
308 mOsm/L • Mild Na+ deficit from vascular system into cells, resulting
• Monitor for FVE & hyperchloremic acidosis in into CV collapse and inc. ICP
pts with: impaired renal func, HF, or edema.
• Only solution to be given with blood HYPERTONIC SOL’N
products
• Tonicity similar to plasma
3% NaCl • Inc ECF
• Decrease cellular swelling
Na+ 513 mEq/L • Hyponatremia
Lactated Ringer’s Solution • Contains multiple electrolytes in similar conc. Cl- 513 mEq/L • Administer slowly and cautiously,
found in plasma 1,026 moSm/L • Monitor for intravascular volume overload
• Hypovolemia and pulmonary edema
Na+ 130 mEq/L • Burns 5% NaCl • Supplies no calories
K+ mEq/L • Fluid lost as bile or diarrhea Na+ 855 mEq/L
Ca++ 3 mEq/L • Acute blood loss replacement Cl- 855 mEq/L
Cl- 109 mEq/L • Lactate metabolized as bicarbonate 1,710 moSm//L
• CI: lactic acidosis— lactate metabolism COLLOID SOL’N
impaired
• pH >7.5
• Kidney injury — risk for hyperkalemia
Dextran in NS or D5W • Volume/plasma expander for intravascular
part of ECF
• Decreases ability to clot
5% Dextrose in Water (D5W) • Renal excretion of solutes • Remains in circulation for 24h
• Hypernatremia • Treats hypovolemia in shock: inc. pulse
• Fluid loss pressure, cardiac output, and arterial BP
No electrolytes • Caution during post op period (ADH sec inc • Improves microcirculation— dec RBC
50g of dextrose DT stress reaction) aggregation
• May dilute plasma electrolyte conc. • CI: hemorrhage, thrombocytopenia, renal dse,
• CI: head injury — inc ICP severe dehydration
• Fluid resuscitation — hyperglycemia • Not a substitute for blood/blood products
• May cause: peripheral circulatory collapse,
anuria with Na deficiency, and inc. body fluid
loss.
• Monitor for water intoxication
• Monitor for hypokalemia
, IG: @danedelion tiktok: @daanedelions Fluids and Electrolytes Cram Sheets Your Nursing Ate 3 of 20
FVD (Hypovolemia)
Nursing Interventions
Loss of ECF volume exceeded the intake of fluid
Monitor I&O
Monitor VS
Contributing Factors -weak rapid pulse
-orthostatic hypotension
- ↓ temp
Vomiting Decreased intake Daily weights
Diarrhea Anorexia Monitor skin turgor
-sternum
Fistulas Nausea -inner thigh
-forehead
Excess sweating Inability to gain access to fluid Monitor tongue turgor
-↑ longitudinal furrows
-smaller in size DT fluid loss
Burns Diabetes insipidus -dry mucous membranes
Monitor mental function
Blood loss Uncontrolled DM
-delirium
-cold extremities
GI suction Third spacing
Encourage/assist with oral hygiene
Manifestations Administer IV fluids
Weight loss Flattened neck veins
Poor skin turgor Weakness
Oliguria Thirst
Concentrated urine Confusion
>3 cap. Refill Sunken eyes
Low CVP Cool clammy skin
↑ HBG, HCT, serum & urine ↓ Urine sodium, CVP
osmolality, specific gravity,
BUN, creatinine
Electrolyte Values Laboratory test Normal Value Description
Na+ 136-145 mEq/L
Serum Osmolality 275-290 mOsm/kg Concentration of solutes (sodium) in ECF
Ca++ 8.6-10.2 mg/dL
K+ 3.5-5.0 mEq/L
Urine Osmolality 200-800 mOsm/kg Indicator of urine concentration. (Urea,
creatinine, uric acid)
Mg++ 1.3-2.1 mEq/L
Cl- 97-107 mEq/L Urine Specific Gravity 1.010-1.025 Measures kidney’s ability to conserve or
excrete H20
HPO4- 3.0-4.5 mEq/dL *inc. glucose/protein in urine can give a
falsely elevated specific gravity.
HCO3- 24-31 mEq/L BUN 10-20 mg/dL Inc: dec renal func, GI bleeding,
(3.6 to 7.2 mol.L) dehydration, inc. protein intake, fever,
sepsis
ABG Values Dec: liver dse, low protein diet,
starvation, expanded fluid vol.
(< Acidosis) (>Alkalosis)
pH 7.35 to 7.45 Creatinine 0.7-1.4 mg/dL Increases when renal function decreases
Higher H+ conc. Lower H+ conc. (62-124 mmol/L)
(<alkalosis) (>acidosis)
PaCO2 35 to 45 mmHg Hematocrit 42%-52% men Inc: dehydration, polycythemia
35%-47% women Dec: over hydration, anemia
(< Acidosis) (>Alkalosis)
HCO3 22 to 26 mEq/L
Urine Sodium 75-200mEq/24hrs Inc Na+ intake, inc = inc. Na- excretion
Partially compensated: Uncompensated: (75-200 mmol/24hrs) Dec in circulating fluid volume = Na+ is
• PaCO2 or HCO3 is out of normal • PaCO2 or HCO3 is normal conserved
range • pH is not normal
Urine output 1 ml/kg/hr for all age groups Dec U/O = dehydration, infection, or
• pH is not normal
>30 cc per hr obstruction in urinary tract.
↑ pH ↓pH ↑ pH ↓pH
↓ PaCO2 ↑ PaCO2 ↑ HCO3- ↓HCO3-
Respiratory Respiratory Metabolic Metabolic
alkalosis acidosis alkalosis acidosis
,IG: @danedelion tiktok: @daanedelions Fluids and Electrolytes Cram Sheets Your Nursing Ate 2 of 20
ISOTONIC SOL’N HYPOTONIC SOL’N
Isotonic • Expands ECF 0.45% NaCl (half strength saline) • Provides Na+, Cl, and free water
• Hypovolemic states • Aids in elimination of solute
0.9% NaCl / NS • Resuscitative efforts Na+ 77 mEq/L • Hypertonic dehydration
• Shock Cl- 77 mEq/L • Na+ and Cl- depletion
Na+ 154 mEq/L • DKA 154 mOsm/L • Gastric fluid loss
Cl- 154 mEq/L • Metabolic alkalosis • Not indicated: 3rd spacing and inc. ICP
(Also available c dextrose 5% conc. common) • Hypercalcemia • Administer cautiously; may cause fluid shifts
308 mOsm/L • Mild Na+ deficit from vascular system into cells, resulting
• Monitor for FVE & hyperchloremic acidosis in into CV collapse and inc. ICP
pts with: impaired renal func, HF, or edema.
• Only solution to be given with blood HYPERTONIC SOL’N
products
• Tonicity similar to plasma
3% NaCl • Inc ECF
• Decrease cellular swelling
Na+ 513 mEq/L • Hyponatremia
Lactated Ringer’s Solution • Contains multiple electrolytes in similar conc. Cl- 513 mEq/L • Administer slowly and cautiously,
found in plasma 1,026 moSm/L • Monitor for intravascular volume overload
• Hypovolemia and pulmonary edema
Na+ 130 mEq/L • Burns 5% NaCl • Supplies no calories
K+ mEq/L • Fluid lost as bile or diarrhea Na+ 855 mEq/L
Ca++ 3 mEq/L • Acute blood loss replacement Cl- 855 mEq/L
Cl- 109 mEq/L • Lactate metabolized as bicarbonate 1,710 moSm//L
• CI: lactic acidosis— lactate metabolism COLLOID SOL’N
impaired
• pH >7.5
• Kidney injury — risk for hyperkalemia
Dextran in NS or D5W • Volume/plasma expander for intravascular
part of ECF
• Decreases ability to clot
5% Dextrose in Water (D5W) • Renal excretion of solutes • Remains in circulation for 24h
• Hypernatremia • Treats hypovolemia in shock: inc. pulse
• Fluid loss pressure, cardiac output, and arterial BP
No electrolytes • Caution during post op period (ADH sec inc • Improves microcirculation— dec RBC
50g of dextrose DT stress reaction) aggregation
• May dilute plasma electrolyte conc. • CI: hemorrhage, thrombocytopenia, renal dse,
• CI: head injury — inc ICP severe dehydration
• Fluid resuscitation — hyperglycemia • Not a substitute for blood/blood products
• May cause: peripheral circulatory collapse,
anuria with Na deficiency, and inc. body fluid
loss.
• Monitor for water intoxication
• Monitor for hypokalemia
, IG: @danedelion tiktok: @daanedelions Fluids and Electrolytes Cram Sheets Your Nursing Ate 3 of 20
FVD (Hypovolemia)
Nursing Interventions
Loss of ECF volume exceeded the intake of fluid
Monitor I&O
Monitor VS
Contributing Factors -weak rapid pulse
-orthostatic hypotension
- ↓ temp
Vomiting Decreased intake Daily weights
Diarrhea Anorexia Monitor skin turgor
-sternum
Fistulas Nausea -inner thigh
-forehead
Excess sweating Inability to gain access to fluid Monitor tongue turgor
-↑ longitudinal furrows
-smaller in size DT fluid loss
Burns Diabetes insipidus -dry mucous membranes
Monitor mental function
Blood loss Uncontrolled DM
-delirium
-cold extremities
GI suction Third spacing
Encourage/assist with oral hygiene
Manifestations Administer IV fluids
Weight loss Flattened neck veins
Poor skin turgor Weakness
Oliguria Thirst
Concentrated urine Confusion
>3 cap. Refill Sunken eyes
Low CVP Cool clammy skin
↑ HBG, HCT, serum & urine ↓ Urine sodium, CVP
osmolality, specific gravity,
BUN, creatinine
