FLUID AND ELECTROLYTE
IMBALANCES ATI
Electrolytes - ANSminerals (sometimes salts) that have an electrical charge and are present in
all bodily fluids.
-regulate fluid imbalance and hormone production
-strengthen skeletal structures
-act as catalysts in nerve responses
-metabolize nutrients
anions vs. cations - ANS-magnesium, potassium, sodium, calcium (+)
-sulfate, phosphate, chloride, bicarbonate (-)
Major electrolytes - ANSsodium, potassium, chloride, magnesium, phosphorus, calcium
Clients at greatest risk for electrolyte imbalance - ANS-infants
-children
-older adults
-cognitive disorders
-chronic illness
Reference range for Sodium - ANS136-145 mEq/L
Reference range for Calcium - ANS9.0-10.5 mg/dL
Reference range for Potassium - ANS3.5-5.0 mEq/L
Reference range for Magnesium - ANS1.3-2.1 mg/dL
Reference range for Chloride - ANS98-106 mEq/L
Reference range for Phosphorus - ANS3-4.5 mg/dL
Sodium (Na+) - ANSmajor electrolyte found in ECF and is present in most bodily
fluids/secretions.
-essential for acid/base fluid balance
-active/passive transport
-irritability and conduction of nerve/muscle tissue
, Hyponatremia - ANSBlood sodium level less than 136 mEq/L
-results from excess water in plasma or loss of sodium rich fluids.
-delays and slows depolarization of membranes
-water moves from ECF to ICF which causes cells in the body to swell
Risk factors of hyponatremia - ANS-deficit ECF volume
-excessive GI losses: vomiting, NG suctioning, diarrhea, enemas
-renal losses: diuretics, kidney disease, adrenal insufficiency, excessive sweating
-skin losses: burns, wound drainage, peripheral edema, ascites
-excessive water intake, SIADH
-heart failure/cirrhosis/nephrotic syndrome
-excessive administration of dextrose
-inadequate sodium intake (NPO status)
-use of hypotonic irrigating solutions
-hyperglycemia
-greater risk for older adults due to increased chronic illnesses (diuretics, insufficient intake)
Expected findings in hyponatremia - ANSphysical: vary with a normal/decreased ECF volume
VS: hypothermia, tachycardia, rapid thready pulse, hypotension, orthostatic hypotension
musculoskeletal: headache, confusion, lethargy, muscle weakness/respiratory compromise,
fatigue, decreased deep tendon reflexes
GI: increased motility, hyperactive bowel sounds, cramping, nausea, anorexia, nausea, vomiting
Nursing care for hyponatremia - ANS-I&O's/weight daily at the same time
-vital signs/LOC
-change positions slowly
-prescribed fluid restrictions
-monitor RESPIRATORY with muscle weakness
-encourage high sodium foods
FLUID OVERLOAD: restrict water (effective if normal to high)
SEVERE CASES: administer hypertonic oral and IV fluids
Hypernatremia - ANSblood sodium level above 145 mEq/L
-SERIOUS electrolyte imbalance
-significant neurologic, endocrine, and cardiac disturbances
IMBALANCES ATI
Electrolytes - ANSminerals (sometimes salts) that have an electrical charge and are present in
all bodily fluids.
-regulate fluid imbalance and hormone production
-strengthen skeletal structures
-act as catalysts in nerve responses
-metabolize nutrients
anions vs. cations - ANS-magnesium, potassium, sodium, calcium (+)
-sulfate, phosphate, chloride, bicarbonate (-)
Major electrolytes - ANSsodium, potassium, chloride, magnesium, phosphorus, calcium
Clients at greatest risk for electrolyte imbalance - ANS-infants
-children
-older adults
-cognitive disorders
-chronic illness
Reference range for Sodium - ANS136-145 mEq/L
Reference range for Calcium - ANS9.0-10.5 mg/dL
Reference range for Potassium - ANS3.5-5.0 mEq/L
Reference range for Magnesium - ANS1.3-2.1 mg/dL
Reference range for Chloride - ANS98-106 mEq/L
Reference range for Phosphorus - ANS3-4.5 mg/dL
Sodium (Na+) - ANSmajor electrolyte found in ECF and is present in most bodily
fluids/secretions.
-essential for acid/base fluid balance
-active/passive transport
-irritability and conduction of nerve/muscle tissue
, Hyponatremia - ANSBlood sodium level less than 136 mEq/L
-results from excess water in plasma or loss of sodium rich fluids.
-delays and slows depolarization of membranes
-water moves from ECF to ICF which causes cells in the body to swell
Risk factors of hyponatremia - ANS-deficit ECF volume
-excessive GI losses: vomiting, NG suctioning, diarrhea, enemas
-renal losses: diuretics, kidney disease, adrenal insufficiency, excessive sweating
-skin losses: burns, wound drainage, peripheral edema, ascites
-excessive water intake, SIADH
-heart failure/cirrhosis/nephrotic syndrome
-excessive administration of dextrose
-inadequate sodium intake (NPO status)
-use of hypotonic irrigating solutions
-hyperglycemia
-greater risk for older adults due to increased chronic illnesses (diuretics, insufficient intake)
Expected findings in hyponatremia - ANSphysical: vary with a normal/decreased ECF volume
VS: hypothermia, tachycardia, rapid thready pulse, hypotension, orthostatic hypotension
musculoskeletal: headache, confusion, lethargy, muscle weakness/respiratory compromise,
fatigue, decreased deep tendon reflexes
GI: increased motility, hyperactive bowel sounds, cramping, nausea, anorexia, nausea, vomiting
Nursing care for hyponatremia - ANS-I&O's/weight daily at the same time
-vital signs/LOC
-change positions slowly
-prescribed fluid restrictions
-monitor RESPIRATORY with muscle weakness
-encourage high sodium foods
FLUID OVERLOAD: restrict water (effective if normal to high)
SEVERE CASES: administer hypertonic oral and IV fluids
Hypernatremia - ANSblood sodium level above 145 mEq/L
-SERIOUS electrolyte imbalance
-significant neurologic, endocrine, and cardiac disturbances
