NUR 113 Fluid & Electrolyte Notes

ELECTROLYTES are IONS that are found in your BODY FLUIDS. They help to

Electrolytes conduct ELECTRICITY, ENERGY, help CONTROL BODY FLUIDS, and maintain
HOMEOSTASIS in the body.

Where FLUIDS go ELECTROLYTES flow!

Nursing Role: Help PREVENT as well as TREAT fluid & electrolyte disturbances.


THERAPEUTIC RANGE: 6 Most POPULAR Electrolytes
The range of concentrations at which a drug is MOST
EFFECTIVE with the LEAST toxic effect. 1. Sodium (Na): 135-145 mEq/L
: 3.5-5.0 mEq/L
HOMEOSTASIS:
The state of equilibrium, or BALANCE that is maintained by self- 3. Calcium (Ca): 8.5-10.5 mEq/L
regulating processes. 4. Magnesium (Mg): 1.3-2.3 mg/dL
: 2.5-4.5 mg/dL
d 6. Chloride (Cl): 97-107 mEq/L

- Human body = 6
- Varies with
- women Electrolyte Depletion
- muscl
Consists of:
- ICF (In
- ins moDILUTION:
- ECF ion (as after hemorrhage)
-I OD resulting from
-
- Third
-L




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yte


intestines



omy)

, Other Ca ns That Affect
Electrolyte I e Balance*
- Medications, Blood Tran
- Calcium = Preservat cs
- Blood Transfusio
- Dietary intake, malabsor tics
- gastric bypass affects s
- Trauma, bone injury/los
- will affect phosphoru vulsants
- Endocrine
- Diabetes, adrenal gla
n
- Kidney disfunction ockers
- Laxatives
DTR = Deep Tendon Reflexes - Chemotherapy

Now now… Let’s BREAK THIS DOWN BY ELECTROLYTE!
H HYPOkalemia
Potassium
(K) Signs & Symptoms
✹ TIGHT & CONTRACTED ✹ Thready, weak, irregular pulse
Normal Levels: 3.5 - 5.0 - Think MURDER ✹ Orthostatic hypotension
M uscle cramps & weakness ✹ Shallow respirations
Think CARDIAC U rine abnormalities ✹ Anxiety, lethargy, confusion, coma
POTASSIUM RICH FOODS: R espiratory distress ✹ Paresthesias
- Potatoes D ecreased cardiac contractility (↓HR, ↓BP) ✹ Hyporeflexia
- Oranges E CG changes • Tall peaked T waves
✹ Hypoactive bowel sounds (constipation)
- Tomatoes R eflexes (↑ DTR ) • Flat P waves ✹ Nausea, vomiting, abdominal distention
• Widened QRS complexes ✹ ECG changes
- beAns • Prolonged PR intervals
- Seeds
- Salt substitutes - May also include GI changes • ST depression Risk Factors
- aprIcots like diarrhea, hyperactive bowel • Shallow or inverted T wave
• Prominent U wave
- mUshrooms sounds
✹ Actual total body potassium loss
- HYPO is MORE common
than HYPER
Risk Factors ✹ Inadequate potassium intake
➥ Fasting, NPO
✹ Medication ✹ Movement of potassium from the extracellular
- Potassium imbalance can
➥ Potassium-spa fluid to the intracellular fluid
cause cardiac dysrhythmias that
can be LIFE- ➥ Ace inhibitor ➥ Alkalosis
THREATENING! ➥ NSAIDs perinsulinism
✹ Excessive potas um potassium
- Potassium imbalance plays a (Example: rapid n
vital role in cell solutions) m-deficient
METABOLISM, and ✹ Kidney dise
TRANSITION of nerve ➥ Decre
impulses, the functioning of ✹ Adrenal in
cardiac, lung, muscle tissues, & ✹ Tissue d
acid-base balance. ✹ Acidosi
✹ Hyper Nursing Management
Potassium & sodium = opposites - IV K+: Dilute
- NEVER IV PUSH
- PO
Med Tx - in fluid, with food
- Monitor ECG - Monitor I&O
mit Dietary K+ -R - Digoxin toxicity
aexalate IV, PO, or Rectal - SAFETY
or severe: Calcium gluconate - Misc. issues
- This will settle cardiac irritability - Salt Substitut
will still need to treat K+ - K-sparing diu
nsulin - NO Alda
Diuretics - Watch sodium