Fluid and Electrolytes

FLUID AND ELECTROLYTES STUDY GUIDE




POTASSIUM: THINK HEART
Major function: maintaining heart and muscle contraction
RANGE: 3.5 - 5
TIP: Think of how many bananas you would get in a bunch: (3-5)




HYPERkalemia: >5.0 = TIGHT & CONTRACTED MUSCLES
Causes: acidosis, renal failure (retaining potassium)
-​ ECG changes (peaked T waves); MONITOR FOR CARDIAC DYSRHYTHMIAS
-​ Muscle weakness
-​ Chest pain
-​ Diarrhea
-​ Increased deep tendon reflexes
TREATMENT:
●​ Calcium gluconate
●​ Kayexalate
●​ Sodium bicarb
●​ ALWAYS HAVE ON TELEMETRY

HYPOkalemia: <3.5 = LOW & SLOW
Causes: vomiting, loop diuretics
-​ Flat T waves/ inverted, ST depression on cardiac monitor
-​ Muscle cramping
-​ Flaccid paralysis
-​ Constipation = paralytic ileus
TREATMENT:
●​ Oral or IVPB potassium; NEVER IVP POTASSIUM!!!!!
●​ Stop loop diuretics, anti nausea meds if needed

, SODIUM: THINK NEURO CHANGES
Major function: maintaining blood volume and BP
RANGE: 135-145​
TIP: WATER FOLLOWS SALT​ ​ ​ ​




HYPERnatremia >145 = BIG AND BLOATED
Causes: Dehydration, diarrhea, CKD, burns, cushings
-​ Flushed skin
-​ Edema
-​ Polydipsia
-​ Muscle twitching
-​ Swollen dry tongue
-​ N/V
TREATMENT:
●​ Fluids (dilute sodium in blood)

HYPOnatremia: <135 = NEURO CHANGES
Causes: vomiting, intestinal obstruction and diarrhea, diuretics, Addisons
-​ Seizures
-​ Coma
-​ Confusion
-​ RESPIRATORY ARREST
TREATMENT:
●​ Eat foods with natural sodium (green leafy, table salt; increase slightly)