What organ is the major regulator of H2O and Na+ balance?
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Kidney
-Regulates F&E balance by adjusting urine volume and excreting
electrolytes
-under the influence of ADH, aldosteronism, and other stress hormones
-Kidneys reabsorb or excrete water and electrolytes
-Impaired renal function increases risk for fluid and electrolyte imbalance
-Urine output less than 20 mL/hr indicates renal disease and impending
renal failure
Safety: Administering IV KCl
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, *IV KCl must ALWAYS be diluted and NEVER given in concentrated
amounts
*NEVER give KCl via IV push or bolus
*Invert IV bags containing KCl several times to ensure even distribution in
the bag
*DO NOT ADD KCl to a hanging IV bag to prevent giving a bolus dose
*Give IV KCL as a slow infusion on an infusion pump
Normal electrolyte levels: POTASSIUM
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3.5-5.0 mEq/L
Water + electrolytes = _____
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HYDRATION
Hyperkalemia
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, ELEVATED SERUM K+
Causes:
-Renal failure (Most common)
-Excessive intake of K+ or drugs containing K+, Impaired renal excretion
(disease or failure), rapid infusion of K+ IV solutions (DO NOT DO THIS), K+-
sparing diuretics, ACE inhibitor use, acidosis, uncontrolled DM
-Shift of K+ out of cells
Potential complication: dysrhythmias
S/S: *fatigue, irritability, muscle cramping (leg), weak or paralyzed skeletal
muscles, paresthesias, abd cramping, diarrhea, irregular pulse, ECG
changes/dysrhythmias (Vfib or standstill)
Tx: eliminate oral & parenteral K+,↑ elimination of K+ (diuretics, dialysis,
Kayexelate), force K+ from ECF to ICF, stabilize cardiac membranes (ECG
monitoring)
Hypovolemia
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FLUID VOLUME DEFICIT
-decreased volume of circulating blood in the body from excess fluid loss
or third spacing
Causes: *diarrhea, vomiting, hemorrhage, polyuria, inadequate fluid intake,
profuse diaphoresis, burns, diuretic Tx, fever, etc. (see Table 11-3, p. 167)
Dehydration: may be from H2O loss alone, or with water and electrolyte
loss
Clinical manifestations: ALOC, thirst, dizziness, nausea, tachycardia,
orthostatic/postural hypotension (ex. pt starting on lasix and dropping all
that fluid can make them dizzy), concentrated urine (good indicator of fluid
balance), weight loss, fat jugular veins, poor skin turgor, weak/absent
peripheral pulses, delayed capillary refill
, Potential complication: hypovolemic shock and decreased perfusion
Tx: correct underlying cause and replace both F&E
-Mild loss: oral rehydration
-Severe: volume replaced w/ blood products and/or balanced IV solutions
Plasma volume expanders
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-Stay in vascular space and increase osmotic pressure
Colloids (protein solutions)
*Albumin
*Plasma
*Commercial plasmas
*Packed RBCs
High calcium foods
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-Broccoli, spinach, green beans, asparagus, onions, almonds, avocados,
celery, pumpkin seeds
What are the body fluid compartments?
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Give this one a try later!
Kidney
-Regulates F&E balance by adjusting urine volume and excreting
electrolytes
-under the influence of ADH, aldosteronism, and other stress hormones
-Kidneys reabsorb or excrete water and electrolytes
-Impaired renal function increases risk for fluid and electrolyte imbalance
-Urine output less than 20 mL/hr indicates renal disease and impending
renal failure
Safety: Administering IV KCl
Give this one a try later!
, *IV KCl must ALWAYS be diluted and NEVER given in concentrated
amounts
*NEVER give KCl via IV push or bolus
*Invert IV bags containing KCl several times to ensure even distribution in
the bag
*DO NOT ADD KCl to a hanging IV bag to prevent giving a bolus dose
*Give IV KCL as a slow infusion on an infusion pump
Normal electrolyte levels: POTASSIUM
Give this one a try later!
3.5-5.0 mEq/L
Water + electrolytes = _____
Give this one a try later!
HYDRATION
Hyperkalemia
Give this one a try later!
, ELEVATED SERUM K+
Causes:
-Renal failure (Most common)
-Excessive intake of K+ or drugs containing K+, Impaired renal excretion
(disease or failure), rapid infusion of K+ IV solutions (DO NOT DO THIS), K+-
sparing diuretics, ACE inhibitor use, acidosis, uncontrolled DM
-Shift of K+ out of cells
Potential complication: dysrhythmias
S/S: *fatigue, irritability, muscle cramping (leg), weak or paralyzed skeletal
muscles, paresthesias, abd cramping, diarrhea, irregular pulse, ECG
changes/dysrhythmias (Vfib or standstill)
Tx: eliminate oral & parenteral K+,↑ elimination of K+ (diuretics, dialysis,
Kayexelate), force K+ from ECF to ICF, stabilize cardiac membranes (ECG
monitoring)
Hypovolemia
Give this one a try later!
FLUID VOLUME DEFICIT
-decreased volume of circulating blood in the body from excess fluid loss
or third spacing
Causes: *diarrhea, vomiting, hemorrhage, polyuria, inadequate fluid intake,
profuse diaphoresis, burns, diuretic Tx, fever, etc. (see Table 11-3, p. 167)
Dehydration: may be from H2O loss alone, or with water and electrolyte
loss
Clinical manifestations: ALOC, thirst, dizziness, nausea, tachycardia,
orthostatic/postural hypotension (ex. pt starting on lasix and dropping all
that fluid can make them dizzy), concentrated urine (good indicator of fluid
balance), weight loss, fat jugular veins, poor skin turgor, weak/absent
peripheral pulses, delayed capillary refill
, Potential complication: hypovolemic shock and decreased perfusion
Tx: correct underlying cause and replace both F&E
-Mild loss: oral rehydration
-Severe: volume replaced w/ blood products and/or balanced IV solutions
Plasma volume expanders
Give this one a try later!
-Stay in vascular space and increase osmotic pressure
Colloids (protein solutions)
*Albumin
*Plasma
*Commercial plasmas
*Packed RBCs
High calcium foods
Give this one a try later!
-Broccoli, spinach, green beans, asparagus, onions, almonds, avocados,
celery, pumpkin seeds
What are the body fluid compartments?
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