Fluid and Electrolyte Balance Quiz ♡
144 Questions
7 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

Which condition is primarily characterized by excessive magnesium levels in the blood?

  • Tumor lysis syndrome
  • Chronic kidney disease
  • Hypermagnesemia (correct)
  • Hypomagnesemia

    • What is a common sign of hypermagnesemia that may aid in its identification?

  • Severe headache
  • High blood pressure
  • Muscle weakness (correct)
  • Rapid heart rate

    • Which of the following is NOT a risk factor for hypomagnesemia?

  • Malabsorption disorders
  • Chronic alcoholism
  • Diuretic use
  • Excessive magnesium intake (correct)

    • Which of the following foods is beneficial for preventing hypomagnesemia?

    <p>Leafy greens</p> Signup and view all the answers

    What type of intravenous solution has a higher osmotic pressure than blood plasma?

    <p>Hypertonic solutions</p> Signup and view all the answers

    Which of the following is an example of an isotonic solution commonly used in intravenous therapy?

    <p>Lactated Ringer's</p> Signup and view all the answers

    What is a primary reason to monitor magnesium levels in patients with chronic kidney disease?

    <p>To prevent hypermagnesemia</p> Signup and view all the answers

    Which of the following conditions is primarily treated by promoting magnesium-rich foods?

    <p>Hypomagnesemia</p> Signup and view all the answers

    What is the primary characteristic of hypermagnesemia in relation to fluid and electrolyte balance?

    <p>Elevated levels of magnesium exceeding normal limits</p> Signup and view all the answers

    Which of the following is a likely consequence of hypomagnesemia?

    <p>Neuromuscular irritability</p> Signup and view all the answers

    What type of intravenous fluid is best suited for a patient with hyponatremia?

    <p>Hypertonic saline</p> Signup and view all the answers

    How does active transport differ from passive transport in fluid and electrolyte balance?

    <p>It requires ATP to move molecules against their concentration gradient</p> Signup and view all the answers

    Which solution would be classified as isotonic in relation to the cells?

    <p>0.9% sodium chloride</p> Signup and view all the answers

    What is the primary effect of a hypertonic solution on cells?

    <p>Cells shrink due to fluid loss</p> Signup and view all the answers

    In evaluating a patient with signs of hypermagnesemia, which lab panel would be essential for diagnosis?

    <p>Basic metabolic panel</p> Signup and view all the answers

    What is a common treatment option for a patient diagnosed with hypomagnesemia?

    <p>Magnesium supplements</p> Signup and view all the answers

    What can excessive intravenous fluid administration potentially lead to?

    <p>Hypervolemia</p> Signup and view all the answers

    Which situation is most likely to contribute to the development of hyponatremia?

    <p>Excessive water intake</p> Signup and view all the answers

    Which of the following is a risk factor for hypercalcemia?

    <p>Hyperparathyroidism</p> Signup and view all the answers

    To prevent hypervolemia, which of the following strategies should be emphasized?

    <p>Monitor daily fluid intake</p> Signup and view all the answers

    What consequence can arise from high sodium levels in the body?

    <p>Severe dehydration</p> Signup and view all the answers

    Which dietary change can help prevent hypernatremia?

    <p>Avoid processed foods</p> Signup and view all the answers

    What is a common risk associated with hypomagnesemia?

    <p>Heart failure</p> Signup and view all the answers

    Which of the following symptoms may indicate hypercalcemia?

    <p>Fatigue and confusion</p> Signup and view all the answers

    What is the significance of measuring bicarbonate levels in a metabolic panel?

    <p>Assesses acid and base balance</p> Signup and view all the answers

    Which of the following conditions might be indicated by an elevated Blood Urea Nitrogen (BUN) level?

    <p>Dehydration or kidney dysfunction</p> Signup and view all the answers

    What normal range is associated with calcium levels in the body?

    <p>8.5 - 10.2 mg/dL</p> Signup and view all the answers

    What is the primary reason for conducting a 24-hour urine test?

    <p>To measure kidney excretion of substances</p> Signup and view all the answers

    What can high levels of glucose indicate about metabolism?

    <p>A sufficient energy supply and regulation</p> Signup and view all the answers

    Which risk factor is most directly associated with dehydration in individuals?

    <p>Excessive fluid loss</p> Signup and view all the answers

    Which electrolyte is not measured in a basic metabolic panel (BMP)?

    <p>Magnesium</p> Signup and view all the answers

    What prevention strategy could be effective in managing dehydration?

    <p>Teach signs of dehydration such as dry mouth and thirst</p> Signup and view all the answers

    What can contribute to the risk of developing fluid overload?

    <p>Excessive intravenous fluid administration</p> Signup and view all the answers

    Which condition is most likely to occur as a result of high sodium levels in the body?

    <p>Dehydration and altered mental status</p> Signup and view all the answers

    Which of the following is NOT a prevention strategy for hyponatremia?

    <p>Increasing fluid intake irrespective of symptoms</p> Signup and view all the answers

    Which of these is a common risk factor that contributes to hypercalcemia?

    <p>Hyperparathyroidism</p> Signup and view all the answers

    What is a notable sign indicating hypernatremia?

    <p>Confusion and dehydration</p> Signup and view all the answers

    Which condition can result from excessive water intake?

    <p>Hyponatremia</p> Signup and view all the answers

    What dietary change can help prevent the risks associated with hypervolemia?

    <p>Reducing sodium intake</p> Signup and view all the answers

    Which of the following is a risk factor specifically associated with hypercalcemia?

    <p>Use of thiazide diuretics</p> Signup and view all the answers

    What is the primary goal of osmosis in fluid and electrolyte balance?

    <p>To equalize solute concentration on both sides of a membrane</p> Signup and view all the answers

    Which process involves the movement of water and solutes across a membrane driven by hydrostatic pressure?

    <p>Filtration</p> Signup and view all the answers

    What characterizes a hypertonic solution in relation to a cell?

    <p>It has a higher concentration of solutes than the cell</p> Signup and view all the answers

    Which transport mechanism requires ATP to move molecules against their concentration gradient?

    <p>Active transport</p> Signup and view all the answers

    In which scenario would a hypotonic solution likely be administered?

    <p>To hydrate dehydrated cells</p> Signup and view all the answers

    What is the normal range for potassium levels in a basic metabolic panel?

    <p>3.5-5.0 mEq/L</p> Signup and view all the answers

    Which statement best defines intracellular fluid?

    <p>Fluid contained within cells</p> Signup and view all the answers

    What distinguishes diffusion from osmosis in terms of molecular movement?

    <p>Diffusion involves solute movement, while osmosis involves water movement</p> Signup and view all the answers

    What condition can result from low potassium levels and may lead to muscle weakness?

    <p>Hypokalemia</p> Signup and view all the answers

    Which of the following is NOT a recommended prevention strategy for hypocalcemia?

    <p>Monitor sodium intake</p> Signup and view all the answers

    What dietary source is advised to limit in order to prevent hyperkalemia?

    <p>Potassium-rich foods such as bananas and oranges</p> Signup and view all the answers

    Which conditions can lead to hypocalcemia?

    <p>Vitamin D deficiency and chronic kidney disease</p> Signup and view all the answers

    What potential complication can arise from hyperkalemia?

    <p>Life-threatening arrhythmias</p> Signup and view all the answers

    What is a key risk factor for the development of hypokalemia?

    <p>Inadequate potassium diet intake</p> Signup and view all the answers

    Which condition involves high phosphate levels primarily due to impaired kidney excretion?

    <p>Hyperphosphatemia</p> Signup and view all the answers

    Excessive potassium intake is primarily associated with which condition?

    <p>Hyperkalemia</p> Signup and view all the answers

    What is a major cause of hypermagnesemia related to medication intake?

    <p>Use of antacids or laxatives containing magnesium</p> Signup and view all the answers

    Which of the following is NOT a common risk factor for developing hypomagnesemia?

    <p>Severe dehydration</p> Signup and view all the answers

    Which dietary item is least likely to be rich in magnesium?

    <p>Refined sugars</p> Signup and view all the answers

    What defines an isotonic solution in relation to blood plasma?

    <p>Same osmotic pressure as blood plasma</p> Signup and view all the answers

    What is a potential consequence of administering hypertonic solutions?

    <p>Fluid moving out of cells</p> Signup and view all the answers

    Which of the following is considered a primary strategy for preventing hypermagnesemia?

    <p>Limit magnesium-containing medications</p> Signup and view all the answers

    Which condition is characterized by low magnesium levels and can result from chronic alcoholism?

    <p>Hypomagnesemia</p> Signup and view all the answers

    What is a common example of a hypotonic solution used in medical settings?

    <p>0.45% Sodium Chloride</p> Signup and view all the answers

    The normal level for calcium in the body is between 8.5 to 10.2.

    <p>True</p> Signup and view all the answers

    A normal BUN level is considered to be between 5-25.

    <p>False</p> Signup and view all the answers

    Metabolic acidosis is characterized by high levels of carbon dioxide (CO) in the body.

    <p>False</p> Signup and view all the answers

    The normal level of glucose in the blood is defined as 70-10.

    <p>False</p> Signup and view all the answers

    Maintaining proper hydration can prevent dehydration-related electrolyte imbalances.

    <p>True</p> Signup and view all the answers

    Magnesium is included in the basic metabolic panel (BMP).

    <p>False</p> Signup and view all the answers

    The 24-hour urine test measures the excretion of various substances including phosphate and uric acid.

    <p>True</p> Signup and view all the answers

    Inadequate fluid intake is a major risk factor for dehydration.

    <p>True</p> Signup and view all the answers

    Fluid overload can be caused by excessive intravenous fluid administration.

    <p>True</p> Signup and view all the answers

    High levels of sodium in the blood can lead to dehydration and confusion.

    <p>True</p> Signup and view all the answers

    Low sodium levels can cause increased thirst and confusion.

    <p>False</p> Signup and view all the answers

    Osmosis involves the movement of water from an area of high solute concentration to an area of low solute concentration.

    <p>False</p> Signup and view all the answers

    Prolonged immobilization can result in hypercalcemia due to bone breakdown.

    <p>True</p> Signup and view all the answers

    Filtration is driven solely by the concentration gradient of solutes across a membrane.

    <p>False</p> Signup and view all the answers

    Diuretic use, particularly thiazides, is associated with hypokalemia.

    <p>False</p> Signup and view all the answers

    Daily weight checks can help in the prevention of fluid overload.

    <p>True</p> Signup and view all the answers

    A hypertonic solution contains a lower concentration of solutes compared to the inside of a cell.

    <p>False</p> Signup and view all the answers

    Active transport requires ATP to move molecules across a cell membrane along their concentration gradient.

    <p>False</p> Signup and view all the answers

    Excessive water intake only poses risks for patients with kidney disease.

    <p>False</p> Signup and view all the answers

    The normal level of potassium in the basic metabolic panel is between 3.0 to 4.5.

    <p>False</p> Signup and view all the answers

    Vitamin D intake is a risk factor for hypocalcemia.

    <p>False</p> Signup and view all the answers

    Extracellular refers to anything that occurs inside the cells.

    <p>False</p> Signup and view all the answers

    Diffusion is the active movement of molecules from an area of lower concentration to an area of higher concentration.

    <p>False</p> Signup and view all the answers

    Isotonic solutions have the same concentration of solutes as those found inside the cell.

    <p>True</p> Signup and view all the answers

    Hypocalcemia can be caused by chronic kidney disease.

    <p>True</p> Signup and view all the answers

    Hyperkalemia can result from excessive consumption of calcium-rich foods.

    <p>False</p> Signup and view all the answers

    Encouraging potassium-rich foods is a prevention strategy for hypokalemia.

    <p>True</p> Signup and view all the answers

    Vitamin D deficiency can increase the risk of hypocalcemia.

    <p>True</p> Signup and view all the answers

    Regularly checking medications is not important for preventing hyperkalemia.

    <p>False</p> Signup and view all the answers

    Hypokalemia can cause muscle spasms and cardiac arrhythmias.

    <p>True</p> Signup and view all the answers

    Encouraging hydration can help prevent kidney stones.

    <p>True</p> Signup and view all the answers

    Hypoparathyroidism is a risk factor for hyperphosphatemia.

    <p>True</p> Signup and view all the answers

    Hypermagnesemia can be caused by excessive magnesium intake from medications such as antacids.

    <p>True</p> Signup and view all the answers

    Hypomagnesemia is primarily characterized by high magnesium levels in the blood.

    <p>False</p> Signup and view all the answers

    Loop diuretics can increase the risk of hypomagnesemia due to their effect on magnesium reabsorption.

    <p>True</p> Signup and view all the answers

    Isotonic solutions have a lower osmotic pressure than blood plasma and cause fluid to move into cells.

    <p>False</p> Signup and view all the answers

    Chronic kidney disease is a significant risk factor for both hypermagnesemia and hypomagnesemia.

    <p>True</p> Signup and view all the answers

    Lactated Ringer's solution is an example of a hypotonic solution commonly used in intravenous therapy.

    <p>False</p> Signup and view all the answers

    Severe diarrhea can lead to hypomagnesemia due to excessive loss of magnesium.

    <p>True</p> Signup and view all the answers

    Dextrose 10% in water is an example of a hypertonic solution.

    <p>True</p> Signup and view all the answers

    Match the process with its correct description:

    <p>Osmosis = Movement of water from low to high solute concentration Diffusion = Passive movement from high to low concentration Active transport = Movement against concentration gradient requiring ATP Filtration = Movement driven by hydrostatic pressure</p> Signup and view all the answers

    Match the type of solution with its effect on a cell:

    <p>Isotonic = Same concentration as inside the cell Hypertonic = Cell shrinks Hypotonic = Cell swells</p> Signup and view all the answers

    Match the laboratory test with the electrolyte being measured:

    <p>Basic metabolic panel = Carbon Dioxide</p> Signup and view all the answers

    Match the terms related to fluid compartments:

    <p>Intracellular = Fluid inside the cells Extracellular = Fluid outside the cells Interstitial = Fluid in the space between cells Plasma = Fluid component of blood</p> Signup and view all the answers

    Match the type of transport with its characteristics:

    <p>Osmosis = Does not require energy Filtration = Driven by pressure Active transport = Requires carrier proteins Diffusion = Can occur in gases and small molecules</p> Signup and view all the answers

    Match the condition with its characteristic:

    <p>Hyponatremia = Low sodium levels in the blood Hypernatremia = High sodium levels in the blood Hypokalemia = Low potassium levels Hyperkalemia = High potassium levels</p> Signup and view all the answers

    Match the principle of movement with its correct definition:

    <p>Osmosis = Equalize solute concentration Diffusion = Passive transport of molecules Filtration = Movement via blood pressure Active transport = Energy-dependent transport</p> Signup and view all the answers

    Match the types of fluids with their characteristics:

    <p>Isotonic solutions = Used in intravenous therapy to maintain equilibrium Hypertonic solutions = Causes cell to lose water Hypotonic solutions = Causes cell to gain water</p> Signup and view all the answers

    Match the conditions to their characteristics:

    <p>Hypocalcemia = Can cause muscle spasms + cardiac arrhythmias Hyperkalemia = High Potassium Levels Hypokalemia = Can cause arrhythmias + muscle weakness Hyperphosphatemia = High Phosphate Levels</p> Signup and view all the answers

    Match the condition with its prevention strategies:

    <p>Hypocalcemia = Encourage a calcium-rich diet Hyperkalemia = Limit potassium-rich food intake Hypokalemia = Encourage potassium-rich foods Hyperphosphatemia = Monitor phosphate intake</p> Signup and view all the answers

    Match the risks to their corresponding conditions:

    <p>Hypocalcemia = Vitamin D deficiency Hyperkalemia = Kidney failure Hypokalemia = Severe vomiting or diarrhea Hyperphosphatemia = Excessive phosphate intake</p> Signup and view all the answers

    Match the conditions to their associated dietary considerations:

    <p>Hypocalcemia = Ensure adequate vitamin D intake Hyperkalemia = Bananas, oranges, potatoes Hypokalemia = Monitor diuretic usage Hyperphosphatemia = Limit phosphate intake</p> Signup and view all the answers

    Match the conditions with their potential complications:

    <p>Hypocalcemia = Cardiac arrhythmias Hyperkalemia = Life-threatening arrhythmias Hypokalemia = Muscle weakness Hyperphosphatemia = Impaired kidney function</p> Signup and view all the answers

    Match the condition with its primary cause:

    <p>Hypocalcemia = Chronic kidney disease Hyperkalemia = Adrenal insufficiency Hypokalemia = Excessive laxative use Hyperphosphatemia = Hypoparathyroidism</p> Signup and view all the answers

    Match the conditions with their symptoms:

    <p>Hypocalcemia = Muscle spasms Hyperkalemia = Arrhythmias Hypokalemia = Fatigue Hyperphosphatemia = Joint pain</p> Signup and view all the answers

    Match the prevention strategies to their related conditions:

    <p>Hypocalcemia = Monitor calcium levels Hyperkalemia = Regularly check medications Hypokalemia = Promote potassium supplementation Hyperphosphatemia = Monitor phosphate levels</p> Signup and view all the answers

    Match the following conditions with their primary risks:

    <p>Fluid Overload = Kidney failure Hypernatremia = Dehydration Hyponatremia = Excessive water intake Hypercalcemia = Hyperparathyroidism</p> Signup and view all the answers

    Match the following conditions with their prevention strategies:

    <p>Fluid Overload = Monitor daily fluid intake Hypernatremia = Follow a low-sodium diet Hyponatremia = Monitor sodium levels regularly Hypercalcemia = Limit calcium and vitamin D intake</p> Signup and view all the answers

    Match the following electrolytes with their corresponding effects:

    <p>Sodium = Confusion and altered mental status Calcium = Weakness and confusion Aldosterone = Water retention Diuretics = Increased sodium loss</p> Signup and view all the answers

    Match the following conditions with their related dietary recommendations:

    <p>Fluid Overload = Limit sodium intake Hypernatremia = Avoid canned foods Hyponatremia = Encourage appropriate sodium intake Hypercalcemia = Limit vitamin D intake</p> Signup and view all the answers

    Match the following symptoms with their associated conditions:

    <p>Hypervolemia = Sudden weight gain of 2+ lbs/day Hypernatremia = Thirst Hyponatremia = Seizures Hypercalcemia = Confusion</p> Signup and view all the answers

    Match the following conditions with their possible causes:

    <p>Fluid Overload = Excessive intravenous fluid administration Hypernatremia = Excessive sodium intake Hyponatremia = Syndrome of inappropriate antidiuretic hormone Hypercalcemia = Excessive vitamin D intake</p> Signup and view all the answers

    Match the following conditions with their management priorities:

    <p>Fluid Overload = Follow fluid restriction orders Hypernatremia = Ensure adequate fluid intake Hyponatremia = Monitor for signs of confusion Hypercalcemia = Limit intake of calcium-rich foods</p> Signup and view all the answers

    Match the following electrolyte imbalances with their characteristics:

    <p>Hypernatremia = High sodium levels Hyponatremia = Low sodium levels Hypervolumia = Excess fluid volume Hypercalcemia = High calcium levels</p> Signup and view all the answers

    Match the following laboratory tests with their normal levels:

    <p>BUN = 7-20 Glucose = 70-100 Calcium = 8.5-10.2 Magnesium = 1.7-2.2</p> Signup and view all the answers

    Match the following conditions with their associated abnormalities:

    <p>Metabolic acidosis = Low CO2 levels Metabolic alkalosis = High CO2 levels Elevated BUN = Dehydration or kidney dysfunction Low glucose = Lack of energy</p> Signup and view all the answers

    Match the electrolyte with its primary role in the body:

    <p>Calcium = Important for bones and muscles Magnesium = Not measured in BMP Sodium = Regulates blood pressure Potassium = Conduction of electrical impulses in muscles</p> Signup and view all the answers

    Match the prevention strategy with the associated risk factor for dehydration:

    <p>Encourage adequate hydration = Inadequate fluid intake Teach signs of dehydration = Excessive fluid loss Adjust fluid intake based on needs = Increased urination Monitoring older adults = Elderly age</p> Signup and view all the answers

    Match the following urine components with their significance:

    <p>Creatinine = Kidney function measurement Protein = Indicator of kidney damage Sodium = Electrolyte balance Cortisol = Stress response measurement</p> Signup and view all the answers

    Match the following consequences of electrolyte imbalances to their description:

    <p>Hypercalcemia = High calcium levels in the blood Hypomagnesemia = Low magnesium levels leading to muscle weakness Hyponatremia = Low sodium levels causing confusion Hypernatremia = High sodium levels resulting in thirst</p> Signup and view all the answers

    Match the following electrolyte with its risk factor for imbalance:

    <p>Sodium = Extreme sweating or fluid loss Potassium = Kidney dysfunction Calcium = Dietary deficiency Magnesium = Malabsorption syndromes</p> Signup and view all the answers

    Match the following signs of dehydration with their descriptions:

    <p>Dry mouth = Low saliva production Thirst = Body's signal for water intake Dark urine = Indicates concentrated waste Fatigue = Reduced energy levels due to fluid loss</p> Signup and view all the answers

    Match the conditions with their corresponding definitions:

    <p>Hypermagnesemia = High magnesium levels in the blood Hypomagnesemia = Low magnesium levels in the blood Rhabdomyolysis = Massive cell breakdown releasing phosphate Tumor lysis syndrome = Breakdown of tumor cells leading to metabolic abnormalities</p> Signup and view all the answers

    Match the prevention strategies with the relevant conditions:

    <p>Limit magnesium-containing medications = Hypermagnesemia Promote magnesium-rich foods = Hypomagnesemia Monitor diuretic use = Hypomagnesemia Educate on signs = Hypermagnesemia</p> Signup and view all the answers

    Match the types of intravenous fluids with their definitions:

    <p>Isotonic solutions = Solutions with the same osmotic pressure as blood plasma Hypertonic solutions = Solutions with a higher osmotic pressure than blood plasma Hypotonic solutions = Solutions with a lower osmotic pressure than blood plasma Dextrose 5% in water = Example of an isotonic solution</p> Signup and view all the answers

    Match the risks of hypomagnesemia with their descriptions:

    <p>Chronic alcoholism = Inadequate magnesium intake Diuretic use = Increased loss of magnesium through urine Severe diarrhea/vomiting = Loss of electrolytes including magnesium Malabsorption disorders = Impaired nutrient absorption including magnesium</p> Signup and view all the answers

    Match the symptoms with their associated conditions:

    <p>Muscle weakness = Hypermagnesemia Lethargy = Hypermagnesemia Twitching = Hypomagnesemia Cramping = Hypomagnesemia</p> Signup and view all the answers

    Match various causes with hypermagnesemia risks:

    <p>Chronic kidney disease = Impaired magnesium excretion Excessive magnesium intake = From supplements or laxatives Adrenal insufficiency = Hormonal imbalance affecting magnesium levels Medications with magnesium = Such as antacids or laxatives</p> Signup and view all the answers

    Match the electrolyte replacements with their roles:

    <p>Sodium = Essential for fluid balance and nerve function Potassium = Crucial for muscle contraction and nerve signals Calcium = Involves muscle contraction and blood clotting Magnesium = Regulates neuromuscular transmission</p> Signup and view all the answers

    Match the electrolyte preparations with the replacement methods:

    <p>Sodium repletion = Administered via IV fluids Potassium repletion = Oral supplements and IV fluids Calcium repletion = Can be given orally or intravenously Magnesium repletion = Via magnesium-rich foods or supplements</p> Signup and view all the answers

    Study Notes

    Fluid and Electrolyte Balance

    • The process of regulating extracellular and intracellular volume, body fluid osmolality and plasma concentrations of electrolytes

    Basic Principles

    • Osmosis: Water moves from areas of low solute concentration to areas of high solute concentration across a selectively permeable membrane to equalize concentration
    • Diffusion: Particles like gas, ions, or small molecules passively move from areas of higher to lower concentration
    • Filtration: Movement of water and solutes across a membrane driven by hydrostatic pressure, typically blood pressure, pushing fluid through capillaries
    • Active Transport: Movement of molecules across a cell membrane against the concentration gradient using ATP and carrier proteins
    • Intracellular: Anything occurring inside the cells
    • Extracellular: Anything outside of the cells
    • Isotonic: Solutions with the same concentrations as the inside of a cell
    • Hypertonic: Solutions with higher concentrations of solutes compared to inside of a cell
    • Hypotonic: Solutions with lower concentrations of solutes compared to inside of a cell

    Assessment

    • Labs
      • Basic Metabolic Panel
        • Sodium: Normal Level: 135-145
        • Potassium: Normal Level: 3.5-5.0
        • Chloride: Normal Level: 96-106
        • Carbon Dioxide: Normal Level: 23-30

    Fluid Overload (Hypervolemia)

    • Risks:
      • Kidney failure
      • Congestive heart failure
      • Liver cirrhosis
      • Hormonal imbalances (e.g., high aldosterone)
    • Prevention:
      • Monitor daily fluid intake
      • Follow fluid restriction orders
      • Limit sodium intake (found in processed and canned foods)
      • Encourage daily weight checks, reporting sudden gains of 2lb/day or more

    Hypernatremia

    • High Sodium Levels
    • Can cause dehydration and altered mental status
    • Risks:
      • Dehydration
      • Diabetes insipidus
      • Excessive sodium intake (dietary or from infusion)
        • Sources of sodium: Processed foods, canned goods, table salt
    • Prevention:
      • Follow a low-sodium diet (avoid canned/processed foods)
      • Ensure adequate fluid intake
      • Monitor for signs of dehydration (e.g., thirst, confusion)

    Hyponatremia

    • Low Sodium Levels
    • Can cause confusion and seizures
    • Risks:
      • Excessive water intake
      • Syndrome of inappropriate antidiuretic hormone (SIADH)
      • Diuretic use (especially thiazides)
      • Severe vomiting or diarrhea
      • Heart failure and liver disease that affect fluid balance
    • Prevention:
      • Follow fluid restrictions in conditions like heart failure
      • Encourage appropriate sodium intake (especially for patients with GI problems)
      • Monitor sodium levels regularly in at-risk patients

    Hypercalcemia

    • High Calcium Levels
    • Can cause weakness and confusion
    • Risks:
      • Hyperparathyroidism
      • Cancer (specifically bone metastasis or certain tumors)
      • Excessive vitamin D intake
      • Prolonged immobilization (bone breakdown and increased calcium release)
      • Thiazide diuretic use
    • Prevention:
      • Limit calcium and vitamin D intake in at-risk patients
      • Patients with hyperparathyroidism are at increased risk

    Hypocalcemia

    • Low Calcium Levels
    • Can cause muscle cramps and tetany (involuntary muscle contractions)
    • Risks:
      • Hypoparathyroidism
      • Vitamin D deficiency
      • Malabsorption disorders (e.g., celiac disease, Crohn's disease)
      • Chronic kidney disease
      • Pancreatitis
      • Certain medications (e.g., bisphosphonates)
    • Prevention:
      • Ensure adequate intake of calcium-rich foods
      • Maintain adequate vitamin D levels
      • Address underlying medical conditions

    Hyperkalemia

    • High Potassium Levels
    • Can cause irregular heart rhythm and muscle weakness
    • Risks:
      • Kidney failure
      • Dehydration
      • Certain medications (e.g., ACE inhibitors, potassium-sparing diuretics)
      • Addison's disease
      • Rhabdomyolysis or tumor lysis syndrome (massive cell breakdown releases potassium)
    • Prevention:
      • Monitor potassium levels closely in patients with kidney disease
      • Limit potassium-rich foods (e.g., bananas, potatoes, avocados)
      • Avoid potassium supplements if not medically indicated

    Hypokalemia

    • Low Potassium Levels
    • Can cause muscle weakness, fatigue and irregular heartbeat
    • Risks:
      • Diuretic use (especially loop diuretics)
      • Severe diarrhea or vomiting
      • Malabsorption disorders (e.g., Crohn's disease)
      • Inadequate dietary intake
    • Prevention:
      • Maintain adequate potassium intake through diet
      • Avoid excessive use of loop diuretics
      • Address underlying medical conditions that cause potassium loss

    Hyperphosphatemia

    • High Phosphate Levels
    • Can lead to calcium phosphate deposition in tissues
    • Risks:
      • Kidney failure
      • Rhabdomyolysis or tumor lysis syndrome (massive cell breakdown releases phosphate)
      • Hypoparathyroidism
    • Prevention:
      • Monitor phosphate levels in patients with kidney failure
      • Treat underlying medical conditions
      • Limit phosphate intake in at-risk patients

    Hypophosphatemia

    • Low Phosphate Levels
    • Can cause muscle weakness, fatigue and bone pain
    • Risks:
      • Malabsorption disorders
      • Alcohol abuse
      • Hyperparathyroidism
      • Certain medications (e.g., antacids)
    • Prevention:
      • Treat underlying medical conditions
      • Ensure adequate intake of phosphate-rich foods

    Hypermagnesemia

    • High Magnesium Levels
    • Can cause muscle weakness, lethargy, and slow reflexes
    • Risks:
      • Chronic kidney disease (impaired excretion)
      • Excessive magnesium intake (supplements or laxatives)
      • Adrenal insufficiency
      • Medications containing magnesium (antacids or laxatives)
    • Prevention:
      • Limit magnesium-containing medications (laxatives and antacids)
      • Monitor magnesium levels in patients with kidney disease
      • Educate patients on signs of hypermagnesemia (muscle weakness, lethargy, slow reflexes)

    Hypomagnesemia

    • Low Magnesium Levels
    • Can cause muscle spasms, seizures, and arrhythmias
    • Risks:
      • Chronic alcoholism
      • Diuretic use (especially loop diuretics)
      • Severe diarrhea or vomiting
      • Malabsorption disorders (e.g., Crohn's disease)
      • Inadequate dietary intake
    • Prevention:
      • Promote magnesium-rich foods (nuts, seeds, whole grains, leafy greens)
      • Monitor diuretic use
      • Monitor alcohol use

    Intravenous Fluids

    • Isotonic Solutions
      • Solutions with same osmotic pressure as blood plasma (e.g., Normal Saline (0.9% NaCl), Lactated Ring er'S, Dextrose 5% in water (D5W))
    • Hypertonic Solutions
      • Solutions with higher osmotic pressure than blood plasma, causing fluid to move out of cells (e.g., 3% Sodium Chloride, Dextrose 10% in water (D10W))
    • Hypotonic Solutions
      • Solutions with lower osmotic pressure than blood plasma, causing fluid to move into cells (e.g., 0.45% Sodium Chloride (half-normal saline), Dextrose 2.5% in water)

    Electrolyte Replacements

    • Sodium
      • Essential for fluid balance, nerve function, and muscle contraction
      • Replaced via IV fluids (e.g., normal saline) or oral supplements
    • Potassium
      • Plays a vital role in nerve and muscle function, as well as heart rhythm
      • Replaced via IV fluids or oral supplements
    • Calcium
      • Important for bone health, muscle function, and nerve transmission
      • Replaced via IV fluids or oral supplements (calcium carbonate, calcium citrate)
    • Magnesium
      • Important for muscle and nerve function, as well as blood sugar control
      • Replaced via IV fluids or oral supplements
    • Phosphate
      • Plays a role in energy production and bone health
      • Replaced via IV fluids or oral supplements

    Fluid & Electrolyte Balance

    • The process of regulating the volume of fluid both inside and outside cells, the concentration of solutes in the body fluids, and the levels of electrolytes in the blood.

    Basic Principles

    • Osmosis: The movement of water across a membrane from an area of low solute concentration to an area of high solute concentration. This process aims to equalize the concentration on both sides of the membrane.
    • Diffusion: The passive movement of molecules from a region of higher concentration to a region of lower concentration. Imagine dumping Kool-Aid powder into a pool or airing out a bad smell.
    • Filtration: Movement of water and solutes across a membrane driven by hydrostatic pressure (like that exerted by blood pressure). This process requires pressure to push the fluid through, allowing smaller molecules like water and salts to pass through capillaries, but holding back larger molecules like proteins.
    • Active Transport: Movement of molecules against their concentration gradient, requiring energy (ATP) and involving carrier proteins.
    • Intracellular: Within cells
    • Extracellular: Outside cells
    • Isotonic: A solution with the same concentration as the inside of a cell.
    • Hypertonic: A solution with a higher concentration of solutes compared to the inside of a cell.
    • Hypotonic: A solution with a lower concentration of solutes compared to the inside of a cell.

    Assessment

    • Labs:
      • Basic Metabolic Panel (BMP): Measures key electrolytes, kidney function, and glucose levels.
        • Sodium (Na+): Normal level 135-145 mEq/L.
        • Potassium (K+): Normal level 3.5-5.0 mEq/L.
        • Chloride (Cl-): Normal level 96-106 mEq/L.
        • Carbon Dioxide (CO2): Normal level 23-30 mEq/L. Indicates bicarbonate levels and helps assess acid-base balance. Abnormalities:
          • Metabolic Acidosis: Low CO2
          • Metabolic Alkalosis: High CO2
        • Blood Urea Nitrogen (BUN): Normal level 7-20 mg/dL. Indicates kidney function and hydration status. Elevated BUN can signal dehydration or kidney dysfunction.
        • Glucose: Normal level 70-100 mg/dL. Provides energy and regulates metabolism.
        • Calcium (Ca2+): Normal level 8.5-10.2 mg/dL. Important for bones, muscles, and nerves.
        • Magnesium (Mg2+): Normal level 1.7-2.2 mg/dL. Not included in the BMP.
      • 24-Hour Urine Collection: Measures how well the kidneys excrete electrolytes and other substances over a full day. The first morning urine is not used, and the urine needs to be stored in a cool place. It measures the excretion of:
        • Volume
        • Creatinine
        • Protein
        • Sodium
        • Potassium
        • Calcium
        • Magnesium
        • Phosphate
        • Cortisol
        • Oxylate
        • Citrate
        • Chloride
        • Sulfate
        • Nitrogen
        • Uric acid
        • Ammonia

    Electrolyte Imbalances Considerations

    Dehydration

    • Risks:
      • Inadequate fluid intake
      • Excessive fluid loss
      • Increased urination
      • Elderly age
      • Hot climates or strenuous exercise
    • Prevention Strategies:
      • Encourage adequate hydration
      • Teach signs of dehydration (dry mouth, thirst, dark urine)
      • Adjust fluid intake based on individual needs

    Fluid Volume Overload (Hypervolemia)

    • Risks:
      • Kidney failure
      • Congestive heart failure
      • Liver cirrhosis
      • Excessive intravenous fluid administration
      • Hormonal imbalances (e.g., high levels of aldosterone, causing water retention)
    • Prevention Strategies:
      • Monitor daily fluid intake
      • Follow fluid restriction orders
      • Limit sodium intake (often found in processed and canned foods)
      • Encourage daily weight checks (report sudden weight gain of 2 or more pounds per day)

    Hypernatremia (High Sodium Levels)

    • Risks:
      • Dehydration
      • Diabetes insipidus (leads to excessive water loss)
      • Excessive sodium intake (dietary or from infusion)
        • Sources of Sodium:
          • Processed foods
          • Canned foods
          • Table salt
    • Prevention:
      • Follow a low-sodium diet
      • Ensure adequate fluid intake
      • Monitor for signs (thirst, confusion)

    Hyponatremia (Low Sodium Levels)

    • Risks:
      • Excessive water intake
      • Syndrome of inappropriate antidiuretic hormone (SIADH)
      • Diuretic use (especially thiazides)
      • Severe vomiting or diarrhea
      • Heart failure
      • Liver disease that affects fluid balance
    • Prevention:
      • Follow fluid restrictions in conditions like heart failure
      • Encourage appropriate sodium intake (especially in patients with GI problems)
      • Monitor sodium levels regularly in at-risk patients

    Hypercalcemia (High Calcium Levels)

    • Risks:
      • Hyperparathyroidism
      • Cancer (specifically bone metastasis or certain tumors)
      • Excessive vitamin D intake
      • Prolonged immobilization (causes bone breakdown and increased calcium release)
      • Use of thiazide diuretics
    • Prevention:
      • Limit calcium and vitamin D intake in at-risk patients. (Patients with hyperparathyroidism are especially at risk.)
      • Encourage hydration to prevent kidney stones.
      • Promote physical activity to prevent calcium release from bones.

    Hypocalcemia (Low Calcium Levels)

    • Risks:
      • Vitamin D deficiency
      • Hypoparathyroidism
      • Chronic kidney disease
      • Magnesium deficiency
    • Prevention:
      • Encourage a calcium-rich diet (dairy, leafy green vegetables)
      • Ensure adequate vitamin D intake for calcium absorption.
      • Monitor calcium levels in patients with thyroid or parathyroid disorders.

    Hyperkalemia (High Potassium Levels)

    • Risks:
      • Kidney failure (impaired potassium excretion)
      • Use of potassium-sparing diuretics
      • Adrenal insufficiency (reduced aldosterone, reduced potassium excretion)
      • Excessive potassium intake
        • Sources of Potassium:
          • Bananas
          • Oranges
          • Potatoes
      • Tissue damage (which releases potassium)
    • Prevention:
      • Limit potassium-rich food intake
      • Regularly check medications.
      • Monitor potassium levels in patients with kidney issues or on medications.

    Hypokalemia (Low Potassium Levels)

    • Risks:
      • Use of diuretics
      • Severe vomiting or diarrhea
      • Excessive laxative use
      • Alkalosis (shifts potassium into cells)
      • Inadequate potassium diet intake
    • Prevention:
      • Encourage potassium-rich foods (bananas, spinach, oranges, potatoes )
      • Monitor diuretic usage and promote potassium supplementation if necessary.
      • Teach athletes/patients who sweat excessively to replace potassium loss.

    Hyperphosphatemia (High Phosphate Levels)

    • Risks:
      • Chronic kidney disease (impaired excretion)
      • Hypoparathyroidism (reduced parathyroid hormone leads to less excretion)
      • Excessive phosphate intake or IV intake
      • Rhabdomyolysis or tumor lysis syndrome (massive cell breakdown releases phosphate)

    Hypermagnesemia (High Magnesium Levels)

    • Risks:
      • Chronic kidney disease (impaired excretion)
      • Excessive magnesium intake (from supplements or laxatives)
      • Adrenal insufficiency
      • Medicines containing magnesium (antacids or laxatives)
    • Prevention:
      • Limit magnesium-containing medications (such as laxatives and antacids)
      • Monitor magnesium levels especially in patients with kidney disease.
      • Educate on the signs (muscle weakness, lethargy, slow reflexes).

    Hypomagnesemia (Low Magnesium Levels)

    • Risks:
      • Chronic alcoholism
      • Diuretic use (especially loop diuretics)
      • Severe diarrhea/vomiting
      • Malabsorption disorders (such as Crohn's disease)
      • Inadequate dietary intake
    • Prevention:
      • Promote magnesium-rich foods (nuts, seeds, whole grains, leafy greens)
      • Monitor diuretic use.
      • Monitor alcohol use.

    Pharmacology

    • Types of Intravenous Fluids:

      • Isotonic Solutions: Solutions that have the same osmotic pressure as blood plasma. They are commonly used to replace fluids lost due to dehydration.
        • Examples: Normal Saline (0.9% NaCl), Lactated Ringer's, Dextrose 5% in water (D5W).
      • Hypertonic Solutions: Solutions that have a higher osmotic pressure than blood plasma, causing fluid to move out of cells.
        • Examples: 3% Sodium Chloride, Dextrose 10% in water (D10W).
      • Hypotonic Solutions: Solutions that have a lower osmotic pressure than blood plasma, causing fluid to move into cells.
        • Examples: 0.45% Sodium Chloride (half-normal saline), Dextrose 2.5% in water.

    • Electrolyte Replacements:

      • Sodium (Na+): Essential for fluid balance, nerve function, and muscle contraction.
        • Replacement Methods: Administered via IV fluids (e.g., normal saline) or oral supplements.
      • Potassium (K+): Essential for nerve function, muscle contraction, and heart rhythm.
        • Replacement Methods: Administered via IV fluids or oral supplements.
      • Calcium (Ca2+): Plays a role in bone health, muscle contraction, and nerve function.
        • Replacement Methods: Oral supplements, IV calcium gluconate.
      • Magnesium (Mg2+): Important for muscle function, nerve function, and blood pressure regulation.
        • Replacement Methods: Oral supplements, IV magnesium sulfate.

    Fluid & Electrolyte Balance

    • Describes regulating extracellular and intracellular fluid volume, body fluid osmolality, and plasma electrolyte concentration.

    Basic Principles

    • Osmosis: Movement of water molecules across a selectively permeable membrane from an area of low solute concentration to an area of high solute concentration. Aims to equalize concentration on both sides.
    • Diffusion: Passive movement of molecules (like gas, ions, or small molecules) from an area of higher concentration to an area of lower concentration. Think of dumping koolaid powder in a pool or airing out a bad smell.
    • Filtration: Movement of water and solutes across a membrane driven by hydrostatic pressure. Needs pressure. Typically force exerted by blood pressure. Fluid passes through capillaries, but large molecules like proteins are held back.
    • Active Transport: Movement of molecules across a cell membrane against their concentration gradient. Requires ATP and involves carrier proteins.
    • Intracellular: Anything occurring inside cells.
    • Extracellular: Anything outside of cells.
    • Isotonic: Solution with the same concentration as the inside of a cell.
    • Hypertonic: Solution with a higher concentration of solutes compared to the inside of a cell.
    • Hypotonic: Solution with a lower concentration of solutes compared to the inside of a cell.

    Assessment

    • Labs:
      • Basic Metabolic Panel (BMP):
        • Sodium: Normal Level: 135-145
        • Potassium: Normal Level: 3.5-5.0
        • Chloride: Normal Level: 96-106
        • Carbon Dioxide: Normal Level: 23-30. Reflects bicarbonate levels and helps assess acid-base balance. Abnormalities:
          • Metabolic Acidosis (low CO2)
          • Metabolic Alkalosis (high CO2)
        • BUN: Normal Level: 7-20. Indicates kidney function and hydration status. Abnormalities:
          • Elevated BUN: Dehydration or kidney dysfunction.
        • Glucose: Normal Level: 70-100. Provides energy and regulates metabolism.
        • Calcium: Normal Level: 8.5-10.2. Important for bones, muscles, and nerves.
      • Bonus: Magnesium: Normal Level: 1.7-2.2. Not part of the BMP.
    • 24 Hour Urine: Measures how well kidneys excrete electrolytes and other substances over a full day. The first morning urine is not used, and the urine needs to be stored in a cool place. Measures:
      • Volume
      • Creatinine
      • Protein
      • Sodium
      • Potassium
      • Calcium
      • Magnesium
      • Phosphate
      • Cortisol
      • Oxalate
      • Citrate
      • Chloride
      • Sulfate
      • Nitrogen
      • Uric acid
      • Ammonia

    Exemplars

    • Specific electrolyte imbalances.
    • Dehydration.
    • Fluid Volume Overload.

    Nursing Process

    • Specific electrolyte imbalances.
    • Dehydration.
    • Dehydration: Risks:
      • Inadequate fluid intake.
      • Excessive fluid loss.
      • Increased urination.
      • Elderly age (decreased thirst sensation).
      • Hot climates or strenuous exercise.
      • Prevention Strategies:
        • Encourage adequate hydration.
        • Teach signs of dehydration (dry mouth, thirst, dark urine).
        • Adjust fluid intake based on needs.
    • Fluid Overload (Hypervolemia): Risks:
      • Kidney failure.
      • Congestive heart failure.
      • Liver cirrhosis.
      • Excessive intravenous fluid administration.
      • Hormonal imbalances (high levels of aldosterone, causes water retention).
      • Prevention Strategies:
        • Monitor daily fluid intake.
        • Follow fluid restriction orders.
        • Limit sodium intake (often found in processed foods and canned foods).
        • Encourage daily weight checks. Report a sudden gain of 2 or more pounds per day.
    • Hypernatremia: High sodium levels. Can cause dehydration and altered mental status. Risks:
      • Dehydration.
      • Diabetes insipidus (leads to excessive water loss).
      • Excessive sodium intake (dietary or from infusion). Sources of sodium: (table salt, processed foods, canned foods).
      • Prevention Strategies:
        • Follow a low sodium diet (avoid canned/processed foods).
        • Ensure adequate fluid intake.
        • Monitor for signs (thirst, confusion).
    • Hyponatremia: Low sodium levels. Can cause confusion and seizures. Risks:
      • Excessive water intake.
      • Syndrome of inappropriate antidiuretic hormone (SIADH).
      • Diuretic use (especially thiazides).
      • Severe vomiting or diarrhea.
      • Heart failure and liver disease that affect fluid balance.
      • Prevention Strategies:
        • Follow fluid restrictions in conditions like heart failure.
        • Encourage appropriate sodium intake (especially in patients with GI problems).
        • Monitor sodium levels regularly in at-risk patients.
    • Hypercalcemia: High calcium levels. Can cause weakness and confusion. Risks:
      • Hyperparathyroidism.
      • Cancer (specifically bone metastasis or certain tumors).
      • Excessive vitamin D intake.
      • Prolonged immobilization (causes bone breakdown and increased calcium release).
      • Use of thiazide diuretics.
      • Prevention Strategies:
        • Limit calcium and vitamin D intake in at-risk patients. (Patients with hyperparathyroidism are at increased risk).
        • Encourage hydration to prevent kidney stones.
        • Promote physical activity to prevent calcium release from bones.
    • Hypocalcemia: Low calcium levels. Can cause muscle spasms and cardiac arrhythmias. Risks:
      • Vitamin D deficiency.
      • Hypoparathyroidism.
      • Chronic kidney disease.
      • Magnesium deficiency.
      • Prevention Strategies:
        • Encourage a calcium-rich diet (dairy, leafy green vegetables).
        • Ensure adequate vitamin D intake for calcium absorption.
        • Monitor calcium levels in patients with thyroid or parathyroid disorders.
    • Hyperkalemia: High potassium levels. Can cause life-threatening arrhythmias. Risks:
      • Kidney failure (impaired potassium excretion).
      • Use of potassium-sparing diuretics.
      • Adrenal insufficiency (reduced aldosterone, reduced potassium excretion).
      • Excessive potassium intake. Sources of potassium: Bananas, oranges, potatoes, etc).
      • Tissue damage (which releases potassium).
      • Prevention Strategies:
        • Limit potassium-rich food intake.
        • Regularly check medications.
        • Monitor potassium levels in patients with kidney issues or on medications.
    • Hypokalemia: Low potassium levels. Can cause arrhythmias and muscle weakness. Risks:
      • Use of diuretics.
      • Severe vomiting or diarrhea.
      • Excessive laxative use.
      • Alkalosis (shifts potassium into cells).
      • Inadequate potassium diet intake.
      • Prevention Strategies:
        • Encourage potassium-rich foods (bananas, spinach, oranges, potatoes).
        • Monitor diuretic usage and promote potassium supplementation if necessary.
        • Teach athletes or patients who sweat excessively to replace potassium loss.
    • Hyperphosphatemia: High phosphate levels. Risks:
      • Chronic kidney disease (impaired excretion).
      • Hypoparathyroidism (reduced parathyroid hormone leads to less excretion).
      • Excessive phosphate intake or IV intake.
      • Rhabdomyolysis or tumor lysis syndrome (massive cell breakdown, releases phosphate).
    • Hypermagnesemia: High magnesium levels. Risks:
      • Chronic kidney disease (impaired excretion).
      • Excessive magnesium intake (from supplements or laxatives).
      • Adrenal insufficiency.
      • Medicines containing magnesium (antacids or laxatives).
      • Prevention Strategies:
        • Limit magnesium-containing medications (such as laxatives and antacids).
        • Monitor magnesium levels, especially in patients with kidney disease.
        • Educate on signs (muscle weakness, lethargy, slow reflexes).
    • Hypomagnesemia: Low magnesium levels. Risks:
      • Chronic alcoholism.
      • Diuretic use (especially loop diuretics).
      • Severe diarrhea or vomiting.
      • Malabsorption disorders (such as Crohn's).
      • Inadequate dietary intake.
      • Prevention Strategies:
        • Promote magnesium-rich foods (nuts, seeds, whole grains, leafy greens).
        • Monitor diuretic use.
        • Monitor alcohol use.

    Pharmacology

    • Types of Intravenous (IV) Fluids:
      • Isotonic Solutions: Have the same osmotic pressure as blood plasma. Common examples: Normal Saline (0.9% NaCl), Lactated Ringer's, Dextrose 5% in water (D5W).
      • Hypertonic Solutions: Have a higher osmotic pressure than blood plasma, causing fluid to move out of cells. Common examples: 3% Sodium Chloride, Dextrose 10% in water (D10W).
      • Hypotonic Solutions: Have a lower osmotic pressure than blood plasma, causing fluid to move into cells. Common examples: 0.45% Sodium Chloride (half-normal saline), Dextrose 2.5% in water.
    • Electrolyte Replacements:
      • Sodium: Essential for fluid balance, nerve function, and muscle contraction. Replacement methods: Administered via IV fluids (e.g., normal saline) or oral supplements.
      • Potassium: Important for muscle contraction, nerve impulses, and heart rhythm. Replacement methods: Oral supplements, IV fluids (e.g., potassium chloride diluted).
      • Calcium: For bones, muscles, nerves, and blood clotting. Replacement methods: Oral supplements, IV fluids.
      • Magnesium: Important for muscle and nerve function, blood sugar control, and blood pressure regulation. Replacement methods: Oral supplements, IV fluids.

    Fluid and Electrolyte Balance

    • Regulates extracellular and intracellular fluid volume, body fluid osmolality, and plasma electrolyte concentrations.

    Basic Principles

    • Osmosis: Water moves across a selectively permeable membrane from an area of low solute concentration to high solute concentration.
    • Diffusion: Passive movement of particles from an area of high concentration to an area of low concentration.
    • Filtration: Movement of water and solutes across a membrane driven by hydrostatic pressure (typically blood pressure).
    • Active Transport: Movement of molecules across a cell membrane against their concentration gradient, requiring ATP and carrier proteins.
    • Intracellular: Anything occurring inside the cells.
    • Extracellular: Anything occurring outside of the cells.
    • Isotonic: Solution with the same solute concentration as the inside of a cell.
    • Hypertonic: Solution with a higher solute concentration than the inside of a cell.
    • Hypotonic: Solution with a lower solute concentration than the inside of a cell.

    Assessment

    • Laboratory Tests:
      • Basic Metabolic Panel (BMP)
        • Sodium: Normal Level: 135-145 mEq/L
        • Potassium: Normal Level: 3.5-5.0 mEq/L
        • Chloride: Normal Level: 96-106 mEq/L
        • Carbon Dioxide: Normal Level: 23-30 mmol/L. Reflects bicarbonate levels and assesses acid-base balance.
        • BUN (Blood Urea Nitrogen): Normal Level: 7-20 mg/dL. Indicates kidney function and hydration status.
        • Glucose: Normal Level: 70-100 mg/dL. Provides energy and regulates metabolism.
        • Calcium: Normal Level: 8.5-10.2 mg/dL. Important for bones, muscles, and nerves.
        • Magnesium: Normal Level: 1.7-2.2 mg/dL. Not included in BMP.
      • 24-hour urine collection: Measures how well the kidneys excrete electrolytes and other substances over a full day.

    Exemplars

    • Specific electrolyte imbalances
    • Dehydration
    • Fluid volume overload

    Nursing Process

    • Specific electrolyte imbalances
    • Dehydration
    • Dehydration:
      • Risks: Inadequate fluid intake, excessive fluid loss, increased urination, elderly age (decreased thirst sensation), hot climates or strenuous exercise.
      • Prevention: Encourage adequate hydration, teach signs of dehydration, adjust fluid intake based on needs.
    • Fluid Overload (Hypervolemia):
      • Risks: Kidney failure, congestive heart failure, liver cirrhosis, excessive intravenous fluid administration, hormonal imbalances (high aldosterone).
      • Prevention: Monitor daily fluid intake, follow fluid restriction orders, limit sodium intake, encourage daily weight checks.
    • Hypernatremia: High sodium levels. Risks: Dehydration, diabetes insipidus, excessive sodium intake.
      • Prevention: Follow a low sodium diet, ensure adequate fluid intake, monitor for signs (thirst, confusion).
    • Hyponatremia: Low sodium levels. Risks: Excessive water intake, syndrome of inappropriate antidiuretic hormone (SIADH), diuretic use, severe vomiting or diarrhea, heart failure, liver disease.
      • Prevention: Follow fluid restrictions in conditions like heart failure, encourage appropriate sodium intake (especially in patients with GI problems), monitor sodium levels regularly.
    • Hypercalcemia: High calcium levels. Risks: Hyperparathyroidism, cancer, excessive vitamin D intake, prolonged immobilization, thiazide diuretics.
      • Prevention: Limit calcium and vitamin D intake, encourage hydration to prevent kidney stones, promote physical activity to prevent calcium release from bones.
    • Hypocalcemia: Low calcium levels. Risks: Vitamin D deficiency, hypoparathyroidism, chronic kidney disease, magnesium deficiency.
      • Prevention: Encourage a calcium-rich diet, ensure adequate vitamin D intake for calcium absorption, monitor calcium levels in patients with thyroid or parathyroid disorders.
    • Hyperkalemia: High potassium levels. Risks: Kidney failure, potassium-sparing diuretics, adrenal insufficiency, excessive potassium intake, tissue damage.
      • Prevention: Limit potassium-rich food intake, regularly check medications, monitor potassium levels in at-risk patients.
    • Hypokalemia: Low potassium levels. Risks: Diuretic use, severe vomiting or diarrhea, excessive laxative use, alkalosis, inadequate potassium diet intake.
      • Prevention: Encourage potassium-rich foods, monitor diuretic usage and promote potassium supplementation, teach athletes to replace potassium loss.
    • Hyperphosphatemia: High phosphate levels. Risks: Chronic kidney disease, hypoparathyroidism, excessive phosphate intake (IV or oral).
    • Hypermagnesemia: High magnesium levels. Risks: Chronic kidney disease, excessive intake (supplements or laxatives), adrenal insufficiency, magnesium-containing medications.
      • Prevention: Limit magnesium-containing medications, monitor magnesium levels in patients with kidney disease, educate on signs (muscle weakness, lethargy, slow reflexes).
    • Hypomagnesemia: Low magnesium levels. Risks: Chronic alcoholism, diuretic use, severe diarrhea/vomiting, malabsorption disorders, inadequate dietary intake.
      • Prevention: Promote magnesium-rich foods, monitor diuretic use, monitor alcohol use.

    Pharmacology

    • Intravenous Fluids:
      • Isotonic: Solutions with the same osmotic pressure as blood plasma (e.g., Normal Saline, Lactated Ringer's, Dextrose 5% in Water).
      • Hypertonic: Solutions with a higher osmotic pressure than blood plasma (e.g., 3% Sodium Chloride, Dextrose 10% in Water).
      • Hypotonic: Solutions with a lower osmotic pressure than blood plasma (e.g., 0.45% Sodium Chloride, Dextrose 2.5% in Water).
    • Electrolyte Replacements:
      • Sodium: Role: Fluid balance, nerve function, muscle contraction.
      • Replacement: IV fluids or oral supplements.
      • Potassium: Role: Muscle contraction, nerve function, heart rhythm.
      • Replacement: IV fluids or oral supplements.
      • Calcium: Role: Bone health, muscle function, nerve function, blood clotting.
      • Replacement: IV fluids or oral supplements.
      • Magnesium: Role: Muscle and nerve function, blood sugar control, blood pressure regulation.
      • Replacement: IV fluids or oral supplements.
      • Phosphate: Role: Bone health, energy production, cell function.
      • Replacement: IV fluids, oral supplements, or phosphate binders.

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Related Documents

    Fluid & Electrolytes Study Guide PDF

    Description

    Test your knowledge on the principles of fluid and electrolyte balance including osmosis, diffusion, and active transport. This quiz covers the key concepts related to intracellular and extracellular environments. Understand how these processes affect body fluid regulation and concentration gradients.

    More Like This

    Fluid and Electrolyte Balance Quiz
    30 questions

    Fluid and Electrolyte Balance Quiz

    InsightfulNephrite9228 avatar
    InsightfulNephrite9228
    NURS 126: Body Fluid Composition and Regulation
    42 questions

    NURS 126: Body Fluid Composition and Regulation

    SuaveRhodolite avatar
    SuaveRhodolite
    Water and Electrolyte Balance Quiz
    5 questions

    Water and Electrolyte Balance Quiz

    MajesticWerewolf70 avatar
    MajesticWerewolf70
    Use Quizgecko on...
    Browser
    Open
    Browser
    Browser