Fluid & Electrolyte Basics III PDF

Fluid & Electrolyte Basics III Fundamentals of Nursing TEST TIP The MOST deadly conditions are typically the MOST tested conditions, since the main goal of nursing school is to create safe nurses. Electrolytes Function...

Fluid & Electrolyte Basics III Fundamentals of Nursing TEST TIP The MOST deadly conditions are typically the MOST tested conditions, since the main goal of nursing school is to create safe nurses. Electrolytes Function HYPER ‘’HIGH’’ Hypo ‘’low’’ Potassium K+ HYPERkalemia HYPOkalemia P (over 5.0) (below 3.0) 3.5 - 5.0 Priority Manifestations (S/S) Heart = HIGH pumps P P Manifestations (S/S) RITY 1 - Peaked T Waves & ST Elevation Heart = Low & slow pump Potassium PRIO Pumps the heart 2 - Severe: V Fib & Cardiac Arrest Causes: - Renal failure 1 - Flat T waves, ST depression & Uwave Potassium 3 - Hypotension & Bradycardia - Low aldosterone Neuromuscular = Low & slow Causes: K+ Neuromuscular = HIGH 1 - Shallow Respirations! Most DEADLY Fluid loss/electrolyte loss Memory Trick for AL 2 - Decreased DTR Potassium 1 - Increased DTR “Where fluids flow, electrolytes goooo!” A - Adds Sodium K+ 3 - Muscle cramping & flaccid paralysis 2 - Paralysis & paresthesia (tingling) (paralyzed limbs) Diarrhea, Diuretics, 3 - Muscle weakness (general feeling L - Loses Potassium Diet, DKA, Aldosterone GI = Low & slow of heaviness) 1 - Constipation 2 - HypOactive bowel sounds GI = HIGH pumps 3 - Paralytic ileus (paralyzed intestine) 1 - Diarrhea Priority* risk for SBO 2 - Hyperactive bowel sounds S Sodium Na+ Sodium HYPERnatremia HYPOnatremia 135 - 145 Sodium (over 145) (below 135) Maintains: Na+ Blood Pressure Manifestations (S/S) Causes: Manifestations (S/S) Causes: Body = Big & Bloated - Low ADH (antidiuretic hormone) Brain = Low & slow - Sweating Sodium Blood volume S 1 - Edema (swollen body) DI: Diabetes Insipidus 1 - Headache = Cerebral edema - Excess water intake Na+ 2 - Mental status changes (running in the extreme heat) TEST TIP pH balance Swells the body with FLUID 2 - Flushed “red & rosey” skin Think Dry Inside 3 - Seizures & Coma - SIADH (Excess ADH 3 - Increased muscle tone - Rapid respirations Muscular = Low & slow - Vomiting & diarrhea, 4 - Swollen dry tongue - Watery diarrhea - Fatigue & muscle cramps - Diuretics & Diuresis - Diet low in salt 5 - Nausea & Vomiting - Loss of thirst Respiratory = Low & slow - Low aldosterone - Respiratory Arrest Chloride Cl- HYPERchloremia HYPOchloremia (over 107) (below 97) NORMAL 97 - 107 HIGH LOW Related to sodium Chloride Chloride Maintains: Cl- Cl- NEARLY SAME Blood pressure AS HIGH SODIUM Chloride NEARLY SAME AS low SODIUM Blood Volume Cl- 1 - Swollen dry tongue 1 - Fatigue & muscle cramps pH balance 2 - Nausea & vomiting 2 - Fever (only difference) pH Metabolic Alkalosis - vomiting Magnesium Mg+ HYPERmagnesemia HYPOmagnesemia 1.3 - 2.1 M M (over 2.1) (below 1.3) Magnesium Mellows the muscles Manifestations (S/S) Heart = High Mellow Manifestations (S/S) Magnesium Causes: Heart = Low Mellow - Excited! Magnesium 1 - Heart block Mg+ 1 - Torsades de Pointes TOP TESTED 2 - Hypotension, bradycardia - Renal failure Mg+ & V Fib (ventricular fibrillation) Causes: DTR = High Mellow - Alcoholism DTR = Low Mellow - Excited! - Crohn's disease - Hyporeflexia (decreased DTR) - Malnourishment - HYPERreflexia (increased DTR) - Celiac disease Lungs & GI = High Mellow GI = Low Mellow - Excited! - Depressed respirations - Diarrhea - Hypoactive bowel sounds - Hyperactive bowel sounds Calcium Ca C HYPERcalcemia HYPOcalcemia Keeps the Calcium 9.0 - 10.5 3 Bs Strong Calcium (over 10.5) (below 9.0) B - Bone B - Blood (clotting) Ca Manifestations (S/S) Manifestations (S/S) B - Beats (heart) HIGH Calm Causes: Low Calm = Excited! Calcium C 1 - Kidney stones, moans & 1 - T - Trousseau’s Sign Causes: Ca - Hyperparathyroidism Twerking arm when BP cuff on -Hypoparathyroidism Inverse Contracts the muscles groans (Renal Calculi) High PTH = High Calcium Tetany: muscle spasms all over 2 - C - Chvostek’s Sign Low PTH = Low Calcium 2 - Constipation - Cancer - Renal failure TEST TIP relationship with 3 - Bone pain - Immobility Cheeky smile when stroking face 3 - Diarrhea Chronic kidney disease (CKD) Phosphate 4 - Weak B’s 4 - Severe muscle weakness Weak Bones = Fractures Weak Blood clotting = r/f bleeding & lethargy Weak Beats = Cardiac dysrhythmias Phosphate - Ca HIGH = Inverse HYPERphosphatemia HYPOphosphatemia Phosphate Low 3.0 - 4.5 - Ca Low = relationship with Calcium (over 4.5) (below 3.0) Phosphate HIGH Manifestations (S/S) Manifestations (S/S) Think High Calcium signs Causes: Calcium Think Low Calcium signs Causes: - Hyperparathyroidism Ca 1 - Kidney stones, moans & groans 1 - Trousseau’s & Tetany - Renal failure TEST TIP (Renal Calculi) High PTH = High Calcium 2 - Chvostek's Chronic kidney disease (CKD) 2 - Constipation - Genetics 3 - Bone Pain - Cancer 3 - Weak B’s (bones, blood, beats) Calcium 4 - Severe muscle weakness & lethargy Ca