2 - Potassium, Sodium, Chloride (1).pdf

Fluid & Electrolyte Basics I Fundamentals of Nursing Contraindication Electrolyte Imbalances We are breaking down the top tested causes & critical manifestations (signs & symptoms) of how our clients present when electrolytes are out of balance. Some imbalances can be deadly. Remember, the MOST de...

Fluid & Electrolyte Basics I Fundamentals of Nursing Contraindication Electrolyte Imbalances We are breaking down the top tested causes & critical manifestations (signs & symptoms) of how our clients present when electrolytes are out of balance. Some imbalances can be deadly. Remember, the MOST deadly conditions are typically the MOST tested conditions since the main goal of nursing school is to create safe nurses who know how to spot when something is not right. Electrolytes Function Hyper HIGH HypO LOw P HYPERkalemia HYPOkalemia Potassium K+ Potassium (over 5.0) (below 3.5) 3.5 - 5.0 Manifestations (S/S) Manifestations (S/S) Potassium Heart = HIGH pumps Heart = Low & slow pump K+ 1 - Peaked T waves & ST elevation 1 - Flat T waves, ST depression, & U waves 2 - Severe: V Fib & cardiac arrest Neuromuscular = Low & slow 3 - Hypotension & bradycardia 1 - Shallow respirations! Most DEADLY P Neuromuscular = HIGH 2 - Decreased DTR Priority 1 - Increased DTR 3 - Muscle cramping & flaccid paralysis 2 - Paralysis & paresthesia (tingling) (paralyzed limbs) Potassium 3 - Muscle weakness (general feeling GI = Low & slow K+ RITY of heaviness) 1 - Constipation PRIO GI = HIGH pumps 2 - HypOactive bowel sounds 1 - Diarrhea 3 - Paralytic ileus (paralyzed intestine) P 2 - Hyperactive bowel sounds Priority* risk for SBO Pumps the heart Causes: - Renal failure Causes: - Low aldosterone Fluid loss, electrolyte loss Memory Trick for AL “Where fluids flow, electrolytes goooo!” A - Adds Sodium Diarrhea, Diuretics, L - Loses Potassium Diet, DKA, Aldosterone Electrolytes Function Hyper HIGH HypO LOw S HYPERnatremia HYPOnatremia Sodium Na+ (over 145) (below 135) 135 - 145 Sodium Sodium Manifestations (S/S) Manifestations (S/S) Brain = Low & slow Na+ Body = Big & bloated 1 - Headache = Cerebral edema 1 - Edema (swollen body) 2 - Mental status changes 2 - Flushed “red & rosey” skin 3 - Seizures & coma 3 - Increased muscle tone Muscular = Low & slow S - Fatigue & muscle cramps 4 - Swollen dry tongue Sodium Swells the body with FLUID Respiratory = Low & slow 5 - Nausea & vomiting Na+ - Respiratory Arrest Causes: Causes: - Sweating - Low ADH (antidiuretic hormone) - Excess water intake DI: Diabetes Insipidus (running in the extreme heat) TEST TIP Maintains: Think Dry Inside - SIADH (Excess ADH - Vomiting & diarrhea, Blood pressure - Rapid respirations - Diuretics & diuresis Blood volume - Watery diarrhea - Diet low in salt pH balance - Loss of thirst - Low aldosterone Electrolytes Function Hyper HIGH HypO LOw Chloride Cl- Related to sodium HYPERchloremia HYPOchloremia Maintains: (Over 107) (Below 97) 97 - 107 Blood pressure NEARLY SAME NEARLY SAME AS low SODIUM Blood Volume pH balance AS HIGH SODIUM 1 - Fatigue & muscle cramps 1 - Swollen dry tongue 2 - Fever (only difference) NORMAL 2 - Nausea & vomiting Chloride Metabolic Alkalosis - vomiting HIGH LOW Chloride Chloride Cl- Cl- Cl- pH