Nursing 1245 fluid & electrolytes
FVD
Fluid volume deficit (hypovolemia)
FVE
Fluid volume excess (hypervolemia)
Hypercalcemia interventions
Increase Ca excretion -Hydration -Diuretics -Hemodialysis Block bone resorption and decreased GI uptake -Steroids -Phosphates
Magnesium range
1.7 to 2.2 mg/dL
Hyponatremia S/S
"SALT LOSS" Seizures & Stupor Abdominal cramping & Attitude changes Lethargic Tendon reflexes diminished Loss of urine & Loss of appetite Orthostatic hypotension & Overactive bowel sounds Shallow respirations (late happening result of muscle weakness) Spasms of muscles
Aldosterone
"salt-retaining hormone" which promotes the retention of Na+ by the kidneys. na+ retention promotes water retention, which promotes a higher blood volume and pressure
FVE interventions
- Diagnose & treat the cause - O2 - Reduce fluids (fluid & Na restriction/diuretics/hemodialysis) - Monitor pt. VS, pulses, I&O, resp status & edema - Daily weight checks - Skin care (breakdown)
Assessment findings FVD
- Dry mm/mouth - Decreased skin turgor - Increased hr - AMS - Decreased cap refill - Hypotension (hypovolemia)
FVD interventions
- Identify & treat cause - Daily weight, most accurate indicator of fluid status (same time, scale and clothes every time) - Fluid replacement (iso / hypo / IV / albumin / blood) - Monitor pt. VS, pulses , LOC - I&O (S/S fluid overload) - Skin & mucous membrane care
Common dilators
- Morphine - Digoxin - Nitro
Causes of hypovolemia (FVD)
- NG tube - Hemmorrage - Trauma - GI loses (V/D) - Sweat - Thoracentesis - Decreased intake - Polyuria (hyperglycemia)
Assessment findings of FVE
-Edema, Weight gain -Taught, shiny skin -Rapid, bounding pulse -Increase BP -Distended veins -Decreased BUN (unless renal failure), Hct, pO2 -CXR: pulmonary congestion -SOB: dyspnea
Hypotonic fluid examples
0.45% NS 2.5 Dextrose in 0.45% NS
Isotonic fluid examples
0.9% NS, LR, D5W
Sodium range
135-145 mmol/L
1L of water weights ____ = to 1kg
2.2
Phosphorus range
2.5-4.5 mg/dl
Hypertonic fluid examples
3% NaCl 5% NaCl D10W
Potassium range
3.5-5.0 mEq/L
Weight change of 1lb = fluid volume change of about ______
500mL
Calcium range (CL-)
95-105 mEq/L
Hypertonic dehydration
A result of deprivation of fluids often seen in the elderly and very young
Isotonic dehydration
A result of hypovolemia or fluid volume loss
Hypotonic dehydration
A result of sodium loss in greater amounts than free water, often seen as a result of a low-sodium diet or diuretic overuse
Trousseau's sign
A sign of hypocalcemia Carpal spasm caused by inflating a blood pressure cuff above the client's systolic pressure and leaving it in place for 3 minutes.
Hypertonic solution
A solution in which the concentration of solutes is greater than that of the cell that resides in the solution The net movement of water will be out of the body and into the solution (body tissues to blood stream) Cells shrink
A client with a serum glucose level of 618 mg/dl (34.33 mmol/L) is admitted to the facility. The client is awake and oriented, has hot dry skin, and has the following vital signs: temperature of 100.6° F (38.1° C), heart rate of 116 beats/minute, and blood pressure of 108/70 mm Hg. Based on these assessment findings, which nursing diagnosis takes highest priority? A: Deficient fluid volume related to osmotic diuresis B: Decreased cardiac output related to elevated heart rate C: Imbalanced nutrition: Less than body requirements related to insulin deficiency D: Ineffective thermoregulation related to dehydration
A: Deficient fluid volume related to osmotic diuresis
Which assessment finding would you expect to have in a fluid volume deficit? A: Increased pulse B: Increased edema C: Increased blood pressure D: Decreased hematocrit
A: Increased pulse
An older adult client is admitted to the hospital with a diagnosis of pneumonia. The nurse learns that the client lives alone and has not been eating or drinking properly. Upon physical assessment, the nurse notes tachycardia, hypotension, and hyperthermia. Which admission order would the nurse implement first? A: Intravenous fluid hydration B: Acetaminophen orally as needed C: Small-volume nebulizer breathing treatments D: Regular diet
A: Intravenous fluid hydration
A client who has been taking furosemide has a serum potassium level of 3.2 mEq/L. Which assessment findings by the nurse would confirm an electrolyte imbalance? A: Muscle weakness and a weak, irregular pulse B: Diarrhea and cramps C: Tetany and tremors D: Mental status changes and poor tissue turgor
A: Muscle weakness and a weak, irregular pulse
The sudden onset of which sign indicates a potentially serious complication for the client receiving an IV infusion? A: Noisy respirations B: Pupillary constriction C: Halitosis D: Moist skin
A: Noisy respirations
A client is placed on hypocalcemia precautions after removal of the parathyroid gland for cancer. The nurse should observe the client for which symptoms? Select all that apply. A: Numbness B: Aphasia C: Tingling D: Muscle twitching and spasms F: Polyuria G: Polydipsia Select all that apply
A: Numbness C: Tingling D: Muscle twitching and spasms
A client with type 1 diabetes has DKA. Which finding has the greatest effect on fluid loss? A: Rapid, deep respirations B: Decreased serum potassium level C: Warm, dry skin D: Hypotension
A: Rapid, deep respirations
A client is admitted for acute kidney injury and has a potassium level of 5.6 mEq/L (mmol/L), a blood glucose level of 80 mg/dL (4.4 mmol/L), and an electrocardiogram demonstrating peaked T waves. What prescription would the nurse question? A: Spironolactone PO. B: Regular insulin and dextrose I.V. C: Sodium polystyrene sulfonate PO. D: Furosemide I.V.
A: Spironolactone PO.
A nurse is caring for a client with a nursing diagnosis of fluid volume deficit related to impaired thirst mechanism. Which outcome would the nurse determine as most appropriate for this client? A: The client's intake and output are balanced. B: The client performs oral hygiene every 4 hours. C: The client verbalized the importance of increasing fluid intake. D: The client's skin remains dry and intact throughout the hospital stay.
A: The client's intake and output are balanced.
Which could result in hypocalcemia? A: Thyroidectomy B: Hyperparathyroidism C: Glucocorticoids D: Hyperglycemia
A: Thyroidectomy
A client has a serum calcium level of 7.2 mg/dl (1.8 mmol/L). During the physical examination, the nurse expects to assess A: Trousseau's sign. B: Homans' sign. C: Hegar's sign. D: Goodell's sign.
A: Trousseau's sign.
Edema
Abnormal accumulation of fluid in interstitial spaces of tissues
Hypocalcemia treatment
Administer Ca Calcium chloride (fast acting with 3 times more available calcium) Calcium gluconate-more commonly used Mg replacement Vitamin D supplements Reduce phosphate Aluminum hydroxide antacids
Hypermagnesemia interventions
Increase elimination Fluids Loop diuretics Avoid giving magnesium to renal patients / renal failure Monitor patient VS, LOC, reflexes, I&O, labs, ECG Teaching -Avoid Mg
ADPIE
Assessment Diagnosis Planning Implementation Evaluation
What order for naloxone would be appropriate for the nurse to administer for reversal of opioid effects? A: 1 mg IV repeat every 2 to 3 minutes B: 0.1 mg IV repeat every 2 to 3 minutes C: 5mg IV repeat every 5 minutes D: 0.4 IV repeat every 3 minutes
B: 0.1 mg IV repeat every 2 to 3 minutes
A client with an I.V. of normal saline at 150 mL/hour reports dyspnea and restlessness. What is the priority nursing action? A: Decrease IV rate B: Assess lung sounds C: Obtain client weight D: Obtain electrolyte laboratory results
B: Assess lung sounds
Signs and symptoms of hypernatremia? A: Hyperreflexia B: Changes in LOC C: Flushing D: Elevated BP
B: Changes in LOC
Which of these solutions becomes hypotonic after entering the body? A: 0.45 NaCl B: D5W C: 0.9 NS D: D50.45 NS
B: D5W
For the past 24 hours, a client with dry skin and dry mucous membranes has had a urine output of 600 ml and a fluid intake of 800 ml. The client's urine is dark amber. These assessments indicate which nursing diagnosis? A: Impaired urinary elimination B: Deficient fluid volume C: Imbalanced nutrition: Less than body requirements D: Excess fluid volume
B: Deficient fluid volume
Hypertonic solutions.....? A: Become hypotonic when metabolized B: Draw fluids from the intercelluar space C: Contain the same concentration of active particles as extracellular fluid D: Move fluids from the extra cellular space into cells
B: Draw fluids from the intercelluar space
Which type of solution, when administered IV, would cause fluid to shift from body tissues to the bloodstream? A: Sodium chloride B: Hypertonic C: Hypotonic D: Isotonic
B: Hypertonic
A physician orders a loop diuretic for a client. When administering this drug, the nurse anticipates that the client may develop which electrolyte imbalance? A: Hypervolemia B: Hypokalemia C: Hyperkalemia D: Hypernatremia
B: Hypokalemia
Electrolyte imbalance that can occur with prolonged laxative abuse? A: Hyponatremia B: Hypokalemia C: Hyperkalemia D: Hypernatremia
B: Hypokalemia
A physician orders an isotonic I.V. solution for a client. Which solution should the nurse plan to administer? A: 5% dextrose and normal saline solution B: Lactated Ringer's solution C: Half-normal saline solution D: 10% dextrose in water
B: Lactated Ringer's solution
What would the nurse anticipate for a patient with rapid fluid loss? A: Crackles B: Rapid infusion of isotonic I.V. fluids C: Rapid infusion of hypertonic IV fluids D: BP 132/86
B: Rapid infusion of isotonic I.V. fluids
Signs and symptoms of hyponatremia? A: Dry skin B: Seizures C: Edema D: Fever
B: Sezuires
A client is receiving intravenous fluids and upon assessment presents with increased pulse, increased respirations, and jugular vein distension. What is the priority action by the nurse? A: Repeat the vital signs in 1 hour. B: Slow the intravenous rate and notify the physician. C: Lower the head of the bed. D: Administer oxygen and encourage the client to breathe deeply.
B: Slow the intravenous rate and notify the physician.
Which is the most accurate method of determining the extent of a client's fluid loss? A: Assess skin turgor B: Weighing the patient C: Assessing VS D: Check I's & O's
B: Weighing the patient
Chloride's relationship to bicarb
Buffer
A client has been taking furosemide for 2 days. The nurse should review the laboratory record for changes in which blood level? A: An elevated blood urea nitrogen (BUN) B: An elevated potassium C: A decreased potassium D: An elevated sodium
C
A client is receiving spironolactone for treatment of bilateral lower extremity edema. The nurse should instruct the client to make which nutritional modification to prevent an electrolyte imbalance? A: Increase intake of milk and milk products. B: Restrict fluid intake to 1,000 mL/day. C: Decrease foods high in potassium. D: Increase foods high in sodium.
C: Decrease foods high in potassium.
When assessing a client diagnosed with third spacing, a nurse should expect to assess what manifestation? A: Oliguria B: Diuresis C: Decreased BP D: Bradycardia
C: Decreased BP
The nurse is caring for a client with a serum sodium level of 128 mEq/L. Which order for intravenous fluids should the nurse should question? A: Dextrose 5% in half-normal saline solution D5.45 B: Normal saline solution 0.9 C: Dextrose 5% in water (D5W) D: Lactated Ringer's solution
C: Dextrose 5% in water (D5W)
A client has a nursing diagnosis of FVD. Which nursing assessment finding would support the diagnosis A: Leathery pliable skin B: Pedal pulse +4 C: Orthostatic BP changes D: Pretibial pitting edema
C: Orthostatic BP changes
What's the priority action if the nurse suspects FVE in a patient who presents with +2 edema and IV fluids running? A: Lower HOB B: Notify provider C: Stop the fluids D: Administer O2
C: Stop the fluids
The student nurse asks why a client is receiving an I.V. of lactated Ringer's with potassium following an episode of diabetic ketoacidosis. What is the best response by the nurse? A: Lactated Ringer's will help lower the blood pH when hypokalemia is related to ketoacidosis. B: Hypokalemia is associated with uncontrolled diabetes, and the lactated Ringer's is isotonic fluid replacement. C: With acidosis, the intracellular potassium switches places with the plasma hydrogen ions to buffer the acidosis; the lactated Ringer's helps restore the bicarbonate reserves. D: In acidosis, the sodium moves into the cells to buffer the acid and displaces the potassium. The lactated Ringer's helps restore the alkaline pH.
C: With acidosis, the intracellular potassium switches places with the plasma hydrogen ions to buffer the acidosis; the lactated Ringer's helps restore the bicarbonate reserves.
K think about
Cardiac & muscle
Hypophosphatemia treatment
Increase intake Oral/IV supplements Pt. safety/teaching/monitoring
Assessment findings for hypokalemia
Cardiac problems -Weak irregular pulse, palpitations, orthostatic hypotension Neuromuscular weakness -Leg weakness, cramps, paresthesia Fatigue, apathy Respiratory weakness Decreased GI motility Decreased deep tendon reflexes
Hyperphosphatemia causes
Causes (Kidney's and hypoparathyroidism decreased PTH) (Phos-lo) Increased intake/decreased excretion Cell destruction Enemas
Hyperkalemia causes "CARED"
Cellular movement of K+ from intracellular to extracellular (burns, tissue damage, acidosis) Adrenal insufficiency (Addison's) Renal failure Excessive K+ intake Drugs ( K+ sparing, Aldactone, ACE inhibitors, NSAIDS)
Chvostek's sign
Cheek, facial spasm when cheek is tapped associates with hypocalcemia
Potassium (ICF)
Chief regulator of cellular enzyme activity and water content (cardiac)
Ca think about
Chvostek & Trousseau, bone changes (cardiac too)
Hypocalcemia S/S "CRAMPS"
Confusion Reflexes will be hyperactive Arrythmias (prolonged QT & ST interval) Muscle spams & seizures Positive Trousseaus (BP cuff, hand contracting) Sign of Chvostek's (facial nerve is hyperexcitable) Laryngeal spasms
Sodium (ECF)
Control and regulate volume of body fluids
The nurse will see an elevated hematocrit level with fluid volume excess? T or F
F
Electrolytes changed with a burn
Increased potassium Decreased sodium (initally, then increases after) Decreased calcium Decreased bicarb
Isovolemic Hyponatremia
Increased water Normal body sodium (dilutes) -Causes SIADH syndrome ADH ( increases ) Retention of fluids Diabetes insipidus Adrenal insufficiency (Will not see Edema)
Which of these solutions is hypotonic? A: 3% sodium chloride solution B: 0.9% sodium chloride C: Dextrose 5% in half normal saline solution D: 0.45% sodium chloride
D: 0.45% sodium chloride
Signs and symptoms of dehydration? A: Elevated BP B: Moist membranes C: Bradycardia D: Dry tongue
D: Dry tongue
What teaching would the nurse provide to a patient prescribed an opioid analgesic after knee replacement surgery? A: Only take 1 to 2 pills to avoid becoming addicted B: Do not take with grapefruit juice C: Take entire prescription even if pain is gone D: Eat plenty of foods that are high in fiber
D: Eat plenty of foods that are high in fiber
A primary health care provider prescribes regular insulin 10 units intravenously (I.V.) along with 50 ml of dextrose 50% for a client with acute renal failure. What electrolyte imbalance is this client most likely experiencing? A: Hypercalcemia B: Hypernatremia C: Hypermagnesemia D: Hyperkalemia
D: Hyperkalemia
Signs and symptoms of hypokalemia? A: Decreased deep tendon reflexes B: Diarrhea C: Low urine production D: Leg cramping
D: Leg cramping
An older adult client with heart failure and 2+ pitting edema is prescribed furosemide. Due to the effects of furosemide, which additional medication should the nurse recommend to the client to supplement when taking furosemide? A: Calcium B: Phosphates C: Magnesium D: Potassium
D: Potassium
Dehydration
Decreased volume of water and electrolyte change
Hypovolemia
Deficiency in the amount of water and electrolytes in ECF with near-normal water/electrolyte proportions
Hypovolemic Hyponatremia
Dehydrated Loss of blood volume Decreased Na+ Decreased H20
When would your hematocrit be elevated?
Dehydration
Osmosis
Diffusion of water through a selectively permeable membrane (less to more)
Hypernatremia causes "HIGH SALT"
Fever Heat Stroke Pulmonary infections Burns Diarrhea Diabetes insipidus NaCl tabs (sodium intake) IVF (sodium intake) -------------- Hypercortisolism (Cushing's) & Hyperventilation Increased Na+ intake (or IV) GI feeding w/out H20 Hypertonic solutions Sodium excretion decreased (corticosteroids, failed compensatory) Aldosterone problems (increased reabsorption of Na+) Loss of fluids (NG suction) Thirst impairment (depletion)
Filtration and reabsorption
Fluid filters out of the arterial end of the capillary and osmotically reenters at the venous end Delivers materials to the cell and removes metabolic wastes
Third-space fluid shift
Distributional shift of body fluids into potential body spaces
Diffusion
Energy-requiring process that moves material across a cell membrane against a concentration difference (more to less)
Hypervolemia
Excessive accumulation of ECF, in either the intravascular compartments or interstitial space
Hyponatremia Interventions
Fluids -No free water (Gatorade OK) -IVF (volume replacement, hypertonic) 3% (caustic) Monitor patient -VS, LOC, I&O, wt. Monitor labs• Safety (altered LOC) Dialysis Teaching -Medications -Lithium -Salt intake NaCl tabs Fluid restriction Encourage high Na foods
Hypernatremia interventions
Free water Salt free fluids (no Gatorade) Na+ restriction Diuretics and water Monitor patient -VS, LOC, I&O, labs, wt Oral hygiene Safety Teaching
Lactated ringers
Give if they have hyperchloremia Used to replace water and electrolyte loss in patients with low blood volume or low blood pressure
Hypertonic
Having a higher concentration of solute than another solution
Hypotonic
Having a lower concentration of solute than another solution
Isotonic
Having the same solute concentration as another solution
Common pts who will have edema
Heart failure
Causes of hypercalcemia "HIGH CAL"
Hyperparathyroidism (too much Ca+ released in blood) Increased intake of Ca+ (too much Ca+ supplement or Vitamin D) Glucocorticoids Hyperthyroidism Calcium excretion decreased (thiazide diuretics, renal failure and bone cancer) Adrenal insufficiency (Addison's) Lithium use (affects parathyroid and decreases phosphorus)
Excess of isotonic fluid
Hypervolemia (FVE)
D5W (5% dextrose in water) ____ in bag, _____ in the body
Isotonic in the bag, hypotonic in the body
Hypokalemia S/S "7 L'S"
Lethargic Low shallow respirations Lethal cardiac concerns Loss of urine Leg cramps Limp muscles Low BP & HR
Hypermagnesemia S/S "LETHARGIC"
Lethargy EKG changes, PR & QT interval wide and prolonged QRS complex Tendon refluxes diminished or absent Hypotension (regulates BP) Arrythmias (bradycardia) Respiratory arrest (sudden) GI issues (N&V) Impaired breathing (muscle weakness) Cardiac arrest
Solvents
Liquid holding a substance in solution (water)
Causes of hypocalcemia "LOW CALCLIUM"
Low parathyroid hormone (destruction or removal, thyroidectomy) Oral intake inadequate (alcoholism, bulimia) Wound drainage (GI) Celiacs disease Acute pancreatitis Low Vitamin -D (allows Ca+ to be reabsorbed) Chronic Kidney Disease (excretion/ waste) Increased phosphorus levels (Ca+ and phosphorus opposite relationship) Using medications (magnesium, laxatives, loop diuretics) Mobility issues (bones)
Hyperkalemia S/S "MURDER"
M.U.R.D.E.R. M - Muscle weakness U - Urine, oliguria, anuria R- Respiratory distress D - Decreased cardiac contractility E - ECG changes R - Reflexes, hyperreflexia, or areflexia (flaccid)
Hypophosphatemia causes
Malnutrition/Malabsorption Aluminum and magnesium-based drugs Hyperglycemia Alcoholism
Do not give IV potassium at a rate greater than 10 mEq/hr (mmol/hr). Why?
May cause cardiac arrest within minutes
Na think about
Mental
Magnesium (ICF)
Metabolism of carbohydrates and proteins, vital actions involving enzymes (ATP)
Electrolytes
Minerals that carry electrical charges that help maintain the body's fluid balance
Active transport
Movement of molecules from an area of higher concentration to an area of lower concentration
Hyponatremia Diagnostics
NA <135 Decreased urine specific gravity
Hyponatremia causes "NO NA+"
Na+ secretion increased w/ renal problems, NG suction, vomiting, diuretics, DI, aldosterone secretion (water held) Overload of fluids (CHF, Hypotonic fluids, Liver failure) Na+ of sodium low, intake / Diet Antidiuretic hormone over secreted (SIADH) adrenal insufficiency (Addison's)
Hypokalemia causes "DITCH"
Not enough intake Too much output (urine/GI) Drugs (lasix, steroids) Hyperglycemia Insulin therapy ---------- Drugs (laxatives, diuretics, corticosteroids) Inadequate intake of K+ (NPO, anorexia N&V) Too much water intake Cushing's Syndrome Heavy fluid loss (NG suction, N&V, wound drainage, Profuse sweating)
Addison's disease
Occurs when the adrenal glands do not produce enough of the hormones cortisol or aldosterone
Hypomagnesemia causes "LOW MAG"
Poor intake/absorption Increased loss from GI or urinary tract Sepsis Pregnancy Hypocalcemia ------------------- Limited intake of mag (Starvation) Other electrolyte issues (hypocalcemia & hypokalemia) Wasting via Kidneys Malabsorption issues and medications (PPI) Alcohol (panaceas issues ) Glycemic issues (DKA)
Intracellular electrolytes
Potassium Magnesium Phosphate
Hydrostatic pressure
Pressure exerted by a volume of fluid against a wall, membrane, or some other structure that encloses the fluid
Colloid osmotic pressure
Pressure exerted by plasma proteins on permeable membranes in the body; synonym for oncotic pressure
Mg think about
Reflex & muscles
Hypomagnesemia interventions
Replace Mg• Oral IV MgSO4 Monitor patient -VS, LOC, dysphagia, reflexes, I&O Safety Teaching -High Mg foods (chocolate, dry beans and peas, green, leafy veggies, meats, nuts, seafood, whole grains)
Hypokalemia interventions
Replace potassium High potassium foods -Dried fruit, nuts, seeds -Fruits: oranges, bananas, apricots, cantaloupe -Veggies: potatoes, tomatoes, carrots, mushrooms -Meats Oral supplements IV replacement Max 10mEq/hr Replace Mg first Always use a pump Monitor patient -VS, HR & rhythm, labs, dig level, I&O (IV site) Teaching -Diet -Medications -Signs and symptoms
Hyperkalemia interventions
Restrict K+ Eliminate K from the body Loop diuretic Dialysis Sodium polystyrene sulfonate (Kayexalate) Shift K into cells NaHCO3 Dextrose & Insulin Administer CaCl or Ca gluconate Monitor patient -VS, EKG, I&O, dig level, labs Safety Teaching
Hyperphosphatemia S/S
S/S (signs of Hypocalcemia) Calcifications/s hypocalcemia (bones and teeth) Hyperactive deep tendon reflexes
Hyperchloremia S/S
SAME AS HYPERNATREMIA You are 'fried' or S.A.L.T. F - Fever (low grade), flushed skin R - Restless (irritable) I - Increased fluid retention and increased BP E - Edema (peripheral and pitting) D - Decreased urinary output, dry mouth S = Skin flushed A = Agitation L = Low-grade fever T = Thirst
Hypochloremia S/S
SAME AS HYPONATREMIA "SALT LOSS" Seizures & Stupor Abdominal cramping & Attitude changes Lethargic Tendon reflexes diminished Loss of urine & Loss of appetite Orthostatic hypotension & Overactive bowel sounds Shallow respirations (late happening result of muscle weakness) Spasms of muscles
Extracellular electrolytes
Sodium Calcium Chloride Bicarbonate
Solutes
Substance dissolved in a solution
SIADH
Syndrome of inappropriate antidiuretic hormone secretion Triggers thirst
A positive Trousseau's sign would indicate hypocalcemia T or F
T
It is the nurse's responsibility to check lab values before administration of any solution or electrolyte replacement. true or false? T or F
T
Jugular vein distention is a sign of fluid excess T or F
T
Loop diuretic use may result in hypokalemia T or F
T
Patients receiving potassium should have a cardiac monitor in place. T or F
T
Osmolarity
The concentration of a solution expressed as the total number of solute particles per liter.
Hypotonic sloution
The solution has a lower concentration of solutes and a higher concentration of water than inside the cell (low solute; high water); result: water moves from the solution to inside the cell): cell swells and bursts open cytolysis
What does fluid do?
Transports nutrients and waste to and from cells Acts as solvent for electrolytes and non-electrolytes Plays role in maintaining body temp, digestion and elimination, acid-base balance, and lubrication of joints and body tissues
Hypomagnesemia S/S "TWITCHING"
Trousseau's sign (related to hypocalcemia) Weak respirations Irritability Torsade's de pointes (fatal, alcohol abuse) Cardiac changes (prolonged PR & QT intervals, wide QRS complexes, increased T-waves) Hypertension Involuntary movements Nausea GI issues (decreased bowl sounds and motility)
A hypertonic solution has a greater osmolarity, causing water to move out of the cells and be drawn into the intravascular compartment, causing the cell to shrink T or F
True
Hypervolemic Hyponatremia
Water increases & Sodium Decreases (dilute) - Fluid volume overload CHF• Kidney failure• Liver failure• Excessive IV fluid
Hypercalcemia S/S "WEAK"
Weakness of muscles (very profound) EKG changes (shortened QT interval and prolonged ST interval) Absent reflexes & Abdominal distention Kidney stone formation
Hypophosphatemia S/S
Weakness, confusion, s/s hypercalcemia PO4 less than 2.5 mg/dl ↑ Ca Bone fractures
Hypernatremia S/S
You are 'fried' or S.A.L.T. F - Fever (low grade), flushed skin R - Restless (irritable) I - Increased fluid retention and increased BP E - Edema (peripheral and pitting) D - Decreased urinary output, dry mouth S = Skin flushed A = Agitation L = Low-grade fever T = Thirst
