Nutrition and Beginning Fluid and Electrolyte Balance
Hypernatremia mnemonic
"Fried Salt" Flushed skin and fever Restless, irritable, anxious, confused Increased BP and fluid retention Edemas, peripheral and pitting Decreased urine output and dry mouth Skin flushed Agitation Low-grade fever Thirst
Hypercalcemia mnemonic
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When levels of an electrolyte are too low, it is important to include food choices that have high quantities of the substance. Here are some food sources for each of the main electrolytes:
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Adenosine Triphosphate (ATP)
- ATP is required for the biochemical reactions involved in any muscle or nerve contraction * need for muscle contractions, nerve contractions, ect
There are three hormones that play key roles in regulating fluid and electrolyte balance:
1) antidiuretic hormone, released from the posterior pituitary; 2) aldosterone, secreted from the adrenal cortex; and 3) atrial natriuretic peptide, produced by the heart.
normal specific gravity
1.010-1.030
Normal magnesium levels
1.5-2.5 mEq/L
normal potassium levels
3.5-5.0 mEq/L
Normal calcium levels
8.5-10.5 mg/dL
Give the average fluid intake per day for adults.
An adult human at rest takes appropriately 2,500 ml of fluid daily.
Food high in sodium
Buttermilk, canned meats or fish, canned soups, canned veggies, casserole and pasta, catsup, cheese, lunch meats, dried fruits, dried soup mixes, MSG, frozen veggies w/ sauce, gravy mix, ham, hot dogs, olives, pickles, prepared mustard, preserved meats, processed foods, salted nuts/ popcorn, soy sauce, tomato or veggie juice.
Hypocalcemia mnemonic
C.A.T.S. C - Convulsions A- Arrhythmias T - Tetany (involuntary contraction of muscles) S - Spasms and stridor
Magnesium required for
Calcium and Vit D absorption
Diffusion
Diffusion, or the process of "being widely spread", is the random movement of molecules from an area of higher concentration to an area of lower concentration.
hemorrhage
Excessive or profuse bleeding
Filtration
Filtration is the transport of water and dissolved materials concentration already exists in the cell.
Hypermagnesemia S/S
Hypotension Bradycardia *Weak pulse* *Sweating* and flushing *Respiratory depression* Loss of deep tension reflexes Prolonged PR interval and widened QRS complex
Normal lab values
Normal magnesium is 1.3 to 2.1mEq/L. Normal sodium levels are 135 to 145 mEq/L. Normal potassium levels are 3.5 to 5 mEq/L. Normal calcium levels are 9 to 10.5mg/dL.
The nurse is teaching a client with hypernatremia about food options low in sodium. Which food choices indicate an understanding of the teaching? Select all that apply. 1. 1 small fresh orange 2. 3 ounces of canned corn 3. 2 ounces of fresh carrots 4. 1 regular corn dog 5. 2 slices of American cheese 6. 1 cup of brown rice
Option 1: Fresh fruit is low in sodium Option 2: Canned vegetables are high in sodium Option 3: Fresh vegetables are low in sodium Option 4: A corn dog is high in sodium Option 5: American cheese is high in sodium Option 6: Brown rice is low in sodium
The nurse is caring for a client receiving furosemide. Which of the following clinical manifestations would be of most concern to the nurse? 1. Paresthesia and irritability 2. Increased blood pressure and muscle spasms 3. Restlessness and agitation 4. Weak, irregular pulse and decreased muscle tone
Option 1: Paresthesia and irritability are clinical manifestations of hypocalcemia. Option 2: Elevated blood pressure and muscle spasms are indicative of hyperkalemia. Option 3: Restlessness and agitation are clinical manifestations of hypernatremia. Option 4: A weak, irregular pulse and decreased muscle tone are symptomatic of hypokalemia.
Hyponatremia Interventions
Orthostatic hypotension, Tachycardia, Lethargy, Twitching, Seizures, Coma Interventions: Monitor Input and output, daily weights, skin turgor, fluid restriction per orders, safety, seizure precautions.
hypertonic solution
Solute concentration is greater than that inside the cell; cell loses water a particular type of solution that has a greater concentration of solutes on the outside of a cell when compared with the inside of a cell.
The most characteristic manifestation of hypocalcemia and hypomagnesemia is: Anorexia and nausea. Constipation Lack of coordination Tetany
Tetany D: Decreased levels of calcium and magnesium leads to tetany. A: Anorexia is a manifestation of hypomagnesemia while nausea is a sign of hypercalcemia. B: Constipation is not a manifestation of hypocalcemia or hypomagnesemia. C: Lack of coordination is not a manifestation of hypocalcemia or hypomagnesemia.
Chvostek sign
To test for Chvostek sign, tap the face below the ear in front of the eye. Facial twitching on that side of the face indicates a positive test for hypocalcemia.
Sodium restriction is recommended for a client with
fluid volume excess.
Potassium and Magnesium
go together "think big papa" - MIa
Hyperkalemia mnemonic
"Murder" Muscle cramps Urine abnormalities Respiratory distress Decreased cardiac contractility EKG changes Reflexes
Fluid volume excess (hypervolemia) symptoms
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Hypokalemia mnemonic
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Hyponatremia mnemonic
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Nursing Mangement of hypocalcemia
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Hypocalcemia causes
*Inadequate dietary intake of calcium* *Inhibited absorption of calcium from the intestinal tract* *Inadequate vitamin D consumption* Diarrhea Long-term immobilization and *bone demineralization* Excessive gastrointestinal losses from diarrhea or wound draining *End-stage* renal disease *Calcium-excreting medications* such as diuretics, caffeine, anticonvulsants, heparin, laxatives, and nicotine *Decrease secretion of parathyroid hormone* Acute pancreatitis Crohn's disease *Excessive administration of blood*
nursing interventions for hypovolemia
-Monitor I&O -Monitor vital signs (including orthostatic measurements) -Increase fluid intake -Adequate nutrition -Monitor weight every 8 hours while fluid replacement is in progress -Initiate fall precautions -Cover with light blankets to prevent overheating -Emphasize importance of oral hygiene
Hypervolemia Signs and Symptoms
-acute weight gain -peripheral edema and ascites -distended jugular veins -crackles -elevated CVP -shortness of breath -increased BP -bounding pulse/cough -increased respiratory rate -increased urine output
electrolyte loss
-sweat -feces -kidneys Electrolyte imbalance is commonly caused by loss of body fluids through prolonged vomiting, diarrhea, sweating or high fever.
What does active transport require?
ATP energy
Third-Spacing of Fluid
Fluid is trapped and unavailable for use (ascites, burns) Third Spacing: occurs when fluid accumulates in areas that normally have no fluid or minimal amount of fluid, such as with ascites, and edema associated with burns. occurs when too much fluid moves from the intravascular space (blood vessels) into the interstitial or "third" space-the nonfunctional area between cells. This can cause potentially serious problems such as edema, reduced cardiac output, and hypotension.
Hypovelemia signs and symptoms
Hypovolemia is caused by a variety of different events, but these can be simplified into two categories: those associated with kidney function and those that are not. The signs and symptoms of hypovolemia worsen as the amount of fluid lost increases. Decreased skin turgor Orthostatic hypotension Flat neck veins Dry mucous membranes Weak, rapid pulse Increased resp Elevated BUN and HCT Change in mental status Cool/clammy/pale skin Greater than 1.030
MOM
Magnesium containing laxative. At risk for hypermagnesium
Foods high in calcium
Milk Cheese Dark green veggies Dried figs Soy Legumes
The nurse is caring for a group of clients. Which of the following clients is at high risk for developing hyponatremia? Select all that apply. 1. A client who is nothing by mouth (NPO) 2. A client with dry skin 3. A client taking diuretics 4. A client with constipation 5. A client who experienced a near-drowning in fresh water 6. A client with a bowel obstruction connected to high intermittent suction
Option 1: A client not consuming water is at risk for hyponatremia Option 2: A client with dry skin is not at risk for hyponatremia. A client with diaphoresis is at risk. Option 3: A client taking diuretics is at risk for hyponatremia. Option 4: A client with diarrhea, not constipation, is at risk for hyponatremia. Option 5: A client who experienced a freshwater near-drowning is at risk for hyponatremia. Option 6: A client who is connected to gastrointestinal suction is at risk for hyponatremia
The nurse is caring for a group of clients. Which clients does the nurse recognize as being at risk for hypomagnesemia? Select all that apply 1. A client with anorexia 2. A client with fluid volume excess 3. A client with hyperthermia 4. A client with kidney disease 5. A client with Crohn's disease 6. A client with chronic alcoholism
Option 1: A client with anorexia is at risk for hypomagnesemia. Option 2: A client with fluid volume excess is not at risk for hypomagnesemia. Option 3: A client with hyperthermia is at risk for hyponatremia. Option 4: A client with kidney disease is at risk for hypomagnesemia. Option 5: Crohn's disease places a client at risk for hypomagnesemia. Option 6: Chronic alcoholism places a client at risk for hypomagnesemia.
The nurse is caring for a group of clients. Which clients does the nurse recognize as being at risk for hypomagnesemia? Select all that apply. 1. A client with anorexia 2. A client with fluid volume excess 3. A client with hyperthermia 4. A client with kidney disease 5. A client with Crohn's disease 6. A client with chronic alcoholism
Option 1: A client with anorexia is at risk for hypomagnesemia. Option 2: A client with fluid volume excess is not at risk for hypomagnesemia. Option 3: A client with hyperthermia is at risk for hyponatremia. Option 4: A client with kidney disease is at risk for hypomagnesemia. Option 5: Crohn's disease places a client at risk for hypomagnesemia. Option 6: Chronic alcoholism places a client at risk for hypomagnesemia.
The nurse is caring for a client with a calcium level of 6 mg/dL. The nurse would expect the client to exhibit which clinical manifestation? 1. Increased blood pressure 2. Altered heart rhythm 3. Constipation 4. Increased heart rate
Option 1: An increase in blood pressure is seen in a client with hypercalcemia. Option 2: An altered heart rhythm is typically seen in clients with hypocalcemia. Option 3: Diarrhea is typically reported in clients with hypocalcemia. Option 4: An increase in heart rate is seen in a client with hypercalcemia.
The nurse is teaching a client about options for food high in calcium. Which food choices made by the client indicate an understanding of the teaching? Select all that apply. 1. 1 large orange 2. 8 ounces of plain yogurt 3. 1 cup of low-fat milk 4. 1 cup of canned pasta with meat sauce 5. 1 slice of white bread 6. 1 cup canned tomato juice
Option 1: An orange is high in potassium, but not calcium. Option 2: Yogurt is high in calcium. Option 3: Low-fat milk is high in calcium. Option 4: Canned pasta with meat sauce is high in sodium but not calcium. Option 5: White bread is high in sodium, but not calcium. Option 6: Tomato juice is high in potassium, but not calcium *Test Taking Tip: Dairy is a food group containing foods high in calcium.
The nurse is caring for a client with severe fluid volume excess. What clinical manifestations should the nurse expect to find on assessment? Select all that apply. 1. Decreased blood pressure 2. Increased respirations 3. Pitting edema in the feet 4. Decreased urine output 5. Weight gain 6. Crackles in the lungs
Option 1: Blood pressure is increased in a client with fluid volume excess. Option 2: Respirations are increased and labored in a client with fluid volume excess. Option 3: Edema of the feet and legs can occur as a result of extra fluid. Option 4: The kidneys produce extra urine, so there is an increase in urine output. Option 5: Weight gain occurs rapidly in a client with fluid volume excess. Option 6: In severe fluid excess, the client may develop moist crackles in the lungs. *Test Taking Tip: In this question, the student should think about what would happen to the body when excess fluid is retained. There is "more" of something, so everything increases (heart and lungs work harder, thus causing an increase in rate), extra fluid causes the feet and legs to swell, urine output increases, and weight increases. You can eliminate the distractors by identifying the options that do not show an increase brought on by excess fluid.
The nurse is caring for a client who just underwent a parathyroidectomy. What should the nurse have readily available for emergency use? 1. Calcium gluconate 2. Vitamin D 3. Loop diuretics 4. Isotonic intravenous (IV) fluid
Option 1: Calcium gluconate intravenous (IV) is given for emergency use if signs of hypocalcemia occur. Option 2: Vitamin D is an important part of treatment for clients with hypocalcemia, but vitamin D will not work quickly. Option 3: Loop diuretics are given for fluid volume excess. Option 4: Isotonic IV fluid is used as fluid replacement, not as an emergency treatment for hypocalcemia. *Test Taking Tip: When a client is experiencing hypocalcemia, calcium is given to correct the deficiency.
The nurse is assessing a client who is being treated for fluid volume excess. Which of the following situations warrants notifying the health-care provider (HCP)? 1. Lung sounds clear bilaterally 2. Neck veins nondistended 3. Urine output 10 mL/hr 4. Weight loss of 1 pound
Option 1: Clear lung sounds indicate effective treatment, and fluid retention may be subsiding. Option 2: Neck veins are distended when a client is exhibiting symptoms of fluid volume excess. This is an indication of effective treatment. Option 3: Urine output below 30 mL/hr should be reported to the RN or HCP. This indicates renal complications. Option 4: Weight loss indicates effective treatment for fluid volume excess.
The nurse is reviewing laboratory values for a client and notes a calcium level of 13 mg/dL. The nurse can expect to see which of the following clinical manifestations? Select all that apply. 1. Confusion 2. Hyperactive deep tendon reflexes 3. Increased heart rate 4. Muscle weakness 5. Elevated body temperature 6. Diarrhea
Option 1: Confusion is a clinical manifestation of hypernatremia. Option 2: Hyperactive DTRs is indicative of hypocalcemia. Option 3: Clinical manifestations of hypercalcemia include increased heart rate and blood pressure, muscle weakness, and decreased GI motility. Option 4: Clinical manifestations of hypercalcemia include increased heart rate and blood pressure, muscle weakness, and decreased GI motility. Option 5: Fever is a clinical manifestation associated with hyponatremia. Option 6: Diarrhea is a clinical manifestation associated with hypocalcemia
The nurse is reviewing lab results for a client with fluid volume deficit and notes a sodium level of 118 mEq/L. The nurse will expect the client to exhibit which of the following clinical manifestations? Select all that apply. 1. Confusion 2. Decreased body temperature 3. Changes in mental status 4. Increase in urine output 5. Weight gain 6. Excessive hunger
Option 1: Confusion is a clinical manifestation of severe hyponatremia (normal sodium level is 135 to 145 mEq/L). Option 2: A client will exhibit an increase in body temperature, not a decrease. Option 3: Changes in mental status will occur in cases of severe hyponatremia. Option 4: A client will experience a decrease in urine output, not an increase. Option 5: A client will experience weight loss, not weight gain, with fluid volume deficit and hyponatremia. Option 6: A client with fluid volume deficit and hyponatremia will not experience excessive hunger.
The nurse is caring for a client with fluid volume excess. Which of the following medications can the nurse expect to administer? 1. Furosemide 2. 0.9% normal saline 3. Clindamycin 4. Dexamethasone
Option 1: Diuretics are given to cause the kidneys to excrete sodium and water, thus ridding the body of excess fluid. Option 2: 0.9% normal saline is given to treat fluid volume deficit, not excess. Option 3: Antibiotics are not given to treat fluid volume excess. Option 4: Corticosteroids can contribute to fluid volume excess, so the nurse will not administer this medication.
The nurse is caring for a client with a diagnosis of fluid volume excess (FVE). Which intervention should the nurse include in the plan of care? 1. Administer 0.9% normal saline intravenously 2. Restrict sodium in the diet 3. Encourage fluid intake 4. Prepare the client for dialysis
Option 1: Fluid should be limited in a client with fluid volume excess. Option 2: Sodium restriction is recommended for a client with fluid volume excess. Option 3: The client may be instructed to restrict fluid, but not to increase fluid intake. Option 4: The client might not need dialysis; the need depends on the underlying cause of the fluid volume excess. *Test Taking Tip: The goal for a client with FVE is to reduce the fluid.
A client admitted with hypovolemia asks the nurse the cause of this condition. The nurse identifies which of the following as risk factors for hypovolemia? Select all that apply. 1. Hemorrhage 2. Vomiting 3. Constipation 4. Liver cirrhosis 5. Burns 6. Dry skin
Option 1: Fluids are lost when severe bleeding occurs, placing the client at risk for hypovolemia. Option 2: Vomiting leads to fluid loss, which places the client at risk for hypovolemia Option 3: Constipation does not lead to fluid loss. Diarrhea leads to fluid loss. Option 4: Hypovolemia can occur when fluid moves from the intravascular space into the interstitial fluid space. This occurs in liver cirrhosis. Option 5: Hypovolemia can occur when fluid moves from the intravascular space into the interstitial fluid space. This occurs when a client has burns. Option 6: Profuse diaphoresis can lead to hypovolemia because fluid is lost through the skin, but dry skin does not lead to hypovolemia. *Test Taking Tip: Think of fluid volume deficit as "the body got rid of fluid by____" and fill in the blank.
The nurse is reviewing lab values for a group of clients and notes a potassium level of 7 mEq/L in a client. Which of the following clients is most at risk for developing this potassium imbalance? 1. A client taking furosemide for heart failure 2. A client who has been vomiting for 3 days 3. A client with chronic kidney failure 4. A client with Cushing's syndrome
Option 1: Furosemide is a potassium-wasting diuretic, so the client is at risk for hypokalemia. Option 2: Gastrointestinal losses place the client at risk for hypokalemia. Option 3: Clients with kidney failure are at risk for hyperkalemia because the kidneys cannot excrete potassium. Option 4: Use of corticosteroids can lead to hypokalemia. A client with Cushing's syndrome has been or is taking corticosteroids.
The nurse is caring for a client admitted with kidney failure waiting to receive dialysis. Which of the following electrolyte imbalances should the nurse expect to see? 1. Hypocalcemia 2. Hyperkalemia 3. Hyponatremia 4. Hypomagnesemia
Option 1: Hyperkalemia, not hypocalcemia, is seen in clients with kidney failure. Option 2: Hyperkalemia is seen in clients with kidney failure. Option 3: Hypernatremia, not hyponatremia, is seen in clients with kidney failure. Option 4: Hypermagnesemia, not hypomagnesia, is seen in clients with kidney failure.
The nurse is caring for a 75-year-old client admitted with dehydration. The nurse knows that the following statements are true regarding dehydration and older adults. Select all that apply. 1. Older adults have an increase in thirst sensation 2. An older adult has a decrease in total body water from 60% to 50% 3. Older adults need to be encouraged to drink fluids often 4. Older adults exhibit the same clinical manifestations of dehydration as a younger adult 5. Older adults require 30 mL/kg/day of fluids to prevent dehydration
Option 1: Older adults have a decrease in thirst sensation. Option 2: This statement is true. Older adults have a decrease in total body water due to increase in body fat and decrease in thirst sensation. Option 3: This statement is true as result of the decrease in thirst sensation Option 4: This is a false statement. Older adults may experience altered mental status, lightheadedness, and syncope because they have an inadequate circulatory volume and a decrease in oxygen to the brain. Option 5: This is a true statement. If the client is unable to drink fluids, alternative routes may be necessary
A client presents to the hospital reporting diarrhea and vomiting for 3 days. The nurse notes the client also has a fever and tachycardia. The nurse suspects the client is experiencing which of the following? 1. Hyponatremia 2. Hypernatremia 3. Hyperkalemia 4. Hypokalemia
Option 1: The client is experiencing hyponatremia. In hyponatremia, the client will experience weakness, elevated body temperature, tachycardia, nausea, vomiting, and diarrhea. Option 2: In hypernatremia, the client will experience thirst, agitation, confusion, and muscle twitches. Option 3: The client is not experiencing hyperkalemia. In hyperkalemia, the client experiences muscle twitches and cramps, muscle weakness, diarrhea, irregular heart rate, weak pulse, and decreased blood pressure. Option 4: The client is not experiencing hypokalemia. In hypokalemia, the client experiences shallow respirations; weak, irregular, thread pulse; muscle cramping; and fatigue.
The nurse is caring for a client who has developed hyperthermia from working in extremely high temperatures. Which of the following electrolyte imbalances will the nurse expect the client to develop? 1. Hypomagnesemia 2. Hypocalcemia 3. Hypokalemia 4. Hyponatremia
Option 1: The client with diarrhea, Crohn's disease, anorexia, or chronic alcoholism is at risk for hypomagnesemia Option 2: The client with Crohn's disease, status post thyroidectomy, or those with hyperphosphatemia are at risk for hypocalcemia. Option 3: Major surgery, hemorrhage, potassium-wasting diuretics, severe vomiting, diarrhea, and prolonged GI suction place a client at risk for hypokalemia. Option 4: The client working in extreme heat is at risk for hyponatremia.
The nurse is caring for a client with a potassium level of 2.4 mEq/L. Which statement made by the client warrants a telephone call to the health-care provider (HCP)? 1. "I feel like my heart is skipping a beat." 2. "I woke up this morning feeling nauseated." 3. "My leg was cramping during the night." 4. "I feel a little sleepy today."
Option 1: This indicates the client may be experiencing a dysrhythmia, and the HCP should be notified. Option 2: Nausea is a common clinical manifestation of hypokalemia. Option 3: Leg cramps are a common clinical manifestation of hypokalemia. Option 4: Hypokalemia affects the nervous system, so the client may be slightly lethargic.
Osmosis
Osmosis is the diffusion of a pure solvent, such as water, across a semipermeable membrane in response to a concentration gradient in situations where the molecules of a higher concentration are non diffusible.
A patient has a potassium level of 9.0. Which nursing intervention is priority? Prepare the patient for dialysis and place the patient on a cardiac monitor Administer Spironolactone Place patient on a potassium restrictive diet Administer a laxative
Prepare the patient for dialysis and place the patient on a cardiac monitor
hypotonic solution
Solute concentration is less than that inside the cell; cell gains water any solution that has a lower osmotic pressure than another solution. In the biological fields, this generally refers to a solution that has less solute and more water than another solution.
Third spacing: medical techniques for relocating this fluid
Techniques for relocating include ; ...administering IV solutions, diuretics or rapid rate of blood products, such as albumin- which pulls trapped fluids back into intravascular space.
Lab tests revealed that patient Z's [Na+] is 170 mEq/L. Which clinical manifestation would nurse Natty expect to assess? Tented skin turgor and thirst Muscle twitching and tetany Fruity breath and Kussmaul's respirations Muscle weakness and paresthesia
Tented skin turgor and thirst Hypernatremia refers to elevated serum sodium levels, usually above 145 mEq/L. Typically, the client exhibits tented skin turgor and thirst in conjunction with dry, sticky mucous membranes, lethargy, and restlessness. Muscle weakness and paresthesia are associated with hypokalemia; fruity breath and Kussmaul's respirations are associated with diabetic ketoacidosis. Muscle twitching and tetany may be seen with hypercalcemia or hyperphosphatemia.
Which patient is at most risk for hypomagnesemia? A. A 55 year old chronic alcoholic B. A 57 year old with hyperthroidism C. A patient reporting overuse of anatacids and laxatives D. A 25 year old suffering from hypoglycemia
The answer is A. The correct answer is a 55 year old who is a chronic alcoholic. Patients who suffer from alcoholism have an increased secretion of magnesium and usually do not eat a proper diet, therefore, they are at risk for lower magnesium levels.
Which patient below would have a potassium level of 5.5? A. A 76 year old who reports taking lasix four times a day B. A patient with Addison's disease C. A 55 year old woman who have been vomiting for 3 days consistently D. A patient with liver failure
The answer is B. A patient with Addison disease suffers from increased potassium levels due to adrenal insufficiency. Therefore, potassium levels higher than 5.1 may present in patients with Addison's disease.
electrolyte excess
Too much sodium, hypernatremia, can cause dizziness, vomiting, and diarrhea. Too much potassium, hyperkalemia, can impact your kidney function and cause heart arrhythmia, nausea, and an irregular pulse. Too much calcium, known as hypercalcemia, can lead to fatigue, lethargy, seizures, and bone and joint pain. Too much magnesium can cause muscle weakness, nausea, dizziness, confusion, and heart arrhythmia. At its worst, it can cause muscular and neurological damage.
Hyponatremia and Hypernatremia
Treatment is based on symptoms and underlying causes. In general, hyponatremia is treated with fluid restriction (in the setting of euvolemia), isotonic saline (in hypovolemia), and diuresis (in hypervolemia). ... The treatment of hypernatremia involves correcting the underlying cause and correcting the free water deficit.
Trousseau's sign
Trousseau's sign involves inflating a blood pressure cuff around the client's arm. The hand and fingers become spastic and go into palmar flexion in a client with hypocalcemia.
Foods high in magnesium
Vegetables, nuts, fish
Osmolarity and Tonicity
______ describes the number of particles of a solute in a solution, whereas ______ is the ability of a solution to affect the fluid volume in a cell.
hemoconcentration
a decrease in plasma volume, which causes a simultaneous increase in the concentration of red blood cells. increased concentration of cells and solids in the blood usually resulting from loss of fluid to the tissues
hemodilution
an increase in blood plasma, resulting in a dilution of the blood's cellular contents decreased concentration (as after hemorrhage) of cells and solids in the blood resulting from gain of fluid — compare hemoconcentration.
tetany
condition affecting nerves causing muscle spasms as a result of low amounts of calcium in the blood caused by a deficiency of the parathyroid hormone
Interstitial fluid
fluid surrounding cells a thin layer of fluid which surrounds the body's cells. Interstitial fluid has become useful in the monitoring of glucose levels in people with diabetes
Intravascular fluid
fluid within blood vessels The main intravascular fluid in mammals is blood, a complex mixture with elements of a suspension (blood cells), colloid (globulins), and solutes (glucose and ions). The blood represents both the intracellular compartment (the fluid inside the blood cells) and the extracellular compartment (the blood plasma).
Signs and symptoms of hypovolemic shock
increased HR low BP pale or cold skin altered mental status. When these signs are seen, immediate action should be taken to restore the lost volume.
Hypervolemia
increased blood volume (Fluid overload) Fluid volume excess or hypervolemia refers to an isotonic volume expansion of the ECF caused by the abnormal retention of water and sodium in approximately the same proportions in which they normally exist in the ECF.
Intracellular fluid (ICF)
is the place where most of the fluid in the body is contained. This fluid is located within the cell membrane and contains water, electrolytes and proteins. Potassium, magnesium, and phosphate are the three most common electrolytes in the ICF. Intracellular fluid functions as a stabilizing agent for the parts of the cell, helps maintain cell shape, and assists with transport of nutrients across the cell membrane, in and out of the cell.
Extracellular fluid (ECF)
is the term for the many fluids that exist in an organism outside of cells of the organism, but sealed within the body cavities and vessels. Extracellular fluid that travels in the circulatory system is blood plasma, the liquid component of blood. Extracellular fluid mostly appears as interstitial tissue fluid and intravascular fluid. Sodium is the most abundant ion of the extracellular fluid and is the main contributor to the osmolarity or solute concentration of blood.
Hypovolemia
low blood volume Fluid volume deficit or hypovolemia occurs when loss of ECF volume exceeds the intake of fluid.
Electrolytes
minerals that help maintain the body's fluid balance. in body fluids are active chemicals or cations that carry positive charges and anions that carry negative charges. They regulate nerve and muscle function, hydrate the body, balance blood acidity and pressure, and help rebuild damaged tissue.
hypernatremia Interventions
monitor cardiovascular, respiratory, neuromuscular, cerebral, renal, and integumentary status. Adminsiter IV if caused by fluid loss if caused by inadequate renal excreation of sodium, administer diurectics that promote sodium loss restrict sodium intake as prescribed
Albumin
protein in blood; maintains the proper amount of water in the blood
kidneys normally balance the amount of
salts and fluids in your body. When they retain salt, they increase the body's total sodium content, which increases your fluid content.
Active Transport
the movement of materials through a cell membrane using energy the movement of molecules across a membrane from a region of lower concentration to a region of higher concentration—against the concentration gradient. Active transport requires cellular energy to achieve this movement. *"Pumping uphill"
hydrostatic pressure
the pressure within a blood vessel that tends to push water out of the vessel
Kayexalate
used to treat a high level of potassium in your blood. Too much potassium in your blood can sometimes cause heart rhythm problems. Sodium polystyrene sulfonate works by helping your body get rid of extra potassium. KAYEXALATE increases fecal potassium excretion through binding of potassium in the lumen of the gastrointestinal tract. ... This action occurs primarily in the large intestine, which excretes potassium ions to a greater degree than does the small intestine.
Isotonic
when the concentration of two solutions is the same refers to two solutions having the same osmotic pressure across a semipermeable membrane. This state allows for the free movement of water across the membrane without changing the concentration of solutes on either side.
Foods high in potassium
• Avocado • Bananas • Cantaloupe • Carrots • Fish • Mushrooms • Oranges • Potatoes • Pork, Beef, Veal • Raisins • Spinach • Strawberries • Tomatoes
Hypomagnesemia S/S
↑HR ↑BP Shallow Respirations Tetany/Twitches/Seizures/Paresthesias ↑DTR Irritability/Confusion + Trousseau's and Chvostek's
