Electrolyte Imbalance Flashcards
(21 cards)
Hypovolemia- Vital Signs
Tachycardia Thready Pulse Hypotension Orthostatic Hypotension Tachypnea Hypoxia Decreased (Low) CVP Hyperthermia
Lab Values of Hypovolemia
Increased sodium (>145 mEq/mL)
Increased hemoglobin & hematocrit
Increased BUN (greater than 25 mg/dL) & creatinine
Increased serum osmolality (>295 mOsm/kg)
Increased urine specific gravity ( >1.030)
Hypervolemia- Vital Signs
Tachycardia Bounding Pulse Hypertension Tachypnea/Dyspnea Increased CVP JVD/Distended neck veins
Crackles Cough Peripheral edema/ascites SOB Acute weight gain
Lab Values of Hypervolemia
Decreased hemoglobin & hematocrit
Decreased serum & urine osmolality
Decreased urine sodium & specific gravity
Decreased BUN d/t plasma dilution
Hypovolemia- Neuromusculoskeletal
Dizziness Syncope Weakness Confusion Fatigue
Hypovolemia- GI
Thirst Dry furrowed tongue Nausea Vomiting Anorexia Acute Weight Loss
Hypovolemia- Renal
Oliguria
Hypovolemia- Other Findings
Muscle Cramps Decreased Skin Turgor/Tenting Decreased capillary refill Cool, clammy skin Diaphoresis Sunken eyeballs Flattened neck veins
Hypovolemic Shock
Decrease MAP
Decrease tissue perfusion
Hypovolemic Shock Nursing Actions
Admin & monitor oxygen saturations
Monitor vital signs at least every 15 mins
Fluid replacement: Colloids (whole blood, packed RBCs, plasma, synthetic plasma expanders) & Crystalloids (lactated Ringer’s & NS)
Admin vasoconstrictors: dopamine, norepinephrine, phenylephrine
Admin meds to increase myocardial perfusion: sodium nitroprusside
Admin positive inotropic meds: dobutamine & milrinone
Hypervolemia- Neuromuscular
Weakness d/t excess fluid retention
Headache
Altered LOC
Hypervolemia- Respiratory
Tachypnea/Dyspnea
Crackles
Cough
Hypervolemia- Other Findings
Peripheral edema
Weight gain
Increased urine output
Hyponatremia- Vital Signs
*Varies based on state of ECF volume- All d/t hypovolemia Hypothermia Tachycardia Rapid/Thready Pulse Hypotension Orthostatic hypotension Diminished peripheral pulses
Hyponatremia- Neuromusculoskeletal
Headache Confusion Lethargy Muscle weakness (possible respiratory compromise) Fatigue Decreased DTRs Seizures Lightheadedness Dizziness
Hyponatremia- GI
Increased motility
Hyperactive BS
Abdominal cramping
Nausea
Lab Values of Hyponatremia
Decreased serum sodium: <135 mEq/mL
Decreased serum osmolarity: <270 mOsm/L
Hypernatremia- Vital Signs
Hyperthermia
Tachycardia
Orthostatic hypotension
Hypernatremia- Neuromusculoskeletal
Restlessness Irritability Muscle twitching causing muscle weakness (possible respiratory compromise) Decreased/Absent DTRs Seizures Coma
Hypernatremia- GI
Thirst Dry mucous membranes Nausea Vomiting Anorexia Occasional diarrhea
Lab Values of Hypernatremia
Increased serum sodium: >145 mEq/L
Increased serum osmolarity: >300 mOsm/L
Decreased urine sodium: decreased urine
Increased urine specific gravity/osmolarity
