fluid + electrolytes (final sg)

Question 1

dehydration

Answer 1

➺ HYPOvolemia
➺ results from INC. output, DEC. intake, or fluid shift
INC. output: vomiting, bleeding, diarrhea, renal, etc.,
fluid shift: ascites, effusions, capillary leak states (burns / sepsis)
➺ decrease in TBW causes reductions in ICF* (40% of body weight) and ECF, can result in shock, end organ failure, and death

Question 2

fluid overload

Answer 2

➺ HYPERvolemia
➺ expansion of ECF volume r/t increased sodium retention
➺ where salt goes, water follows
➺ may present as edema

Question 3

physiology of electrolyte imbalances

Answer 3

➺ ECF electrolytes: Na+ and Cl-
➺ ICF electrolytes: K+
➺ others: Ca, Mg, Ph

Question 4

dehydration treatments

Answer 4

➺ crystalloids: fluids given by IV that are solutions of salt, water, and minerals
EX: NS or LR
➺ colloids: fluids given by IV used to maintain circulating fluid volume after blood loss from trauma / surgery
EX: albumin, dextran, hetastarch
➺ blood products: indicated when patient has lost 25% or more blood volume

Question 5

fluid overload treatments

Answer 5

➺ dialysis
➺ paracentesis
➺ fluid restriction
➺ sodium restriction

Question 6

potassium

Answer 6

➺ most abundant + charged electrolyte INSIDE cels, 95% of K is intracellular
➺ RANGE: 3.5 - 5 mEq/L, critical to body function
➺ responsible for muscle contraction, transmitting nerve impulses, regulation of heartbeat, maintenance of acid-base balance, isotonicity

Question 7

hypokalemia

Answer 7

➺ K levels > 3.5 mEq/L
➺ can be caused by diuretics that are not K sparing or excessive output
CUES: constipation, muscle weakness, cramps, arrhythmias, respiratory distress (weak respiratory muscles)

Question 8

hyperkalemia

Answer 8

➺ K levels < 5 mEq/L
➺ can be caused by supplements, ACE inhibitors, renal failure, K sparing diuretics, burns, trauma, metabolic acidosis, etc.,
CUES: cramping, diarrhea, muscle weakness, arrhythmias, malaise

Question 9

hyperkalemia treatment

Answer 9

➺ kayexalate: a cation exchange resin that works in the intestine; do NOT give to patient with dysfunctional bowel
➺ patiromer: non-absorbed cation exchange polymer; dilute + give with food, do NOT give within 6 hours of others drugs, used for NON-EMERGENT cases

Question 10

sodium

Answer 10

➺ most abundant + charged electrolyte OUTSIDE cells
➺ RANGE: 135-145 mEq/L
➺ responsible for control of water distribution, F+E balance, osmotic pressure of body fluids, acid-base balance

Question 11

hypernatremia

Answer 11

➺ levels < 145 mEq/L
➺ may be indicated by edema, hypertension, red + flushed skin, dry + sticky mucus membranes, increased thirst
➺ may be caused by poor renal excretion from kidney dysfunction, inadequate water consumption, or dehydration

Question 12

hypernatremia treatment

Answer 12

➺ focus on balance fluid + sodium content
➺ fluid replacement: water, small amount of sodium IV, oral fluid replacement, diuretics

Question 13

hyponatremia

Answer 13

➺ levels < 135 mEq/L
➺ may be indicated by lethargy, stomach cramps, hypotension, vomiting, diarrhea, seizures
➺ may be caused by excessive perspiration, prolonged diarrhea / vomiting, or renal disorders

Question 14

hyponatremia treatment

Answer 14

➺ mild cases treated with oral sodium chloride / fluid restriction
➺ severe cases treated with IV NS or LR