University:
West Coast University
Course:
NURS 110 | Introduction to Professional Nursing
Academic year:

2019
Views:

91

Pages:

2
Author:

Lanrwst4tn

Fluid/Electrolyte Imbalance Hypovolemia Causes -Excess fluid loss -Decreased intake -Third spacing shif Body Fluids Hypervolemia -Excess fluid intake -Increased fluid retention (CHF) -Secondary response to Sodium Hypernatremia Hypokalemia Potassium Hyperkalemia Hypocalcemia Lab Values Management  BUN/creatinine, Fluid replacement—IV NaCl hgl, hct, specific or blood products gravity Monitor I/O, vital signs, weight management  urine sodium Weight gain, Resp: SOBOE,  hgl and hct, orthopnea, crackles, osmolality wheeze, coughlow O2 JVD,  BP, weak pulse, pitting edema Fluid/Sodium restrictions, diuretics, high fowlers -Water excess (ADH) -Fluid loss -Renal disease -Diuretics Dry skin,  saliva + BP, h/a, seizures <135 mEq/L Water restriction Sodium replacement Hypertonic solution -Excess water loss or sodium intake -Diabetes insipidus -Heat stroke Thirst, tonic-clonic seizures, dry mucous membranesHR+BP+temp >145 mEq/L Hypotonic solution Sodium restriction Diuretics -GI loss -Poor nutrition/starvation -Diuretics -Alkalosis EKG—prominent U wave, lethal ventricular dysrhythmias -Increased intake -Renal dysfunction -Tissue trauma -Acidosis -Meds -Decreased intake, vit D -Acute pancreatitis Cardiac dysrhythmia, EKG —peaked T wave, prolonged QRS, limb numb/tingling, GI issues increased sodium content Hyponatremia Signs/Symptoms Weight loss, less & concentrated urine, dizzy,  skin turgor, orthostatic, thirst, confusion, nausea, diaphoretic,  temp Tetany, seizures, Resp— stridor, bronchospasm, <3.5 mEq/L >5.0 mEq/L Monitor I/O, vital signs, weight management Increase diet intake Monitor renal function and toxicity with digoxin -IV insulin, sodium bicarb, calcium gluconate to move K+ from ECFICF -kayexelate to increase elimination Increase Ca intake, Vit D supplement Calcium Phosphorus -Multiple blood transfusions -Alkalosis Hypercalcemia -Excess Vit D, calcium intake -Certain cancers -Prolonged immobilization -Acidosis -Meds Hypophosphatemia -Increased renal excretion -Alcohol abuse -Malnutrition/vit D deficient -Alkalosis, DKA -antacids Hyperphosphatemia -Renal failure -Excess intake, Vit D -Excess laxative use -Acidosis -Chemotherapy Chvostek and Trousseau signs, circumoral numbness and tingling Kidney stones, EKG changes—shortened QT, poor reflexes/memory, bradycardia, confusion, lethargy Neuro sxs—mental status changes, tissue hypoxia, osteomalacia, bleeding disorders, leukocyte alterations <8.6 mg/dL Decrease phosphorus Mobilize patients, IV NS, high fiber diet, >10.2 mg/dL Meds: phosphate, bisphosphonates, calcitonin, loop diuretics Increase intake Prevent infection <2.5 mg/dL **Sxs due to hypocalcemia >4.5 mg/dL Sof tissue calcifications Decrease intake, hydration, dialysis, hypocalcemia management Meds: aluminum hydroxide, sevelamer