Chap 75 Disorders Of Fluid/electrolyte

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Chapter 75 Fluids Disorders
(2) Differentiate among the following fluid compartments: intracellular, extracellular, interstitial and intravascular

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Body fluids are divided between two main compartments: Intracellular and Extracellular. ICF is the fluid inside the cells and makes up about 2/3 of total body fluid. ECT if fluid outside the cells and makes up aobut 1/3 of total body fluid. ICF funtions as a stablizing agent helps cells keep their shape. ICF transports nutrients across cell membrane. ECF appears mostly in interstitial fluid (tissue) and intravascular fluid (within the blood). Without enough volume of ECT the body can't maintain blood pressure. Interstiital fluid is BETWEEN the cells. Intravascular fluid is in the watery bluid of the blood known as plasma.

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(3) Discuss at least four major nursing responsiblities associated with laboratory tests ordered by a clinician.

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The nurse is responsible for (1) preparing the client either by instruction or explanation of what is taking place. (2) gathering necessary equipment needed, i.e. speciman cup (3) making sure the specimen is submitted to the lab timely (4) when lab results are returned they are reviewed and the doctor called if abnormal.

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(4) In the clinical laboratory, demonstrate a client and family teaching session, emphasizing the importance of fluid and electrolyte balance and the types of care that may be needed for the client.

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I would teach that drinking water is very important to our body. The client with a fluid or electrolyte imbalance will need specifics on their I/O. I will stress the importance of this and suggest a diary of food and drink is kept. A regimen will need to be followed to resolve any imbalance. Explain how and why we are doing things because if client understands the rationale, they are more likely to comply.

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(5) Identify at least four possible causes of the two major types of fluid imbalances (fluid volume excess and fluid volume deficiet), including at least two nursing considerations for each cause.

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Causes of Fluid Volme Excess: (1) inceased fluid intake (2) decreased urine output (3) physical disorder such as heart failure (4) excess ingestion of sodium (5) stress. FLOOD VOLUME DEFICIENT. (1) inadequate fluid intake and starvation (2) loss of body fluids from excessive sweating or vomitting (3) prolonged fever (4) inability of the body to conserve and reuse water by concentrating the urine, i.e. renal failure

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State at least two nursing consideration for each: dependent edema, sacral edema, pitting and non-pitting edema, and pulmonary edema.

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DEPENDENT edema: (1) exercise and elevate feet SACRAL (1) position client with limbs above heart level (2) reposition to avoid ulcers PITTING EDEMA (1) restrict fluids and sodium (2) Monitor I/O NON-PITTING EDEMA (1) monitor weight (2) suggest a pressure mattress
If the patient cannot tolerate his limbs lifted and develops dyspnea, lower the limbs and elevate the head of the bed.

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(7) State the normal serum levels for the following electrolytes: sodium, K+, Calcium, magnesium Mg, Chloride Cl, and Phosphorus.

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Sodium Na+ 135-145
Potassium K+ 3.5 - 5.0
Calcium 8.5 - 10.0
Magnesium Mg 1.5 - 2.0
Chloride Cl ___________
Phosphorus 2.5 - 4.5

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(8) Identify at least four causes of each type of electrolyte imbalance.

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Na+ (1) Hyper or Hyp NATREMIA. Causes for Na+ imbalance are endocrine disorders, hyperventilation, serious burn, Pneumonia, Asthma.
Potassium K+ imbalances are caused by burns, tissue damage, acidosis, excessive intake of salt, Alkalosis can lead to hypokalemia along with renal diseae and vomiting.
Calcium: hyper or hypo calcemia. causes of imbalance are cancer, hyperparathyroidism, immobilization affects the bone absorption affecting hypercalcemia. HYPO most commonly caused by parathroid horomone deficit, abnormal vitamin D metabolism. Cancer and chronic alcoholism are other causes of HYPO calcemia.
Magnesium Mg. HYPERmagnesemia causes are renal function or those with normal renal function but have been aggressively treated with over-the-counter medicaiton such as laxative/antacid. CALCIUM GLUCONATE is the antidote for Magnesium intoxication. Causes of HYPO are severe congestive heart failure, chronic alcoholism, GI losses, renal or endocrine disease.
Chloride Cl causes are associated with acid based

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(9) Discuss the major symptoms associated with each type imbalance, state at least three nursing considerations related to each condition.

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S/S Potassium: vague muscle weakness, malaise, hypotension and cardiac dyshythmias.
S/S Sodium. Thirst, dry mucous membranes, flushed dry skin, anorexia, nausea and abdominal muscle cramps.
CALCIUM. HYPER-hypertension, altered state of consciousness progressing to coma, depressed reflexes. HYPO dyshrythmia, tetany, altered mood, confusion.
MAGNESUIM. HYPER. weakness, dimished deep-tendon relfexes, hypotension. HYPO. tremors and generalized seizures, most s/s hard to identify due to similar to hypokalemia.
CHLORIDE. HYPER associated with hypernatremia and metabolic acidosis. HYPO associated with deficiet of sodium and potassium and metabolic alkalosis.
PHOSPHORUS. HYPER. few symptoms, but salts around joints pain often confused with hypocalcemia. HYPO amenia, infection and bleeding due to imparied function and survival time of RBC

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(10) Differentiate among the four major types of acid-base imbalances; respiratory acidosis, respiratory alkalosis, metabolic acidosis and metabolic alkalosis

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(a) Metabolic Acidosis is caused by uncontolled diabetes mellitus, fasting or stravation. s/s diarrhea, nausea, anorexia.
(b) Respiratory Alkalosis caused by high fever, hysteria, yperventilation. s/s deep respirations with rapid breathing, irritability, panic
(c) Respiratory Acidosis caused by respiratory center depression from sedative or overdose, lung disorders such as pneaumonia. s/s shallow respirations, headachd, weakness altered mental state.
(4) Metabolic Alkalosis caused by excess ingestion of sodium bicarbonate or blood transfusion containing citrate, GI loss of hydronge ions from vomitting. s/s confusion, hyperactive reflexes, tetany, hypotension

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(11) Identify at least four nursing considerations related to the data collection, assessment, monitoring, and care of a client with acidosis and a client with alkalosis

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x

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(12) Identify dietary modifications for the client with disorders in fluid and electrolyte balance

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Limit salt and do not eat anything with sodium or salt in large quanity. Beef jerky is bad for you.

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(13) Identify commom medications for the client with disorders in fluid and electrolyte balance.

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Duiretics such as Lasix