Fluid & Electrolytes

Front 1

Normal Sodium level

Back 1

135-145 mEq

Front 2

Hyponatremia Risk factors

Back 2

loss of sodium: via GI fluid loss, sweating, use of diuretics. gain of water via: hypotonic tube feedings, excessive drinking of water, excessive IV D5W.

Front 3

s/s of Hyponatremia

Back 3

lethargy, confusion, apprehension, muscle twitching, abdominal cramps, anorexia, nausea, vomiting, headache, seizures, coma. Lab findings: Sodium level < 135 mEq amd serum osmolality < 280

Front 4

Nursing interventions for Hyponatremia

Back 4

assess clinical manifestations, monitor I&O, monitor lab data, assess clients closely if administering hypertonic saline solutions, encourage food and fluid high in sodium, limit water intake as indicated.

Front 5

Risk factors for Hypernatremia

Back 5

Loss of water via hyperventialation or fever, diarrhea, water deprovation. Gain of sodium via parenteral adminiatration of saline soulutions, hypertonic tube feedings without adequate water, excessive use of table salt.

Front 6

s/s of hypernatremia

Back 6

thirst, dry sticky mucous membranes, toungue red, dry, swollen and weakness. Sever hypernatremia: fatigue, restlessness, decreased L.O.C, disorientation, convulsions. serium sodium level >145 serum osmolality > 300.

Front 7

nursing interventions for hypernatremia

Back 7

monitor I&O, behavior changes (restlessness, disorientation), monitor lab findings, encourage fluids as ordered, monitor diet as ordered (restrict intake of salt and foods high in sodium).

Front 8

Normal potassium levels

Back 8

3.5-5

Front 9

Risk factors for hypokalemia

Back 9

loss of potassium via vomiting and gastric suction, diarrhea, heavy sweating, use of potassium wasting drugs (diuretics), poor intake of K+ (debilitated clients, alcoholics, anorexia nervosa), hyperaldosteronism.

Front 10

s/s of hypokalemia

Back 10

muscle weakness, leg cramps, fatigue, lethargy, anorexia, nausea, vomiting, decreased bowel sounds and bowel motility, cardiac dysrhythmias, depressed deep tendon reflexes, weak irregular pulses. K+ below 3.5, ABGs may show alkalosis, Twave flattening and ST segment depression on ECG.

Front 11

interventions for hypokalemia

Back 11

monitor HR and Rhythm, monitor those receiving digitalis closely increases risk of toxicity, administer oral potassium with fluid to prevent gastric irritation, administer K+ IV slowly 10-20 mEq/hr, monitor for pain and inflammation at the injection site, teach about K+ rich foods, teach to avoid excessive use ofdiuretics and laxatives to prevent loss of K+.

Front 12

risk factors for hyperkalemia

Back 12

decreased potassium excretion due to renal failure, hypoaldosteronism, potassium sparing diuretics. High potassium intake. Excessive use of K+ containing salt substitutes, excessive rapid IV infusion of K+, Potassium shift out of the tissue cells into the plasma (infections, burns, acidosis)

Front 13

s/s of hyperkalemia

Back 13

GI hyperactivity, diarrhea irritability, apathy, confusion, cardiac dysrhythmias or arrest, muscle weakness, areflexia (absence of reflexes), decreased HR and irregular pulse. Parasthesia and numbness in extremitites. K+ > 5.0 peaked T wave widened QRS on ECG.

Front 14

interventions for hyperkalemia

Back 14

closely monitor cardiac status and ECG, administer diuretics and other medications such as glucose and insulin as ordered. Hold K+ supplements and K+ conserving diuretics. Monitor K+ levels carefully, a rapid drop may occur as potassium shifts into the cells. Teach to avoid foods high in K+ and salt substitutes.