Fluids & Electrolytes

Front 1

Concentrations of Water in Body

Back 1

-60-70% of weight in Adults
-45-50% in Elderly

-ICF 60%
-ECF 40% (intravascular, interstitial, lymph)

Front 2

4 Functions of Body Fluids

Back 2

Transportation of O2, nutrients & electrolytes.
Heat regulation.
Lubrication of joint membranes.
Hydrolyzation of food into water.

Front 3

Functions of Electrolytes

Back 3

-Regulates water distribution (osmosis) (Na+).
-Osmosis changes action potential of membranes for muscle & nerve activity.
-Assist in transport of nutrients across cell membranes.
-Maintains optimum acid-base balance for metabolism of O2 & glucose (K+, Bicarb).
-Muscle contractions (Ca+, Mg++, K+, Na+).
-Energy - ATP generation (PO4-3)
-Transmission of nerve impulses (Ca+, Na+, K+, Bicarb)
-Clotting of blood (Ca+).

Front 4

Sodium (Na+)
Where most found:
Serum Levels:
Functions:

Back 4

-ECF
-135-145 mEq/L
-Regulates volume, osmolality & distribution of ECF.
-Maintains neuromuscular activity.

*Na+ & fluid balance probs. usu. occur together.

Hint 4

No cardiac fx!

Front 5

Hyponatremia
Causes:
Symptoms:

Back 5

NG Suctioning, Excessive drainage, Low intake, Sweating, Adrenal Insufficiency (low aldosterone), Diuretics, SIADH, CHF, Diarrhea, Vomiting.

Positive Babinski (plantar/toe) reflex, Muscle cramps, fatigue, Dyspnea on exertion, Anorexia, N/V, Postural BP changes, poor turgor (fingerprint), Weakness, Confusion (cerebral edema symptoms)

Front 6

Hypernatremia
Causes:
Symptoms:

Back 6

Lack of fluid intake, Osmotic Diuretics, Diarrhea, Abnormal salt intake, Excessive Aldosterone secretion, Diabetes Insipidus (excessive urine output), CRF.

Thirst, Red dry swollen tongue, Fever, Disorientation, Lethargy, Irritability, Seizures, Hallucinations.

Hint 6

Water loss or sodium gain

Symptoms usually dehydration

Front 7

Potassium (K+)
Where found:
Serum levels:
Function:

Back 7

-ICF
-3.5-4.5 mEq/L
-Neuromuscular and Cardiac fx.

Aldosterone helps K+ elimination

Front 8

Hyperkalemia
Causes:
Symptoms:

Back 8

Renal disease/failure, Massive cell destruction, Rapid transfusion of aged blood, Catabolic states, Metabolic acidosis, Adrenal insufficiency, Salt substitute.

Cardiac arrest if sudden, V.Fib., Irregular pulse, Muscular weakness, Paresthesias, Intestinal Colic (spasm/diarrhea)
Heightened T Wave

Hint 8

Increased cellular excitability

Front 9

Hypokalemia
Causes:
Symptoms:

Back 9

Diuretics, Hyperaldosteronism, Stress, NG suct., diarrhea, vomiting, ileostomy drainage, Malnutrition/starv/anorexia, Alcoholism

Dysrrhythmias, Weak irregular pulse, Neuromuscular skeletal weakness, Muscle flaccidity, Anorexia, N/V, Paresthesias, Decreased reflexes, Decreased bowel sounds.
Flattened T Wave

Hint 9

Causes reduced excitability of cells

Front 10

Calcium (Ca+)
Where found:
Serum levels:
Function:

Back 10

-Bones, teeth, ICF/ECF equally (one of most abundant ions in body)
-4.5-5.5 mEq/L
-Tx of nerve impulses, Myocardial & Muscle
contractions, Clotting, Teeth/bones

PTH raises levels in blood

Front 11

Hypercalcemia
Causes:
Symptoms:

Back 11

Malignancies r/t bone reabsorption (mult. myeloma or neoplastic disease), Hyperparathyroidism, Vit D overdose, Prolonged immobilization

Dec. memory/attention span, Confusion/disorientation, neurotic behavior, Fatigue, Polyuria (lot of urine), Polydipsia (lot of intake), Muscle weakness, incoordination, Dysrrhythmias, Renal stones

Hint 11

Reduced excitability of muscles and nerves

Front 12

Hypocalcemia
Causes:
Symptoms:

Back 12

Acute pancreatitis (malabsorption of Ca+), Multiple blood transfusions (citrate in transfused blood binds Ca+), Hypoparathyroidism, Chronic hypoglycemia

Trousseau's Sign (carpopedal spasm), Chvostek's sign (facial nerve tap), Neuroexcitability, Numbless/tingling, Laryngeal stridor, Convulsions, Tetany, Arrhythmias.

*Calcium/Phosphorous levels are inversely proportional.

Hint 12

Increased excitability of nerves and sustained muscle contraction

Front 13

Magnesium (Mg+)
Where found:
Serum levels:
Function:

Back 13

-ICF, Bones
-1.5-2.5 mEq/L
-Neuromuscular transmission, Cardiac function

Excreted by kidneys

Front 14

Hypermagnesemia
Causes:
Symptoms:

Back 14

Advanced renal failure, Increase of Mg+ WITH renal failure.

Hypoactive DTRs, Decreased BP & Temp, Resp. failure, Coma, Flushed red skin, Lethargy, Drowsiness,

Front 15

Hypomagnesemia
Causes:
Symptoms:

Back 15

Chronic alcoholism, Pancreatitis (dec. absorption), Burns, Excessive losses thru GI tract, Prolonged IV feeding w/out Mg+ supp.

Hyperactive deep tendon reflexes, Agitation, Muscle Tremors, Confusion, Hallucinations, Mood changes, Dysrrhythmias

Hint 15

High type symptoms

Front 16

Phosphate (PO4-3)
Where found:
Serum levels:
Function:

(Chloride Cl- & Bicarbonate HCO3- are the other two anions)

Back 16

-ICF/ECF (but it's the primary IC anion)
-2.8-4.5 mEq/L
-Production of ATP, RBC function, Vital for O2 delivery to tissues, Nervous system fx, Muscle fx., Metabolism of Fats, Carbs & Protein
*It is deposited with Ca+ for bone/teeth formation.

Absorbed in jejunum w/Calcium & excreted in kidneys

Front 17

Hyperphosphatemia
Causes:
Symptoms:

Back 17

Renal failure, Chemotherapy, Excessive ingestion of milk, Direct injury to muscle tissue (exercise), Fleet laxative.

*Calcium/Phosphorous levels are inversely affected.

Tetany, Neuromuscular irritability, Anorexia, N/V

Front 18

Hypophosphatemia
Causes:
Symptoms:

Back 18

Malabsorption Syndromes, Malnutrition, Alcoholism/ withdrawal, Diabetic Ketoacidosis

Only when chronic: Depression, confusion, seizures, Hemolytic anemia, Chest pain, Memory loss, Bone pain

Hint 18

Alcohol inhibits absorption of minerals