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212 Cards in this Set
- Front
- Back
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optimal health and normal body function depends on what balance?
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the balance between fluids, electrolytes and acid/base levels
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1 liter of fluid loss = how many Kg or lbs?
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1Kg or 2.2lbs
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what is the fluid distribution for ICF and ECF?
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Intracellular: 40% (25L)
Extracellular: 20% (15L) |
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what is % of fluids for infants? average healthy adult? older adult?
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infants: 80%
adult: 60% older adult: 50% |
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how does a loss of fluids affect the body.. what if you lost 10%? 20%?
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loss of body fluids > problems
10% loss is serious 20% fatal |
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what is the most important indicator of fluid state?
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weight
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what are substances that dissolve in solution, & conduct weak electrical currents?
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electrolytes
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what is the name for a positively charged electrolyte?
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cation
think: people love cats (+) |
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what is the name for a negatively charged electrolyte?
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anion
think: antagonist, against (-) |
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what measurement is used to measure the chemical activity of electrolytes?
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milliequivalents
(mEq) |
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what is the cation and anion for ECF?
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cation is sodium
anion is chloride |
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what is the cation and anion for ICF?
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cation is potassium
anion is phosphate |
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what is osmolarity?
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the # of molecules in a liter of any solution
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what is osmolality?
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the # of particles per kilogram of water
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what refers to concentration of particles in plasma?
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osmolality
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what affects pulling power by osmotic pressure regarding particles in plasma?
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osmolality
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the greater the osmolality the greater the.. ?
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pulling power
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the regulation of fluid compartments are maintained by?
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diffusion
osmosis active transport filtration |
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what is in constant motion / maintains balance?
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fluid
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define diffusion.
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solid matter moves from higher conc to lower conc distributing solute(s)
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define osmosis.
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the movement of solvent(s) via semipermeable membrane from lower conc to higher conc
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what is active transport?
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ions moving from higher to lower against conc gradient (needs ATP)
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explain filtration.
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when water and substances move together in response to fluid pressure
high hydrostatic pressure (arterial) to low hydrostatic pressure (venous) |
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on every IV bag you can read the osmolarity level, this determines what?
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the tonicity of the solution and how if affects fluid movement
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what is the normal serum osmolality (#particles in plasma)? and what affects it?
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280-295
high if dehydrated low if overhydrated |
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tell me about isotonic solutions.
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they resemble the same osmolality of blood 250-350; and there is no fluid movement in the compartment
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0.9% sodium chloride(NS); lactated ringers solution (LR); 5% dextrose in water(D5W); & 5% dextrose, 1.2% sodium chloride (D5.2NS) are examples of what?
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isotonic solutions
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what has less concentration than our plama solutes (<250)?
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hypertonic solutions
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how does hypotonic solutions affect fluid movement?
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fluid will shift from the vascular compartments to the cell causing the cell to swell
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.45NS and .33NS are examples of what type of solutions?
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hypotonic solutions
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this solution has greater solute concentration than our plasma solutes (>350)?
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hypertonic solutions
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how does hypertonic solutions affect fluid movement?
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fluid moves from the cell into vascular compartments, shrinking the cell, and expanding the vascular compartment
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D5.45NS; D5.9NS; D5LR;
10%,20%,&50%Dextrose in water; 3%NS,5%N; & amino acid solutions (TPN) are examples of what solution? |
hypertonic solutions
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what should be the fluid intake for 24hrs?
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2500cc/24hrs
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there should be 2500cc per 24hrs (intake).. split it up between fluid, food, and metabolism. how many cc's for each?
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1200cc fluid intake
1000cc foods 300cc metabolism |
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what stimulates the thirst main regulator?
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plasma osmolality
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what are substances that dissolve in solution, & conduct weak electrical currents?
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electrolytes
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what is the name for a positively charged electrolyte?
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cation
think: people love cats (+) |
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what is the name for a negatively charged electrolyte?
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anion
think: antagonist, against (-) |
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what measurement is used regarding electrolytes?
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milliequivalents
(mEq) |
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what is the cation and anion for ECF?
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cation is sodium
anion is chloride |
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what is the cation and anion for ICF?
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cation is potassium
anion is phosphate |
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what is osmolarity?
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the # of molecules in a liter of any solution
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what is osmolality?
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the # of particles per kilogram of water
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what refers to concentration of particles in plasma?
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osmolality
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what affects pulling power by osmotic pressure regarding particles in plasma?
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osmolality
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the greater the osmolality the greater the.. ?
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pulling power
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the regulation of fluid compartments are maintained by?
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diffusion
osmosis active transport filtration |
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what is in constant motion / maintains balance?
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fluid
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define diffusion.
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solid matter moves from higher conc to lower conc distributing solute(s)
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define osmosis.
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the movement of solvent(s) via semipermeable membrane from lower conc to higher conc
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intake should match output so if you intake 2500cc/24hr then you should output 2500cc/24hr. your output consists of breathing, perspiration, kidneys, and feces. what is the output cc's for each?
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500cc breathing
500cc perspiration 1400cc kidneys 100cc feces |
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what causes a insensible loss of body fluids, not perceived by client?
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fever
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what is a sensible loss of fluids, perceived by client?
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perspiration
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what is the main regulator for perspiration?
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kidneys
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what are factors regulating fluid balance?
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age, environmental temperature, diet, hormone regulation
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what hormone acts on the renal tubule to reabsorb Na?
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aldosterone
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what hormone acts on the renal tubules to increase water absorption, diluting blood, and decreasing osmolarity and u/o?
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ADH
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what does aldosterone increase?
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electrolyte of Na
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what am i talking about?? fluid moves out of vessel at higher end & into at lower; the pushing & pulling effects determined by the differences in pressure
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starlings law of the capillaries
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what effect does isotonic solutions have on urine output?
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increased u/o
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what effect does hypotonic solutions have on urine output?
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u/o is same if body is in balanced state
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what effect does hypertonic solutions have on u/o?
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u/o is increased
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who is at high risk for dehydration?
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infants & older adults
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what inhibits the antidiuretic hormone?
hint: regarding diet |
beer
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Na retentions leads to retention of what?
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water
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sodium is regulated by dietary intake and what else?
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secretion of aldosterone
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postassium is regulated by dietary intake and what else?
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renal excretion
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calcium is regulated by dietary intake and what else?
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PTH (parathyroid hormone)
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magnesium is regulated by dietary intake and what else?
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renal mechanisms and PTH
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list the 4 cations..
regarding regulation, what do cations have in common? |
sodium, potassium, calcium, magnesium
all regulated by dietary intake |
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what is regulated by dietary intake and kidneys? is it a cation or anion?
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chloride
anion |
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what regulates bicarbonate?
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this anion is regulated by the kidneys
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what effect does calcium and phosphate have on eachother?
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they are proportional, if one rises the other falls
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dietary intake, renal excretion, intestinal absorption, and PTH regulate what? anion or cation?
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the anion phosphorus
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acid/base balance is reflected by what stable ions?
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Hydrogen ions
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what is normal blood pH?
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7.35-7.45
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if pH is <7.35, blood is..?
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acidic
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if pH is >7.45, blood is..?
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alkaline
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what released H ions when dissolved in water?
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acid
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what will bind to a hydrogen ion when dissolved in water being NAHCO3?
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base
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what does the body do in order to keep the pH within range?
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the carbonic/bicarb buffer system will absorb or release acid
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when does the biological regulation of acid/base happen?
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occurs after chemical buffering takes place
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what am i explaining? occurs 2-4hrs; H enters cell and K+ leaves cell making ECF<acid; CO2 diffuses into RBC forms carbonic acid; bicarb diffuses into cell, maintaining neutrality
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biological regulation of acid/base
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what is rapid adaptation?
hint: physiological regulation |
lungs increase H ions by respiratory rate
body reacts in second of pH change |
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what is rapid adaptation in acidosis?
hint: physiological regulation |
body will INCREASE depth and rate to blow off CO2
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what is rapid adaptation in alkalosis?
hint: physiological regulation |
body will DECREASE respiratory rate to conserve CO2
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which adaptation to pH takes a few hrs to few days?
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kidney adapation
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how does the body adapt to kidney pH changes when H ions are elevated or decreased?
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elevated- reabsorb HCO3 (bicarb)
decreased- excrete HCO3 (bicarb) |
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what causes respiratory acidosis?
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HYPOVENTILATION, retaining H ions
increased CO2 builds up and ph <7.35 |
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what is the tx for respiratory acidosis?
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increased ventilation which will decrease H ions
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what are the S/S of respiratory acidosis?
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impaired respiration, disorientation, weakness, h/a, increased pulse, increased resp, increased BP, convulsions, coma
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what causes respiratory alkalosis?
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HYPERVENTILATION, there is a decrease in H ions d/t excessive respirations which decrease the CO2, pH>7.45
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what is the tx for respiratory alkalosis?
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rebreathe CO2, slow breathing down
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what are S/S of respiratory alkalosis?
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deep, rapid respirations, tetany, paresthesia, tinnitus, blurred vision, diaphoresis, dry mouth, n/v, inability to concentrate, disorientation, coma
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what is the cause of metabolic acidosis?
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high acid content:
-an increase in H ion by loss of bicard (lower GI losses) -plasma pH <7.35 -plasma bicarb <24 |
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what is the tx for metabolic acidosis?
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give bicarb as ordered, find cause
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what are S/S of metabolic acidosis?
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SOB w/exertion, hyperventilation, weakness, disorientation and coma
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what is the cause of metabolic alkalosis?
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loss of acid: (vomiting)
-an elevation in bicarb -plasma pH >7.45 -plasma bicarb >26 |
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what is the tx for metabolic alkalosis?
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treat underlying cause
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what are S/S of metabolic alkalosis?
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numbness and tingling of extremities, hypertonicity of muscles, slow and shallow respirations/apnea, bradycardia, dizziness, convulsions
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what is ABG? what does it indicate?
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arterial blood gas
indicates the regulatory mechanism of the lungs or kidneys maintaining pH |
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tell me about this part of the ABG, Partial pressure of oxygen (PaO2). whats the norm?
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This measures the pressure of oxygen dissolved in the blood and how well oxygen is able to move from the airspace of the lungs into the blood.
80-100% @21% 02(room air) |
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tell me about this part of the ABG, Partial pressure of carbon dioxide (PaCO2). whats the norm?
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This measures how much carbon dioxide is dissolved in the blood and how well carbon dioxide is able to move out of the body.
35-45 norm |
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tell me about SaO2 part of the ABG and the norms.
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measures amount of saturated oxygen in ciculating hemoglobin
norms 95% or greater |
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tell me about Bicarbonate (HCO3). norms?
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Bicarbonate is a chemical that keeps the pH of blood from becoming too acid. If the pH level drops, HCO3 is absorbed by the kidneys and returned to the blood instead of passing out of the body in the urine.
norms 22-26 |
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you gotta know your norms!
pH, CO2, bicarb (HCO3) |
pH 7.35-7.45
CO2 35-45 HCO3 22-26 |
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you gotta know what outside of norms means?
pH, CO2, HCO3 (bicarb) |
pH <7.35 =acidic
pH >7.45 =alkalosis CO2 <35 =resp alk CO2 >45 =resp acid HCO3 <22 =metabolic acid HCO3 >26 =meta alk |
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what will tell the regulating mechanism?
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ABGs will tell if its lungs or kidneys
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ABG example.
pH 7.48 CO2 38 HCO3 30 |
pH is alkaline
CO2 is normal HCO3 is alkalotic ------------------ metabolic alkalosis |
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AGB example.
pH 7.30 CO2 50 HCO3 24 |
pH is acidotic
CO2 is highin in carbonic acid HCO3 is normal ------------------- respiratory acidosis |
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ABG example.
pH 7.49 CO2 30 HCO3 24 |
pH is alkaline
CO2 is low HCO3 normal ---------------- resp alk |
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ABG example.
pH 7.26 CO2 60 HCO3 26 |
resp acidosis
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ABG example.
pH 7.28 CO2 42 HCO3 21 |
metabolic acidosis
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ABG example.
pH 7.46 CO2 36 HCO3 28 |
metabolic alkalosis
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ABG example
pH 7.45 CO2 48 HCO3 28 |
resp acidosis c compensation
the HCO3 elevated to balance the high CO2 causing a normal pH |
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ABG example.
pH 7.20 CO2 60 HCO3 24 |
resp acidosis
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what is compensation?
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the body is trying to restore the pH
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ABG example.
pH 7.38 CO2 60 HCO3 37 |
resp acidosis c compensation
the HCO3 elevated to balance the high CO2 causing a normal pH |
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the pH represents the primary disorder. meaning..?
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this means that if the pH is acidic the bicarb or CO2 will be as well and vice versa.
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sodium is the primary cation of ECF responsible for water retention. what is the mEq norms of sodium?
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135-145 mEq
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what is hyponatremia? what is caused by?
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<135 low sodium level
loss of Na or gain of H20 (increase in ADH) |
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what are the s/s of hyponatremia?
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postural hypotension, dizziness, personality changes, neuro symptoms
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what are the nursing implications for hyponatremia?
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restrict fluids
monitor I&O's & body weight neuro assessment seizure precautions monitor Na levels |
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what is hypernatremia, and what is it caused by?
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>145 mEq high sodium level
Na excess d/t excess water loss, excess aldosterone secretion, hypertonic tube fdgs, deprivation of water, diabetes insipidus [cells shrink] |
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what are the S/S of hypernatremia?
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increase in thirst, dry MM, restlessness, disorientation, muscle irritability
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what are nursing implications for hypernatremia?
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add water or remove Na c hypertonic solutions, monitor I&O's and Na level, give adequate amt of water c tube feedings
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potassium: 97% is in cells
what are mEq/L norm? |
3.5-5.3 mEq/L
if high acid if low alk |
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why is potassium important?
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promotes nerve transmission/conduction & contraction of skeletal, cardiac, & smooth muscles
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whats hypokalemia? range? whats it caused by?
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<3.5 low K+ level
electrolyte alteration such as potassium wasting diuretics, decreased dietary intake vomiting, diarrhea, gastic suctioning |
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what are S/S of hypokalemia?
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abnormal cardiac conduction (irreg pulse), muscle weakness
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what are the nursing implications for hypokalemia?
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ample K+ intake (OJ, apricots, cantaloupe, oranges, potatoes, milk) give K+ supplements as ordered [must have functioning kidneys]
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what is hyperkalemia? whats the range? whats the cause?
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>5.3 high K+ level
primary cause is decreased renal function or condition that decreases amount K+; kidneys excrete, also from salt substitutes & acidosis |
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S/S hyperkalemia?
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anxiety, abd cramps, diarrhea, weakness, abnormal heart rhythms
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what are the nursing implications of hyperkalemia?
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restrict K intake, diuretics that promote K+ excretion (lasix) as ordered; kayexalate enema, regular insulin (used for severe cases); aldactone is a potassium sparring diuretic used in hypokalemia state
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what is the normal ranges for calcium?
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1500-2000mg/day or 4.0-5.0
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what is trousseau's sign? whats is for?
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inflate BP cuff, leave on for 3min and look for carpal spasm (+ if spasm present)
used to test for hypocalcemia and hypomagnesemia |
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what is chvostek's sign? whats it for?
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tapping in front of ear and look for twitching of eyelids (+ if twitch present) used to test for hypocalcemia and hypomagnesemia
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what is hypocalcemia? range? cause?
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<8.5 or 4.0 low calcium level
caused by diseases thyroid, parathyroid glands, inadequate Vit D, & alkalotic state |
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what are S/S of hypocalcemia?
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neuromuscular manifestations, tetany, tingling sensation around mouth, hands, feet
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what are the nursing implications for hypocalcemia?
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seizure precautions (severe), monitor airway, calcium supplements as ordered
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what is hypercalcemia? range? cause?
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>10.5 or 5.0mg/dL high Ca
cause is an underlying disease that increases bone resorption, immobilization, osteoporosis, excessive ingestion of Ca |
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whats the S/S of hypercalcemia?
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neuromuscular changes, muscle weakness, N/V, low back pain r/t stones (renal calculi)
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what are the nursing implications for hypercalcemia?
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increase fluid intake, strain urine, turn Q2hrs, give calcitonin as ordered, increase activity
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whats the norms for magnesium?
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1.5-2.5mg/dL or 350-500mg/day
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whats hypomagnesemia? range? cause?
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<1.5 low mg level
caused by chronic malnutrition and alcoholism |
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S/S hypomagnesemia?
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confusion, dissorientation, +Chovstek, +Trousseau, hyperactive deep tendon reflex
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whats the deep tendon reflex scale?
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0- no response
1+ diminished reflex 2+ normal 3+ brisk reflex 4+ hyperactive reflex |
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what are the nursing implications for hypomagnesemia?
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seizure precautions (severe), diet rich in green leafy veggies, magnesium supplements as ordered, monitor LOC and neuro status
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what is hypermagnesemia? range? cause?
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>2.5 high mg
causes- renal failure, excessive dosage of mg |
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S/S hypermagnesemia?
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resp depression, hypotension, flusing, hypoactive deep tendon reflexes
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what are the nursing implications for hypermagnesemia?
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ventilate, check resp rate frequently, avoid mg preparations
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whats chloride? range?
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major ECF anion that maintains cellular integrity and acid/base balance. (found in sweat)
100-106 mEq/L |
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what is hypocholremia? range?
cause? |
<100 low chloride level
cause- vomiting, nasogastric drainage, loop diuretics, diarrhea |
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S/S of hypocholremia and nursing implication?
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metabolic acidosis;
NI: treat underlying cause, administer saline solutions as ordered |
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whats hyperchloremia? range? cause?
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>106 high chloride level
cause- conditions that lower bicarb ions, associated with acid/base imbalance |
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S/S of hyperchloremia? NI?
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deep rapid breathing, stupor, weakness
NI: treat underlying cause of acidosis, administer solutions free of NaCl (Hypotonic) |
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why is phosphorus important? norms?
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major ICF anion that control muscle fxn, RBCs, nervous system, & metabolism of carbs, proteins and fats
(kidneys responsible for excretion) 2.4-4.6, 800-1200mg/day |
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what is hypophosphatemia? range? cause?
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<2.4 low phosphorus level caused by alcoholism, vomiting, diarrhea, overuse of binding agents
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S/S of hypophosphatemia?
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release of CPK, irritability, neuromuscular dysfunction, fatigue, confusion
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Tx of hypophosphatemia?
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treat underlying cause of acidosis, increase of phosphorus w/ foods & supplements
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whats hyperphosphatemia? range? s/s?
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4.6-6.0 high phosphate levels, s/s similiar to hypercalcemia
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what is fluid volume deficit(FVD)?
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FVD is a contracted vascular compartment d/t loss of ECF or accumulation of luid in interstitial space
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cause of FVD?
symptoms? |
most common: GI dysfunction
also, renal and endocrine dysfunction sx: dehydrated state [*30mL/hr urine to sufficiently hydrate kidneys] |
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tx of FVD?
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fluid replacement (po or IV) use caution to fluid overload
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what is fluid volume excess (FVE)?
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overhydration of intravascular compartment
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cause and s/s of fve?
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primary cause is cardiovascular dysfunction, also: excess water intake, excess ADH secretion
sx: wt gain(5%TBW), edema, tachycardia, dyspnea, ^BP, cerebral edema, decreased LOC, coma, death |
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tx of fve?
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Na& fluid restriction, diuretic therapy, treat underlying cause, elevate edematous extremities, weights daily,
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check for edema by measuring depression of skin in mm. whats the scale?
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1+ 2mm
2+ 4mm 3+ 6mm 4+ 8mm |
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FVD vs FVE
how does each affect.. pulse and JVD |
FVD : pulse increases, weak, and rapid(tachycardia); no JVD
FVE: pulse increases, bounding and JVD is present |
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FVD vs FVE
how does each affect.. labs |
FVD: ^BUN, ^HCT, ^urine SG d/t hemoconcentration
FVE: decreased BUN, HCT, & urine specific gravity d/t hemodilution |
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FVD vs FVE
how does each affect.. BP and lungs |
FVD: ^BP, lung sounds clear
FVE: decreased BP, lung sounds crackles, SOB, orthopnea, moist cough, dyspnea |
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FVD vs FVE
how does each affect.. skin, wt, edema |
FVD: skin is warm, dry, sluggish turgor, no edema, and weight gain or loss
FVE: skin is wet, moist, tight, smooth, +edema, puffy eyelids, and wt gain |
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FVD vs FVE
how does each affect.. U/O & neuro |
FVD: decreased u/o, neuro is disorientated and lethargic
FVE: u/o ^ or dec depends, change in LOC, and possible seizures |
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nursing implications for wt's, and I&Os..
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wt's: same time each day, balance scale before use, wear same clothing, not type of scale DOCUMENT
In's: ice chips, parenteral fluids, tube feedings, water flushes catheter irrigants Out's: urine, liquid feces, vomitus, NG drainage, diaphoresis, wound drainage, draining fistulas, rapid breathing |
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nursing dx r/t fluid and electrolytes
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-tissue perfusion r/t hypovolemia
-altered thought process r/t confusion,disorientation resulting from chemical imbalance -FVD r/t loss of body fluids -FVE r/t compromised regulatory function -hyperthermia r/t dehydration |
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give some special considerations for geriatric patients d/t physiological changes
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-check turgor over sternum
-cardiovascular changes: less elasticity -resp: decrease vital capacity -skin: loss of supporting tissues -renal changes: dec glomerular filtration rate -check temp, wt, I&O, postural BP, filling of veins in hands and feet, swallowing abilities |
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what is BUN? whats the normal range?
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Blood Urea Nitrogen
8-25mg/dl |
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what are some reasons a BUN might be high?
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d/t decreased renal flow secondary to volume deficit (dehydration) OR excessive protein intake b/c increased urea production OR increased catabolism d/t trauma, starvation, and also catabolic drugs
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why might a BUN be low?
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overyhydration and low protein intake
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what is a creatinine test for and what are the norms?
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indicator of renal disease more specific and sensitive than BUN
0.6-1.5mg/dl |
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why could a creatinine test be high?
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slight elevation may occur in severe fluid depletion, which results in decreased glomerular filtration rate OR increases can occur c certain drugs (ie: cefoxitin, cimetidine) and in rhabdomyolosis which gives sudden release of muscle creatine phosphate
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what is the BUN/creatinine ratio? what happens when the ratio is > or <??
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Normal is 10:1 (BUN is 10x greater than creatinine)
if ratio is > 10:1= hypovolemia, low perfusion pressures to kidney, increase protein metabolism may be present <10:1= low protein intake, hepatic insufficiency, or repeated dialysis may be present |
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what happens when both BUN & creatinine are increased?
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problem may be kidney disease
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what is an Hematocrit? what are the norms for males and females?
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determines the % of RBC in plasma
M: 44-52 F: 39-47 |
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what does an elevation or decrease mean regarding the HCT?
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if increased: FVD b/c RBC are condensed in smaller plasma
if decreased: FVE b/c RBC are in larger plasma volume |
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what are the norms for albumin?
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3.5-4.8g/dl or 35-48g/L
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what happens when there is a decrease in albumin level?
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causes reduced colloidal osmotic pull in intravascular space, allowing fluid to shift to interstitial space and PRODUCE EDEMA
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what is serum osmolality? whats the norm?
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concentration of (#of) sodium particles found in serum
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why would a serum osmolality be high or low?
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high: dehydration
low: overhydration high: found in hyperglycemia and in presence of elevated BUN |
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what is a urine s/g? what is the range?
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urine specific gravity measures the kidney's ability to concentrate urine
norm: 1.003 to 1.025 (most random specimens are b/t 1.010 to 1.020 c normal fluid intake) |
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what does it mean when urine s/g is elevated or decreased?
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high: w/FVD =dehydration
low: w/FVE =overhydration |
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what is a hyperglycemic hyperosmolar nonketotic coma?
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acute condition characterized by insulin deficiency in pt with diabetes also characterized by hyperglycemia & dehydration WITHOUT KETOSIS OR ACIDOSIS
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Pt presents with such lab values: BS>600mg/dL, serum osmolality >330, elevated HCT, ^BUN, decreased LOC
whats happening here? what do we do now? |
hyperglycemic hyperosmolar nonketotic coma
management: lower BS, regular insulin in small doses IV, correct water and NA deficits |
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what is SIADH? d/t what?
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syndrome of inappropriate antidieuretic hormone d/t levels of ADH
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causes of SIADH?
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head trauma & endocrine disorders
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water intoxication, ECF expansion d/t inappropriate reabsorption, mental confusion, weakness, N/V, ascites, edema, seizure, coma, weight gain, decreased u/o are S/S of what??
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SIADH
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what do you do when dealing with a pt with SIADH?
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correct water excess by fluid restriction, monitor electrolytes, diuretics as ordered
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what is diabetes insipidus? cause? what is it characterized by?
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disorder of posterior lob of pituitary gland d/t decreased ADH, caused by trauma, tumor
characterized by polydipsia, polyuria, urine s/g 1.001-1.005 |
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what is tx plan for pt with diabetes insipidus?
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fluid replacement, vassopressin, search for underlying pathology
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what type of solution is D5W?
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isotonic - no fluid movement
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what type of solution is .45%NS?
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hypotonic - ECF -> ICF
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what type of fluid is 09%NS?
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isotonic - no fluid movement
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what type of fluid is LR?
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isotonic - no fluid movement
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what type of fluid is D5.45NS?
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hypertonic - ICF -> ECF
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Describe how the nurse should institute fluid restrictions for a client?
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time schedule, remove free fluids from food trays, display sign for other staff
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Identify 5 risk factors for fluid and electrolyte or acid base imbalances.
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age, environment, stress, hormones, illness (also diet and exercise)
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Identify electrolyte imbalance.
serum sodium 125mEq/L |
hyponatremia
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Identify electrolyte imbalance.
serum potassium 5.8 mEq/L |
hyperkalemia
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Identify electrolyte imbalance.
serum calcium 3.7 mEq/L |
hypocalcemia
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Identify electrolyte imbalance.
serum magnesium 1.2 mEq/L |
hypomagnesemia
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Client that has experienced prolonged vomiting may develop what?
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metabolic alkalosis d/t loss of hydrochloric acid from GI tract
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