Fluids Electrolyte

Front 1

Sodium (NA+)

Back 1

135-145 mEq/L

Front 2

Potassium (K+)

Back 2

3.5-5.0 mEq/L

Front 3

Calcium (Ca2+)

Back 3

4.5-5.5 mEq/L

Front 4

Magnesium (Mg2+)

Back 4

1.5-2.5 mEq/L

Front 5

Bicarbonate (HCO3-)

Back 5

Arterial 22-26 mEq/L
Venous 24-30 mEq/L

Front 6

Chloride (Cl-)

Back 6

95-105 mEq/L

Front 7

Phosphate (PO43-)

Back 7

2.8-4.5 mg/dl

Front 8

Hyponatremia Signs and Symptoms

Back 8

Apprehension, personality change, postural hypotension, postural dizziness, abdominal cramping, nausea and vomiting, diarrhea, tachcardia, dry mucous membranes, convulsions and coma

Laboratory Findings:
serum sodium BELOW 135 mEq/L
serum osmolality 280 mOsm/kg
urine specific gravity BELOW 1.010

Front 9

Hyponatremia Imbalance and Related Causes

Back 9

Vomiting, diarrhea, NG suction, kidney disease resulting in salt wasting, diuretics, adrenal insufficiency, excessive perspiration, burns, polydipsia, Syndrome of inappropriate ADH (SIADH)

Front 10

Hypernatremia Imbalance and Related Causes

Back 10

excess salt intake
excess aldosterone secretion
diabetes insipidus
increased sensible and insensible water loss
water deprivation

Front 11

Hypernatremia Signs and Symptoms

Back 11

extreme thirst, dry and flush skin, dry and sticky tonge and mucous membranes
postural hypotension, fever, agitation, convulsions, restlessness, irritability

Laboratory Findings:
serum sodium ABOVE 145 mEq/L
serum osmolality 300 mOsm/kg
urine specific gravity 1.030

Front 12

Hypokalemia Imbalance and Related Causes

Back 12

use of potassium wasting diuretics
diarrhea, vomiting, or other GI losses
alkalosis
excess aldosterone secretion
polyuria
extreme sweating
excessive use of potassium free IV solutions
treatment of diabetic ketoacidosis with insulin

Front 13

Hypokalemia Signs and Symptoms

Back 13

weakness and fatigue, muscle weakness, nausea and vomiting, intestinal distention, decreased bowel sounds, decreased deep tendon reflexes, ventricular dysrhythmias, paresthesias and weak, irregular pulse

Laboratory Findings: Serum potassium BELOW 3.5 mEq/L
ECG abnormalities: flattened T wave, ST segment depression, U wave, potentiated digoxin effects (Ventricular dysrhythmias)

Front 14

Hyperkalemia Imbalance and Related Causes

Back 14

renal failure, fluid volume deficit, massive cellular damage such as from burns and trauma
iatrogenic administration of large amounts of potassium IV
acidosis, especially diabetic ketoacidosis
rapid infusion of stored blood
use of potassium sparing diuretics
ingestion of K+ salt substitutes

Front 15

Hyperkalemia Signs and Symptoms

Back 15

anxiety, dysrhythmias, paraesthesia, weakness, abdominal cramps, diarrhea

Laboratory Findings: serum potassium level ABOVE 5.0 mEq/L
ECG abnormalities: peaked T wave and widened QRS complex (bradycardia, heart block, dysrhythmias)
eventually QRS pattern widens and cardiac arrest occurs

Front 16

Hypocalcemia Imbalance and Related Causes

Back 16

rapid administration of blood transfusions containing citrate
hypoalbuminemia, hypoparathyroidism, vitamin D deficiency, pancreatitis, alkalosis, chronic renal failure, chronic alcoholism

Front 17

Hypocalcemia Signs and Symptoms

Back 17

numbness and tingling of fingers and circumoral (around mouth) region, hyperactive reflexes, positive Trousseau's sign (carpopedal spasm with hypoxia)
positive Chvostek's sign (contraction of facial muscles when facial nerve is tapped)
tetany, muscle cramps, and pathological fractures (chronic hypocalemia)

Laboratory Findings: serum ionized calcium level BELOW 4.5 mEq/L or total serum BELOW 8.5 mg/dL and ECG abnormalities: ventricular tachycardia

Front 18

Hypercalcemia Imbalance and Related Causes

Back 18

hyperparathyroidism, osteometastasis, paget's disease, osteoporosis, prolonged immobilization, acidosis, thiazide diuretics

Front 19

Hypercalcemia Signs and Symptoms

Back 19

anorexia, nausea and vomiting, weakness, hypoactive reflexes, lethargy, flank pain (from kidney stones) decreased level of consciousness, personality changes and cardiac arrest

Front 20

Hypomagnesemia Imbalance and Related Causes

Back 20

inadequate intake: malnutrition and alcoholism
inadequate absorption or loss: diarrhea, vomiting, nasogastric drainage, fistulas, diseases of small intestine, excessive loss resulting from thiazide diuretics, aldosterone excess, polyuria

Front 21

Hypomagnesemia Signs and Symptoms

Back 21

muscular tremors, hyperactive deep tendon reflexes, confusion and disorientation, tachycardia, hypertension, dysrhythmias, and positive Chvostek's sign and Trousseau's sign

Front 22

Hypermagnesemia Imbalance and Related Causes

Back 22

renal failure
excess oral or parenteral intake of magnesium

Front 23

Hypermagnesemia Signs and Symptoms

Back 23

acute elevations in magnesium levels
hypoactive deep tendon reflexes
decreased depth and rate of respirations
hypotension and flushing

Front 24

Fluid Volume Deficit Imbalance and Related Causes

Back 24

Water and electrolytes lost in equal or isotonic proportions

diarrhea, vomiting, drainage from fistulas or tubes
loss of plasma or whole blood, sich as with burns or hemorrhage
excessive perspiration, fever
decreased oral intake of fluids,
confusion or depression
use of diuretics

Front 25

Fluid Volume Deficit Signs and Symptoms

Back 25

postural hypotension, tachycarida, dry mucous membranes, poor skin turgor, thirst, confusion, rapid weight loss, slow vein filling, flat neck veins, lethary, oliguria (<30mL/hr), weak pulse

Front 26

Fluid Volume Excess Imbalance and Related Causes

Back 26

water and sodium retained in Isotonic Proprortions

congestive heart failure
renal failure
cirrhosis of the liver
increased serum aldosterone and steroid levels
excessive sodium intake or administration

Front 27

Fluid Volume Excess Signs and Symptoms

Back 27

rapid weight gain, edema, hypertension, polyuria, neck vein distension, increased blood and venous pressure, crackles in lungs, confusion

Front 28

Hyperosmolar Imbalance - Dehydration Related Causes

Back 28

diabetes insipidus
interruption of neurologically driven thirst drive
diabetic ketoacidosis
osmotic diuresis
administration of hypertonic parenteral fluids or tube feeding formulas

Front 29

Hyperosmolar Imbalance - Dehydration Signs and Symptoms

Back 29

dry and sticky mucous membranes, flushed and dry skin, thirst, elevated body temp, irritability, convulsions, coma

Front 30

Hypoosmolar Imbalance - Water Excess Related Causes

Back 30

syndrome of inappropriate of antidiuretic hormone (SIADH)
excess water intake

Front 31

Hypoosmolar Imbalance - Water Excess Signs and Symptoms

Back 31

decreased level of consciousness, convulsions, coma

Front 32

Thiazide Diuretic

Back 32

Causes loss of water and potassium

Watch for hypokalemia
Can also lower magnesium and increase calcium

Eat with food at breakfast to prevent nocturia - don't have diuretic on empty stomach

Front 33

What is likely to be decreased with Chronic Renal Failure?

Back 33

Calcium
Would have a high phosphorus level and since they are inverse to each other, calcium would drop

Also hemoglobin would decrease because the kidneys would not produce as much as they start to fail

Front 34

pH - 7.35
PO2 - 96
PCO2 - 30
HCO3 - 18

Back 34

Metabolic acidosis (compensated)
Excess bicarbonate is excreted causing HCO3 levels to decrease= metabolic acidosis

Compensation is increased resp rate and depth to bring CO2 down and bring pH back to normal

Front 35

End Stage Renal Disease Symptoms

Back 35

yellow-gray pallor, anemia, uremia,