Parental Fluids Therapy Fluids and electrolytes disturbances.
Lect15&16 Fluids&Electrolytes (2)
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Transcript of Lect15&16 Fluids&Electrolytes (2)
7/18/2019 Lect15&16 Fluids&Electrolytes (2)
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Stressors Afecting
Fluid & ElectrolyteBalanceNUR 101
FALL 2008LECTURE # 15 & #16K. Burger, MSEd, MSN, RN,
CNE
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Body Fluids Water= ost i!ortant nutrient "or li"e. Water= !riary #ody $uid.
Adult %eigt is ''()*+ %ater. oss o" -*+ #ody $uid = + %eigt loss SERIOUS
oss o" /*+ #ody $uid = -'+ %eigt loss FATAL
Fluid gained eac day sould = $uid lost eac day0/ (12day a3erage4
Wat is te iniu out!ut !er our necessary toaintain renal "unction5
30ml!"
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Fu$%ios o Body Fluid Mediu "or trans!ort Needed "or cellular eta#olis Sol3ent "or electrolytes and oter
constituents
6el!s aintain #ody te!erature 6el!s digestion and eliination Acts as a lu#ricant
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'($!)isms o
Fluid *)i )d Loss
*)i
Fluid inta7e -'**l Food inta7e -***l 89idation o"
nutrients 1**l
0-*l o" 6/* !er -**Kcal4
Loss
:Sensi#le;Can #e seen.<rine -'**lS%eat -**l
:nsensi#le;Not 3isi#le.S7in 0e3a!oration4 '**lungs >**lFeces /**l
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Regulation o" Fluids
+y,o%!)lmus ?tirst rece!tors 0osorece!tors4
continuosly onitor seru osolarity0concentration4. " it rises, tirst ecanis istriggered.@aso!ressin 0AKA A6 4? increasing 6/* rea#sor!tion
-i%ui%)"y "(.ul)%io( !osterior !ituitaryreleases A6 0antidiuretic orone4 in res!onseto increasing seru osolarity. Causes renaltu#ules to retain 6/*.
irst is a late sign o" %ater deDcit
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Regulation o" Fluids
0continued
4 R()l "(.ul)%io( Ne!ron rece!tors
sense decreased !ressure 0lo%
osolarity4 and 7idney secretes RENN.Renin ? Angiotensin ? Angiotensin
A.io%(si II causes Na and 6/*retention #y 7idneys AN..
Stiulates Ad"()l Co"%(/ to secreteAldos%("o( %ic causes 7idneys toe9crete K and retain Na and 6/*.
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Cosid(" T!is e *("i)%"i$ Cli(%
(noral !ysiological aging results in
decreased tirst ecanis decreased o" s%eat glands decreased renal "unction
(tere also ay #e decreased o#ilityand2or cogniti3e "unction %ic i!actsteir a#ility to get adeGuate $uid inta7e.
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)"i)%ios i Body
Fluids Eld("lyH 6a3e lo%er + o" total #ody
$uid tan younger adults om(H 6a3e lo%er + total #ody
$uid tan en
+4 O 4OU T+IN T+IS IS 77777
Muscle tissue as ore 6/* content 6AN adi!ose
tissue
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Fluid Co!artentsI%")$(llul)"
$uid 0ICF4 Fluid inside
te cell 'os% 0/214 o"
te #odyIs+20 is in teICF.
E/%")$(llul)" Fluid0ECF4
Fluid outside te cell. 13 o" #odyIs +20 More !rone to loss 1 ty!esHI%("s%i%i)l $uid
around2#et%een cellsI%")9)s$ul)" 0!lasa4
$uid in #lood 3essels ranscellular ?CSF,
Syno3ial $uid etc
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Cosid(" %!is Age 3ariations e9ist in regards to
6/* content o" $uid co!artents n"ants =
)*+ o" 6/* is "ound in ECF>*+ o" 6/* is "ound in CF
Wat igt tis ean in regards to$uid loss "or an in"ant5Re3erse o" adultsJ
n"ant M8RE R8NE to
$uid 8SSJ
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Fluid Balance ynaic !rocess
Balance #et%een #ody $uidsand electrolytes Attraction #et%een ions
0electrolytes4 and %ater 0$uids4causes $uids to o3e acrosse#ranes and lea3e teirco!artents.
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Sol3ent 06/*4
Mo3eent Cell e#ranes are sei!erea#le
allo%ing %ater to !ass troug
Osmosis( aLor %ay $uidstrans!orted Water si"ts "ro lo%solute concentration to ig soluteconcentration to reac oeostasis0#alance4.
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Osmol)"i%y
Concentration o" !articles in solution e greater te concentration 08solarity4 o" a
solution, te greater te !ulling "orce 08sotic!ressure4 Noral seru 0#lood4 osolarity = /*(/'
8SM27g
A solution tat as 66 osolarity is one tat
is O seru osolarity = +4-ERTONIC solution A solution tat as 8W osolarity is one tat
is P seru osolarity = +4-OTONIC solution A solution tat as eGual osolarity as seru
= ISOTONIC solution
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6y!ertonic Fluids 6y!ertonic $uids a3e a iger
concentration o" !articles 0ig
osolality4 tan CF is !i.!(" osmo%i$
,"(ssu"( si"ts $uid "ro te
cells into te ECF ere"ore Cells !laced in a
y!ertonic solution %ill s!"i:
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6y!ertonic Fluids
<sed to te!orarily treat y!o3oleia
<sed to e9!and 3ascular 3olue Fosters noral B and good urinary out!ut
0o"ten used !ost o!erati3ely4 Monitor "or y!er3oleia J
Not used "or renal or cardiac disease. 6NK ? Wy not5 '+ *.>'+ NS '+ NS
'+ R
-ulmo)"yEd(m)
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6y!otonic Fluids 6y!otonic $uids a3e less
concentration o" !articles 0lo%osolality4 tan CF
is lo; osmo%i$ ,"(ssu"(
si"ts $uid "ro ECF into cells Cells !laced in a y!otonic
solution %ill s;(ll
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+y,o%oi$ Fluids <sed to :dilute; !lasa
!articularly in y!ernatreia reats cellular d(!yd")%io o not use "or !ts %it increased
C ris7 or tird s!acing ris7
*.>'+NS
*.11+NS
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Iso%oi$ Fluid sotonic $uids a3e te sae
concentration o" !articles
0osolality4 as CF 0/Q'(/'8s24
Osmo%i$ ,"(ssu"( is tere"ore te
s)m( inside & outside te cells Cells neiter srin7 nor s%ell in an
isotonic solution, tey stay te s)m(
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sotonic Fluid E9!ands #ot intracellular and
e9tracellular 3olue <sed coonly "orH e9cessi3e
3oiting,diarrea
*.+ Noral saline 'W RingerIs actate
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O%!(" Osmo%i$ F)$%o"s
ALBU'IN 0 a seru !rotein 4 Al#uin in te seru as osotic !ro!erties
calledcolloid pressure
Al#uin !ulls 6/* "ro te interstitialco!artents into te intra3ascularco!artents 0seru4. 6el!s to aintain B.
ersons %it lo% seru al#uin le3els tend toretain $uid in teir interstitial layers.
Wat a#noral assessents igt you Dnd in
te client %it lo% seru al#uin le3els5 Ed(m)<
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+mmm
Wat ty!e o" $uid0y!otonic ? isotonic ? y!ertonic4
igt #e o" #eneDt to tis client%it lo% al#uin le3els5
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Cosid(" %!is
Wen tissue inLury occurs, !roteins!atologically lea7 "ro te
intra3ascular s!ace into teintersititial s!ace.
eredH Third spacing
is e9!lains as a signo" te in$aatory !rocess.
EE'A
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Solu%( 'o9(m(% i=usio
Mo3eent o" solu%(s "ro igconcentration to lo% concentration
t is a ASSE o3eent 8WN teconcentration gradiant. (requires no energy)
Many #ody !rocesses use difusion.E9a!leH 8/ and C8/ e9cange
Rate is afected #yH concentrationgradiant, !erea#ility(sur"ace area(tic7ness o" e#ranes, and sie o"!articles.
0Fic7Is a%4
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Solu%( 'o9(m(% >o%!(" m($!)isms
A$%i9( %")s,o"%( reGuires energy 0A4to o3e "ro lo% concentration to igconcentration 0uphill)E9a!leH Na 2 K !u!
May #e enanced #y carrier olecules
%it #inding sites on cell e#raneE9a!leH lucose0nsulin !rootes te insertion o" #indingsites "or lucose on cell e#ranes4.
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Fil%")%io
Sol3ent AN solute o3eent assage "ro an area o" 6ig ressure to an
area o" o% ressure eredH +yd"os%)%i$ -"(ssu"(
E9a!leHArterioles a3e iger !ressure tan CFFluid, o9ygen and nutrients o3e into cellsenules a3e lo%er !ressure tan CFFluid, car#on dio9ide and %astes o3e out o"
cells
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Fluid 3olue deDcit F
06y!o3oleia4 Loss o ?o%! +20 )d
(l($%"oly%(s "om ECF Causes includeH
ncreased out!ut, 6eorrage,3oiting, diarrea, #urns,8R
Fluid si"t out o" 3ascular s!ace0 :tird s!acing; 4 into interstitials!aces
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eydration
Iso%oi$ d(!yd")%io = 6/* &electrolyte loss in eGual aountsT
diarrea and 3oiting
+y,("%oi$ d(!yd")%io = 6/* loss
greater tan electrolyte lossT e9cessi3e!ers!iration, dia#etes insi!idus
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AssessentF ( 6y!o3oleia
C)"dio9)s$ul)"H iinised !eri!eral !ulsesT Guality -@
0tready4 ecreased B & ortostatic y!otension ncreased 6R Flat nec7 & and 3eins in de!endent !osition Ele3ated 6eatocrit 06ct4
*)s%"oi%(s%i)l@ irst ecreased otilityT diinised #o%el sounds,
!ossi#le consti!ation
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AssessentF ? 6y!o3oleia0continued4
N(u"omus$ul)"H ecreased CNS acti3ity
0letargy to coa4 ossi#le "e3er S7eletal uscle %ea7ness 6y!eracti3e R
R()lH ecreased out!ut ncreased s!ec gra3 o"
urine Weigt loss 6y!ernatreia
I%(.um(%)"y@ ry out & s7in
oor turgor 0tenting4 itting edea Sun7en eye#alls
R(s,i")%o"y@ ncreased rate and de!t
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Nursing iagnosis ( F
($i(% Fluid olum(
R2 loss o" Fluids 3ia 3oitingAEB ele3ated 6ct, dry ucouse#ranes, decreased out!ut,
tirst
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lanning ( F
Client %ill deonstrate $uid#alance ae# oist ucous
e#ranes, #alanced & 8easureents, 6ct WN, #y.
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nter3entions "orF ( 6y!o3oleia
re3ent "urter $uid loss 8ral reydration tera!y
tera!y MedicationsT antieetics, antidiarreals Monitor C, Res!, Renal, status
Monitor electrolytes ? !ossi#le su!!leent r9 M8N8R WE6 and & 8
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NCEU ractice
ntra3enous $uids are ordered "or your client
%o is e9!eriencing diarrea and 3oiting "or
te !ast / days. Wic solution %ould tenurse e9!ect to see !rescri#ed5
a. 'NS
#. *.>'+NSc. '-2/NS
d. R
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Fluid olue E9cessFE ( 6y!er3oleia
Fluid o3erload is an e9cess o"#ody $uid ( o9("!yd")%io
E9cess $uid 3olue in teintra3ascular area(!y,("9ol(mi)
E9cess $uid 3olue in interstitials!aces (d(m)
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Fluid olue E9cess
CausesH ncreased Na26/8 "(%(%io E9cessi3e i%):( o" Na 08 or 4 E9cessi3e i%):( o" 6/8 0 8 or 4
0Water into9ication4
Syndroe o" ina!!ro!riateantidiuretic orone 0SA64
Renal "ailure, congesti3e eart "ailure
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AssessentFE ( 6y!er3oleia
C@ Ele3ated !ulseT >@#ounding, ele3ated B,
distended nec7 & and3eins, 3entricular gallo!0S146y!onatreia
R(s,@ ys!nea, MoistCrac7les,acy!nea
I%(.um(%)"y@ erior#ital edea
itting or Non(!itting edea
*I@ncreased otilityStoac cra!sNausea & oiting
R()l@Weigt gain
ecreased s!ec gra3o" urine
N(u"omus$ul)"@ Altered 8C,
eadace, s7eletaluscle t%itcing
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Nursing iagnosis ( FE
Fluid 9olum( e9cess
R2 e9cessi3e 6/* inta7e
AEB con"usion, eadace, uscle
t%itcing, a#doinal cra!s,ele3ated B and 6R, y!onatreia.
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lanning ( FE
Client %ill deonstrate $uid#alance #y #alanced & 8
easureents, Seru Na WN,etc. #y .
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nter3entionsFE ( 6y!er3oleia
Restore noral $uid #alance,!re3ent "urter o3erload
rug tera!yT diuretics iet tera!yT decrease Na & $uids Monitor inta7e and out!ut 0 & 84
Monitor %eigts Monitor electrolytes Monitor C, Res!, Renal systes
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Clinical A!!lication
Vou a3e #een assigned to care "or an *y.o.client aditted %it y!ernatreia tat as
an in"using *.>'+ NS -**l2r 3ia!u! and an ind%elling urinary cateter. At--a you assess an out!ut in te urinarydrainage #ag o" -'*l d7 a#er urine. Vou
also notice tat te client is S8B %iles!ea7ing on te !one to er daugter.
Wat do you tin7 is a!!ening55
Wat %ill you do55
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S<MMARV
Want ore n"oration555C6ECK 8< 6E
WEBNKSFor Ca!ter >- on
E8E
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Electrolytes
Wor7 %it $uids to 7ee! te #ody ealtyand in #alance
ey are solu%(s tat are "ound in3arious concentrations and easured inters o" illieGui3alent 0EG4 units
Can #e negati3ely carged 0)ios4 or
!ositi3ely carged 0$)%ios4 For oeostasis #ody needsH
otal #ody AN8NS = otal #ody CA8NS
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Electrolytes
C)%ios
ositi3ely carged
Sodiu Na@
otassiu K @ Calciu Ca@@
Magnesiu Mg@
@
Aios
Negati3ely carged
Cloride Cl(
os!ate 8>( Bicar#onate
6C81(
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Electrolyte Functions
Regulate %ater distri#ution
Muscle contraction Ner3e i!ulse transission Blood clotting Regulate enye reactions 0A4 Regulate acid(#ase #alance
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Sodiu Na@
-1'(->'EG2 MaLor Cation Cie" electrolyte o" te ECF Regulates 3olue o" #ody $uids Needed "or ner3e i!ulse & uscle
D#er transission 0Na2K !u!4 Regulated #y 7idneys2 orones
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6
6y!er and 6y!o Natreia are te ost
coon electrolyte distur#ances. Wy do
you tin7 tat is5
t is ost a#undant in teEURACE<AR F< and tere"oreore !rone to $uctuation.
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6y!onatreia
Seru Na@ P-1'EG2 Results "ro e9cess o" %ater or loss
o" Na@ Water si"ts "ro ECF into cells SS@ a#d cra!s, con"usion, N2,
62A, !itting edea o3er sternu T/@ iet2 tera!y2$uid restrictions
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ets tin7 a#out 6y!onatreia
Wat are soe edical conditions tat ay cause adilutional y!onatreia5C6FRenal FailureSA6 0 Cancer, !ituitary traua 4Addisons isease 0 y!oaldosteronis & Na loss 4
Wat are soe conditions tat igt cause actual losso" sodiu "ro te #ody5 losses ? nasogastric suctioning, 3oiting, diarreaCertain diuretic tera!ies
eranent neurological daage can occur %en seruNa le3els "all #elo% --* EG2. Wy56y!otonic en3ironent s%ells cells, increasing C ?
#rain daage
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6y!ernatreia Seru Na@O ->'EG2 Results "ro Na@ gained in e9cess o"
6/8 8R Water is lost in e9cess o" Na@ Water si"ts "ro cells to ECF SS@ tirst, dry ucous e#ranes &
li!s, oliguria, increased te! &!ulse,$used s7in,con"usion
T/@ tera!y2diet
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etIs tin7 a#out.6y!ernatreia
Wat are soe edical conditions tat ay cause ele3atedseru Na5Renal "ailureia#etes nsi!idus
ia#etes Mellitus 0 y!erglyceic deydration4Cusings syndroe 0y!eraldosteronis4
Wat are soe oter !atient !o!ulations at ris7 "ory!ernatreia5Elderly 0 decreased tirst ecanis 4atientIs recei3ingH(tu#e "eedings(corticosteroid drugs(certain diuretic tera!ies
Seiures, coa, deat y result i" y!ernatreia is le"tuntreated. Wy5
Cells loose $uid into te ECF causing irre3ersi#le celldaage.
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Critical in7ing6y!o 2 6y!er Natreia
For te client e9!eriencing
FE & y!onatreia d2t
e9cessi3e inta7e o" %ater,%ic solution %ould
you
e9!ect te !ysician to
order5
a. 'NS
#. NS
c. 'W
d. X NS
For te cliente9!eriencing
F and y!ernatreiad2t e9cessi3e %ater loss,
%ic solution %ould
you e9!ect te !ysician
to order5a. ' X NS
#. 'R
c. 'W
d. X NS
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otassiu K@
1.'('.* EG2 Cie" electrolyte o" CF
MaLor ineral in all cellular $uids Aids in uscle contraction, ner3e &
electrical i!ulse conduction, regulates
enye acti3ity, regulates C 6/*content, assists in acid(#ase #alance Regulated #y 7idneys2 orones n3ersely !ro!ortional to Na
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6y!o7aleia
Seru le3el P 1.'EG2 Results "ro decreased inta7e, loss 3ia
2Renal & !otassiu de!leting diuretics i"e treatening(all #ody systes afected SS uscle %ea7ness & leg cra!s,
decreased otility, cardiac arrytias T/@ diet2su!!leents2 tera!y
i 7 #
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ets tin7 a#out 6y!o7aleia
Wat are soe edical conditions tat ay cause ay!o7aleia5Renal isease 2 C6F 0dilutional4Meta#olic Al7alosisCusings isease 0 Na retention leads to K loss 4
Wat are soe conditions tat igt cause actual losso" !otassiu "ro te #ody5 losses ? nasogastric suctioning, 3oiting, diarreaCertain diuretic tera!iesnadeGuate inta7e ? 0 #ody cannot conser3e K, need 8inta7e4
Cardiac arrest ay occur %en seru K le3els "all#elo% /.' EG2. Wy5ncreased cardiac uscle irrita#ility leads to ACs and
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6y!er7aleia
Seru le3el O' EG2 Results "ro e9cessi3e inta7e, traua,
crus inLuries, #urns, renal "ailure SS uscle %ea7ness, cardiac
canges, N2, !aratesias o""ace2Dngers2tongue
T/@diet2eds2 tera!y2 !ossi#ledialysis
t ti 7 # t
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ets tin7 a#out 6y!er7aleia
Wat are soe edical conditions tat ay causey!er7aleia5Renal isease=ost coon causeBurns and oter aLor tissue trauaMeta#olic AcidosisAddisonIs isease 0 Na loss leads to K retention 4
Wat are soe conditions tat igt cause !otassiule3els to rise in te #ody5Certain diuretic tera!iesE9cessi3e inta7e ? 0 ina!!ro!riate su!!leents4
Cardiac arrest ay occur %en seru K le3els risea#o3e EG2. Wy5ecreased electrical i!ulse conduction leads to#radycardia and e3entual asystole.
C iti l i 7i
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Critical in7ingotassiu additi3es
Wic o" te "ollo%ing inter3entions %ill tenurse underta7e %en adinistering
!arenteral K additi3es5Monitor te site "or !le#itislace on cardiac onitor i" O -* EGAssure o" adeGuate i9ing o" K in solution
Monitor "or ele3ated K le3elsMonitor "or decreased Na le3elsAdinister !otassiu #y slo% !us etod
N E 2 E
R B B B
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Calciu Ca@@
>.'('.'EG2 Most a#undant in #ody #utH
+ in teet and #ones Needed "or ner3e transission,
3itain B-/ a#sor!tion, uscle
contraction & #lood clotting n3erse relationsi! %it os!orus itain needed "or Ca a#sor!tion
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6y!ocalceia
Seru Ca P >.1EG2 Results "ro lo% inta7e, loo!
diuretics, !aratyroid disorders, renal"ailure SS osteoalacia, EK canges,
nu#ness2tingling in Dngers, uscle
cra!s 2 tetany, seiures, Co3ste7Sign & rousseau Sign
T/@ diet2 tera!y
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Co3ste7 rousseau
t ti 7 # t
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ets tin7 a#out 6y!ocalceia
Wat are soe edical conditions tat ay causey!ocalceia56y!o!aratyroidis 0lo% 6 le3els = decreased releaseo" Ca "ro #ones4
S2 tryoid surgery 0 lo% Calcitonin = decreased release o"Ca "ro #ones4 Acute !ancreatitisCrons isease6y!er!os!ateia 0 ESRF4
Wat are soe oter conditions tat igt cause lo% Ca5
losses ? nasogastric suctioning, 3oiting, diarreaong ter io#iliationactose intolerance
" y!ocalceia is !rolonged, te #ody %ill utilie storedCa "ro #ones.Wat co!lication igt arise5Fractures 0 late sign 4
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6y!ercalceia
Seru Ca O '.1EG2 Results "ro y!er!aratyroidis,
soe cancers, !rolongedio#iliation
SS uscle %ea7ness, renal calculi,
"atigue, altered 8C, decreased otility, cardiac canges T/@ edication2 tera!y
t ti 7 # t
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ets tin7 a#out 6y!ercalceia
Wat are soe edical conditions tat ay causey!ercalceia56y!er!aratyroidis 0ig 6 le3els = increased releaseo" Ca "ro #ones4
agetIs iseaseSoe Cancers ? Multi!le MyleoaCronic Alcoolis 0 %it lo% seru !os!orus 4
Wat are soe oter conditions tat igt cause lo% Ca5
E9cessi3e inta7e o" Ca 8R itain E9cessi3e inta7e o" 8C antacids
" y!ercalceia is uncorrected, A #loc7 and cardiacarrest ay occur.
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Magnesiu Mg/@
-.'(/.'EG2 Most located %itin CF Needed "or acti3ating enyes,
electrical acti3ity, eta#olis o"car#s2!roteins, NA syntesis
Regulated #y intestinala#sor!tion and 7idney
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6y!oagneseia
Seru P -.'EG2 Results "ro decreased inta7e, !rolonged
N8 status, cronic alcoolis & nasogastric
suctioning SS@ uscle %ea7ness, $)"di)$ $!).(s,
ental canges, y!eracti3e re$e9es &oter y!ocalceia S2S.
T/@ re!laceent tera!y restore noral Ca le3els 0 Mg iics Ca4 seiure !recautions
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6y!oagneseia
Coon in critically ill !atients
Associated %it ig ortality rates ncreases cardiac irrita#ility and
3entricular dysrytias ( es!ecially in!atients %it recent M
Maintenance o" adeGuate seru Mg as#een so%n to reduce ortality rates !ostM
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6y!eragneseia
SeruO/.'EG2 Results "ro renal "ailure,
increased inta7e S2SH $using, letargy, cardiac
canges 0decreased 6R4,decreased
res!, loss o" dee! tendon re$e9es 9H restrict inta7e diuretic r9
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Cloride Cl(
'(-*'EG2 Most a#undant anion in ECF Co#ines %it Na to "or salts Maintains %ater #alance, acid(#ase
#alance, aids in digestion 0ydrocoric acid4
& osotic !ressure 0%it Na and 6/*4
Regulated #y 7idneys Follo%s Sodiu 0Na4
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6y!ocloreia
Seru le3el )EG2 Results "ro !rolonged 3oiting &
suctioning SS eta#olic al7alosis, ner3e
e9cita#ility, uscle cra!s,
t%itcing, y!o3entilation,decreased B i" se3ere
T/@ diet2 tera!y
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6y!ercloreia
Seru le3el O -*)EG2 Results "ro e9cessi3e inta7e or
retention #y 7idneys ? eta#olicacidosis SS Arrytias, decreased cardiac
out!ut, uscle %ea7ness, 8C
canges, KussaulsIs res!irations T/@ restore $uid & electrolyte #alance
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os!ate 8>(
/.'(>.'g2dl Needed "or acid(#ase
#alance,neurological & uscle "unction,energy trans"er A & afectseta#olis o" car#s2!roteins2li!ids, B3itain syntesis
Found in te #ones Regulated #y inta7e and 7idneys n3ersely !ro!ortional to Calciu
ere"ore soe regulation #y 6 as %ell
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6y!o!os!ateia
Seru le3el P -.EG2 Results "ro decreased intestinal
a#sor!tion and increasede9cretion
SS #one & uscle !ain, ental
canges, cest !ain, res!. "ailure T/@ iet2 tera!y
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6y!er!os!ateia
Seru le3elO /.)EG2 Results "ro renal "ailure, lo% inta7e o"
calciu SS@ neurouscular canges 0tetany4, EK
canges, !aratesia(Dngerti!s2out T/@ ietT y!ocalceic inter3entions
MedicationsH !os!ate #inding
e #ody can tolerate y!er!os!ateia"airly %ell B< te acco!anyingy!ocalceia is a larger !ro#leJ
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Critical in7ing ( NCEU
e nurse is caring "or a client %it renal"ailure %ose agnesiu le3el is 1.)g2d. Wic o" te "ollo%ing signs%ould te nurse ost li7ely e9!ect tonote in te client #ased on tis Mg le3el5
a. %itcing
#. 6y!eracti3e re$e9esc. rrita#ility
d. oss o" dee! tendon re$e9es
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Electrolyte oeostasis
is eans to aintain#alance to control #y
#alancing te dietary inta7e o"electrolytes %it te renale9cretion and rea#sor!tion o"
electrolytes
nter3entions "or F2E
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nter3entions "or F2E#alance
Assess !atient care"ully( notecanges
Monitor & 8 0nta7e & 8ut!ut4 Monitor %eigt canges Monitor urine Monitor 3s Monitor la# results and d9 test
Maintain !ro!er tera!y
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Suary
Fluid co!artents in te #ody ust#alance
Body systes regulate F&E #alance Assessent o" #ody $uid is i!ortant
to deterine causes o" i#alance
nter3entions "or i#alances are#ased on te cause