Transcript Chapter 13, Fluid and Electrolyte
Chapter 13 The student will be able to review the following areas: ◦ Clients at risk for fluid and electrolyte imbalances ◦ Use laboratory data and clinical manifestations to assess fluid and electrolyte disturbance Extracellular fluid Intracellular fluid Interstitial fluid Transcellular fluids Fluid intake is less than what is needed to meet the body’s fluid needs, causing fluid volume deficit. Older adults with mental status impairment at highest risk ^ hemoglobin ^ hematocrit ^ serum osmolarity ^ glucose ^ protein ^ BUN ^ electrolytes Hemoconcentration Fluid replacement Drug therapy ◦ IV- *D5W in 0.45%NS for severe dehydration or shock ◦ IV QuickTime™ and a YUV420 codec decompressor are needed to see this picture. Excess of body fluid Mostly caused by over hydration R/T fluid volume excess in the vascular space or to dilution of specific electrolytes and blood components See p. B/R/E-76 for others & the uses ◦ 0.9% NaCl)-Isotonic ◦ 0.45% NaCl-Hypotonic ◦ D5 0.9 NaCl-Hypertonic ◦ Lactated Ringer’s (LR)-Isotonic Potassium (3.5 to 5.0 mEq/L) Sodium (135 to 145 mmol/L) Calcium (9.0 to 10.5 mg/dL) Phosphorus (3.0 to 4.5 mg/dL) Chloride (98 to 106 mEq/L) Case scenario/fluid electrolytes You are a nurse in the ER and you presented with a patient who is pale, diaphoretic, and lethargic and is breathing excessively. He states that he was out for a routine run when all of sudden he became very lightheaded, confused, and began seeing “weird colors”. What assessment information would support a diagnosis of dehydration, what interventions would be appropriate to alleviate dehydration symptoms, and finally what clinical information would you use in order to evaluate the effectiveness of the plan of care.