Transcript Chapter 13, Fluid and Electrolyte

Chapter 13
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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
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Extracellular fluid
Intracellular fluid
Interstitial fluid
Transcellular fluids
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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
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^ hemoglobin
^ hematocrit
^ serum osmolarity
^ glucose
^ protein
^ BUN
^ electrolytes
Hemoconcentration
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Fluid replacement
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Drug therapy
◦ IV- *D5W in 0.45%NS
for severe
dehydration or shock
◦ IV
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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
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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
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Potassium (3.5 to 5.0 mEq/L)
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Sodium (135 to 145 mmol/L)
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Calcium (9.0 to 10.5 mg/dL)
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Phosphorus (3.0 to 4.5 mg/dL)
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Chloride (98 to 106 mEq/L)
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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.