![\"Fluid](\"https:\/\/nursingstudy.org\/examples\/wp-content\/uploads\/2024\/01\/CN-article-_700x435.png\")
<\/figure>\n\n\n\nMovement of Water<\/h3>\n\n\n\n
-Fluid constantly circulates throughout the<\/p>\n\n\n\n
body and moves relatively freely, depending<\/p>\n\n\n\n
on the permeability of the membranes<\/p>\n\n\n\n
between compartments by the processes of<\/p>\n\n\n\n
filtration or osmosis.(Fluid electrolyte and acid base imbalance Comprehensive Nursing Paper Example)<\/p>\n\n\n\n
-depending on the relatively hydrostatic and<\/p>\n\n\n\n
osmotic pressure within the compartments.<\/p>\n\n\n\n
Proteins and electrolytes contribute to the<\/p>\n\n\n\n
osmotic pressure of a fluid and therefore are<\/p>\n\n\n\n
important in maintaining fluid volumes.<\/p>\n\n\n\n
-Fluid excess occurs in the extracellular<\/p>\n\n\n\n
compartment and may be referred to as<\/p>\n\n\n\n
isotonic\/iso-osmolar, hypotonic\/ hypo-<\/p>\n\n\n\n
osmolar, or hypertonic\/hyper-osmolar,<\/p>\n\n\n\n
depending on the cause.(Fluid electrolyte and acid base imbalance Comprehensive Nursing Paper Example)<\/p>\n\n\n\n
ELECTROLYTES<\/h3>\n\n\n\n
SODIUM (135-145)<\/p>\n\n\n\n
-Primary cation (positively charged ion) in<\/p>\n\n\n\n
the extracellular fluid<\/p>\n\n\n\n
-Sodium is important for the maintenance of<\/p>\n\n\n\n
extracellular fluid volume through its effect<\/p>\n\n\n\n
on osmotic pressure because it makes up<\/p>\n\n\n\n
approximately 90% of the solute in<\/p>\n\n\n\n
extracellular fluid.(Fluid electrolyte and acid base imbalance Comprehensive Nursing Paper Example)<\/p>\n\n\n\n
HYPONATREMIA<\/h3>\n\n\n\n
sodium deficit can result from direct loss of<\/p>\n\n\n\n
sodium from the body or from an excess of<\/p>\n\n\n\n
water in the extracellular compartment,<\/p>\n\n\n\n
resulting in dilution of sodium.<\/p>\n\n\n\n
CAUSES:<\/h3>\n\n\n\n
– sodium deficit – excess water in the<\/p>\n\n\n\n
extra cellular compartment.<\/p>\n\n\n\n
– Common causes for low sodium<\/p>\n\n\n\n
– Excessive sweating, vomiting, and<\/p>\n\n\n\n
diarrhea(Fluid electrolyte and acid base imbalance Comprehensive Nursing Paper Example)<\/p>\n\n\n\n
– Use of certain diuretics drugs with<\/p>\n\n\n\n
low salt diets<\/p>\n\n\n\n
– Hormonal imbalances (insufficient<\/p>\n\n\n\n
ADH secretion)<\/p>\n\n\n\n
– Early chronc renal failure<\/p>\n\n\n\n
– Excessive water intakeDocument continues below<\/p>\n\n\n\n
EFFECTS:<\/h3>\n\n\n\n
Low levels impair nerve conduction,<\/p>\n\n\n\n
-manifestations include fatigue, muscle<\/p>\n\n\n\n
cramps, and abdominal discomfort or<\/p>\n\n\n\n
cramps with nausea and vomiting(Fluid electrolyte and acid base imbalance Comprehensive Nursing Paper Example)<\/p>\n\n\n\n
HYPERNATREMIA<\/h3>\n\n\n\n
Excessive sodium level in the blood and<\/p>\n\n\n\n
extracellular fluid > 145<\/p>\n\n\n\n
CAUSES:<\/h3>\n\n\n\n
Specific causes include the following:<\/p>\n\n\n\n
1. Insufficient ADH, which results in a<\/p>\n\n\n\n
large volume of<\/p>\n\n\n\n
dilute urine (diabetes insipidus)<\/p>\n\n\n\n
2. Loss of the thirst mechanism<\/p>\n\n\n\n
3. Watery diarrhea<\/p>\n\n\n\n
4. Prolonged periods of rapid<\/p>\n\n\n\n
respiration(Fluid electrolyte and acid base imbalance Comprehensive Nursing Paper Example)<\/p>\n\n\n\n
EFFECTS:<\/h3>\n\n\n\n
The major effect of hypernatremia is a fluid<\/p>\n\n\n\n
shift out of the cells owing to the increased<\/p>\n\n\n\n
osmotic pressure of interstitial or<\/p>\n\n\n\n
extracellular fluid; this effect is manifested<\/p>\n\n\n\n
by the following:(Fluid electrolyte and acid base imbalance Comprehensive Nursing Paper Example)<\/p>\n\n\n\n
\uf0b7Weakness, agitation<\/p>\n\n\n\n
\uf0b7Firm subcutaneous tissues (see Table<\/p>\n\n\n\n
2.5)<\/p>\n\n\n\n
\uf0b7Increased thirst, with dry, rough<\/p>\n\n\n\n
mucous membranes<\/p>\n\n\n\n
\uf0b7Decreased urine output because<\/p>\n\n\n\n
ADH is secreted(Fluid electrolyte and acid base imbalance Comprehensive Nursing Paper Example)<\/p>\n\n\n\n
S & S<\/h3>\n\n\n\n
Hyponatremia<\/p>\n\n\n\n
Anorexia, nausea, cramps Fatigue, lethargy,<\/p>\n\n\n\n
muscle weakness<\/p>\n\n\n\n
Headache, confusion, seizures Decreased<\/p>\n\n\n\n
blood pressure<\/p>\n\n\n\n
Hypernatremia<\/p>\n\n\n\n
\uf0b7Weakness, lethargy, agitation<\/p>\n\n\n\n
\uf0b7Fatigue, lethargy, muscle weakness<\/p>\n\n\n\n
\uf0b7Edema, elevated BP<\/p>\n\n\n\n
\uf0b7Thirst; tongue and mucosa are dry<\/p>\n\n\n\n
and<\/p>\n\n\n\n
POTASSIUM (3.5-5)<\/h3>\n\n\n\n
**Most important, abnormal potassium<\/p>\n\n\n\n
levels, both high and low, have a significant<\/p>\n\n\n\n
and serious effect on the contractions of<\/p>\n\n\n\n
cardiac muscle causing changes in the<\/p>\n\n\n\n
electrocardiogram (ECG) and ultimately<\/p>\n\n\n\n
cardiac arrest or standstill. **(Fluid electrolyte and acid base imbalance Comprehensive Nursing Paper Example)<\/p>\n\n\n\n
HYPOKALEMIA:<\/h3>\n\n\n\n
Low potassium levels < 3.5 mEq\/ L<\/p>\n\n\n\n
CAUSES:<\/p>\n\n\n\n
Low serum potassium levels may result<\/p>\n\n\n\n
from the following:<\/p>\n\n\n\n
1. Excessive losses from the body due to<\/p>\n\n\n\n
diarrhea<\/p>\n\n\n\n
2. Diuresis associated with certain diuretic<\/p>\n\n\n\n
drugs ; patients with heart disease who are<\/p>\n\n\n\n
being treated with certain diuretic drugs<\/p>\n\n\n\n
such as furosemide may have to increase<\/p>\n\n\n\n
their intake of potassium in food or take a <\/p>\n\n\n\n
potassium supplement because hypokalemia<\/p>\n\n\n\n
may increase the toxicity of heart<\/p>\n\n\n\n
medications such as digitalis(Fluid electrolyte and acid base imbalance Comprehensive Nursing Paper Example)<\/p>\n\n\n\n
3. The presence of excessive aldosterone or<\/p>\n\n\n\n
glucocorticoids in the body (in Cushing<\/p>\n\n\n\n
syndrome, in which glucocorticoids have<\/p>\n\n\n\n
some mineralocorticoid activity, retaining<\/p>\n\n\n\n
sodium and excreting potassium)<\/p>\n\n\n\n
4. Decreased dietary intake, which may<\/p>\n\n\n\n
occur with alcoholism, eating disorders, or<\/p>\n\n\n\n
starvation(Fluid electrolyte and acid base imbalance Comprehensive Nursing Paper Example)<\/p>\n\n\n\n
5. Treatment of diabetic ketoacidosis with<\/p>\n\n\n\n
insulin<\/p>\n\n\n\n
EFFECTS:<\/h3>\n\n\n\n
\uf0b7Cardiac dysrhythmias , ECG patter<\/p>\n\n\n\n
changes; lead to cardiac arrest.<\/p>\n\n\n\n
\uf0b7Hypokalemia interferes with<\/p>\n\n\n\n
neuromuscular function. Muscles<\/p>\n\n\n\n
less respondent to stimuli; shown in<\/p>\n\n\n\n
fatigue & muscle weakness<\/p>\n\n\n\n
\uf0b7Parasthesias (pins and needles<\/p>\n\n\n\n
develop)<\/p>\n\n\n\n
\uf0b7Decreased GI , decreased appetite<\/p>\n\n\n\n
\uf0b7In severe defieciency; muscle<\/p>\n\n\n\n
become weak; followed by shallow<\/p>\n\n\n\n
respirations<\/p>\n\n\n\n
\uf0b7In severe cases; renal function is<\/p>\n\n\n\n
impaired ; increased urine output.(Fluid electrolyte and acid base imbalance Comprehensive Nursing Paper Example)<\/p>\n\n\n\n Increased levels of potassium > 5 mEq\/L<\/p>\n\n\n\n 1. Renal failure<\/p>\n\n\n\n 2. Deficit of aldosterone<\/p>\n\n\n\n 3. Use of “potassium-sparing” diuretic<\/p>\n\n\n\n drugs, which prevent potassium from being<\/p>\n\n\n\n excreted in adequate amounts(Fluid electrolyte and acid base imbalance Comprehensive Nursing Paper Example)<\/p>\n\n\n\n 4.Leakage of intracellular potassium in to<\/p>\n\n\n\n the extracellular fluids in patients with<\/p>\n\n\n\n extensive tissue damage such as traumatic<\/p>\n\n\n\n crush injuries or bums<\/p>\n\n\n\n 5. Displacement of potassium from cells by<\/p>\n\n\n\n prolonged or severe acidosis<\/p>\n\n\n\n \uf0b7ECG shows typical dysrhythmias;<\/p>\n\n\n\n can progress to cardiac arrest<\/p>\n\n\n\n \uf0b7Muscle weakness, progression to<\/p>\n\n\n\n paralysis(possible)<\/p>\n\n\n\n \uf0b7Fatigue, nausea, paresthesias also<\/p>\n\n\n\n common<\/p>\n\n\n\n Hypokalemia<\/p>\n\n\n\n \uf0b7Cardiac arrhythmias, cardiac arrest<\/p>\n\n\n\n \uf0b7Anorexia, nausea, constipation<\/p>\n\n\n\n \uf0b7Fatigue, muscle twitch, weakness,<\/p>\n\n\n\n leg cramps(Fluid electrolyte and acid base imbalance Comprehensive Nursing Paper Example)<\/p>\n\n\n\n \uf0b7Shallow respirations, paresthesias<\/p>\n\n\n\n \uf0b7Postural hypotension, polyuria, and<\/p>\n\n\n\n nocturia<\/p>\n\n\n\n \uf0b7Serum pH elevated-7.45 (alkalosis)<\/p>\n\n\n\n Hyperkalemia<\/p>\n\n\n\n \uf0b7Arrhythmias, cardiac arrest<\/p>\n\n\n\n \uf0b7Nausea, diarrhea(Fluid electrolyte and acid base imbalance Comprehensive Nursing Paper Example)<\/p>\n\n\n\n \uf0b7Muscle weakness, paralysis<\/p>\n\n\n\n beginning in legs<\/p>\n\n\n\n \uf0b7Paresthesias-fingers, toes, face,<\/p>\n\n\n\n tongue<\/p>\n\n\n\n \uf0b7Oliguria(Fluid electrolyte and acid base imbalance Comprehensive Nursing Paper Example)<\/p>\n\n\n\n \uf0b7Serum pH decreased-7.35 (acidosis) Document continues below<\/p>\n\n\n\n CALCIUM ( 4.5- 5)<\/p>\n\n\n\n Extracellular cation, calcium balance<\/p>\n\n\n\n controlled by PTH (parathyroid<\/p>\n\n\n\n hormone)<\/p>\n\n\n\n Also influenced by Vitamin D and<\/p>\n\n\n\n phosphate levels<\/p>\n\n\n\n HYPOCALCEMIA < 4 mEq\/L<\/p>\n\n\n\n 1. Hypoparathyroidism-decreased<\/p>\n\n\n\n parathyroid hormone results in<\/p>\n\n\n\n decreased intestinal calcium<\/p>\n\n\n\n absorption<\/p>\n\n\n\n 2. Malabsorption syndrome-resulting in<\/p>\n\n\n\n decreased intestinal absorption of<\/p>\n\n\n\n vitamin D or calcium<\/p>\n\n\n\n 3. Deficient serum albumin<\/p>\n\n\n\n 4. Increased serum pH-resulting in<\/p>\n\n\n\n alkalosis In renal failure,<\/p>\n\n\n\n hypocalcemia results from retention<\/p>\n\n\n\n of phosphate ion, which causes loss<\/p>\n\n\n\n of calcium; also, vitamin D is not<\/p>\n\n\n\n activated, thereby decreasing the<\/p>\n\n\n\n intestinal absorption of calcium.<\/p>\n\n\n\n Increase permeability & excitability of nerve<\/p>\n\n\n\n membranes( muscle twitching<\/p>\n\n\n\n Contraction of the fingers & hyperactive<\/p>\n\n\n\n reflexes<\/p>\n\n\n\n Chvostek signs (spasms of the lip, face)<\/p>\n\n\n\n Trousseau sign (carpopedal spasms when a<\/p>\n\n\n\n blood pressure cuff blocks circulation)<\/p>\n\n\n\n Tetany (skeletal muscle spasms. Causing<\/p>\n\n\n\n contraction and or cramps)<\/p>\n\n\n\n Heart contractions (become weak),<\/p>\n\n\n\n conduction is delayed ; arrythmias develop ,<\/p>\n\n\n\n BP drops<\/p>\n\n\n\n CALCIUM LEVELS > 5 mEq\/L<\/p>\n\n\n\n CAUSES:<\/p>\n\n\n\n 1. Uncontrolled release of calcium ions<\/p>\n\n\n\n from the bones<\/p>\n\n\n\n 2. Hyperparathyroidism<\/p>\n\n\n\n 3. Immobility, which may decrease<\/p>\n\n\n\n stress on the bone leading to<\/p>\n\n\n\n demineralization.<\/p>\n\n\n\n 4. Increased intake of calcium due<\/p>\n\n\n\n either to excessive<\/p>\n\n\n\n 5. vitamin D or to excess dietary<\/p>\n\n\n\n calcium<\/p>\n\n\n\n 5. Milk-alkali syndrome, associated<\/p>\n\n\n\n with increased milk and antacid<\/p>\n\n\n\n intake, which may also elevate serum<\/p>\n\n\n\n calcium levels(Fluid electrolyte and acid base imbalance Comprehensive Nursing Paper Example)<\/p>\n\n\n\n \uf0b7Depression of neuromuscular<\/p>\n\n\n\n activity ; leads to muscle weakness ,<\/p>\n\n\n\n loss of muscle tone, lethargy and<\/p>\n\n\n\n stupor (accompanied by personality<\/p>\n\n\n\n changes, anorexia, nausea)<\/p>\n\n\n\n \uf0b7High levels interfere with function of<\/p>\n\n\n\n ADH, if case is severe blood volume<\/p>\n\n\n\n drops, renal function decreases,<\/p>\n\n\n\n nitrogen waste accumulates ; lead to<\/p>\n\n\n\n cardiac arrest)Document continues below<\/p>\n\n\n\n <\/p>\n\n\n\n \uf0b7Cardiac contractions increase ;<\/p>\n\n\n\n dysrhythmias develop<\/p>\n\n\n\n \uf0b7If excess PTH bone density will<\/p>\n\n\n\n decrease leads to spontaneous bone<\/p>\n\n\n\n fractures.<\/p>\n\n\n\n \uf0b7Formation of kidney stones<\/p>\n\n\n\n S&S<\/p>\n\n\n\n Hypocalcemia<\/p>\n\n\n\n \uf0b7Tetany-involuntary skeletal muscle<\/p>\n\n\n\n spasm, carpopedal spasm,<\/p>\n\n\n\n laryngospasm<\/p>\n\n\n\n \uf0b7Tingling fingers<\/p>\n\n\n\n Mental confusion, irritability<\/p>\n\n\n\n Arrhythmias, weak heart<\/p>\n\n\n\n \uf0b7contractions<\/p>\n\n\n\n Hypercalcemia<\/p>\n\n\n\n \uf0b7Apathy, lethargy Anorexia, nausea,<\/p>\n\n\n\n \uf0b7constipation<\/p>\n\n\n\n Polyuria, thirst<\/p>\n\n\n\n Kidney stones Arrhythmias,<\/p>\n\n\n\n prolonged(Fluid electrolyte and acid base imbalance Comprehensive Nursing Paper Example)<\/p>\n\n\n\n \uf0b7strong cardiac contractions,<\/p>\n\n\n\n increased blood pressure<\/p>\n\n\n\n MAGNESIUM (1.5- 2.5)<\/p>\n\n\n\n Intracellular<\/p>\n\n\n\n Stored in bone<\/p>\n\n\n\n Often linked with chronic alcoholism,<\/p>\n\n\n\n malabsorption. Malnutrition<\/p>\n\n\n\n Causes of Hypomagnesemia<\/p>\n\n\n\n \uf0b7Use of diuretics<\/p>\n\n\n\n \uf0b7Diabetic ketoacidosis<\/p>\n\n\n\n \uf0b7Hyperparathyroidism<\/p>\n\n\n\n \uf0b7Hyperaldosteronism<\/p>\n\n\n\n Effects of Hypomagnesemia<\/p>\n\n\n\n \uf0b7Neuromuscular hyperirritability<\/p>\n\n\n\n \uf0b7Tremors or chorea (involuntary<\/p>\n\n\n\n repetitive movements)<\/p>\n\n\n\n \uf0b7Insomnia<\/p>\n\n\n\n \uf0b7Personality changes<\/p>\n\n\n\n \uf0b7Increased heart rate with arrhythmias<\/p>\n\n\n\n Cause of Hypermagnesemia<\/p>\n\n\n\n \uf0b7Usually occurs with renal failure<\/p>\n\n\n\n Effects of Hypermagnesemia<\/p>\n\n\n\n \uf0b7Depressed neuromuscular<\/p>\n\n\n\n function<\/p>\n\n\n\n \uf0b7Decreased reflexes<\/p>\n\n\n\n \uf0b7Lethargy<\/p>\n\n\n\n![\"Fluid](\"https:\/\/nursingstudy.org\/examples\/wp-content\/uploads\/2024\/01\/image-42.png\")
<\/figure>\n\n\n\nHYPERKALEMIA<\/h3>\n\n\n\n
CAUSES:<\/h3>\n\n\n\n
EFFECTS:<\/h3>\n\n\n\n
S&S<\/h3>\n\n\n\n
CAUSES:<\/h3>\n\n\n\n
EFFECTS:<\/h3>\n\n\n\n
HYPERCALCEMIA:<\/h3>\n\n\n\n
EFFECTS:<\/h3>\n\n\n\n
HYPOMAGNESEMIA<\/h3>\n\n\n\n
HYPERMAGNESEMIA<\/h3>\n\n\n\n