fluid and electrolytes

  1. can anyone give me any advice and fluid and electrolytes balance for testing???
  2. 8 Comments

  3. by   Ginyer
    Hmm...what exactly are you looking for? Normal ranges? I just started my first semester of nursing school so maybe that's why I don't understand your question.

  4. by   klone
    I wish I could remember the exact words to the song our instructor just taught us.


    Sodium is for the brain
    Potassium is for the heart
    Calcium and Magnesium is for the muscles

    Sodium and water are married: where sodium goes, water will follow. Sodium and potassium are enemies: where sodium goes, potassium will go in the other direction.

    Potassium, Calcium and Magnesium are a family and generally all go in the same direction together.

    Not sure exactly what you're looking for as far as info...
  5. by   jenrninmi

    Here is some important info:


    Good luck!
  6. by   onduty23
    nice breakdown
  7. by   Jess-RN in 2006
    There's also a book out there called Fluid and Electrolytes Made Incredibly Easy....my friend and I both bought a copy of it before our test, she found it very helpful, and I just never took the time to sit down and read it oops....if you are having problems with F/E, it really simplies things and gives you easy ways to remember....you can get those books at most books stores, also check your school library...just a thought....
  8. by   dave1117
    [font=Footlight MT Light]Fluid and Electrolyte Balance

    - [font=Footlight MT Light]60% - 70% of total body weight is water, this is the largest constituent of the body

    - [font=Footlight MT Light]Daily balance depends on an equal ratio btw ingested and excreted fluids

    - [font=Footlight MT Light]Fluids, electrolytes, and acid base balances within the body are essential in maintaining the health and function of all systems

    [font=Footlight MT Light]In order to maintain balance within the body look at:

    - [font=Footlight MT Light]I&Os (intake and output)

    - [font=Footlight MT Light]Distribution of water

    - [font=Footlight MT Light]Electrolytes

    - [font=Footlight MT Light]Regulation of renal function

    - [font=Footlight MT Light]Regulation of pulmonary function

    - [font=Footlight MT Light]Respiration

    - [font=Footlight MT Light]Metabolism

    - [font=Footlight MT Light]Central Nervous System function

    [font=Footlight MT Light]Distribution of Fluids

    [font=Footlight MT Light]Intra Cellular Fluid (ICF)

    - [font=Footlight MT Light]Intra [font=Footlight MT Light]=[font=Footlight MT Light] inside

    - [font=Footlight MT Light]Fluid inside the cell

    - [font=Footlight MT Light]2/3 of body fluid is intracellular

    - [font=Footlight MT Light]Contains nutrients (K, Mg, HPO/phosphate)

    - [font=Footlight MT Light]40% of body weight


    [font=Footlight MT Light]Extra Cellular Fluid (ECF)

    - [font=Footlight MT Light]Extra [font=Footlight MT Light]=[font=Footlight MT Light] outside

    - [font=Footlight MT Light]Fluid outside the cell (interstitum or plasma)

    - [font=Footlight MT Light]1/3 of body fluid is extra cellular

    - [font=Footlight MT Light]Transcellular or interstitial fluid is extra cellular

    - [font=Footlight MT Light]20% of body weight

    [font=Footlight MT Light]Composition of Body Fluid

    - [font=Footlight MT Light]Electrolytes:[font=Footlight MT Light] water that moves through the body that contains minerals/salts

    - [font=Footlight MT Light]Substances that develop electrical changes when dissolved in water

    - [font=Footlight MT Light]Cations:[font=Footlight MT Light] positively charged ions (Na, K, Ca, Mg)

    - [font=Footlight MT Light]Anions:[font=Footlight MT Light] negatively charged ions (Cl, HCO3, HPO4/phosphate)

    [font=Footlight MT Light]Electrolytes

    - [font=Footlight MT Light]Hold fluid within compartments (intracellular or extracellular)

    - [font=Footlight MT Light]Helps maintain acid base balance relationship

    - [font=Footlight MT Light]Are essential for enzyme activity

    - [font=Footlight MT Light]Aid in the transmission of impulses

    - [font=Footlight MT Light]Help to facilitate protein and carbohydrate metabolism

    [font=Footlight MT Light]Movement of Body Fluids:

    - [font=Footlight MT Light]Diffussion:[font=Footlight MT Light] process in which molecules move from higher concentration to lower concentration by random movement until the concentration is equal

    - [font=Footlight MT Light]Osmosis:[font=Footlight MT Light] movement of a solvent (water) through a semi permeable membrane from an area of lower concentration (more dilute) to a higher concentration (less dilute)

    - [font=Footlight MT Light]Most body membranes are semi permeable allowing water and any uncharged molecules to pass freely

    - [font=Footlight MT Light]Active Transport:[font=Footlight MT Light] movement of large or charged particles from an area of lesser to greater concentration requires metabolic and energy

    - [font=Footlight MT Light]Filtration:[font=Footlight MT Light] process which force is used to push fluid through a filter b/c of the difference in pressure btw 2 sides of the filter, substances move in response to pressure, hemodialysis is based on filtration

    [font=Footlight MT Light]Classification of Fluids

    [font=Footlight MT Light]Isotonic Solutions:

    - [font=Footlight MT Light]Same osmolarity as blood plasma (280-295)

    - [font=Footlight MT Light]Osmolarity: is the drawing power of water dependent on the number of molecules in the solution

    - [font=Footlight MT Light]Has the same electrolyte concentration as plasma (ie normal saline 0.9%)

    - [font=Footlight MT Light]ICF & ECF remain balanced

    [font=Footlight MT Light]Hypertonic Solution:

    - [font=Footlight MT Light]Has greater concentration than plasma

    - [font=Footlight MT Light]Solution will leave water out of the cells

    - [font=Footlight MT Light]Pull water in vascularate

    - [font=Footlight MT Light]Ie D5 NS, DW50%

    [font=Footlight MT Light]Hypotonic Solution:

    - [font=Footlight MT Light]Lesser electrolyte concentration than plasma

    - [font=Footlight MT Light]Water will not necessarily remain in vascularate

    - [font=Footlight MT Light]Therefore moving water in the cells

    - [font=Footlight MT Light]Ie 0.45%NaCl/ NS

    [font=Footlight MT Light]Body Fluids are Regulated by:

    - [font=Footlight MT Light]Fluid intake

    - [font=Footlight MT Light]Hormonal controls

    - [font=Footlight MT Light]Fluid output

    - [font=Footlight MT Light]Homeostasis: physiological balance the body is able to maintain by responding to disturbances in fluids and electrolytes preventing and repairing damage

    - [font=Footlight MT Light]Fluid volume is regulated by osmotic pressure(pulling water by the number of molecules present)

    [font=Footlight MT Light]Fluid Intake:

    - [font=Footlight MT Light]Regulated by thirst mechanism (conscious desire for water)

    - [font=Footlight MT Light]When osmolarity increases the thirst mechanism is stimulated by the hypothalamus

    [font=Footlight MT Light]Thirst is stimulated by:

    - [font=Footlight MT Light]Fluid loss

    - [font=Footlight MT Light]Hypovolemia

    - [font=Footlight MT Light]Vomiting

    - [font=Footlight MT Light]Hemorrhaging

    - [font=Footlight MT Light]K+/potassium depletion

    - [font=Footlight MT Light]Psychological factors

    - [font=Footlight MT Light]Dry pharyngeal mucous membranes

    [font=Footlight MT Light]Hormonal Regulation

    [font=Footlight MT Light]ADH-Anti Diuretic Hormone: [font=Footlight MT Light]released in response to changes in blood osmolarity

    - [font=Footlight MT Light]Increase in osmolarity ADH is released

    - [font=Footlight MT Light]ADH works directly on renal tubules

    - [font=Footlight MT Light]Water returns to vascular system

    - [font=Footlight MT Light]Dilutes the blood and decreases its osmolarity

    - [font=Footlight MT Light]Temporary decrease in urinary output until blood is sufficiently diluted

    [font=Footlight MT Light]Aldosterone:[font=Footlight MT Light] volume regulator

    - [font=Footlight MT Light]Released in response to increased plasma (K/potassium)

    - [font=Footlight MT Light]To save sodium and eliminate K/potassium

    [font=Footlight MT Light]Angiotansin:[font=Footlight MT Light] causes selective vasoconstriction

    - [font=Footlight MT Light]Increases the blood flow to kidneys

    - [font=Footlight MT Light]Improves renal perfusion

    [font=Footlight MT Light]Fluid Output
    [font=Footlight MT Light]Involves 4 organs:

    - [font=Footlight MT Light]Kidneys: major regulatory organ

    - [font=Footlight MT Light]Lungs: expire about 400ml/day

    - [font=Footlight MT Light]GI Tract: loses 100-200ml/day (feces)

    - [font=Footlight MT Light]Skin: activated sweat glands

    [font=Footlight MT Light]Insensible Fluid Loss:[font=Footlight MT Light] continuous and not perceived by person

    [font=Footlight MT Light]Sensible Fluid Loss:[font=Footlight MT Light] occurs through excess perspiration and can be perceived

    - [font=Footlight MT Light]An average of 500-600ml of sensible and insensible fluid is lost via skin per day

    [font=Footlight MT Light]Regulation of Electrolytes (Cations +)

    - [font=Footlight MT Light]When one cation leaves the cell it is replaced by another cation

    - [font=Footlight MT Light]Maintains neutrality

    [font=Footlight MT Light]
    Major Cations:

    [font=Footlight MT Light]Sodium (Na)

    - [font=Footlight MT Light]Most abundant in ECF

    - [font=Footlight MT Light]Regulates metabolic activities

    - [font=Footlight MT Light]Normal level is 135-145 mEq/L

    [font=Footlight MT Light]Potassium (K+)

    - [font=Footlight MT Light]Is the principle cation in ICF

    - [font=Footlight MT Light]Regulates metabolic activities

    - [font=Footlight MT Light]Necessary for transmission and conduction of nerve impulses

    - [font=Footlight MT Light]Regulated by diet and renal excretion

    - [font=Footlight MT Light]Normal level is 3.5-5 mEq/L

    [font=Footlight MT Light]Calcium (Ca++)

    - [font=Footlight MT Light]Stored in the bone, blood, and body cells

    - [font=Footlight MT Light]99% is in bone and 1% is in blood ECF

    - [font=Footlight MT Light]Calcium is needed for bone and teeth formation, blood clotting, nerve impulses, and muscle contraction

    - [font=Footlight MT Light]Normal level is 4.5 mEq/L

    [font=Footlight MT Light]Magnesium (Mg++)

    - [font=Footlight MT Light]Essential for enzyme and neuro chemical activities

    - [font=Footlight MT Light]Muscle excitability

    - [font=Footlight MT Light]Regulated by diet, renal and parathyroid hormone

    - [font=Footlight MT Light]Located in ICF and ECF, and in bones

    - [font=Footlight MT Light]Normal level is 1.5-2.5 mEq/L

    [font=Footlight MT Light]Major Anions:

    [font=Footlight MT Light]Chloride (Cl-)

    - [font=Footlight MT Light]Found in ECF

    - [font=Footlight MT Light]It follows sodium

    - [font=Footlight MT Light]Regulated by diet and kidneys

    - [font=Footlight MT Light]Normal values are 95-108 mEq/L

    [font=Footlight MT Light]Bicarbonate (HCO3-)

    - [font=Footlight MT Light]Found in ECF and ICF

    - [font=Footlight MT Light]Essential component of carbonic acid (bicarb buffering system), need in acid base balance

    - [font=Footlight MT Light]Normal values are 22-26 mEq/L

    [font=Footlight MT Light]Phosphate (PO4-)

    - [font=Footlight MT Light]Buffer primarily found in ICF

    - [font=Footlight MT Light]Assist in acid base regulation

    - [font=Footlight MT Light]Helps to develop and maintain teeth and bones

    - [font=Footlight MT Light]Inversely proportional with calcium (if one rises the other falls)

    - [font=Footlight MT Light]Regulated by diet, kidneys, and intestinal absorption

    - [font=Footlight MT Light]Normal values are 2.5-4.5 mg/100ml

    [font=Footlight MT Light]Sodium (Na+)

    [font=Footlight MT Light]Hyponatremia

    - [font=Footlight MT Light]Lower than normal sodium concentrations in the blood

    - [font=Footlight MT Light]Results of Na loss (ie increased sweating, low Na diet)

    - [font=Footlight MT Light]Result of H2O excess (ie adrenal insufficiency)

    - [font=Footlight MT Light]Tx depends on the cause

    [font=Footlight MT Light]Usually Na is lost hen water is lost

    [font=Footlight MT Light]The body then adapts by decreasing water excretion and therefore Na excretion is also decreased b/c Na follows water

    [font=Footlight MT Light]If this continues

    [font=Footlight MT Light]You can have Na in the ECF that is diluted

    [font=Footlight MT Light]S/S: Personality change, Postural hypotension, N/V/D, Tachycardia

    [font=Footlight MT Light]Hypernatremia

    - [font=Footlight MT Light]Higher than[font=Footlight MT Light]normal Na concentration in the blood

    - [font=Footlight MT Light]Result of excess water loss (ie increased sensible and insensible water loss

    - [font=Footlight MT Light]Result of Na excess (ie ingestion of large amount of salt solutions)

    - [font=Footlight MT Light]The body will try to conserve as much water as possible via renal absorption

    - [font=Footlight MT Light]If the cause is b/c of increased aldosterone secretion than Na is retained and K/potassium is excreted

    [font=Footlight MT Light]S/S: Dry flushed skin, Thirst, Dry mucous membranes, Agitation

    [font=Footlight MT Light]Nursing Care Plan r/t (Na imbalances)

    - [font=Footlight MT Light]No NANDA Dx regarding specific electrolyte disturbances

    - [font=Footlight MT Light]But if a pt had hyponatremia (low Na) due to Na loss, pt can have postural hypotension and you can state:
    NANDA: Risk of injury r/t dizziness secondary to postural hypotension and hypotension

    [font=Footlight MT Light]Nursing Intervantions:

    - [font=Footlight MT Light]ID pts at risk for Na imbalances

    - [font=Footlight MT Light]Monitor lab tests: electrolytes, H&H, Urine specific gravity

    - [font=Footlight MT Light]Health teaching regarding fluid intake/restriction and Na needs

    - [font=Footlight MT Light]Read labels for Na content (increased Na intake for canned, processed, and frozen foods)

    [font=Footlight MT Light]Potassium (K+)

    [font=Footlight MT Light]Hypokalemia

    - [font=Footlight MT Light]Inadequate amts of K+ in the ECF

    - [font=Footlight MT Light]Since normal levels of K+ are low (3.5-5 mEq/L) there is little tolerance for function

    - [font=Footlight MT Light]Most common cause is K+ wasting diuretics

    - [font=Footlight MT Light]Also from GI loss

    - [font=Footlight MT Light]Polyuria

    - [font=Footlight MT Light]Excessive use of K+ free IV solutions

    [font=Footlight MT Light]S/S: Weakness, fatigue, decreased muscle tone, decreased bowel sounds, weak irregular pulse, parathesias (tingling in extremities), EKG changes, ventricular disrhythmias

    [font=Footlight MT Light]Hyperkalemia

    - [font=Footlight MT Light]Greater than normal amts of K+ in the blood

    - [font=Footlight MT Light]Severe hyperkalemia produces cardiac conduction abnormalities

    - [font=Footlight MT Light]Primary cause: renal failure b/c renal impairment decreases amounts of K+ the kidney can excrete

    - [font=Footlight MT Light]Also caused by massive cellular damage in burns and adrenal insufficiency

    [font=Footlight MT Light]S/S: anxiety, dysrhythmias, weakness, diarrhea

    [font=Footlight MT Light]Cardiac arrest can occur

    [font=Footlight MT Light]Nursing Care:

    - [font=Footlight MT Light]ID those at risk

    - [font=Footlight MT Light]Monitor K+ levels, lab data

    - [font=Footlight MT Light]Monitor K+ intake (diet, IV fluids)

    - [font=Footlight MT Light]Health teaching (ie K+ meds/restrictions)

    - [font=Footlight MT Light]Monitor S/S

    [font=Footlight MT Light]Hypokalemia

    - [font=Footlight MT Light]Foods high in K+ (bananas, coffee, apricots, cantaloupe, OJ, dry fruit)

    - [font=Footlight MT Light]K+ supplement may be ordered

    [font=Footlight MT Light]Hyperkalemia

    - [font=Footlight MT Light]Discourage foods w/ high in K+

    [font=Footlight MT Light]Calcium (Ca)
    - [font=Footlight MT Light]Normal level 4.0-5.0 mEq/L

    - [font=Footlight MT Light]Promotes muscle contraction

    - [font=Footlight MT Light]Transmission of nerve muscles

    - [font=Footlight MT Light]Cell membrane integrity (bones, teeth building and maintenance)

    [font=Footlight MT Light]Hypocalcemia

    - [font=Footlight MT Light]Low Ca levels

    - [font=Footlight MT Light]Thyroid disease (parathyroid) hypothyroid

    - [font=Footlight MT Light]Increased phosphorus levels (cause decreased Ca levels)

    - [font=Footlight MT Light]Decreased vitamin D in diet

    [font=Footlight MT Light]S/S:

    [font=Footlight MT Light]r/t diminished function of neuromuscular/cardiac/renal systems

    [font=Footlight MT Light]Numbness and tingling in fingers and toes, tetany(muscle cramps), pathological function, EKG abnormalities

    [font=Footlight MT Light]Hypercalcemia

    - [font=Footlight MT Light]Increased serum Ca level

    - [font=Footlight MT Light]Often s/s of underlying disease w/excess bone re absorption and release of Ca in blood (ie noeplastic disease, osteoporosis, prolonged immobilization)

    [font=Footlight MT Light]S/S: N/V, weakness, lethargy, back pain, personality changes, cardiac arrest

    [font=Footlight MT Light]Nursing Care

    - [font=Footlight MT Light]ID those at risk (immobilized pts)

    - [font=Footlight MT Light]Monitor lab data

    - [font=Footlight MT Light]Monitor Ca in diet/IV fluids

    - [font=Footlight MT Light]Health teaching (sources are milk and dairy, refrigeration, exp dates, safety precautions with weakness, confusion and weak bones, vitamin D r/t Ca)

    - [font=Footlight MT Light]Monitor s/s Ca imbalances

    - [font=Footlight MT Light]Ca supplements

    - [font=Footlight MT Light]Increase mobilization with hypercalcemia
  9. by   FutureNurse2005
    dave, that sure helped me! lol I have a test on this next week! thank you!
  10. by   cherokeesummer
    Thanks, that sure was a lot of information but I bet it will help me out on my test next week!!!!