Fluid and Electrolyte Disorders

[Epona]

Hello all nurses!! I have a few questions about fluid and electrolyte disorders. I am studying my NCLEX prep book this summer.

With FLUID VOLUME EXCESS it has listed renal failure and CHF as causes. Can you explain WHY?? I know it's related to the heart not pumping properly, but I do not know the details here.

With SODIUM DEFICIT it says administer ISOTONIC SOLUTION-- if serum sodium is less then 118 mEq/L, adminsiter HYPERTONIC sodium intravenous solution at a slow rate. WHEN DO YOU ADMINISTER ISOTONIC and when do you adminsiter HYPERTONIC?? Can someone explain the differences in iso. and hypertonic?? Also, for sodium excess it says admin. hypotonic solution. Can someone tell me what pulls what?? Like hyper goes to a low concentration, so it pulls blank... (it's been a while since I went over how these Isontonic, hypertonic, etc. work).

I APPRECIATE YOUR HELP!!!

[jadu1106]

hi~

i am posting information that i hope will help you.

first if you follow the "random facts" sticky on the nclex forum page, it has all this information and more on many other topics to help you prepare for the nclex.

this is information that joanie dee posted on the "random facts" thread:

the following is a great site for visual about this topic:

http://www.authorstream.com/presenta...pt-powerpoint/

isotonic solutions go in and out of cells; therefore, there is no net movement of water (there are equal amounts of water entering and leaving)

hypotonic solutions move water into the cells, causing cytolysis (the cells swell and burst)

hypertonic solutions move water out of the cells, causing plasmolysis (the cells shrink and shrivel)

hypotonic...........0.45% saline (1/2 ns)

isotonic..............0.9% saline (ns)

5% dextrose in water (5% d/w)

5% dextrose in 0.225 saline (5%d-1/4ns)

lactated ringer's solution

hypertonic...........5% dextrose in 0.9% saline (5%d-ns)

5% dextrose in 0.45% saline (5%d-1/2ns

5% dextrose in lactated ringer's solution

10% dextrose in water (10% d/w)

this is information i found on another sticky that i also posted on the "random facts" thread.

i am posting a link that has a fabulous fluids flow chart. it is post #13 on the page by vickyrn. the flow chart is 1 page, but it has everything you need to know about the different kinds of ivf, hypotonic, isotonic, and hypertonic. i know this isn't everything about fluids and eletrolytes together, but everything about the different types. hope it helps. good luck.

here is the link:

https://allnurses.com/forums/f205/pathophysiology-p-microbiology-fluid-electrolyte-resources-145201-2.html

when you go to the page, scroll down to post #13.

good luck to you!!!

hope this is what your looking for.

jadu1106 :)

[CABG patch kid, BSN, RN]

Really simplified explanations here (don't feel like quoting my patho book right now).

Renal failure causesfluid volume excess (FVE) because the kidneys are not able to concentrate and/or dilute urine like they normally would, so the fluid keeps circulating around the vessels instead of being excreted out. When the vascular space has too much fluid, it will start leaking out of the capillaries into the interstial tissues, causing third spacing.

The same exact thing happens with CHF, but for a different reason. With CHF, the heart is floppy and weak, and is unable to pump blood around with enough force. The kidneys aren't perfused with enough force to effectively pull the fluid off the circulating volume. This causes third spacing. If it is left side heart failure, the left side of the heart isn't strong enough to pump the blood out to the body efficiently, so some of the fluid ends up backing into the lungs, causing pulmonary edema. Just remember right side, right hand, peripheral edema; left side L for lung, pulmonary edema.

Good luck on NCLEX

[Epona]

Hi! You all are AWESOME! I understand it MUCH better now. Our teachers did not really explain it very well. You all did.

Thanks again!!!

[ozirg123]

Thanks so much for all the posts on this topic. They have been very helpful!