fluid and electrolytes

I think you might have to be more specific on this question...what is it you don't understand? the levels? what works with what? what does what?

I'm just starting this chapter and I'm already confused. Where to start............Hyper and Hyponatremia; osmolarity.....hyper & hypotonic solutions; ROME, and respiratory/metabolic acidosis/alkalosis. Why does your RRs change with each (respiratory or metabolic)? I'm a mess with this stuff.

This website said the best way to understand it is to make diagram of it. I don't know if they mean the pH, HCO3, CO2 levels?? Any help would be so grateful.

Thanks,

Tami

Hi,

I am 6 weeks away from finishing block I and I'm not understanding fluid and electrolytes. My instructor said this would be our hardest test. Well, she is right.

I was told to make a diagram to learn what goes where, but I'm so lost. Can anyone help a rookie out??

Tami

As far as the diagram goes I am pretty sure for fluids she wants something like the following:

Acid/base metabolic/respiratory imbalances are always a learning effort for me, and I learn more and more everytime I have an ABG drawn on a patient, so I don't have much advice in that area.

To me, the information wasn't difficult to understand, it was just that there was a lot to learn.

Here is where you need to start...start with the following electrolytes.

Sodium

Potassium

Calcium

Phosphate

Chloride

Magnesium.

The FIRST thing that you need to do is write each one down with the normal range of lab values and put them to memory...this will be the core of your entire exam.

Next...you have to look up in your text if what happens to the body when they are high or low and list them in order of PRIORITY according to ABC's.

For example:

Potassium:

Too high = hyperkalcemia

Too low = hypokalcemia

You will easily find that there is an entire laundry list of signs and symptoms when each of the electrolytes are either high or low...but for example, when potassium is high OR low, it can cause cardiac arrythmias which can equal death....Potassium is what they use IV during lethal injections (hyperkalcemia), but if it bottoms out, you are just as dead.

Just keep going from there.

THEN do your ABG values using ROME..there are TONS of threads on this issue here.

Oh...you also need to know osmolality of fluids very well..this is how fluid is shifted within the body.

Thank you so much for taking the time to write all this down for me. This was my first time on and you have been wonderful. I will write each one out along with their s/sx and see where I'm at.

We do not learn too much in bock I about ABG's unfortunately. Thanks once again HOPEFULL2009!

Here is a simple tutorial for interpreting ABG's (post #9). here

Osmolarity (thickness of the blood) goes up as the number of solutes (solids) in the blood (plasma) goes up. The thicker the blood, the higher the osmolality.

But realize this number will go up if the volume of the blood goes down as well.

If you have a beaker full of salt and water, and you take out some of the water, the salt stays behind, and the osmolality has increased.

So, in a case of dehydration, you have lost water thus increasing the amount of sodium and osmolality, resulting in hypernatremia.

In a case of excess secretion of ADH, the body holds on to fluids, diluting the sodium, decreasing osmolality (thinning the blood), and results in hyponatremia.

Potassium:

Too high = hyperkalcemia

Too low = hypokalcemia

Hopefull meant:

Potassium:

Too high = hyperkalemia

Too low = hypokalemia

Thank you for your help. Its starting to make a little sense. I printed this out so I can refer back to it. Hopefully it will start to get easier. I did go by the book today on fluid & electrolytes made easy.

This is very helpful. Thank you so much.

Thank you for all the great links.

Do not know how to reply to PM. I'm new.

Just picked you because I needed some encouraging words. That is all!

I know how you feel, when I started it was like learning a foreign language. just keep at it and it will eventually make sense.

as far as acidosis/alkalosis, here's how I remembered it:

acidosis pH is low

alkalosis pH is high

for respiratory look at the CO2 level

for metabolic look at the HCO3 level

if it's respiratory then the CO2 level goes in the same direction as the pH (both CO2 and pH are high for alkalosis, both low for acidosis)

if it's metabolic then the HCO3 level and pH go in opposite directions (HCO3 high, pH low then metabolic acidosis, HCO3 low, pH high then metabolic alkalosis)

this is a nice one to make a simple arrow diagram for