Fluids and Electrolytes test

niddy21. . .there is no doubt that this is a difficult subject. however, when you start working, the worst of it will be recognizing the abnormal levels on labwork and perhaps some of the signs and symptoms. patients will have way worse problems to be attending to. doctors will be fixing their electrolyte problems almost immediately because they will be caught very early. the major electrolytes that will generally need immediate, direct treatment are calcium and potassium. while the others (sodium, chloride, magnesium, and phosphate) are also important, they're replacement and correction are handled through iv maintenance solutions. however, calcium and potassium replacement or removal are handled with other more aggressive therapies.

i have been working on electrolyte charts to post on allnurses, but they are not completed yet. a student this past week was looking for some information on electrolytes and i posted some of the information i already had

https://allnurses.com/forums/f205/major-electrolytes-277734.html

not that i'm in any way proud of this, but the first time i took the national certification exam for iv therapy, i failed by two questions with the most questions missed on the section in fluid and electrolytes after being warned it was the hardest part and studying for it. one thing that i can suggest in learning the symptoms of the hypo- and hyper-(s) of the electrolytes is to try to remember what the pathophysiology of each of them is causing to the body. for instance, water always follow sodium so hypernatremia always results in fluid volume build up in the body and the signs and symptoms of hypernatremia have to do with fluid retention and fluid build up in the body. hyponatremia, then is the exact opposite with water being lost from the body. the other thing is to focus on how that would affect each of the body systems to complete the picture of the symptoms the patient will have. i always remember hyperkalemia because it's what they use to execute prisoners for their death sentences and what dr. kavorkian used to kill people who wanted to die. too much potassium causes the heart to go into progressively slowing bradycardia, stop beating and eventually cardiac arrest. too little potassium overuses the muscles and puts them into a fatigue and weakness situation. i had the opportunity to see a patient with very low calcium after surgery where the surgeon accidentally removed a parathyroid gland (this is how he found out). the patient called us to her room and was having carpopedal spasms, a symptom of tetany. muscle spasms like this cause a lot of pain to the patient, not to mention the weird positioning of the hands and feet that results as the muscles in these anatomical structures tighten up in spasm. we gave her iv calcium over an hour and her recovery was dramatic. calcium replacement for her for the remainder of her life would be the treatment.

i have for many years had a copy of fluid & electrolyte balance: nursing considerations by norma m. metheny. it is currently in its 4th edition. it was a recommended book when i was in my nursing program back in the early 1970s and i have the current edition of it now. your school library may have a copy of it so you don't have to buy it. in this book, along with discussing each of the major electrolytes, ms. metheny gives scenarios and nursing implications to give people an idea of how f&e problems might present themselves in the clinical area. another thing you can do is when you find a friendly nurse during your clinicals is to ask them if they've ever seen a patient who had hypercalcemia or hypernatremia and what happened. but i'll tell you now, learning f&e will be a lengthy pursuit. it is for most because it is a complex subject.