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Paresthesias in Pt with fluid volume excess

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My nclex prep book says that patients with fluid volume excess may experience paresthesia. The only reason I can think for why this would occur would be because of an associated electrolyte imbalance, but it seems like that would be more likely in hypovolemia. Can someone help me understand the underlying pathophysiology?

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A sign of low serum K (hypokalemia) is paresthesia, and low serum K can be caused by hemodilution (excess fluid volume diluting extracellular K).

A sign of high serum K (hyperkalemia) is paresthesia, and hyperkalemia can be caused by decreased excretion from kidney disease.

A sign of low serum Ca (hypocalcemia) is paresthesia, which can be caused by end-stage kidney disease (inhibition of Ca absorption from GI tract) and kidney disease (increased Ca excretion).

Damaged kidneys can lead to FVE, because they cannot get rid of excess water. The damaged kidneys can also lead to electrolyte abnormalities, such as hyperkalemia and hypocalcemia - both of which cause paresthesia. Also, calcium is cation found in extracellular fluid. A S&S associated with hypocalcemia is paresthesia. If you have FVE, the excess fluid volume could be diluting calcium, causing hypocalcemia.

Just my thoughts! Hope this helps!

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