Term
Hyponatermia:
Anorexia, nausea, and vomiting,
lethargy, confusion, muscle cramps
muscular twitching, seizures,
coma, serum Na below 135 mEq/L,
Urine specific gravity < 1.010 |
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Definition
Hyponatremia:
risk factors: loss of sodium as in : loss of Gi fluids,
use of diuretics,
adrenal insufficiency,
Gains of water, as in :
excessive administration of D 5 W ,
Water intoxication,
disease states associated with SIADH (a form of hyponatremia),
Pharmacologic agents that may impair water excretion |
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Term
Hypernatremia:
Risk factors:
water deprivation,
Increased sensible and insensible water loss,
ingestion of large amount of salt ,
Excessive parental administration of sodium-containg solutions,
profuse sweating
Diabetes insipidus |
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Definition
hypernatremia S/S
Thirst
elevated body temperature
tongue dry and swollen, sticky mucous membranes
sever hypernatremia
diorientation
hallucinations
lethargy when undisturbed
irritable and hyperactive
focal or grand mal seizures
coma
serum Na above 145 mEq/L
urine specific gravity> 1.015 |
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Term
hypokalemia 3.5 - 5.3
Risk factors:
diarrhea
vomiting or gastric suction
potassum-wasting diuretics
steroid administration and certain anibiotics
poor intake as in anorexia nervosa, alcholim.potassium-free parential fluids
polyuria |
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Definition
hypokalemia S/S
fatigue
Anorexia, nausea, and vomiting
muscle weakness
decreased bowl motility
cardia arrhythmias
increased sensitivity to digitalis
polyuria, nocturia,dilute urine
postural hypotension
serum K below 3.5 mEq/L
ECG changes
Paresthesia or tender muscles |
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Term
hyper kalemia 3.5 - 5.3
decreased potassium excretion:
oliguric renal failure
potassuim - sparing diretics
hypoaldosteronism
High potassuim intake, especially in presence of renal insufficiency
Shift of potassium out of cells (acidosis, tissue trauma, malignant cell lysis) |
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Definition
hyperkalemia s/s
vague muscle weakness
cardiac arrhythmias
paresthesias of face, tongue, feet, and hands
flaccid muscle paralysis
Gi symptoms such as nausea, intermittent intestinal colic, or diarrhea may occur
Serum K above 5.0 mEq/L |
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Term
hypocalemia 8.5 - 10.5
Risk Factors:
Surgical hypoparathyroidism
malabsorption
vitamin D deficiency
Acute Pancreatitis
Excessive administration of citrated blood
Alkalotic states |
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Definition
hypocalcemia
Trousseau's and Chvostek's signs
numbness and tingling of fingers and toes
mental changes
seizures
spasm of laryngeal muscles
ECG changes
cramps in muscles of extremities
total serum calcium <8.5 mg /DI |
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Term
hypercalemia 8.5 - 10.5
Risk Factors
hyperparathyroidism
malignant neoplastic disease
prolonged immobilization
large doses of vitamin D
overuse of calcium supplements
Thiazide diuretics |
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Definition
hypercalcemia s/s
muscular weakness
tiredness, lethargy
consitpation
anorexia, nausea, and vomiting
decreased memory and attention span
polyuria and polydipsia
renal stones neurotic behavior
cardiac arrest
serum calcium > 10.5 mg/DI |
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Term
Fluid volume deficit Hypovolemia
risk factors :
Gi: vomiting, diarrhea, suction, fistulas
hemorrhage
excessive sweating
skin trauma, burns, draining wounds
third-space fluid shifts
excessive laxative or diuretic
hyperglycemia
change in mental status (unable to gain access to fluids, depression, confusion |
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Definition
Fluid volume deficit hypovolemia s/s
thirst
weight loss over short period
weakness, fatigue, anorexia
dry mucous membranes
poor skin and tongue turgor
sunken eyes
flat neck veins
urine output < mL/hr
postural hypotensions
weak, rapid pulse
increased urine specific gravity
increased hematocrit
increased BUN
increased serum soduim
altered sensorium |
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Term
fluid volume excess hypervolemia
risk factors
compromised requlatory mechanism: renal failure, CHF, Cirrhosis of liver,
cushing's syndrome
Gi irrigation with hypotonic fluid
Excess IV fluids with soduim
corticosteroid therapy
excessive ingestion of sodium- containing substances in diet or sodium- containing medications |
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Definition
Fluid volume excess hypervolemia s/s
Weight gain over short period
peripheral edema (may be pitting)
increased BP
shortness of breath
crackles and wheezes in lungs
full, bounding pulse
neck vein distention
polyuria if renal function is normal
ascites, pleural effusion
pulmonary edema
decreased BUN due to plasma dilution
Decreased hematocrit
decreased serum sodium
decreased urine specific gravity |
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