unit 2 med surg electrolytes

1/3(15L) of total body water Interstitial fluids – 3 rd spacing (fluid between cells) Blood, Lymph, Bone, Connective Tissue water, transcellular fluids. Transcellular fluids: CSF, Synovial Fluid, Peritoneal fluid, Pleaural Fluid. Intracellular fluid – ICF – fluid inside the cells, 2/3(25L) of total body water Filtration: no hydrostatic pressure difference between 2 spaces: equilibrium Disequilibrium: hydrostatic pressure different. S/S: Hyponatremia 135-145 Hypernatremia Confusion, Lethargy, Weakness Muscle Cramping Seizures Anorexia, N&V Thirst, dry, sticky mucous membranes Weakness, elevated temp. SEVERE HYPERNATREMIA: Confusion/irritable Decreased LOC, hallucinations, seizures Risk for Hypernatremia—> fever, dehydration, steroids, excessive dieresis, hyperventalation. Foods for Na Diet: Cold cut turkey sandwhich, soup, chicken, bread. Treatment: Hyponatremia Hypernatremia Administer IVF with Na Eat foods with Na Monitor VS, I&O, Labs Administer Hypertonic IV Saline as ordered Monitor VS, LOC, Labs Decrease H20 intake Na restricted diet Administer Hypotonic IV solution as ordered S/S: Hypokalemia 3.5-5 Hyperkalemia Irregular Pulse, Weak Decreased Peristalsis, Hypoactive BS Paresthesia, Cardiac Dysrhythmias Muscle weakness, cramping, anorexia, N&V Fatigue, Lethargy Cardiac Dysrhythmias, Cardiac Arrest Bradycardia & Heart block Muscle weakness, Flaccid Paralysis Paresthesia, GI Hyperactivity, Diarheea, ABD Cramping Irregular pulses Foods: Raisins, Beans, Spinach, Broccoli, Bananas, Avacado Treatment: Hypokalemia Hyperkalemia Never bolus K, Never push K!!! Administer K supplements, IVF with K as needed Eat foods rich in K If patient on diuretic, make sure it’s K sparing Tele monitor Monitor VS, P, Cardiac Rhythm, Labs Kayexalate Glucose & Insulin moves K back into cell Limit K foods Dialysis Tele monitor Monitor VS, P, Cardiac Rhythm, Labs