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Examples of these Fluids include:
What are transcellular fluids?
*Found in the skeleton and intracellular fluid
*2nd most abundant cation
*Normal serum levels are 1.5-2.5 mEq/L
*Necessary for protein DNA synthesis
*Found in grains, nuts, dried fruits, legumes and green leafy vegetables
What is Magnesium?
-This fluid loss occurs through the skin and the lungs
-It is usually not detectable and cannot be measured
-Normally accounts for 300-400mL of fluid loss/day
What is insensible losses?
-Total serum calcium of over 10.5mg/dL
-May be due to prolonged immobilization
-s/s of lethargy, weakness, anorexia, n/v, constipation, depressed tendon reflexes, polyuria
What is hypercalcemia?
The Movement of water across cell membranes from the less concentrated to the more concentrated solution
What is Osmosis
-Most abundant cation in the extracellular fluid
-It is found in most body secretions
-Usually accompanies any water imbalances
What is sodium Na+?
-Primary regulator of fluid intake
-Located in the hypothalamus of the brain
-Osmotic pressure and vascular volume and angiotensin trigger it.
What is the thirst mechanism?
-Water is drawn out of the vascular compartment into interstitial tissues and cells
-Lethargy, confusion, weakness
-Muscle twitching, cramping
-Headache seizures, coma
What is hyponatremia?
-Major cation in intracellular fluid
-Vital electrolyted for skeletal, cardiac and smooth muscle activity
-Involved in maintaining acid/base balance
-Normal levels are 3.5-5 mEq/L
What is potassium?
-Body retains both water and sodium
-Edema may be present
-Fluid intake greater than output
What is fluid volume excess (FVE) or hypervolemia?
-Muscle weakness, cramps
-Weak, irregular pulses
-Serum levels below 3.5
What is hypokalemia?
-Normal total serum levels 8.5-10.5mg/dL or
-Normal ionized serum levels 4-5 mg/dL
What is normal Calcium levels?
-Avocados, carrots, spinach, tomato, potato
-Dried fruits, bananas, apricot, orange, cantaloupe
-Beef, cod, pork, veal
-Milk, orange juice, apricot nectar
What are foods high in potassium?
-Water is drawn into the vascular compartment from the interstitial cells
-May be due to decreased thirst mechanism, hyperventilation, fever or insufficient water intake
What is dehydration or fluid volume deficit (FVE)?
-Dry, sticky membranes
-Red, dry, swollen tongue
-Serum levels over 145mEq/L
What are s/s of hypernatremia?
-Bicarbonate exceeds the normal 20:1 ratio
-May be caused by ingestion of too many antacids
-Happens after prolonged vomiting
-Respirations are slow and shallow
What is metabolic alkalosis?
-Uses the interview process to obtain client information
-Current and past medical problems are assessed
-Identifies risk factors
-Elicits data about the client's food & fluid intake and output
What is a nursing (or patient) history?
-Acute lung conditions the impair alveolar gas exchange
-Overdose of narcotics or sedatives
-Chronic lung disease
-Mechanical chest injury
What are risk factors for respiratory acidosis?
-Monitor intake and output closely
-Treat underlying problem
-Monitor vital signs, especially respirations and LOC
-Administer ordered IV fluids carefully
What are interventions for metabolic acidosis?
-Often results from hyperventilation
-May also be caused by fever and respiratory infections
-Complains of SOB, numbness & tingling of extremities
-Light-headedness & blurred vision
What is respiratory alkalosis?
-Examining the skin, oral cavity, mucous membranes
-Skin turgor check
-Cardiovascular and respiratory status
-Neurological and muscular status
What is a physical assessment?
-Excessive ingestion of acids or salicylates
What is risk factors metabolic acidosis?
-Monitor airway and ventilation
-Administer pulmonary therapy if ordered
-Monitor fluid intake/output, vitals, ABG's
-Administer narcotic antagonists
-Frequently assess respiratory status and lung sounds
-Maintain adequate hydration
What is are nursing interventions for Respiratory Acidosis?
-Bicarbonate levels are low
-May develop in renal failure, starvation or diabetic ketoacidosis
-Headache, weakness, lethargy confusion
-Deep, rapid respirations
-Nausea and vomiting
What is metabolic acidosis?
-Measures the solute concentration of the blood
-Evaluates fluid balance
-Includes sodium, glucose and urea measurements
-Normal values are 280-300mOsm/kg
What is Serum osmolarity?
-Vomiting, gastric suction
-↑ use of K+ wasting diuretics
-Excessive bicarbonate intake
What are risk factors for Metabolic alkalosis?
-Monitor ABG values, I & O and LOC
-Treat underlying problem as ordered
-Administer sodium bicarbonate carefully if ordered
What are nursing interventions for metabolic acidosis?
-Hypoventilation and carbon dioxide retention can cause this
-Asthma and COPD are common causes
-Anesthesia or narcotic overdose can cause this also
What is respiratory acidosis?
-Fluid intake and output monitoring and recording
What are clinical measurements the nurse should do in her daily assessment?
-Brain stem injury
-Hyperventilation due to:
*↑ body temp, ↑BMR
What are risk factors for respiratory alkalosis?
-Monitor vital signs, ABG's
-Assist client to breath more slowly
-Help client breath in a paper bag
-Apply a re-breather mask
What are nursing interventions for respiratory alkalosis?
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