Fluid and Electrolytes for Nurses

Introduction

• Importance of fluid and electrolyte balance for life maintenance.
• The human body is 70% water, crucial for transporting nutrients and maintaining blood composition.
• Electrolytes: Potassium, Sodium, Chloride, Calcium, Phosphate, Magnesium.
• Electrolytes produce ions essential for electrical signaling.

Functions of Electrolytes

• Muscle contraction & nerve impulses.
• Bone creation.
• Fluid balance via osmosis.
• Acid-base balance in the blood.

Maintenance of Electrolyte Balance

• Primarily obtained from food and drinks.
• Kidneys filter blood and regulate electrolytes.
• Imbalances often related to kidney or GI issues.
• Diuretics and conditions like burns, trauma, and diseases can affect electrolyte levels.

Sodium (Na)

• Role: Regulates water balance, muscle contraction, nerve impulses.
• Normal range: 135-145 mEq/L.
• Hyponatremia (<135 mEq/L): Causes include diuretics, GI losses, and SIADH.
  • Symptoms: Salt Loss Mnemonic (Seizures, Abdominal cramping, etc.).
• Hypernatremia (>145 mEq/L): Causes include hormonal imbalances, dehydration.
  • Symptoms: F.R.I.E.D. foods mnemonic (Fatigue, Restlessness, etc.).

Chloride (Cl)

• Role: Acid-base balance, digestion (HCl production), fluid balance.
• Normal range: 95-105 mEq/L.
• Hypochloremia: Causes often overlap with hyponatremia.
• Hyperchloremia: Often occurs with hypernatremia, decreased bicarbonate.

Potassium (K)

• Role: Muscle contraction, nerve impulses.
• Normal range: 3.5-5 mEq/L.
• Hypokalemia (<3.5 mEq/L): Causes include diuretics, corticosteroids, insulin.
  • Symptoms: The 7 L's mnemonic (Lethargy, Low respirations, etc.).
• Hyperkalemia (>5 mEq/L): Causes include burns, renal failure.
  • Symptoms: MURDER mnemonic (Muscle weakness, Urinary output, etc.).

Calcium (Ca)

• Role: Bone/teeth health, muscle/nerve conduction, clotting.
• Normal range: 8.5-10.5 mg/dL.
• Hypocalcemia (<8.5 mg/dL): Causes include surgery, vitamin D deficiency.
  • Symptoms: CRAMPS mnemonic (Convulsions, Reflexes hyperactive, etc.).
• Hypercalcemia (>10.5 mg/dL): Causes include hyperparathyroidism, excess vitamin D.
  • Symptoms: WEAK mnemonic (Weakness, EKG changes, etc.).

Magnesium (Mg)

• Role: Nerve/muscle function, regulates sodium-potassium pump.
• Normal range: 1.5-2.5 mg/dL.
• Hypomagnesemia: Causes include malabsorption, alcoholism.
  • Symptoms: TWITCH mnemonic (Trousseau's and Chvostek's signs, Weakness, etc.).
• Hypermagnesemia: Often due to excessive magnesium correction.
  • Symptoms: LETHARGIC mnemonic (Lethargy, EKG changes, etc.).

Phosphate (P)

• Role: Bone/teeth health, energy storage, red blood cell function.
• Normal range: 2.5-4.5 mg/dL.
• Hypophosphatemia: Causes include antacid overuse, refeeding syndrome.
  • Symptoms: BONE mnemonic (Bone pain, Osteomalacia, Neuro changes, etc.).
• Hyperphosphatemia: Often due to renal failure, excess vitamin D.
  • Symptoms: Similar to hypocalcemia (Convulsions, Reflexes hyperactive, etc.).

Conclusion

• Understanding fluid and electrolyte balance is crucial for nurses.
• Imbalances can result from various conditions and treatments, requiring careful monitoring and intervention.